Current issue
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
Cervicogenic headache
Cervicogenic headache is a type of secondary headache that affects 0.17-4% of the general population and is defined by a primary lesion in the cervical spine with a painful syndrome in the head and/or facial area. It is characterized by unilateral pain on the side of the primary lesion in the neck, with variable accompanying symptoms that may pose a differential diagnostic challenge compared to other types of headaches. The most widely accepted mechanism of this headache's onset is the propagation of pain from the neck to the structures of the head, sometimes even to the face, due to the convergence of afferent neurons originating from the C1-C3 spinal nerves and nociceptive fibers of the trigeminal nerve in the trigeminocervical complex. Since most of the clinical characteristics of this headache are nonspecific, in the absence of a clear chronological connection to a lesion in the cervical spine, imaging or targeted nerve blockade is required to establish a diagnosis. The response to pharmacotherapy is often modest, and therapeutic methods include physical therapy, periodic injections of analgesics and/or corticosteroids into the joints of the cervical vertebrae or their associated nerves, as well as neurosurgical methods such as radiofrequency ablation and nerve decompression.
Vladimir Bošković, Armin Korać, Milija Mijajlović
31.03.2025.
Case Report
Case Report: Severe Upper Lip and Hard Palate Necrosis Associated With Chronic NSAID Abuse
A 67-year-old woman experienced extensive soft-tissue ulceration of the right upper lip and adjacent maxillary bone as a consequence of attempted abuse of aspirin (NSAID). All oral lesions healed within 28 days after local and systemic therapy. Oral ulceration has many potential causes ranging from physical trauma to malignancy. Chemicals are a less common cause of traumatic ulceration. Most chemical burns are characterized by mild to moderate tissue damage that heals spontaneously within seven to 15 days without scarring. The primary intervention involves discontinuing the aspirin use and addressing the underlying vascular compromise. Treatment may include supportive measures, wound care, and in severe cases, reconstructive surgery.
Drago Jelovac, Danilo Nikolić, Aleksandar Oroz
12.11.2025.
Review Article
Synchronous Gastrointestinal Stromal Tumor and Pancreatic Ductal Adenocarcinoma: A Rare Case Report With Clinical Implications and Molecular Overlaps
The synchronous occurrence of a gastrointestinal stromal tumor (GIST) and pancreatic ductal adenocarcinoma (PDAC) is exceptionally rare and poses significant diagnostic and therapeutic challenges. We report a 67-year-old female presenting with biliary obstruction, right upper quadrant pain, and dyspeptic symptoms. CT imaging revealed a pancreatic head mass, while a submucosal gastric lesion was identified only intraoperatively. Laparotomy enabled excision of a pedunculated gastric GIST, whereas the unresectable pancreatic tumor involved critical vascular structures, necessitating a palliative double bypass comprising cholecystectomy, hepaticojejunostomy, gastrojejunostomy, and enteroenterostomy. Histopathology confirmed a low-risk GIST and a moderately differentiated PDAC with distinct immunohistochemical profiles, supporting the presence of two independent primary tumors.
This case underscores the critical importance of meticulous intraoperative exploration, particularly in the presence of atypical or incidentally discovered lesions, and demonstrates the durable palliation afforded by surgical bypass in unresectable PDAC. Beyond the clinical context, potential molecular overlaps—activation of MAPK/ERK and PI3K/AKT/mTOR pathways, VEGF-mediated angiogenesis, and defects in DNA repair—provide a plausible biological basis for the synchronous occurrence of these otherwise unrelated neoplasms, informing potential strategies for personalized therapy
Nebojša Mitrović, Nemanja Trifunović, Jovana Trifunović, Milica Lakićević
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
Delayed epidural hematoma of posterior cranial fossa
We present a 51-year-old patient who sustained multiple brain injuries after falling from a height of 5 meters. The patient was treated conservatively with barbiturate sedation, antiedematous and other supportive therapy. He recovered well. However, fifteen days after injury control, a brain-computer tomography (CT) scan revealed a posterior cranial fossa epidural hematoma on the right side, without signs of brain compression and midline shift. Since the patient was in good condition, without complaints, and with normal neurological findings, and since de novo hematoma didn’t show signs of brain compression, he was observed for a few days and discharged from the hospital in good condition. According to the literature, and which is in our case, occipital bone fracture, antiedematous therapy, and sedation are risk factors for delayed posterior fossa epidural hematoma occurrence after traumatic brain injury, so in similar circumstances, we suggest more frequent control brain CT scans. The most common localization of the epidural hematoma is in the temporal region due to middle meningeal artery injury in temporal bone fractures. Other localizations of epidural hematomas are rare. Posterior cranial fossa epidural hematomas are exceedingly uncommon findings. Also, most epidural hematomas have an acute clinical picture, and delayed epidural hematomas are atypical. So, delayed posterior cranial fossa epidural hematomas are unique findings with an incidence of less than 0.1% of all epidural hematomas.
Milenko Stanić, Lidija Mikić, Sofija Marković, Kristina Krstić, Marina Stojić, Aleksandra Živković, Vuk Aleksić
01.01.2023.
Seminars
Histological techniques: Immunocytochemical staining
The aim of this seminar is to present the basic methodologies of immunocytochemical and immunohistochemical staining, prerequisites for success in their performance and the practical importance of their application in routine practice. The main difference between ICC and IHC is that IHC is performed on tissue without destroying the histological architecture and it is possible to analyze the expression of molecules in the microenvironment as well. Immunochemical staining is a powerful technique routinely used to detect, localize, and quantify (quantify) cellular macromolecules in preserved tissues. Regardless of the specific method used, the first step of this technique is always the selective binding of the primary antibody to its specific antigen. Immunohistochemistry (IHC) is a method used to determine the expression of biomarkers in tissue. It is used for research and diagnostic purposes in pathology and core branches of medicine.
Dimitrije Milenkovic, Vanja Stanojevic, Biljana Drobac