Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Thesis (Ph.D. in Biostatistics, Department of Preventive Medicine and Biometrics) -- University of Colorado Denver, 2007. / Typescript. Includes bibliographical references (leaves 89-93). Free to UCD affiliates. Online version available via ProQuest Digital Dissertations;

O câncer bucal é uma doença que afeta principalmente homens acima de 40 anos com hábito de fumar e beber. Em geral, esses pacientes têm o diagnóstico da enfermidade realizado tardiamente, acarretando tratamentos complexos, mutilantes e de alto custo tanto financeiro como social e de prognóstico sombrio a ponto do câncer bucal apresentar uma taxa de sobrevida em 5 anos inferior a 50%. O diagnóstico precoce representa uma alternativa importante para alterar esse panorama. Os recursos de que os profissionais da área da saúde, principalmente os cirurgiões-dentistas, dispõem são o diagnóstico clínico de lesões estabelecidas acompanhado da biópsia com exame histopatológico.Outra alternativa para o diagnóstico precoce dos carcinomas espinocelulares ocorre quando estes são precedidos de lesões cancerizáveis. Nas duas últimas décadas, a utilização da citopatologia como método de diagnóstico de danos celulares prévios ao aparecimento de lesões clínicas possibilitou sua utilização em mucosa bucal. Os estudos apresentados tratam especificamente desta aplicação clínica, abordando: a) os aspectos genéticos do câncer bucal; b) a correlação histocitopatológica de lesões cancerizáveis em câncer bucal e na mucosa normal exposta aos carcinógenos; c) a validação das amostras citopatológicas; d) a padronização da técnica de extração de DNA em células esfoliadas da mucosa bucal. / Oral cancer affects mainly men over 40 years who are exposed to tobacco and alcohol. These patients usually receive a late diagnosis, which results in complex, mutilating treatments with high financial and social costs, poor prognosis, and, therefore, a 5-year survival rate lower than 50%. Early diagnosis is critical to change this situation. The resources currently available to healthcare professionals, particularly dentists, are the clinical diagnosis of lesions and biopsies for histopathologic examination. Another alternative for the early diagnosis of squamous cell carcinomas is the identification of precursor lesions. In the last two decades, cytopathology has been used as a method to diagnose cell damage that precedes the appearance of clinical lesions, and this use can be extended to the oral mucosa. The studies reported here deal specifically with this clinical application, and discuss: A) the genetic factors in oral cancer; B) the cytohistologic correlation of cancer precursor lesions and the normal mucosa exposed to carcinogens; C) the validation of cytopathologic samples; D) the standardization of the technique to extract DNA of cells exfoliated from the oral mucosa.

Submitted by Claudio Rodrigues (cmrodrigues@fiocruz.br) on 2016-06-28T19:14:00Z No. of bitstreams: 1 CLAUDIO RODRIGUES_DISSERTAÇAO CORRIGIDA .pdf: 2265812 bytes, checksum: 68f7d8387b81a68dfe4e2de14e1cb850 (MD5) / Approved for entry into archive by Vanessa Suane (vanessa.suane@icict.fiocruz.br) on 2016-06-30T13:57:52Z (GMT) No. of bitstreams: 1 CLAUDIO RODRIGUES_DISSERTAÇAO CORRIGIDA .pdf: 2265812 bytes, checksum: 68f7d8387b81a68dfe4e2de14e1cb850 (MD5) / Made available in DSpace on 2016-06-30T13:57:52Z (GMT). No. of bitstreams: 1 CLAUDIO RODRIGUES_DISSERTAÇAO CORRIGIDA .pdf: 2265812 bytes, checksum: 68f7d8387b81a68dfe4e2de14e1cb850 (MD5) Previous issue date: 2016 / Made available in DSpace on 2016-07-13T19:26:55Z (GMT). No. of bitstreams: 3 CLAUDIO RODRIGUES_DISSERTAÇAO CORRIGIDA .pdf.txt: 244228 bytes, checksum: d272b68943e8fa361482f6a470d564f7 (MD5) license.txt: 2991 bytes, checksum: 5a560609d32a3863062d77ff32785d58 (MD5) CLAUDIO RODRIGUES_DISSERTAÇAO CORRIGIDA .pdf: 2265812 bytes, checksum: 68f7d8387b81a68dfe4e2de14e1cb850 (MD5) Previous issue date: 2016 / Fiocruz. Centro de Desenvolvimento Tecnológico em Saúde / A leptospirose é a zoonose de maior incidência mundial, apesar de não haver uma confiável estimativa de sua carga global. Calcula-se que anualmente ocorram mais de um milhão de casos no mundo, o que possivelmente leve a 58.900 óbitos em todo planeta. No Brasil, o Ministério da Saúde vem empregando esforços para qualificar o diagnóstico e o tratamento da doença, mas que não necessariamente repercute na elevação do número de notificações de suspeitos. Sendo assim, foi proposta a Matriz do Círculo Vicioso da Negligência da Leptospirose no Brasil avaliando diversos aspectos inerentes a falta de um diagnóstico mais precoce e preciso para evitar a subnotificação de casos e a falta de uma real incidência e de carga global da doença, o que impactaria diretamente no planejamento da gestão em saúde, corroborada por pesquisa de opinião com especialistas defendendo a visão da negligência para com a informação em saúde no Brasil. A coleta de dados foi realizada por um questionário eletrônico, do tipo opinião, e disponibilizada através de e-mail a profissionais e pesquisadores selecionados previamente através de parâmetros curriculares na Plataforma Lattes. Como uma síntese do resultado podemos afirmar que, no geral, tanto os pesquisadores quanto os profissionais em saúde humana e animal foram coesos quanto à adesão às premissas enunciadas. Das 22 questões apenas três foram fortemente refutadas, o que confere certo grau de adesão às premissas apresentadas, agregando valor simbólico à matriz proposta. / Leptospirosis is the worldwide most incident zoonosis in the world, although there is no estimate global load that can be trustable. The annual appraisal cases suggested more than a million cases in a globally analysis, what may lead to a death rate near 58.900 people. Therefore, to leptospirosis ongoing circle matrix was proposed in Brazil to evaluate inherent features of the disease, as the lack of a real incidence rate, by means of underreporting and the absence of a precise global charge disease information. These two factors has an impact that could inevitably lead to a lack of awareness to implement forthright health planning emplacement in the future, by Brazilian government, coupled to the fact that the country public health specialist standpoints agreed with the lack of this reliability about Brazilian health data. The process of data gathering was performed by statement opinion electronic quiz, sent by email to previously selected researchers trough curriculum background criteria at Plataforma Lattes. As a synthesis of the results, we could assure allege that as well as researchers and professionals, even at human or animal health agreed with the prior placed assumptions. Only three of 22 questions at the quiz were contested, which besides conferring some adhesion to the previously presented assumptions, also adds emblematic value to the proposed matrix.

O câncer bucal é uma doença que afeta principalmente homens acima de 40 anos com hábito de fumar e beber. Em geral, esses pacientes têm o diagnóstico da enfermidade realizado tardiamente, acarretando tratamentos complexos, mutilantes e de alto custo tanto financeiro como social e de prognóstico sombrio a ponto do câncer bucal apresentar uma taxa de sobrevida em 5 anos inferior a 50%. O diagnóstico precoce representa uma alternativa importante para alterar esse panorama. Os recursos de que os profissionais da área da saúde, principalmente os cirurgiões-dentistas, dispõem são o diagnóstico clínico de lesões estabelecidas acompanhado da biópsia com exame histopatológico.Outra alternativa para o diagnóstico precoce dos carcinomas espinocelulares ocorre quando estes são precedidos de lesões cancerizáveis. Nas duas últimas décadas, a utilização da citopatologia como método de diagnóstico de danos celulares prévios ao aparecimento de lesões clínicas possibilitou sua utilização em mucosa bucal. Os estudos apresentados tratam especificamente desta aplicação clínica, abordando: a) os aspectos genéticos do câncer bucal; b) a correlação histocitopatológica de lesões cancerizáveis em câncer bucal e na mucosa normal exposta aos carcinógenos; c) a validação das amostras citopatológicas; d) a padronização da técnica de extração de DNA em células esfoliadas da mucosa bucal. / Oral cancer affects mainly men over 40 years who are exposed to tobacco and alcohol. These patients usually receive a late diagnosis, which results in complex, mutilating treatments with high financial and social costs, poor prognosis, and, therefore, a 5-year survival rate lower than 50%. Early diagnosis is critical to change this situation. The resources currently available to healthcare professionals, particularly dentists, are the clinical diagnosis of lesions and biopsies for histopathologic examination. Another alternative for the early diagnosis of squamous cell carcinomas is the identification of precursor lesions. In the last two decades, cytopathology has been used as a method to diagnose cell damage that precedes the appearance of clinical lesions, and this use can be extended to the oral mucosa. The studies reported here deal specifically with this clinical application, and discuss: A) the genetic factors in oral cancer; B) the cytohistologic correlation of cancer precursor lesions and the normal mucosa exposed to carcinogens; C) the validation of cytopathologic samples; D) the standardization of the technique to extract DNA of cells exfoliated from the oral mucosa.

Este estudo teve como objetivo conhecer as ações que os cirurgiões-dentistas das unidades básicas de saúde do município de São Paulo têm desenvolvido quanto à prevenção e ao diagnóstico precoce do câncer bucal, além de suas percepções para a realização de tais ações, a fim de analisar o comportamento destes profissionais a cerca das questões relativas a esta morbidade. A maioria dos diagnósticos de câncer bucal é feita em estágios avançados em São Paulo, cidade que possui as maiores taxas de incidência nacionais, semelhantes a de outras regiões do mundo. O cirurgião-dentista exerce um papel fundamental e estratégico no combate aos fatores ligados ao aparecimento desse agravo. Foram enviados, em março de 2005, 885 questionários aos cirurgiões-dentistas das 286 unidades básicas de saúde de São Paulo, via Correio. Foi feito um banco de dados utilizando o software de informática Epi Info – versão 6.04b. Participaram da pesquisa 282 profissionais, (taxa de resposta de 32%), em sua maioria do sexo feminino, com mais de 20 anos de graduação, com perfil generalista e que possui outros vínculos empregatícios. Além do baixo grau de conhecimento constatado quanto aos fatores de risco ligados à etiologia e às condições bucais em relação a possível evolução para um câncer bucal, a maioria dos participantes expôs limitações relevantes quanto às práticas relativas ao apoio à cessação do hábito do tabagismo e etilismo e às aptidões para executarem citologia esfoliativa e biópsia. Verifica-se a necessidade de se propor políticas públicas de enfrentamento do câncer bucal em São Paulo, que considere o aprimoramento dos cirurgiões-dentistas das unidades básicas de saúde em relação a esse problema e a melhor estruturação desses locais para a pronta realização dos exames complementares para fins diagnósticos. / The purpose of this study was to know the actions that dentists from basic health units of the city of São Paulo have been developing for the prevention and early diagnosis of oral cancer, besides their perceptions for the accomplishment of such actions, in order to analyze the behavior of these professionals about these subjects in relation to this morbidity. Most of the diagnosis of oral cancer is made in advanced stages in São Paulo that possesses the largest national incidence taxes, similar to other areas of the world. The primary health care dental professional plays a fundamental and strategic role against the linked factors related to the greater appearance of this malignant neoplasm. Eight hundred and eighty-five dentists from 286 basic health units of the city of São Paulo were surveyed in march 2005. It was made a database using the computer software Epi Info, version 6.04b. Two hundred and eighty-two professionals have answered the questionnaires (a response rate of 32% was obtained) and their majority composed by female general dental practitioners, with more than 20 years of graduation and that have other kinds of employment. Besides the low degree of knowledge verified for the risk factors linked to the etiology and the oral conditions in relation to a possible evolution for an oral cancer, most of the participants exposed relevant limitations as for the relative practices to support tobacco and alcohol cessation as for the accomplishment of esfoliative cytology and biopsy. It is verified the need of proposing public policies to face the problem of oral cancer in São Paulo, which considers not only the technical improvement of the primary health care dental practitioners but also the best structuring of those places for the ready accomplishment of the complemental exams to leading final diagnosis.

Background: Reported rates of bipolar syndromes are highly variable between studies because of age differences, differences in diagnostic criteria, or restriction of sampling to clinical contacts. Method: In 1395 adolescents aged 14–17 years, DSM-IV (hypo)manic episodes (manic and hypomanic episodes combined), use of mental health care, and five ordinal subcategories representing the underlying continuous score of (hypo)manic symptoms (‘mania symptom scale’) were measured at baseline and approximately 1.5, 4 and 10 years later using the Munich-Composite International Diagnostic Interview (DIA-X/M-CIDI). Results: Incidence rates (IRs) of both (hypo)manic episodes and (hypo)manic symptoms (at least one DSM-IV core symptom) were far higher (714/105 person-years and 1720/105 person-years respectively) than traditional estimates. In addition, the risk of developing (hypo)manic episodes was very low after the age of 21 years [hazard ratio (HR) 0.031, 95% confidence interval (CI) 0.0050–0.19], independent of childhood disorders such as attention deficit hyperactivity disorder (ADHD). Most individuals with hypomanic and manic episodes were never in care (87% and 62% respectively) and not presenting co-morbid depressive episodes (69% and 60% respectively). The probability of mental health care increased linearly with the number of symptoms on the mania symptom scale. The incidence of the bipolar categories, in particular at the level of clinical morbidity, was strongly associated with previous childhood disorders and male sex. Conclusions: This study showed, for the first time, that experiencing (hypo)manic symptoms is a common adolescent phenomenon that infrequently predicts mental health care use. The findings suggest that the onset of bipolar disorder can be elucidated by studying the pathway from non-pathological behavioural expression to dysfunction and need for care.

Diffuse idiopathic skeletal hyperostosis (DISH) is a spondyloarthropathy traditionally defined as having spinal and extra-spinal manifestations. However its diagnostic criteria only allow the identification of advanced DISH and there is little consensus regarding the extra-spinal enthesopathies. In this project, individuals with DISH from the WM Bass Donated Skeletal Collection were analysed to investigate the pathogenesis of DISH and archaeological English and Catalan samples (3rd–18th century AD) were studied to investigate how diet might have influenced the development of DISH. From the individuals from the Bass Collection, isolated vertical lesions representing the early stages of DISH (‘early DISH’) were identified. Both sample sets showed that the presence of extra-spinal manifestations varies significantly between individuals and that discarthrosis and DISH can co-exist in the same individual. In all archaeological samples, the prevalence of DISH was significantly higher in males and older individuals showed a higher prevalence of DISH. In both regions, the prevalence of DISH was the lowest in the Roman samples, the highest in the early medieval ones and intermediate in the late medieval samples. While when using documentary resources and archaeological data, it was hypothesised that the prevalence of DISH in the English and Catalan samples might have been different, the results show no significant differences even if English samples tend to show higher prevalence of DISH than the Catalan samples. This possibly suggests that the development of DISH depends on a combination of dietary habits and, possibly, genetic predisposition might influence the development of DISH. The individuals from the Bass Collection showed high prevalence of metabolic and cardiovascular conditions. In contrast, no association was found between DISH and rich-diet associated conditions (e.g. carious lesions and gout) or deficiency-related conditions (e.g. scurvy, healed rickets). / Institute of Life Sciences Research from the University of Bradford

The accuracy of neuropsychological assessment is critical in the diagnosis of cognitive impairments in older adults. However, existing neuropsychological tests may not be suitable for minority populations. This thesis aimed to address this issue by recruiting cognitively-healthy South Asian older adults and assessing cognitive function in this group. Results showed that typically used assessments, despite being translated, were not suitable for this cohort. Furthermore, skills required for test completion such as mathematics and writing/hand dexterity (which are related to education levels) influenced test scores. Therefore, new assessments of general cognitive function and associative memory were developed to improve the accuracy of neuropsychological test scores. The new tests were not affected by education and they achieved high internal and test re-test reliability. Time of day (TOD) that testing takes place is also known to affect cognition. Interestingly, no TOD effects were observed in this cohort. It was hypothesised that engagement in the daily five Islamic prayers may have contributed to this lack of a TOD effect. However, the results did not confirm this. The thesis then looked at overall prayer engagement and cognition. Results showed that engagement in the daily five prayers and Quran recitation significantly increased scores on assessments of processing speed. This thesis demonstrates that accurately assessing cognition in South Asian older adults is challenging and that the cognitive tests used must be suitable for this cohort. Interesting findings emerged for prayer engagement which may have wider implications for the field of cognitive reserve.

<p>UVOD: Kolorektalna anastomoza koja se formira u dubini karlice radi uspostavljanja kontinuiteta gastrointestinalnog trakta nakon resekcije dijela crijeva ima svoje specifičnosti u toku formiranja, zarastanja, kao i kada se jave komplikacije. Na sam proces zarastanja kolorektalnih anastomoza utiču sistemski, lokalni i tehnički faktori. Bilo kakav kompromis po pitanju ovih principa nosi povećan rizik od komplikacija! Najteža komplikacija na anastomozi je dehiscencija. &bdquo;Samo neučinjena anastomoza neće dehiscirati&ldquo;. Ova stara hirur&scaron;ka poslovica je važeća i danas, a &scaron;to je anastomoza distalnija, mogućnost dehiscencije je veća, posebno kod niskih subperitonealnih anastomoza sa rektumom ili anusom. Učestalost dehiscencija ovih anastomoza u literaturi varira od 0,5 - 69 %, &scaron;to može ukazivati na kvalitet hirur&scaron;kog rada, kori&scaron;ćenje definicije dehiscencije, način dijagnostike, itd. Međunarodna grupa za karcinom rektuma definisala je dehiscenciju anastomoze kao defekt crijevnog zida, uključujući &scaron;avnu ili staplersku liniju neorektalnog rezervoara, &scaron;to dovodi do komunikacije između intra i ekstra luminalnog prostora. CILJEVI: Osnovni cilj ove studije je bio da se utvrde preoperativni i perioperativni faktori rizika značajni za nastanak dehiscencija kolorektalnih anastomoza, kao i značaj prokalcitonina i C-reaktivnog proteina u detekciji dehiscencija kolorektalnih anastomoza u subkliničkoj fazi bolesti. MATERIJAL I METODOLOGIJA: Istraživanjem je obuhvaćeno 100 pacijenata operisanih u elektivnom programu, kod kojih je urađena radikalna operacija karcinoma rektuma uz kreiranje dvostruke staplerske kolorektalne anastomoze. Svi pacijenti uključeni u istraživanje, odabrani metodom slučajnog izbora, bili su podijeljeni u dvije grupe. Grupa A: pacijenti kod kojih je urađena radikalna operacija karcinoma rektuma i kreirana primarna staplerska kolorektalna anastomoza. Grupa B: pacijenti kod kojih je urađena radikalna operacija karcinoma rektuma Hartmanovom procedurom u prvom aktu, a rekonstrukcija kontinuiteta gastrointestinalnog trakta uspostavljena u drugom aktu kreiranjem sekundarne staplerske kolorektalne anastomoze. Primjenom statističkih testova analizirani su preoperativni (pol, godine života, komorbiditeti, ASA skor, indeks tjelesne mase preoperativna primjena hemoradioterapije, laboratorijske analize) i perioperativni (vrijeme trajanja operacije, udaljenost anastomoze od anokutane linije, veličina tumora u cm, intraoperativna primjena krvi) faktori rizika za nastanak dehiscencije anastomoze kod obje grupe. Kod svih pacijenata drugog i četvrtog postoperativnog dana kontrolisane su vrijednosti C reaktivnog proteina i prokalcitonina u serumu, bez obzira da li su postojali ili ne klinički manifestni znaci dehiscencije anastomoze. Takođe, primjenom ROC krive analizirana je senzitivnost, specifičnost i dijagnostička tačnost C reaktivnog proteina i prokalcitonina drugog i četvrtog postoperativnog dana u detekciji dehiscencije kolorektalne anastomoze. REZULTATI: Nema statistički značajne razlike u pojavi dehiscencije anastomoze između primarnih i sekundarnih dvostrukih staplerskih anastomoza. Incidencija dehiscencija anastomoza je bila 11% u ukupnom uzorku. Osam pacijenata je reoperisano, dok su tri pacijenta tretirana konzervativno. Kod tri pacijenta, kod kojih je nastala dehiscencija i koji su reoperisani, zbog posljedice sepse i septičnog &scaron;oka nastupio je smrtni ishod. Pol, godine života, komorbiditeti, stadijum bolesti, dužina trajanja operacije, intraoperativna primjena krvi, nisu statistički značajni faktori rizika (p&gt;0,05) za nastanak dehiscencije primarnih i sekundarnih dvostrukih staplerskih kolorektalnih anastomoza. Udaljenost anastomoze od anokutane linije (&lt;7cm), veličina tumora preko 5 cm su statistički značajni faktori rizika za nastanak dehiscencije anastomoze. Postoji visoko statistički značajna razlika (p&lt;0,001) vrijednosti CRP-a i PCT-a četvrtog postoperativnog dana kod bolesnika sa i bez prisutne dehiscenecije kolorektalne anastomoze. Na osnovu ROC analize CRP&ndash;a za četvrti postoperativni dan, za graničnu vrijednost od 130 mg/l senzitivnost iznosi 82%, specifičnost 96% i dijagnostička tačnost 94%. Za graničnu vrijednost PCT-a od 0,78 ng/ml za četvrti postoperativni dan primjenom ROC krive utvrđena je sezitivnost 91%, specifičnost 92%, dok je dijagnostička tačnost bila 86%. Četvrti postoperativni dan CRP ima veću dijagnostičku tačnost i specifičnost u detekciji dehiscencije kolorektalne anastomoze u odnosu na PCT. ZAKLJUČAK: I pored velikog tehnolo&scaron;kog napretka, usavr&scaron;avanja hirur&scaron;kih tehnika, boljeg razumijevanja prirode maligne bolesti, unapređivanja intraoperativnog i postoperativnog kontinuiranog praćenja bolesnika, uvođenja novih antimikrobnih lijekova, problem u liječenju i pojava dehiscencija kolorektalnih anastomoza su i dalje značajno prisutni. Otkrivanjem dehiscencija kolorektalnih anastomoza u subkliničkoj fazi, identifikovanje preoperativnih i perioperativnih faktora rizika značajnih za nastanak dehiscencija, omogućilo bi da se dehiscencija ranije uoči i efikasnije rije&scaron;i.</p> / <p>INTRODUCTION: Colorectal anastomosis, which is formed deep in the pelvis because of establishment of continuity of gastrointestinal tract after resection of the part of intestines, has got its specifities during forming and healing process and when complications occur. Systemic, local and technical factors influence the healing process of anastomosis itself. Any kind of compromise in terms of these principles causes higher risk of complications! The most serious complication of anastomosis is dehiscence. &ldquo;Only anastomosis which is not carried out will not dehisce.&rdquo; This old surgical saying is still true, and the more distal anastomosis is, the possibility of development of dehiscence is higher, especially in lower subperitoneal anastomosis with rectum and anus. Incidence of dehiscence of these anastomosis in literature varies from 0,5 to 69 %, which may indicate the quality of surgical work, use of definition of dehiscence, kind of diagnostics etc. International group for rectal cancer defined dehiscence of anastomosis as a defect of intestinal wall, including suturing or stapler line of neorectal reservoir, which leads to communication between intra and extra luminal space. AIMS: Basic aim of this study was to determine preoperative and postoperative risk factors significant for the development of dehiscence of colorectal anastomosis, as well as significance of procalcitonin and C-reactive protein in detection of dehiscence of colorectal anastomosis at the subclinical stage of the disease. MATERIAL AND METHODOLOGY: The study included 100 patients operated on in the elective programme, on which radical operation of the rectal cancer was carried out with creation of double stapler colorectal anastomosis. All patients included in the study were randomly chosen and divided into two groups. Group A: the patients on which radical operation of the rectal cancer was carried out and primary stapler colorectal anastomosis created. Group B: the patients on which radical operation of the rectal cancer was carried out using Hartman&#39;s procedure in the first act, and reconstruction of the continuity of gastrointestinal tract was established in the second act by creation of secondary stapler colorectal anastomosis. By application of statistical tests preoperative (sex, age, comorbidities, ASA score, body mass index, preoperative application of haemoradiotherapy, laboratory analyses) and perioperative (duration of operation, distance of anastomosis from anocutaneous line, size of tumor in cm, intraoperative application of blood) risk factors for development of dehiscence of anastomosis in both groups were analysed. In all patients on the second and fourth postoperative day values of C-reactive protein and procalcitonin in the serum were analysed, regardless of the existence of clinically or non-clinically manifested signs of dehiscence of anastomosis. Also, sensitivity, specifity and diagnostically accurate C-reactive protein and procalcitonin on the second and fourth postoperative day in detection of dehiscence of colorectal anastomosis were analysed by application of ROC curve. RESULTS: There is no statistically significant difference in the development of dehiscence of anastomosis between primary and secondary double stapler anastomosis. Incidence of dehiscence of anastomosis was 11% in all samples. Eight patients were reoperated on, whereas three patients were treated conservatively. In three patients who developed dehiscence and were reoperated on, the death occurred due to sepsis and septic shock. Sex, age, comorbidities, stage of the disease, duration of operation, intraoperative application of blood were not statistically significant risk factors (p&gt;0,05) for the development of dehiscence of primary and secondary double stapler colorectal anastomosis. Distance of anastomosis from anocutaneous line (&lt;7cm), size of tumor over 5 cm were statistically significant risk factors for the development of dehiscence of anastomosis. There is highly statistically significant difference (p&lt;0,001) values of CRP and PCT on the fourth postoperative day in patients with and without dehiscence of colorectal anastomosis. On the basis of ROC analysis of CRP for the fourth postoperative day, for the bordering value of 130 mg/l sensitivity is 82%, specificity 96% and diagnostic accuracy 94%. For bordering value of PCT of 0,78 ng/ml for the fourth postoperative day, by application of ROC curve, the following values were determined: sensitivity 91%, specificity 92% and diagnostic accuracy 86%. CRP for the fourth postoperative day has got higher diagnostic accuracy and specificity in detection of dehiscence of colorectal anastomosis in relation to PCT. CONCLUSION: In spite of huge technological advance, improvement of surgical techniques, better understanding of the nature of malignant diseases, improvement of intraoperative and postoperative continuous follow up of the patient, introduction of new antimicrobial medicines, the problem in treating and development of dehiscence of colorectal anastomosis is still significantly present. Detection of dehiscence of colorectal anastomosis at the subclinical stage, identification of preoperative and perioperative risk factors significant for the development of dehiscence would help in early detection of dehiscence and contribute to more effective operations.</p>