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

Background: Bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor A (VEGF-A), represents an important component of systemic therapy for metastatic colorectal cancer (mCRC). By inhibiting angiogenesis and promoting vascular normalization, bevacizumab enhances the efficacy of cytotoxic drugs. However, despite proven benefits, some uncertainties remain regarding its safety profile, particularly the risk of gastrointestinal perforation and other vascular toxicities. Materials and Methods: This retrospective, single-center, observational study included patients with histologically confirmed mCRC treated with combination chemotherapy and bevacizumab (FOLFOX/FOLFIRI + bevacizumab) at the Oncology Department of Zemun Clinical Hospital Center between July 2022 and July 2025. Efficacy was assessed according to RECIST 1.1 criteria, including objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and duration of response (DoR). Adverse events were classified according to CTCAE v6.0. Results: A total of 74 patients were analyzed (56.8% male; mean age 67 ± 9 years). The median PFS was 6.5 months (IQR 3–9.8), and DoR 7.3 months (95% CI 5.2–9.5). ORR was 35.1%, and DCR 82.4%. The most common toxicities were hypertension (12.2%) and proteinuria (10.9%), while gastrointestinal perforation was observed in 4.1% of patients—slightly higher than in larger real-world series, which may be related to locally advanced disease, peritoneal carcinomatosis, or an intact primary tumor. Conclusion: Bevacizumab-based therapy demonstrated consistent efficacy and an acceptable safety profile in patients with mCRC. Although the incidence of perforation and fistula formation was somewhat higher, the therapy remained safe with careful patient selection and monitoring.

The aim of this review article is to provide an overview of available literature data on serum basal calcitonin (bCT) and stimulated calcitonin (sCT) cut-off values, highlighting them as a valuable diagnostic tool in everyday thyroidology practice. During the diagnostic evaluation of thyroid nodular disease, mildly elevated bCT values ​​are frequently encountered. If bCT values ​​remain above the reference range but are <100 pg/ml on repeated measurements, further evaluation is warranted. In addition to the usual diagnostic procedure for thyroid nodular disease (medical history, family history of thyroid malignancy, clinical examination, thyroid function tests, and thyroid ultrasonography), a stimulation test, most often a calcium test, is performed to assess the response by measuring the sCT levels. A precise diagnostic threshold, the so-called cut-off for clinically significant pathological values ​​of bCT and sCT that indicate medullary thyroid carcinoma (MTC), is still lacking. However, there are studies that recommend appropriate cut-off values ​​for bCT and sCT that allow a clear and safe distinction between healthy individuals and individuals with C-cell hyperplasia (CCH) from those with MTC. The aim of this review article is to present the latest literature data on existing cut-off values ​​for bCT and sCT in blood, which can certainly be useful to clinicians in everyday practice.

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.