Introduction: Endometrial cancer is one of the most common malignant tumors of the female reproductive system. PCOS is a complex endocrinological disease of women of reproductive period.Conservative therapy implies a safe oncological outcome while preserving reproductive function.

Methods: This study is a cross-sectional clinical study conducted at Unirvesity Clinical Center of Serbia,Clinic for Gynecology and Obstetrics in the period from 2012 to 2024. The study included 62 patients who were between 23 and 45. The study included patients who were consecutively examined and treated conservatively for endometrial hyperplasia or endometrial cancer. Statistical analysis included methods of descriptive and analytical statistics.

Results: The results obtained in our study indicate that by evaluating the endocrinological status in patients with endometrial cancer, appropriate hygienic and dietary regimen, application of conservative therapy as well as psychosocial support to the patient. It is possible to obtain good therapeutic outcomes while preserving fertility in patients with endometrial cancer.

Conclusion: This study highlights the importance of alternative conservative treatment for endometrial cancer, especially in younger women with well-differentiated, early-stage endometrioid cancer

Introduction: Preoperative imaging staging of colorectal cancer is essential for optimal therapeutic planning. Multidetector computed tomography (MDCT) is the standard imaging modality for initial staging; however, its diagnostic accuracy in assessing tumor depth and nodal status remains debated.

Objective: To evaluate the diagnostic accuracy of MDCT in preoperative T and N staging of colorectal cancer by comparison with operative and histopathological findings as the reference standard.

Methods: A retrospective analysis was conducted in 63 patients with histopathologically confirmed colorectal cancer who underwent preoperative contrast-enhanced CT of the abdomen and pelvis. CT-based assessment of T and N stages was compared with operative and histopathological findings. Agreement was evaluated using appropriate statistical methods.

Results: MDCT demonstrated the highest diagnostic accuracy in identifying T3 tumors. Overall agreement between CT and histopathological findings for individual T stages was low but statistically significant (Kappa = 0.166; p = 0.049), with a predominant tendency toward understaging. When T stages were grouped into low (T1–T2) and high (T3–T4) categories, diagnostic accuracy reached 71.4%. Nodal staging with morphological status showed high agreement in binaryclassification  (Kappa = 0.682; p < 0.001), but limited reliability acording to size of lymph node

Conclusion: MDCT shows good diagnostic performance in preoperative T staging of colorectal cancer, particularly in advanced stages, while nodal staging remains limited and requires cautious interpretation.

Introduction: Type 2 diabetes mellitus (T2DM) is linked to increased vascular morbidity and mortality. Well-controlled diabetes is indicated by effective glycemic and HbA1c regulation and low-grade inflammation management. This study evaluates glycolipid control and inflammatory status in T2DM patients on metformin.

Methods: A pilot study involved 11 participants divided into two groups: a T2DM group on metformin therapy and a control, non-diabetic group. Demographic, clinical, anthropometric, glycolipid (glycemia, HbA1c, TC, LDL-C, HDL-C, TG), and inflammatory parameters (CRP, FFA, PL, UA, FLI) were evaluated.

Results: Significant intergroup differences were found in glycemia, HbA1c, TC, LDL-C, UA, FLI, and WC. Glycemia influenced PL (p<0.05), UA (p<0.01), and FLI (p<0.01), while HbA1c affected UA (p<0.05) and FLI (p<0.01). LDL-C and HDL-C impacted UA (p<0.05, p<0.01). Age affected FLI (p<0.05), gender influenced PL (p<0.01), and BW, BH, WC, and BMI significantly impacted UA and FLI (p<0.01).

Conclusion: T2DM patients showed signs of low-grade systemic inflammation, emphasizing the need for comprehensive diabetes management and early cardiovascular risk detection. Intensified interventions are necessary for patients with inadequate glycemic control on metformin.

Prolonged endotracheal intubation in intensive care units (ICUs) is a frequent and clinically challenging aspect of managing critically ill patients. While intubation is essential for airway protection and adequate ventilation, its extended use is associated with a substantial risk of complications, including laryngeal and tracheal injury, ventilator-associated pneumonia, increased sedation requirements, prolonged mechanical ventilation, longer ICU stays, and higher mortality. In this setting, tracheotomy represents an important therapeutic alternative for patients anticipated to require long-term respiratory support.

This paper aims to examine the challenges of prolonged intubation, outline its most common complications, and explore the issue of optimal timing for tracheotomy. Particular attention is given to the comparison between early and late tracheotomy and their impact on key clinical outcomes, such as duration of mechanical ventilation, infection rates, patient comfort, sedation needs, and overall length of hospitalization. Evidence from the literature indicates that timely consideration of tracheotomy, combined with an individualized approach based on the patient’s clinical status and prognosis of the underlying condition, may reduce complication rates, facilitate ventilator weaning, and improve overall outcomes.

Furthermore, decision-making regarding tracheotomy is influenced by several factors, including the primary diagnosis, neurological status, expected duration of ventilatory support, and the risk of extubation failure. Modern clinical practice emphasizes the use of structured weaning protocols and close multidisciplinary collaboration among intensivists, anesthesiologists, otorhinolaryngologists, and nursing staff. This coordinated approach supports early identification of appropriate candidates for tracheotomy, reduces variability in clinical practice, and enhances patient safety.

In conclusion, determining the timing of tracheotomy requires careful assessment of risks and benefits within a multidisciplinary framework. Although no universally optimal time point exists, early recognition of patients likely to need prolonged mechanical ventilation and timely intervention may provide significant clinical benefits in contemporary intensive care medicine.

Introduction. Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease nowadays which has contributed to significant cardiovascular and hepatic morbidity and mortality. Recognizing the metabolic concept resulted in an evolution in disease nomenclature, as well as the development of innovative treatments for MASLD, the hepatic manifestation of metabolic syndrome.

Objective. To present contemporary trends in the management of MASLD.

Methods. For the search methodology, we used the PubMed database. We employed the following keywords to search for original articles,  reviews, and clinical guidelines from 2018. to 2025. year, such as „NAFLD/MASLD“, „NAFLD/MASLD biomarkers“, „NAFLD/MASLD diagnostic scores“, „NAFLD/MASLD innovative therapy“. We used original articles and reviews written in English, Serbian and Balkan-familiar languages. Special attention was given to the FIB-4 algorithm, newly developed non-invasive scores (SAFE, LiverRisk, MAFS), and biomarkers (MDA, 8-OHdG, CK-18, PRO-C3).

Results. MASLD has been associated to an increased risk of liver fibrosis and cirrhosis, hepatocellular carcinoma (HCC), and cardiovascular diseases. Emerging biomarkers enable early and accurate diagnosis and monitoring of treatment response, while innovative treatments including PPAR agonists, GLP-1 receptor agonists, and Resmetirom are mapping the personalized MASLD treatment.

Conclusion. MASLD is a chronic systemic disease requiring a multidisciplinary approach. Proper diagnosis and personalized innovative therapy create the favorable conditions for reducing cardiovascular and hepatic morbidity and mortality.

Tranexamic acid (TXA) is an established antifibrinolytic therapy in the management of severely injured trauma patients with hemorrhage, demonstrating a proven effect on mortality reduction. Its mechanism of action is based on the inhibition of plasminogen activation, thereby stabilizing fibrin clot formation and limiting the progression of trauma-induced coagulopathy. Contemporary evidence consistently indicates that the clinical efficacy of TXA is highly time-dependent. The greatest reduction in mortality is achieved when administration is initiated early after injury, particularly within the first 3 hours, while delayed treatment is associated with a substantial loss of clinical benefit. Prehospital administration is additionally linked to improved outcomes, emphasizing the importance of minimizing time to treatment delivery within emergency care systems. Pharmacokinetic and clinical data indicate that TXA achieves effective plasma concentrations rapidly, with intravenous administration remaining the standard due to its predictable bioavailability and precise dosing capability. Meta-analyses and systematic reviews confirm a reduction in mortality without a consistent increase in overall adverse events, although heterogeneous data regarding thromboembolic complications warrant further evaluation.

Observed variability in dosing regimens and clinical implementation highlights the lack of standardized protocols and underscores the need for further stratification of patients and harmonization of treatment strategies. The administration of TXA can therefore be considered a highly effective but time-sensitive intervention, whose full therapeutic potential depends on timely and system-integrated administration within trauma care systems.

The human microbiota has emerged as one of the most dynamic fields of modern medicine. It is now recognized as an active regulator of metabolism, immune defence, and neuropsychiatric functions.. Dysbiosis, the alteration of microbiota, has been linked to gastrointestinal disorders, autoimmune diseases, metabolic syndrome, and neuropsychiatric conditions, highlighting the systemic roles of the microbiome. Current therapeutic strategies include probiotics, prebiotics, postbiotics, individualized dietary interventions, and medical fasting, while fecal microbiota transplantation represents the most promising method for restoring a healthy microbiome. The aim of this review is to present the historical background, pathophysiology, and clinical implications of the microbiota, and to emphasize the need for introducing faecal transplantation into clinical practice in Serbia as a significant step toward the personalized medicine.

The presence of a foreign body in the airway represents an emergency in otorhinolaryngology and may lead to serious or even fatal outcomes. Laryngectomized patients represent a particularly high-risk group, as the absence of the larynx’s protective function allows foreign bodies to accidentally enter the tracheobronchial tree through a permanent tracheostoma. This paper presents a case of a 65-year-old laryngectomized patient in whom a metallic foreign body (tweezers) accidentally entered the trachea during routine tracheostomy care. The patient was asymptomatic and respiratory stable. The diagnosis was confirmed by chest radiography, and the foreign body was successfully removed by instrumental extraction through the tracheostoma. This case highlights the importance of timely diagnosis, appropriate management, and proper education of personnel responsible for tracheostomy care.

Diabetic foot syndrome represents one of the most severe complications of diabetes and is the leading cause of non-traumatic amputations. Wound healing is often impaired due to hypoxia, infection, and vascular changes. Hyperbaric oxygen therapy (HBOT) is used as an adjuvant method in the treatment of chronic wounds.

A 57-year-old patient is presented with a non-healing wound following amputation of the left foot due to gangrene associated with diabetic foot syndrome. After standard therapy and the introduction of HBOT (25 sessions at 2 ATA), a significant reduction in wound size and the development of granulation tissue were observed. Six months later, due to persistence of a smaller wound, an additional cycle of therapy was administered.

HBOT improves tissue oxygenation, stimulates angiogenesis, enhances the bactericidal activity of leukocytes, and accelerates tissue repair. When combined with standard treatment measures, it can significantly improve outcomes in patients with diabetic foot syndrome.

HBOT represents an effective adjuvant therapy in the treatment of chronic wounds in diabetic foot syndrome and may contribute to reducing the need for further amputations.

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&#39;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 &gt; 15 and CRS &gt; 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 &lt; 0.05) and between GBS and surgical intervention (r = +0.32, p &lt; 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.