Atherosclerosis is a chronic process characterized by inflammation and the progressive accumulation of inflammatory cells and lipids in the blood vessel wall, resulting in narrowing of the blood vessel’s circumference. Treatment of people with dyslipidemia aims to reduce the risk of developing atherosclerotic disease and prevent major adverse cardiovascular events (MACE). The results of previous studies indicated that lipoprotein(a) (Lp(a)) is a critical causal factor in the estimated risk of developing a cardiovascular (CV) incident even after achieving desirable low-density lipoprotein (LDL) cholesterol levels. Lp(a) is a low-density lipoprotein particle, like LDL cholesterol. The levels of Lp(a) in plasma are genetically determined. Lp(a) catabolism is still controversial. The pathogenic potential of Lp(a) can be divided into three categories: promotion of plaque formation, thrombogenicity, and proinflammatory effects. Lp(a) levels above the 75th percentile reduced the risk of aortic valve stenosis and myocardial infarction, whereas higher levels (above 90th percentile) were associated with an increased risk of heart failure. However, no hypolipidemic agents have been approved for targeted use in patients with high Lp(a) levels. There are insufficient randomized controlled trials assessing CV outcomes that would support the evidence that current treatment options, which effectively lower Lp(a) levels, also effectively prevent CV event. However, according to some studies, there is strong evidence that better CV outcome is one of the benefits of such therapy. The results of ongoing clinical trials are eagerly awaited.

SUMMARY Hypopituitarism is a rare clinical condition that can present as a partial or complete absence of pituitary hormones. Hypopituitarism is most commonly caused by a sellar or parasellar mass, particularly a tumor, and the gold standard for its differential diagnosis is magnetic resonance imaging (MRI). Intrasellar aneurysm is an unusual cause of hypopituitarism. Indeed, about 0.17% of all cases of hypopituitarism are due to intrasellar aneurysms. We report the case of a 72-year-old man who was admitted to the [...] SUMMARY Hypopituitarism is a rare clinical condition that can present as a partial or complete absence of pituitary hormones. Hypopituitarism is most commonly caused by a sellar or parasellar mass, particularly a tumor, and the gold standard for its differential diagnosis is magnetic resonance imaging (MRI). Intrasellar aneurysm is an unusual cause of hypopituitarism. Indeed, about 0.17% of all cases of hypopituitarism are due to intrasellar aneurysms. We report the case of a 72-year-old man who was admitted to the

Introduction: Primary dysmenorrhea is a common disorder in women, with a significant impact on quality of life. Aim: The objective of this academic study was to investigate the severity of dysmenorrhea in female students of the Faculty of Medicine in Novi Sad, to estimate the self-medication prevalence of primary dysmenorrhea, to identify the most commonly used conventional, herbal, homeopathic remedies and manner of their usage, as well as non-pharmacological measures in the treatment of primary dysmenorrhea. Material and Methods: This study was performed on a random sample of 100 respondents from different departments of the Faculty of Medicine in Novi Sad, from December 1st to December 15th, 2016. The data were obtained by using a standardized questionnaire. Results: The sample included 59 female medical students and 41 female students of the other study groups. Most of the respondents had medium expressed symptoms due to dysmenorrhea (48.0%). The most common symptoms were cramps and pain in the lower abdomen, anxiety, and appetite changes. 11% of respondents were absent from classes at the university minimum one day of each menstrual cycle, because of dysmenorrhea. 66% of respondents used drugs due to symptoms of dysmenorrhea. The most commonly used group of drugs were non-steroid anti-inflammatory drugs (75.76%), primarily ibuprofen (53.03%), and diclofenac (10.61%). Self-medication prevalence was 48.48%. Conclusion: According to the results of this study, dysmenorrhea symptoms significantly impact the quality of life.

Introduction: Surgical treatment is the method of choice for treating primary hyperparathyroidism. Determining parathyroid hormone (PTH) levels intraoperatively allows for real-time monitoring of the functional activity of parathyroid gland tissue and facilitates minimally invasive parathyroidectomy. Aim: Our study aimed to investigate the significance of intraoperative parathyroid hormone level determination in achieving physiological parathyroid hormone levels and cure. Material and Methods: A retrospective academic study analyzed 70 patients from the Clinic for Endocrinology, Diabetes, and Metabolic Disorders at the University Clinical Center of Vojvodina who underwent parathyroidectomy. Participants were divided into control and study groups based on whether intraoperative parathyroid hormone levels were determined. Demographic and laboratory-clinical data from medical records were statistically analyzed. Results: In the study group, the median of parathyroid hormone level was 104.30 pg/mL, while in the control group, it was 128.09 pg/mL; no statistically significant difference was observed (p=0.380). There was no statistically significant difference between groups regarding the number of reoperations indicated and the diagnosis of persistent hyperparathyroidism (p=0.355). A statistically significant difference in treatment outcomes was found among participants who met the Miami and Dual protocol criteria. Conclusion: Determining parathyroid hormone levels during surgical treatment while meeting the criteria of current protocols can contribute to a higher cure rate. A more extensive prospective study is required for a more in-depth analysis of our healthcare center's experience.

Introduction. Fine needle aspiration biopsy is a non-surgical invasive diagnostic method for the cytological evaluation of the thyroid gland. Complications of fine needle aspiration biopsy are rare. Case Report. A female patient, 64 years of age, underwent left-sided nodulectomy in 2006, due to a follicular adenoma of the thyroid gland. In September of 2016, ultrasonography of the thyroid gland confirmed a node in the right lobe, approximately 10 mm in the longest diameter. The thyroid-stimulating hormone level was within the reference range (1,8 mIU/L), as well as calcitonin and carcinoembryonic antigen levels, but with elevated anti-thyroid peroxidase antibodies and anti-thyroglobulin antibodies, so fine needle aspiration was indicated. The cytological finding indicated a suspected follicular lesion and total thyroidectomy with an ex tempore biopsy was proposed in November of 2016. Prior to the surgery, hormone levels were measured and high thyroid-stimulating hormone levels were recorded (79 mIU/L). Further investigation showed low levels of free thyroid hormone concentrations, and levothyroxine was initiated at a dose of 75 mcg per day and the surgical treatment was delayed. The indicated dose of levothyroxine resulted in satisfactory values of the thyroid gland free hormones, and in February 2017, right-sided lobectomy was performed, whereas the histopathological findings indicated lymphocytic thyroiditis. Levothyroxine replacement therapy showed satisfactory results in the postoperative period. Further outpatient ultrasonographic monitoring showed a residual thyroid tissue, with slightly non-homogeneous echostructure in the left thyroid bed, 12 x 11 x 32 mm in size. Regular follow-up was suggested. Conclusion. Hypothyroidism has not been reported as a fine needle aspiration complication in the available literature.

Introduction: The incidence of thyroid nodules is increasing. Fine-needle aspiration (FNA) of all thyroid nodules is unnecessary, but it is necessary to provide a more precise identification of those nodules that are potentially malignant in nature. In the literature there are several suggested systems for assessing malignancy of nodules in the thyroid gland. Objective: To determine the differences between EU and ACR TIRADS recommendation for fine-needle aspiration in patients with thyroid nodules in our center. Methods and material: The study involved 127 patients, with 132 nodes referring to FNA. An ultrasound examination was performed before the FNA, and according to its ultrasonic properties, the nodes was classified according to the EU and ACR TI-RADS classification. After the cytopathological result was obtained, differences in FNA indications, which were determined according to these two classifications, were analyzed. Results: The analysis found that there is a statistically significant difference in relation to the classification of a node in certain TI-RADS categories when compared to the EU and ACR system (χ²=11.105, P=0.0254). In 23.5% of the nodules, a different category was obtained. FNA was indicated in 76.5% of nodules according to ACR TI-RADS criteria, and in 81.8% of nodules according to EU TI-RADS criteria. In one case, FNA was indicated only according to EU TI-RADS, and the cytopathological finding corresponded to the Bethesda IV category. In other cases, when the indication for FNA was different, the cytopathological finding indicated a benign nodule. Conclusion: The EU and ACR TI-RADS is a useful tool in assessing malignancy of thyroid nodules. If EU TI-RADS is used, FNA is indicated in a slightly larger number of cases.