HEALTH CARE

CHALLENGES IN MANAGING THE REPRODUCTIVE CELL DONATION PROGRAM PROCESS IN SERBIA

2026-03-06T15:02:35+01:00

Introduction/Aim: This study examines the governance challenges in Serbia's egg and sperm donation system. The necessity of donors importing donated reproductive cells requires coordination among clinics, regulatory agencies, and international tissue banks. The main objective is to analyse the roles, responsibilities of key institutions and stakeholders in the donation program, exploring opportunities for system improvement through clinical alignment and analysis of implementation in Fertility clinics.

Methods: A descriptive statistical method was applied to the data collected using a questionnaire sent to IVF clinics, utilising the Resposinble, Accoutable, Consulted and Informed (RACI) matrix to define institutional roles, and conducting a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis based on the RACI matrix results.

Results: RACI analysis revealed that the Ministry of Health bears the highest number of information responsibilities, confirming its leading, regulatory, and supervisory role. Based on the questionnaire, Clinical Embryologists handle most documentation tasks, including packaging and shipping (47.1%) and communication with tissue banks (58.8%). Most respondents (41.2%) reported that documentation errors rarely occur, while non-compliances from foreign banks were very uncommon (70.6%), and the Ministry's institutional support was viewed as limited.

Conclusion: The results highlight a system with unclear and limited strategic communication, utilising the RACI matrix, which proved to be useful in clarifying institutional roles. The SWOT analysis emphasised both strengths (professional capacity) and threats, highlighting that excessive centralisation of roles can overload an institution and slow down processes. Future research should focus on quantitative analyses of clinical outcomes related to the origin and quality of donated material, as well as comparative evaluations of communication between institutions, banks and regulatory bodies.

INCIDENCE OF ACUTE MYOCARDIAL INFARCTION IN THE REPUBLIC OF SERBIA FROM 2006 TO 2022

2026-03-06T15:02:35+01:00

Introduction/Aim: Cardiovascular diseases represent the leading cause of mortality worldwide and were responsible for more than 19.8 million deaths in 2022, accounting for 32% of all deaths according to World Health Organization data. Of all deaths due to cardiovascular diseases, as many as 85% were caused by acute myocardial infarction and stroke. The highest number of deaths occurs in countries with low and middle incomes. The aim of this study was to analyze trends in the incidence of acute myocardial infarction in the Republic of Serbia from 2006 to 2022.

Methods: Data on newly diagnosed cases of acute myocardial infarction for the period 2006–2022 were obtained from the National Registry for Acute Coronary Syndrome, maintained by the Institute of Public Health of Serbia “Dr Milan Jovanović Batut”, as well as from official Health Statistical Yearbooks of the Republic of Serbia for the observed period. Crude incidence rates (CR) and age-standardized incidence rates adjusted to the European and world standard populations (ASR-E and ASR-W) were analyzed.

Results: During the observed period, a decline in age-standardized incidence rates adjusted to the European standard population (ASR-E: 170.9 → 147.4) and to the world standard population (ASR-W: 118.2 → 101.8 per 100,000 population) was observed. Incidence rates varied over time, with the highest age-standardized incidence rate adjusted to the European standard population recorded in 2009 (183.7 per 100,000), and the lowest in 2017 (132.3 per 100,000) (Figure 1). The highest age-standardized incidence rate adjusted to the world standard population ranged from 126.1 per 100,000 in 2009 to 91.0 per 100,000 in 2017.

Conclusion: The reduction in age-standardized incidence rates of acute myocardial infarction in the Republic of Serbia from 2006 to 2022 is likely the result of improved control of cardiovascular risk factors, including wider use of statins and modern antihypertensive therapies in primary and secondary prevention, as well as the effectiveness of national preventive programs such as public education on symptom recognition, healthy diet and physical activity, and smoking cessation campaigns. In addition, the development of networks of catheterization laboratories for emergency interventions in Serbia has enabled faster patient management, thereby influencing clinical outcomes and the incidence of recurrent myocardial infarction.

RISK FACTORS FOR ACUTE MYOCARDIAL INFARCTION IN THE REPUBLIC OF SERBIA

2026-03-06T15:02:35+01:00

Background/Aim: Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality from cardiovascular diseases (CVD) globally. The development of the disease is strongly associated with the presence and interaction of multiple risk factors – non-modifiable (sex, age, family history) and modifiable (hypertension, dyslipidemia, smoking, obesity, physical inactivity, diabetes mellitus, stress). The aim of this study is to analyze the prevalence of key risk factors for AMI among patients with acute coronary syndrome (ACS) treated in coronary care units in the Republic of Serbia (2006–2011), as well as in the general population of Serbia (2012–2022). Furthermore, these findings are compared with European and global averages to better understand the burden of risk factors and provide additional insight into the need for improved national preventive interventions.

Methods: A descriptive epidemiological study was conducted. Data on the prevalence of risk factors in hospitalized patients with acute coronary syndrome (ACS) for the period 2006–2011 were retrieved from the annual publications of the "Dr Milan Jovanović Batut" Institute of Public Health of Serbia – the National Registry for Acute Coronary Syndrome. The prevalence of the same risk factors in the general population of the Republic of Serbia for the period 2012–2022 was analyzed using national and international secondary data sources, including reports from the World Health Organization (WHO), the Global Adult Tobacco Survey (GATS), the Global Burden of Disease Study (GBD), the National Health Surveys from 2013 and 2019, and the European Health Interview Survey (EHIS). Risk factors were defined in accordance with the methodology of the data sources used and current international guidelines.

Results: A high prevalence of all analyzed risk factors was recorded among patients with ACS hospitalized in coronary care units in the Republic of Serbia. In 2011, approximately 35% of patients were recorded as smokers at the time of hospitalization (active smokers), about 73% had arterial hypertension, approximately 28% had diabetes mellitus, about 20% had obesity (BMI ≥30 kg/m²), and roughly 37% were physically inactive. More than half had dyslipidemia and a positive family history, while approximately 31% reported elevated psychosocial stress. Trend analysis for the 2012–2022 period indicates persistently high values of these modifiable risk factors in the general population, which match or exceed the levels recorded among hospitalized ACS patients in the preceding period.

Conclusion: The findings of this study indicate a persistently high prevalence of modifiable risk factors in the Republic of Serbia, which transitioned from the ACS patient population (2006–2011) to the general population over the following decade (2012–2022). These trends, which are more unfavorable than the European average, highlight the urgent need for integrated preventive strategies targeting modifiable risk factors to reduce the overall cardiovascular burden in the Republic of Serbia.

SPECIFICS OF NURSING CARE FOR PATIENTS WITH AFFECTIVE MOOD DISORDERS

2026-03-06T15:02:36+01:00

Introduction/Aim: Affective mood disorders (AMD) are among the most common psychiatric illnesses of the modern era, with a growing prevalence among the younger population. Unipolar depression, as the most frequent form, represents one of the leading global causes of disease burden and suicide mortality. The aim of this paper is to analyze the specific aspects of nursing care and the role of the nurse in the therapeutic treatment of patients with AMD.

Methods: The study applied the method of analyzing professional and scientific literature available in electronic databases (PubMed, NCBI, SCIndex, Google Scholar). The following keywords were used: "affective mood disorders", "nursing care", "nursing interventions", "nurse". The literature that was published in the period 2014-2024 was searched

Results: The most prevalent forms of AMD are depressive and bipolar disorders. The etiology is complex, with psychosocial stressors and trauma playing a significant role. Nurses, through therapeutic communication and continuous monitoring, contribute crucially to patient stabilization and the implementation of the therapeutic plan.

Conclusion: AMD is characterized by high prevalence and predominance of female gender. Improving the care process through a holistic approach and the standardization of interventions significantly contributes to the quality of treatment and the reduction of the risk of complications.

ROLE OF MICROBIOLOGY AND INFLAMMATORY BIOMARKERS IN PLANNING RECONSTRUCTIVE TREATMENT OF CHRONIC WOUNDS: LITERATURE REVIEW

2026-03-06T15:02:36+01:00

Chronic wounds represent a significant clinical and public health burden, with increasing prevalence among elderly and patients with diabetes and vascular diseases. Proper planning of reconstructive treatment requires a comprehensive understanding of microbiological processes and inflammatory biomarkers reflecting wound status. The aim of this study was to analyze contemporary approaches to the diagnosis and planning of reconstructive treatment of chronic wounds, emphasizing the role of microbiology and inflammatory biomarkers. Review of 18 studies published between 2010 and 2025 was presented in the paper, focusing on microbial profiles, inflammatory markers, and reconstructive treatment modalities. The most common microorganisms are Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii. Elevated CRP and IL-6 levels correlate with infection and poor graft outcomes, while normalization indicates readiness for reconstruction. Epidemiological data show an 8–10% annual increase in chronic wound prevalence in Europe, alongside rising bacterial resistance. Microbiological evaluation and biomarker monitoring should be integral to reconstructive planning protocols in chronic wounds. This approach improves outcome prediction, reduces postoperative complications, and promotes rational therapy use.

ENDOCRINE AND IMMUNOLOGICAL ALTERATIONS IN SEVERE TRAUMA: CONTEMPORARY BIOMARKERS, PROGNOSTIC FACTORS, AND CLINICAL IMPLICATIONS

2026-03-06T15:02:36+01:00

Severe trauma triggers a complex and dynamic response of the organism that includes simultaneous endocrine, immunological and metabolic alterations with a direct impact on the clinical course and treatment outcome. Hypothalamic-Pituitary-Adrenal (HPA) axis activation, changes in the secretion of catecholamine, disorders of the thyroid function and imbalance of the inflammatory response are key components of the systemic response to traumatic stress. The aim of this review article was to systematize endocrine and immunological biomarkers that have prognostic relevance in patients with severe trauma based on contemporary literature, as well as to review their clinical implications in intensive care medicine. Relevant papers published in the period 2014 to 2025 were reviewed in order to analyze changes in cortisol and catecholamine concentrations, Critical Illness-related Corticosteroid Insufficiency (CIRCI) Syndrome, Non-Thyroid Illness Syndrome (NTIS), as well as inflammatory biomarkers such as Interleukin-6 and C-reactive protein. Special attention was paid to their role in predicting mortality, development of multiple organ dysfunction, respiratory deterioration and septic complications. Available data indicate that early disorders of endocrine axes, especially abnormal patterns of cortisol and thyroid reactions have a significant prognostic values, while inflammatory and transcriptomic biomarkers allow more precise risk stratification in the early stages of critical disease. The integration of endocrine, immunological and metabolic biomarkers with clinical parameters and demographic characteristics of patients is the basis of a modern, personalized approach in the treatment of severe trauma. Further research should be directed towards standardization of diagnostic criteria, optimal sampling time and evaluation of therapeutic interventions, with the aim of improving outcomes and reducing mortality in critically ill patients.

CRANIOFACIAL METASTASES OF GASTROINTESTINAL ADENOCARCINOMA: A DIAGNOSTIC CHALLENGE

2026-03-06T15:02:37+01:00

Introduction/Aims: Adenocarcinomas of gastrointestinal origin rarely metastasize to the craniofacial region. Such manifestations, especially when associated with suspected leptomeningeal involvement, are characterized by high aggressiveness and a very poor prognosis. The aim of this paper is to present a rare case of a massive craniofacial metastasis from an adenocarcinoma with an atypical presentation and a fulminant clinical course.

Case Report: A retrospective analysis of the medical records of a 74-year-old female patient was performed. The patient was admitted to the Emergency Center due to a sudden disturbance in the level of consciousness. Radiology revealed a massive frontoparietal lesion with extensive destruction of craniofacial bones and invasion of the orbit, sphenoid and temporal bones, and the infratemporal fossa. No primary intraparenchymal brain lesions were observed, but radiological findings suggested leptomeningeal involvement. Metastases were also detected in the liver and vertebral bodies (Th1, L1, L3). Histopathological and immunohistochemical analysis of the craniofacial mass biopsy confirmed an adenocarcinoma with an immunophenotype indicative of gastrointestinal origin. Despite intensive multidisciplinary treatment, the clinical course was fulminant, resulting in a lethal outcome on the fourth day of hospitalization.

Conclusion: Craniofacial metastases of adenocarcinoma can be the first manifestation of an occult gastrointestinal malignancy. Extensive bone destruction and suspected leptomeningeal dissemination lead to an extremely unfavorable outcome. This case highlights the importance of rapid diagnosis and a high degree of clinical suspicion in patients presenting with atypical cranial bone lesions and acute neurological deterioration.