Srpski medicinski časopis Lekarske komore

PROMOTING RESILIENCE AND WELL-BEING FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES IN PSYCHOSOCIAL CRISIS

Mila Goldner Vukov, Snežana Mijalković — Mon, 29 Sep 2025 20:04:00 +0200

Introduction: It is estimated that up to 70% of people experience at least one serious traumatic event during their lives. Trauma usually causes a psychosocial crisis, which is a state of instability and danger. Trauma and the psychosocial crisis are addressed at the level of the individual, the family, and the community. Promoting resilience and well-being is very useful in helping a person “bounce back” after encountering adversity.

Objective: This paper explores the dynamics of psychosocial crisis and the ways of promoting resilience and well-being at the individual, family, and community levels.

Materials and methods: A literature review was conducted on psychosocial crises, their causes and consequences, as well as on resilience and well-being as key resources for addressing these challenges.

Results: Resilience factors – such as optimism, facing one’s fear, a strong moral compass, religion and spirituality, social support, cognitive and emotional flexibility, and a sense of meaning and purpose – play a crucial role in coping with psychosocial crises. Well-being can be further enhanced by prioritizing physical health, nurturing social connections, and engaging in mental stimulation.

Conclusion: Psychosocial crises can be observed on several levels – maturational, situational, existential, spiritual, and adventitious. If trauma is not properly addressed and the crisis persists, it may lead to both intergenerational and transgenerational trauma. Strengthening resilience and enhancing well-being at the levels of the individual, family, and society are essential strategies for coping with trauma and mitigating negative outcomes such as PTSD, substance abuse, suicidality, depression, and physical health problems. By fostering resilience and well-being, traumatic experiences and psychosocial crises can be transformed into opportunities for personal, family, and social growth and development.

POSSIBILITIES OF USING INERTIAL MEASUREMENT UNIT SENSOR FOR ASSESSING BALANCE ABILITIES IN THE ELDERLY

Thu, 25 Sep 2025 09:04:48 +0200

Aim: This study aimed to evaluate age-related changes in postural stability among healthy older adults using inertial measurement unit (IMU) sensors and assess the clinical potential of wearable technology for balance assessment in geriatric populations.

Methods: Thirty-four healthy participants aged > 65 years were divided into two age groups (65–75 and > 75 years). Balance was assessed using a sacrum-mounted IMU sensor during a 30-second semi-tandem stance in three trials.

Results: Participants > 75 years showed increased postural sway compared to younger counterparts. Gender differences revealed greater medio-lateral sway in males (p = 0.038). No significant differences were observed in sway velocity or ellipse area, suggesting effective compensatory mechanisms in static conditions.

Conclusion: IMU-based balance assessment demonstrates sensitivity in detecting subtle age-related postural changes, with practical advantages for both clinical and community settings.

PUBLIC HEALTH ASPECTS – MISUSE AND INAPPROPRIATE USE OF ANTIBIOTICS

Ana Miljković, Marko Koprivica — Mon, 08 Sep 2025 21:22:38 +0200

Introduction/Aim: Since their discovery, antibiotics have represented a key defense against bacterial infections, but an increasing number of strains are developing resistance through spontaneous genetic mutations and the acquisition of resistance genes, a process further stimulated by their improper and frequent use. This literature review encompasses studies published between 2010 and 2024 and analyzes four key areas: the misuse and inappropriate application of antibiotics, the development of superbugs, the global aspects of antimicrobial resistance (AMR), and preventive strategies with an emphasis on the role of vitamins. This review aims to present evidence on antibiotic misuse, resistance development, and preventive strategies, with particular attention to the importance of vitamins in maintaining immunity and improving the functioning of healthcare systems.

Methods: This literature review includes studies published from 2010 to 2024, focusing on the analysis of antibiotic misuse, the development of superbugs, the global impact of AMR, and the role of vitamins in prevention strategies.

Results: The results indicate that the most common causes of inadequate therapy are self-medication, prescription without microbiological confirmation, and poor communication between physicians and patients. AMR has been recognized as one of the greatest threats to public health, with significant consequences for morbidity, mortality, and healthcare system costs. Preventive measures include education of healthcare professionals and the general population, regulation of antibiotic sales, the development of new diagnostic and therapeutic methods, and the promotion of healthy lifestyle habits. Of particular importance are vitamins with antioxidant properties (retinol, tocopherol, and L-ascorbic acid), which may reduce the need for antibiotics, especially with the contribution of vitamin D, known to stimulate the immune system.

Conclusion: An integrated approach, in line with the One Health concept, is crucial for preserving the effectiveness of existing drugs and reducing the public health burden caused by AMR.

THE FIRST FIVE YEARS OF THE SERBIAN JOURNAL OF THE MEDICAL CHAMBER – A BRIEF OVERVIEW AND ANALYSIS

Biljana Vukcevic Lackovic — Wed, 10 Sep 2025 10:55:05 +0200

This is a brief overview of the Serbian Journal of the Medical Chamber, marking its fifth anniversary. It aims to inform the reader about the Journal in the context of other Serbian medical publications and present a concise analysis of the types of articles published and the topics covered to date, thus providing insight into what the Journal offers to both readers and authors.

DUCTAL CARCINOMA IN SITU: CURRENT DIAGNOSTIC AND THERAPEUTIC APPROACHES

Jelena Petrović, Stefan Stevanović — Wed, 10 Sep 2025 11:01:04 +0200

Advancements in breast cancer screening have significantly increased the incidence of ductal carcinoma in situ (DCIS) diagnoses. Despite its favorable prognosis, DCIS poses a clinical challenge due to its biological heterogeneity and potential progression to invasive ductal carcinoma (IDC). Mammography remains the primary diagnostic modality, with microcalcifications as the most common radiological finding. Management is primarily surgical, involving either breast-conserving surgery (BCS) or mastectomy, depending on the extent of the lesion. In patients undergoing BCS, adjuvant radiotherapy is recommended to reduce the risk of local recurrence, while hormonal therapy (tamoxifen or aromatase inhibitors) is indicated for hormone receptor-positive tumors. Axillary lymph node dissection is not routinely performed but may be considered in cases with suspected microinvasion. Recently, active surveillance has emerged as a potential alternative for selected low-risk patients. Ongoing research is focused on the identification of prognostic factors to enable more precise risk stratification.

This review provides an overview of current multidisciplinary approaches to the diagnosis and treatment of DCIS, based on the latest scientific evidence.

THIRTY YEARS OF FAMILY MEDICINE SPECIALTY IN POLAND: A CASE STUDY OF ITS INSTITUTIONALIZATION, PRACTICE, AND PATIENT PERCEPTION WITHIN PRIMARY HEALTHCARE

Mateusz Guziak — Sun, 21 Sep 2025 19:29:26 +0200

Background: Family medicine (FM) specialty in Poland was introduced in the early 1990s as part of broader health reforms aimed at restructuring primary healthcare (PHC) and improving access, continuity, and coordination of care. Despite three decades of development, FM continues to face systemic and professional challenges within the Polish healthcare system.

Objective: This study used a case study approach to explore the evolution of family medicine specialty in Poland, examining its institutional foundation, specialist training, its role in PHC delivery, and patient satisfaction with services.

Methods: An explanatory case study design was employed, drawing on policy documents, training curricula, peer-reviewed literature, and national statistics. Thematic analysis was guided by a framework for case study evaluation in healthcare systems.

Results: Family medicine specialty has gained full recognition as a clinical and academic specialty in Poland. However, only a minority of PHC physicians are formally trained in FM. While the postgraduate training program aligns with European standards, it lacks longitudinal assessment and consistent quality of supervision. Patients report generally high satisfaction with interpersonal aspects of care but rate family medicine lower than specialist services in areas such as communication, empathy, and emotional support. The specialty also faces recruitment difficulties, with many FM residency slots unfilled despite financial incentives.

Conclusion: Family medicine specialty in Poland has achieved significant structural milestones but remains underutilized and undervalued within the broader PHC system. Reforms should prioritize strengthening its educational pathways, improving working conditions, and addressing public perceptions. Enhancing communication skills and increasing the visibility of family physicians could improve both patient satisfaction and the attractiveness of the specialty.

SIGNIFICANCE OF THE PREVENTIVE ULTRASOUND DIAGNOSTICS IN THE EARLY DETECTION OF RARE AND AGGRESSIVE THYROID CARCINOMAS – CASE REPORT

Mon, 08 Sep 2025 21:26:34 +0200

Introduction: Medullary thyroid carcinoma (MTC) is an aggressive tumor associated with a significantly poorer prognosis compared to other types of thyroid cancer. Doppler ultrasound and familiarity with the Thyroid Imaging Reporting and Data System (TIRADS) nodule classification are essential.

Objective: This case highlights the significance of precise ultrasound imaging, crucial for early detection and subsequent management of such aggressive disease.

Case report: We describe the case of a 31-year-old woman who underwent systemic ultrasound imaging. Upon ultrasound examination, a 5 mm x 4 mm x 3 mm hypoechoic, ill-defined solid nodule with echogenic foci (TIRADS 4, score 6) was identified in the mid portion of the left thyroid lobe. Given the suspicious ultrasound features, the location of the nodule, and the elevated serum calcitonin level, the micronodule raised concerns for malignancy, particularly suggesting medullary thyroid microcarcinoma. The patient underwent thyroidectomy, and histopathological analysis confirmed the diagnosis. The histopathology report described a small white nodule (5 mm) in the left lobe. There was no remarkable necrosis, and amyloid deposits were inconspicuous. Lymphovascular invasion was not observed, and mitoses were rare. The tumor stage was T1 (pTNM), and no distant metastases were found. C-cell hyperplasia was noted around the tumor. Immunohistochemical analysis showed positive reactions for calcitonin, chromogranin, and mCEA. The proliferative index was low, approximately 4%. After surgery, serum calcitonin levels decreased. Three years after the surgery, the patient is in good general condition and is under regular monitoring. In the meantime, the patient has become a mother.

Conclusion: Early detection and treatment of micro-MTC are crucial, as these tumors have the potential for aggressive behavior. Adequate ultrasound imaging assessment could significantly improve the prognosis and outcome for these patients.

SCLEROCHOROIDAL CALCIFICATION MIMICKING CHOROIDAL OSTEOMA: A CASE REPORT

Dolika Vasović, Dejan M. Rašić, Mirjana Mitrović — Fri, 12 Sep 2025 07:25:27 +0200

Introduction: Sclerochoroidal calcifications are uncommon, benign ocular findings characterized by the deposition of calcium and phosphate within the sclera and adjacent choroid. These lesions are most frequently discovered incidentally during routine ophthalmologic evaluation, particularly in elderly individuals, and may resemble more serious intraocular pathologies.

Case report: We present the case of a 62-year-old male patient referred for evaluation of a subretinal lesion in the peripheral retina of the left eye, initially detected during a routine ophthalmologic examination. The patient was asymptomatic, with no visual complaints. Fundus examination revealed a yellowish, placoid lesion with indistinct borders located suprapapillary, between the superior vascular arcades. B-scan ultrasonography demonstrated high internal reflectivity with posterior acoustic shadowing. Fluorescein angiography revealed a hypofluorescent lesion without leakage or staining. The lesion remained stable over several years, and systemic workup showed no evidence of metabolic abnormalities. Based on clinical and imaging findings (B-scan ultrasonography and fluorescein angiography), the diagnosis of sclerochoroidal calcification was established.

Conclusion: Sclerochoroidal calcifications may clinically and ultrasonographically mimic more serious intraocular lesions. B-scan ultrasonography and fluorescein angiography, play a key role in distinguishing these benign findings from other conditions. In asymptomatic patients without signs of progression, annual follow-up is recommended, with no need for therapeutic intervention.