Intensive Care Units (ICUs) are inevitably positioned at the top of the treatment pyramid for patients with acute and life-threatening conditions according to current medical practice. The number of critically ill patients has dramatically increased owing to better treatment quality, a longer life expectancy, and the impact of modern technologies. This has raised concerns regarding the intensive care and surveillance of these patients. Compared to colleagues in non- intensive care services, the profiles of physicians and nurses/technicians working ICUs differ considerably in their patients’ approach and skills performance. Specific indications for ICU admission have been established due to the restricted number of available ICU beds. These patients are transferred to semi-intensive care (SICUs) services within the departments that correspond to their pathology once their critical condition has stabilized. The ICU patients cannot be fully recovered, but can have their conditions stabilized to the point where they may receive further treatment outside of the ICU. Thus, ICUs and SICUs represent one functional unit. The aim of this review is to present the indications for admission to the Department of Internal Medicine ICU of the Clinical Hospital Center Zemun.

Introduction: Voice dysfunction represents a significant postoperative complication following total thyroidectomy, particularly in patients whose profession depends on their voice (singers, lecturers). The main causes include injury to the recurrent laryngeal nerve (RLN) and superior laryngeal nerve (SLN), as well as vocal cord trauma during intubation or the occurrence of postoperative edema. Methods: A systematic search of PubMed and Cochrane databases was conducted for studies published between 2014 and 2025. Included studies comprised randomized controlled trials, meta-analyses, systematic reviews, and relevant clinical guidelines. Data were analyzed regarding the incidence of voice dysfunction, mechanisms of nerve injury, surgical and anesthetic risk factors, prevention strategies, and postoperative management, including the use of intraoperative neuromonitoring (IONM). Results and Discussion: Recurrent laryngeal nerve paresis leads to dysphonia and reduced phonatory power, whereas superior laryngeal nerve injury decreases the high-frequency vocal range and vocal endurance. The risk is increased in reoperations, large retrosternal goiters, and invasive tumors. The use of IONM reduces the risk of permanent RLN injury, although its reliability may be compromised by improper use of neuromuscular blockers or anesthetic protocols. Anesthetic factors, including improper intubation, excessive cuff pressure, and multiple intubation attempts, significantly contribute to voice changes. Prevention includes careful anesthetic management, precise intubation technique, and coordinated work between surgeons and anesthesiologists. Early postoperative evaluation, fiberendoscopic examination, acoustic analysis, and speech therapy contribute to preserving vocal cord function. Conclusion: Voice dysfunction following total thyroidectomy arises from both surgical and anesthetic factors. Prevention of complications requires a multidisciplinary approach, coordination between surgeons and anesthesiologists, and the use of intraoperative neuromonitoring. Therapy and rehabilitation, including otolaryngological assessment and speech therapy, aim to preserve and restore vocal function.

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.

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.