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Volume 39, Issue 2, 2025
Online ISSN: 3042-3511
ISSN: 3042-3503
Volume 39 , Issue 2, (2025)
Published: 12.11.2025.
Open Access
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Contents
31.03.2025.
Review Article
The Importance of Intraoperative Exploration and Intensive Postoperative Monitoring in the Detection and Management of Synchronous and Metachronous Colorectal Tumors
Introduction: Colorectal cancer (CRC) is among the most common malignancies, with a rising global incidence. Synchronous tumors refer to the presence of multiple tumors simultaneously in different segments of the colon or rectum, while metachronous tumors occur during follow-up after initial treatment. These tumors are often undetected during standard diagnostic procedures, making intraoperative exploration and postoperative monitoring crucial for timely diagnosis and successful treatment. Case Report: A 63-year-old patient was admitted for sideropenic anemia and weight loss. Colonoscopy revealed a tumor in the cecum, confirmed as adenocarcinoma. During surgery, two additional tumor lesions were discovered in the ascending and transverse colon. Following an extended right hemicolectomy and adjuvant chemotherapy according to the FOLFOX protocol, the patient remained disease-free until May 2023, when a metachronous tumor in the rectum was detected. The lesion was removed via transanal excision, and histopathological findings indicated intramucosal carcinoma. Continuous follow-up until November 2024 showed no disease progression. Conclusion: Intraoperative exploration enabled the identification of previously undetected synchronous tumors, influencing the extent of surgery and the postoperative treatment plan. Regular monitoring, including colonoscopy and radiological methods, is essential for the early detection of metachronous tumors and achieving optimal outcomes. This case highlights the importance of a multidisciplinary approach in managing patients with synchronous and metachronous CRC.
Marija Nikolić, Nebojša Mitrović, Dejan Stevanović, Nemanja Trifunović, Jovana Trifunović, Milica Radivojević, Damir Jašarović
12.11.2025.
Review Article
Pseudoaneurysms after coronary interventions: risk factors, diagnosis, and criteria for surgical treatment
Introduction: Pseudoaneurysm (PSA) is defined as a defect in the arterial wall at the puncture site, leading to an extraluminal blood collection surrounded by fibrous tissue, and represents the most common vascular complication after coronary angiography. The aim of this study was to identify risk factors for PSA development after coronary interventions and to define criteria for surgical treatment. Materials and Methods: A retrospective analysis was conducted on 32 patients treated at CHC Zemun over a ten-year period (2012–2022). During the observed period, 16,787 coronary procedures were performed (10,498 coronary angiographies, 6,289 PCIs). The study group included 17 patients with PSA, and 15 patients in the control group with a hematoma that did not progress to PSA. Demographic data, comorbidities, laboratory parameters, therapy, smoking habits, procedural details, and PSA characteristics were recorded, with comparison between surgically and conservatively treated patients. Results: The mean time to PSA diagnosis was 3.29 ± 4.7 days, whereas hematomas were diagnosed within 24 hours. No significant differences in sex or age were observed between groups. More than half of the patients had hypertension, hyperlipidemia, and chronic cardiac or renal diseases. Low hemoglobin, thrombocytopenia, and INR >3 were identified as independent risk factors. Most interventions were performed via the right femoral artery, with PSA most commonly located in the common femoral artery. Median PSA diameter was 44 mm in surgically treated patients and 19 mm in conservatively treated patients. No deaths occurred; the most common postoperative complication was residual hematoma. Conclusion: The first 72 hours after intervention represent the most critical period for PSA detection. PSA diameter is a key factor in therapy selection, lesions >2 cm and complicated ones require surgical intervention, while smaller lesions can be treated conservatively. Timely diagnosis and treatment improve outcomes, and our findings may help optimize patient monitoring protocols and early surgical intervention selection.
Dimitrije Surla, Marija Nikolić, Nemanja Trifunović, Dimitrije Surla, Dejan Stevanović
12.11.2025.
Review Article
One Hundred Years of Colposcopy: Legacy and Lessons of Hans Hinselmann
The development of colposcopy and the Papanicolaou (Pap) test marked a turning point in the prevention and early detection of one of the most aggressive gynecological cancers—cervical carcinoma. Hans Hinselmann (1884–1959) first used the colposcope in March 1924 and published his research, along with a description of the instrument, in 1925. This year is considered the beginning of the colposcopic era. Using his device, Hinselmann was able to identify early stages of cervical cancer and describe epithelial changes he termed “precancerous lesions.” He emphasized the importance of systematic prevention and advocated for the establishment of centers dedicated to early cervical cancer detection. Although a persistent and methodical researcher, Hinselmann crossed ethical boundaries under the Nazi regime, participating in forced sterilization programs of women from 1935 onward. After World War II, he spent three years in prison (1946–1949), was removed from clinical work, and later incriminated for his involvement. Following his sentence, he was allowed to practice privately until his retirement in 1949. Hinselmann died in 1959 in Goethehaus. In Serbia, the first article on the importance of colposcopy in gynecological diagnostics was published by Berislav Berić in 1954. Štucinova and Mladen Broćić were pioneers in introducing colposcopy in the country. The Section for Colposcopy and Cervical Pathology was established on September 26, 1995, in Brezovica, marking the institutionalization of this field in Serbia. With the adoption of a new Statute on November 12, 2006, the Section evolved into the Serbian Association for Colposcopy and Cervical Pathology.
Ana Dević, Nikola Kolarović, Marija Nikolić
01.01.2023.
Original Article
Prevalence and effect of respiratory syncytial virus infection on clinical course in children up to two years of age hospitalized for small airways infection
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.
Sladjana Pekmezovic, Nevena Tasic, Mladen Tasic
01.01.2023.
Original Article
Examination of the impact and consequences of the COVID-19 pandemic on the mental health of the population in the Republic of Serbia in the population aged 30-50
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.
Bojana B. Petrovic, Anita Milanovic, Katarina Bozovic
01.01.2023.
Original Article
Clinical and morphological characteristics of colorectal adenocarcinoma-ours experiences
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.
Janko Zujović, Batric Vukcevic, Novica Bojanic, Elvira Spirtović, Nina Jancic
01.01.2023.
Original Article
Awareness of the necessity of screening as a health imperative
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”.
Igor Pljesa, Sladjana Pekmezovic, Mina Ivanov
01.01.2023.
Review article
Damage to the health of employees due to occupational exposure to ionizing radiation
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.
Svetlana Banovic, Kristina Vojvodic, Dusan Vesovic, Ivana Zivanovic
01.01.2023.
Case Report
Degenerative mitral valve disease, type of Barlow’s disease and papillary fibroelastoma: a case report
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.
Marija Milinkovic, Vesna Bozic, Ivana Jovanovic, Olga Petrovic, Duško Terzicć
01.01.2023.
Case Report
Application of brachytherapy in patient with local recurrence of prostate adenocarcinoma after radical radiation therapy: a case report
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.
Nikola Kolarović, Perica Jockić, Predrag Petrašinović, Vesna Libek, Vuk Aleksić