Introduction. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease nowadays which has contributed to significant cardiovascular and hepatic morbidity and mortality. Recognizing the metabolic concept resulted in an evolution in disease nomenclature, as well as the development of innovative treatments for MASLD, the hepatic manifestation of metabolic syndrome.

Objective. To present contemporary trends in the management of MASLD.

Methods. For the search methodology, we used the PubMed database. We employed the following keywords to search for original articles,  reviews, and clinical guidelines from 2018. to 2025. year, such as „NAFLD/MASLD“, „NAFLD/MASLD biomarkers“, „NAFLD/MASLD diagnostic scores“, „NAFLD/MASLD innovative therapy“. We used original articles and reviews written in English, Serbian and Balkan-familiar languages. Special attention was given to the FIB-4 algorithm, newly developed non-invasive scores (SAFE, LiverRisk, MAFS), and biomarkers (MDA, 8-OHdG, CK-18, PRO-C3).

Results. MASLD has been associated to an increased risk of liver fibrosis and cirrhosis, hepatocellular carcinoma (HCC), and cardiovascular diseases. Emerging biomarkers enable early and accurate diagnosis and monitoring of treatment response, while innovative treatments including PPAR agonists, GLP-1 receptor agonists, and Resmetirom are mapping the personalized MASLD treatment.

Conclusion. MASLD is a chronic systemic disease requiring a multidisciplinary approach. Proper diagnosis and personalized innovative therapy create the favorable conditions for reducing cardiovascular and hepatic morbidity and mortality.

The human microbiota has emerged as one of the most dynamic fields of modern medicine. It is now recognized as an active regulator of metabolism, immune defence, and neuropsychiatric functions.. Dysbiosis, the alteration of microbiota, has been linked to gastrointestinal disorders, autoimmune diseases, metabolic syndrome, and neuropsychiatric conditions, highlighting the systemic roles of the microbiome. Current therapeutic strategies include probiotics, prebiotics, postbiotics, individualized dietary interventions, and medical fasting, while fecal microbiota transplantation represents the most promising method for restoring a healthy microbiome. The aim of this review is to present the historical background, pathophysiology, and clinical implications of the microbiota, and to emphasize the need for introducing faecal transplantation into clinical practice in Serbia as a significant step toward the personalized medicine.

Hyponatremia is an electrolyte disorder frequently encountered in clinical practice. The first step in the diagnostic evaluation of hyponatremia is the volume assessment (clinical estimation of hypo/hypervolemia presence). In the cases of euvolemic hyponatremia, followed by decreased plasma osmolality (<275mOsm/kg) with urine osmolality >100mOsm/kg, urine sodium >30mmol/L along with normal intake of salt and water, preserved pituitary, adrenal, thyroid, adrenal function as well as no recent use of diuretics, syndrome of inappropriate diuresis (SIAD) is diagnosed. In symptomatic, especially acute hyponatremia, careful and gradual substitution by 3 (10) % sodium-chloride infusion is advised with liquid intake restriction, the administration of demeclocycline, urea, or vaptans, as well as causal treatment of SIAD. SIAD is often transient and etiologically clear. In this paper, we present two cases with idiopathic, chronic SIAD with poor outcomes. During the diagnostic follow-up, the cause of SIAD was not found. The autopsy finding was also adverse. In most cases, euvolemic hyponatremia in patients with chronic, idiopathic SIAD is an ominous sign.

Stafilokokni toksični šok sindrom (STŠS) se obično javlja kod novorođenčadi i dece, ali se povremeno može javiti i kod odraslih. U tom slučaju, obično ukazuje na disfunkciju imunog sistema. Prikazan je slučaj kritično-obolelog odraslog muškarca sa STŠS i simptomima i znacima životno-ugrožavajuće sistemske infekcije (hemodinamska nestabilnost, akutna insuficijencija bubrega, konfuzija). Nakon završenog lečenja (anti-stafilokoni antibiotici, hemodijaliza, vazopresori, suportivna i simptomatska terapija), postignuta je potpuna remisija kod obolelog. Pravovremena dijagnostika i adekvatan tretman je glavno uporište u lečenju STŠS kod odraslih.

Za postavljanje dijagnoze sepse, najpouzdanije je određivanje PSP u kombinaciji sa drugim markerima sistemske infekcije. Pojedinačno merenje je često bez značaja, tako da je kontinuirano merenje u vremenu, sa trendovima pada ili porasta nivoa markera sistemske infekcije, daleko informativnije. Nivo PSP značajno zavisi od GFR. Kod obolelih od ABI, PSP je solidan pokazatelj sistemske infekcije do težih i prologiranih stadijuma ABI. Kod obolelih od HBI, tumačenje vrednosti PSP je veoma spekulativno, te postoji potreba za definisanjem novihcut-off vrednosti za PSP kod ovih bolesnika. Kod oblelih pod tretmanom HD, pokazan je različit klirens PSP sa različitim dijaliznim membranama. Svakako, nivo PSP se po HD vraća na pređašnji nivo, koji je inače povišen.

This article presents a case of patient with acute and complicated dyslipidaemic pancreatitis, managed by team, consisted of the endocrinologists, gastroenterologists and transfusiologists. Dyslipidaemia, predominantly type IV, is a common cause of acute pancreatitis in young patients, especially in the cases of poor compliance (irregular taking of recommended fibrates and failure to comply with the dietary regime). The treatment of acute pancreatitis, regardless of the aetiology, is due to the severity of the condition, the complexity of the treatment, and the monitoring of patients, in the Intensive Care Units. In cases where dyslipidaemia is the cause of acute pancreatitis, in the context of acute care, a therapeutic plasma exchange is often performed. It rapidly and significantly corrects lipid levels, primarily triglycerides. Therapeutic plasma exchange requires the activity of transfusiology team, which are often unavailable in smaller hospitals.

Za postavljanje dijagnoze sepse, najpouzdanije je određivanje PSP u kombinaciji sa drugim markerima sistemske infekcije. Pojedinačno merenje je često bez značaja, tako da je kontinuirano merenje u vremenu, sa trendovima pada ili porasta nivoa markera sistemske infekcije, daleko informativnije. Nivo PSP značajno zavisi od GFR. Kod obolelih od ABI, PSP je solidan pokazatelj sistemske infekcije do težih i prologiranih stadijuma ABI. Kod obolelih od HBI, tumačenje vrednosti PSP je veoma spekulativno, te postoji potreba za definisanjem novihcut-off vrednosti za PSP kod ovih bolesnika. Kod oblelih pod tretmanom HD, pokazan je različit klirens PSP sa različitim dijaliznim membranama. Svakako, nivo PSP se po HD vraća na pređašnji nivo, koji je inače povišen.

Za postavljanje dijagnoze sepse, najpouzdanije je određivanje PSP u kombinaciji sa drugim markerima sistemske infekcije. Pojedinačno merenje je često bez značaja, tako da je kontinuirano merenje u vremenu, sa trendovima pada ili porasta nivoa markera sistemske infekcije, daleko informativnije. Nivo PSP značajno zavisi od GFR. Kod obolelih od ABI, PSP je solidan pokazatelj sistemske infekcije do težih i prologiranih stadijuma ABI. Kod obolelih od HBI, tumačenje vrednosti PSP je veoma spekulativno, te postoji potreba za definisanjem novihcut-off vrednosti za PSP kod ovih bolesnika. Kod oblelih pod tretmanom HD, pokazan je različit klirens PSP sa različitim dijaliznim membranama. Svakako, nivo PSP se po HD vraća na pređašnji nivo, koji je inače povišen.

U okviru ovog rada prikazan je slučaj bolesnika sa komplikovanim akutnim dislipidemijskim pankreatitisom u čijem je zbrinjavanju učestvovao tim, koji su činili endokrinolozi, gastroenterolozi i transfuziolozi. Dislipidemija, prevashodno tip IV dislipidemije, predstavlja čest uzrok nastanka akutnog pankreatitisa u populaciji mladih ljudi, posebno u slučajevima nezadovoljavajuće komplijanse (neredovno uzimanje preporučenih fibrata i nepridržavanje higijensko-dijetetskog režima). Tretman akutnog pankreatitisa se nezavisno od etiologije, zbog težine stanja, kompleksnosti lečenja i monitoringa bolesnika, sprovodi u Jedinicama intenzivnog lečenja. U slučajevima kada je dislipidemija uzrok akutnog pankreatitisa, često se u sklopu akutnog zbrinjavanja sprovodi i terapijska izmena plazme, kojom se brzo i značajno koriguju nivoi lipida, prevashodno triglicerida. Terapijska izmena plazme zahteva aktivnost transfuzioloških ekipa, koje su u manjim centrima, često nedostupne.