Introduction: Gastrointestinal bleeding represents a serious clinical challenge due to the complexity of diagnosis and the therapeutic options required for effective management. Small bowel bleeding, although relatively rare, poses a significant diagnostic dilemma due to the difficulty in identifying the source and the variability of causes, which differ depending on the patient's age. In the elderly population, vascular malformations are the most common causes, whereas in younger patients, the etiology can be broader, including inflammatory diseases, tumors, and congenital abnormalities. The aim of this study was to investigate the clinical characteristics and outcomes of patients with hemodynamic instability due to small bowel bleeding, with a particular focus on the application of predictive scores (GBS and CRS). Materials and Methods: This retrospective observational study, conducted from January 2023 to January 2024, included 24 hemodynamically unstable patients with diagnosed small bowel bleeding. All patients were assessed using the Glasgow Blatchford Score (GBS) and Clinical Rockall Score (CRS) to evaluate risk and predict clinical outcomes. Demographic data, clinical and diagnostic information were analyzed, with comparative analyses of preoperative, intraoperative, and histopathological findings. Results: The mean age of the patients was 69.8 years, and 79.2% presented with hematochezia. All patients had GBS > 15 and CRS > 6. Conservative treatment was effective in 62.5% of patients, while 37.5% required surgical intervention. The mortality rate was 12.5%. Statistically significant positive correlations were found between GBS and mortality (r = +0.76, p < 0.05) and between GBS and surgical intervention (r = +0.32, p < 0.05). The most common causes of bleeding were vascular lesions, although the source of bleeding was unidentified in 11 patients. Conclusion: Small bowel bleeding remains a major challenge for clinicians, requiring a multidisciplinary approach to diagnosis and treatment. The use of predictive scores such as GBS and CRS aids in assessing severity, guiding decision-making, and planning further treatment.

Introduction: Primary adenocarcinoma of the appendix is a rare and heterogeneous malignancy, most commonly presenting as mucinous adenocarcinoma. Due to its nonspecific clinical manifestations, the diagnosis is often established at an advanced stage, frequently with already present peritoneal dissemination. Standard treatment for advanced mucinous appendiceal carcinoma involves cytoreductive surgery with HIPEC followed by systemic chemotherapy, or initial systemic therapy for downstaging, followed by repeat CRS and HIPEC. In cases where radical surgery is not feasible, the average survival is less than one year. Case report: We report a case of a 72-year-old woman with no relevant family history, who presented with acute right lower abdominal pain and distension. Imaging revealed multiple cystic peritoneal implants, ascites, and small bowel obstruction. Palliative emergency surgery demonstrated an appendiceal mass invading the right ovary, with widespread peritoneal mucinous deposits. Histopathological analysis confirmed mucinous adenocarcinoma of the appendix with peritoneal carcinomatosis. Postoperatively, the patient received 12 cycles of bevacizumab plus FOLFOX chemotherapy, achieving marked radiologic and biochemical improvement. Maintenance therapy with bevacizumab plus 5-FU/LV led to sustained disease stabilization. After 32 cycles, the patient developed an entero-vaginal fistula, which was surgically managed due to poor quality of life. Intraoperatively, the decision was made for cytoreductive surgery and fistulectomy. Postoperative imaging showed no evidence of disease. The patient remains progression-free for nearly three years, and disease-free for one year. Conclusion: This case highlights the potential for long-term survival in initially inoperable patients with advanced mucinous appendiceal adenocarcinoma and peritoneal carcinomatosis when treated with combined cytoreductive surgery and bevacizumab plus chemotherapy. Multimodal and individualized treatment strategies may significantly improve outcomes in this rare malignancy.

Introduction: Parasitic leiomyomas are extremely rare benign smooth muscle tumors that develop independently of the uterus. They may arise spontaneously from pedunculated subserosal fibroids that detach and establish an independent blood supply from surrounding structures, or they may develop iatrogenically following laparoscopic morcellation. Owing to their nonspecific clinical and radiologic features, they are often misdiagnosed preoperatively. Surgical excision with histopathological verification remains the standard of care. Case report: We present the case of a 51-year-old postmenopausal woman with progressive abdominal distension and a sensation of pelvic pressure. Imaging revealed a large heterogeneous abdominopelvic mass measuring 30 × 20 cm, compressing adjacent bowel loops and major vessels. The uterus was myomatous but of normal size, and both ovaries appeared unremarkable. The patient underwent open surgical resection of the mass with total hysterectomy, bilateral adnexectomy, and omentectomy. Intraoperatively, a giant tumor connected to the uterine fundus by a thin pedicle was identified. Histopathological examination confirmed a benign leiomyoma without atypia or necrosis and a Ki-67 proliferation index below 1%. The postoperative course was uneventful, and the patient remained asymptomatic three months after surgery. Conclusion: Primary parasitic leiomyomas are exceedingly uncommon, particularly in patients without a history of prior gynecologic surgery. They should be considered in the differential diagnosis of large abdominopelvic masses. This case emphasizes the importance of comprehensive diagnostic evaluation and highlights that parasitic leiomyomas can attain remarkable size while maintaining benign histological features.

The aim of this study was to examine the difference in RSV small respiratory tract infections and small respiratory tract infections of other etiologies, regarding length of hospitalization and need of oxygen therapy. The examined populations were children treated for small respiratory tract infections in KBC Zemun during 2 years, aged from birth to the end of the second year of life. Treatment outcomes were examined: duration of hospitalization, length of oxygen therapy, combined pneumonia (confirmed by X-ray). A total of 78 children with a clinical picture of severe infection were selected. The data were taken from the existing documentation of KBC Zemun. The study found that in the first year a higher percentage of RSV positive girls was 76.19% than boys 73.91%, and in the second year 78.57% of RSV positive girls and 60% of boys. Children with low birth weight, premature birth as well, fed adapted formulas are more likely to develop RSV bronchiolitis. The duration of hospitalization was longer in RSV bronchiolitis, as well as in associated bacterial infection. The length of oxygen therapy was not affected by the presence of RSV infection, but children with bronchiolitis complicated by pneumonia were longer on oxygen therapy. Our research is in line with previous research, existing treatment protocols. Certain deviations can be explained by a small sample, which gives the need for systematic and broader examination of the relationship between risk factors, etiological factors in small respiratory tract infections.

The aim of the survey conducted at the Galen Farm Pharmacy in Belgrade is to analyze the impact of the COVID-19 infection on the mental health of the population aged 30-50. The end of 2019 marked the beginning of the COVID-19 (Coronavirus disease 2019) pandemic from China, which affected more than 214 countries and territories around the world. Preventive strategies play a major role in reducing the spread of the virus. The advent of vaccines slows down the transmission of the virus and alleviates the symptoms of the disease. The ongoing pandemic poses a serious threat to human health and the global economy and has resulted in enormous stress on health care systems worldwide, and mental and physical health are equally important components of overall health. 104 respondents, users of the services of the “Galen Farm” Pharmacy in Belgrade, were included in the research. An original questionnaire of 15 questions was created, and the research was anonymous. The DASS-21 scale (The Depression, Anxiety and Stress Scale-21 Items) was used in the research. For the largest number of respondents, the pandemic affected their quality of life, while a smaller number of respondents estimated that the pandemic had no effect. The largest number of respondents were positive for the virus, while twice as many respondents were not positive. More than half of the respondents were in mandatory isolation. The largest number of respondents reported that someone close to them was positive for the virus. The largest number of respondents had no the experience of the death of a close person. In order to gain insight into the impact of the COVID-19 infection on the mental health of the respondents, the answers of the respondents on the DASS-21 scale were processed in more detail. The respondents more often report experiencing stress symptoms during the past period. Medical workers have statistically significantly higher scores on average, on the individual scales of the DASS questionnaire, compared to non-medical workers, and this also applies to people who have had someone close to them die due to COVID-19. The obtained results are partially consistent with previous research. During the outbreak of any infectious disease, the psychological reactions of individuals play an important role in the spread of the disease, as well as in the frequency of emotional distress and social disturbances during and after the outbreak of a pandemic.

The aim of the work is to examine the relationship between the clinical and pathological characteristics of colorectal cancer and indicators of disease progression. The examined group consisted of operative biopsies of colorectal carcinoma (n=75), and the control group (n=75) consisted of biopsies of adjacent non-tumor tissue of the colon from the operative preparation submitted to the Pathology Centre of the Clinical Center of Montenegro. After routine histopathological processing, classic Hematoxylin-Eosin and immunohistochemical ABC method with anti-Ki67 antibodies were applied to the 4 μm sections. The histological grade of the tumor is significantly related to the proliferation index, while the pT status depends on the invasion of lymphatic vessels, metastases in the lymph nodes and the Astler-Coller stage. Metastases in lymph nodes are highly significantly associated with invasion of lymphatic vessels and Astler-Coller tumor stage. Distant metastases are significantly related to blood vessel invasion, perineural invasion and Astler_Coller stage. The histological grade of the tumor, lymphovascular and perineural invasion, the presence of metastases in the lymph nodes, distant metastases and the Astler-Coller stage depend on the proliferative index of the tumor cells. Ki67 expression is a good marker of colorectal cancer progression due to its high sensitivity and specificity.

Cervical cancer in Serbia is one of the leading causes of illness and death in the female population. Every year, about 1,300 women fall ill and approximately 500 lose their lives due to this disease. The importance of screening for this disease is very high, but unfortunately insufficiently known in the population. We conducted a short survey on 30 women aged 20 to 40 who filled out a pre-prepared cervical cancer screening questionnaire. The results indicate that the health awareness of the female population regarding cervical cancer screening in Serbia is very low, but there is also a clear insight into the importance of geting new informations, and we believe that this study contributes to raising awareness about cervical cancer screening, which is in line with the general trend population policy in the world, given that January 2023 was declared the month dedicated to the prevention of cervical cancer with the theme: Ending cervical cancer within a few generations”.

Electromagnetic radiation represents energy transmission through an immaterial medium through a flow of energy particles or quanta of energy. When passing through the material medium, there is an interaction with the medium through which they pass, and energy is transferred to the particles of the material medium. Ionising radiation (JZ) is electromagnetic radiation consisting of EM - --waves or particles with kinetic energy sufficient to ionise the substance they pass. During ionisation, orbital electrons are ejected from the atoms of the environment as negative ions and positive ions are formed from the rest of the particles. The ions formed in this way disturb the biochemical processes in the cells, which can lead to disturbances in their functioning and division and even to the occurrence of diseases, such as tumours. The effect of ionising radiation is reflected in the impact on proteins, lipids, carbohydrates and nucleic acids. The following can be recognised as occupational diseases: acute radiodermatitis, acute radiation sickness, acute radiation cataract, chronic radiodermatitis in case of exposure to ionising radiation for at least ten years, regular radiation cataract in case of exposure to ionising radiation for at least five years, malignant diseases and damage to the hematopoietic system. It is necessary to educate the entire population about the consequences that ionising radiation has on human health, provide complete protection to workers who work in radioactive radiation zones, apply all preventive and protective measures against the effects of ionising radiation in the workplace, and provide adequate, timely and professional assistance to all workers who were exposed to ionising radiation.

In this article, we present the case of a patient with classic signs of Barlow’s disease and discrete mass on the posterior myxomatously altered cusp that were observed on echocardiographic examination. Barlow’s disease is a degenerative disease of the mitral valve in which leaf prolapse and mitral regurgitation occur, which is a significant cause of cardiovascular mortality and morbidity. Papillary fibroelastoma of the heart is a rare benign tumor of the heart, mostly located on the valves, it is detected incidentally, but it can be the cause of transient neurological defects and ischemia of the heart due to embolization or prolapse in the coronary ostia. Differentiating degenerative mitral valve disease is important, because choice of surgical correction techniques depend on this distinction, and pathohistological analysis (classical, histochemical and immunohistochemical staining) contributes to the confirmation of the diagnosis, which is important for future outcome research.

Prostate cancer is the second most common cancer in men, and the fifth most common cause of cancer death in the world. Therapeutic options are divided on the basis of staging and accurate diagnosis. Due to the lack of randomized prospective controlled studies on the treatment of prostate cancer, no therapeutic option can be preferred, although there are some recommendations. Therapy options for intraprostatic tumor include: monitoring the course of the disease, radical prostatectomy, or radiation therapy. Radical radiotherapy is an alternative to surgical treatment in the localized form of primary prostate cancer. Radiotherapy treatment has shown good results. In case of local recurrence of the disease, the recommendations are even more scarce. We present a case of a 65-year-old patient who was treated for prostate adenocarcinoma with radical radiation therapy combined with androgen deprivation therapy for one year and then about 6 years after initial therapy he was successfully treated with adjuvant salvage brachytherapy because of local carcinoma recurrence. In addition to certain recommendations for the implementation of this therapy which we proposed in the following text, we certainly recommend a personalized medical approach in such cases.