Ana Dimitrijević

Recurrent facial nerve palsy, particularly when alternating sides and accompanied by orofacial edema, should raise suspicion for Melkersson–Rosenthal syndrome. Recognition of fissured tongue as part of the clinical triad may facilitate timely diagnosis, avoid unnecessary investigations, and enable appropriate corticosteroid treatment.

Background/Objectives: This study investigates the correlation between substantia nigra (SN) hyperechogenicity, detected via transcranial sonography (TCS), and retinal thinning in patients with Parkinson’s disease (PD). Methods: In this cross-sectional study, 86 PD patients (172 eyes) underwent clinical assessment (UPDRS, Hoehn–Yahr), TCS for SN area measurement, and optical coherence tomography (OCT) for retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GCIPL), and macular thickness analysis. Results: PD patients exhibited significant thinning of the GCIPL, average RNFL, and central macular thickness compared to healthy controls (p < 0.001 in all instances). Pathological SN hyperechogenicity (>0.19 cm²) was detected in 85.9% of patients with a preserved temporal bone window (71 out of 86). A significant negative correlation was found specifically between the SN echogenic area and central macular thickness (r = −0.248, p = 0.003). Patients with pathological SN findings had a significantly thinner central macula (p = 0.006) compared to those with a normal SN, while no significant correlations were observed between the SN area and RNFL or GCIPL. Conclusions: These findings demonstrate a specific correlation between SN hyperechogenicity and central macular thinning. While RNFL and GCIPL effectively differentiate PD from controls, the central macula might serve as a promising biomarker candidate reflecting SN changes. Further longitudinal studies are required to evaluate the role of these combined markers in the PD diagnostic algorithm.

Purpose Malignant major salivary gland tumors (MMSGTs) are rare neoplasms with increasing incidence. This study aimed to assess Serbia’s epidemiological trends of MMSGTs over a 14-year period and compare them with global epidemiological patterns. Methods A retrospective descriptive epidemiological study was performed using national data from the Institute for Public Health spanning 2007 to 2020. MMSGT cases were identified using ICD-10 codes C07 and C08 (malignant neoplasms of the parotid gland and malignant neoplasm of other and unspecified major salivary gland including sublingual and submandibular glands, respectively). Standardized incidence and mortality rates were calculated per 100,000 population, and linear regression analysis was used to evaluate temporal trends. Results The average standardized incidence rate of MMSGTs was 0.68 per 100,000 persons (95% CI: 0.53–0.83), while the average standardized mortality rate was 0.32 per 100,000 persons (95% CI: 0.23–0.42). Linear regression analysis demonstrated no significant trend in incidence in the overall population (p = 0.089) or among males (p = 0.707). In contrast, incidence increased among females (β = 0.0233, R² = 0.377, p = 0.019), corresponding to an estimated annual percent change of 4.1% (95% CI: 0.5%–7.8%). No significant trends in mortality were identified. Conclusions This nationwide population-based analysis provides the first assessment of MMSGT incidence and mortality trends in Serbia. Although overall incidence and mortality remained stable between 2007 and 2020, a significant increase in incidence was observed among females. Continued surveillance and improved registry granularity, including histological and age-specific data, are needed to better characterize evolving epidemiological patterns.

Introduction. Uveal melanoma is the most common primary malignant intraocular tumor in adults, characterized by a high risk of haematogenous metastasis, particularly to the liver. The clinical presentation varies considerably, from asymptomatic lesions discovered incidentally to severe visual impairment. Early diagnosis and multidisciplinary management are essential to optimize functional and oncological outcomes. This study presents the clinical characteristics and diagnostictherapeutic management of patients with uveal melanoma treated at a secondarycare hospital.Case series. Three patients with different clinical presentations of uveal melanoma were evaluated. A 53-year-old man presented for routine presbyopic correction without any visual complaints. Fundus examination revealed serous retinal detachment associated with a pigmented choroidal lesion. B-scan ultrasound confirmed an intraocular tumor, and enucleation was performed after multidisciplinary assessment. Histopathology confirmed choroidal melanoma. A 63-year-old woman presented with floaters in the left eye. Ophthalmic examination identified a pigmented superotemporal choroidal lesion; subsequent diagnostic workup confirmed melanoma. She underwent brachytherapy and maintained good visual acuity without metastases during followup. A 58-year-old man with progressive visual decline had been previously treated for chronic uveitis and cataract. Initial B-scan findings were inconclusive; however, intraoperative suspicion of a ciliary body melanoma during cataract surgery prompted ultrasound biomicroscopy, which confirmed the tumor. Iridocyclectomy was subsequently performed, with a postoperative uncorrected visual acuity of 0.6.Conclusion. Uveal melanoma can present with diverse and subtle clinical manifestations, underscoring the importance of a detailed fundus examination even in asymptomatic patients. Diagnostic challenges are particularly evident in ciliary body melanoma, where standard ultrasonography may be inconclusive.

Background/Objectives: Clinical differentiation between Parkinson’s disease (PD) and atypical parkinsonism (AP) remains complex. Current diagnostic procedures helpful in their distinction lack specificity, making non-invasive tools like optical coherence tomography (OCT) crucial in evaluating possible retinal changes as potential biomarkers. Our study examined the thickness of the ganglion cell inner plexiform layer complex (GCIPL), peripapillary retinal nerve fiber layer (RNFL) and macular segments in individuals with PD, multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and healthy controls (HC). The objective of our study was to determine if OCT analyses can effectively discriminate PD patients from HC and whether retinal thickness can distinguish typical PD patients from those with AP. Methods: Research was an observational, cross-sectional study. Multiple retinal layers measured with OCT of PD and AP patients were compared with age- and sex-matched HC. An intergroup assessment was conducted. Results: Patients with PD and PSP exhibit a thinner GCIPL compared to HC, with no difference observed in the MSA group. GCIPL thickness between investigational groups does not differentiate between PD and AP. The RNFL and central macula thickness were statistically significantly reduced in all patient groups compared to HC. The RNFL was thinner in PSP compared to PD. Nearly all inner and outer macular segments were thinner in the investigational groups compared to HC. The preservation of outer nasal segments distinguished HC from both typical and AP. Patients with PSP and PD differed in the thickness of all macular segments, being thinner in PSP patients. Conclusions: Thickness of multiple retinal layers and macular regions might serve as a distinguishing feature between PD, AP and HC.

Background/Objectives: Certain aspects of retinal thickness assessed by optical coherence tomography (OCT) in patients with Parkinson’s disease (PD) require additional clarification. It is supposed that attributing reduced retinal thickness in PD to dopaminergic loss may not be acceptable as it also happens in diseases where dopaminergic loss does not occur. The objective of our study is to compare the ganglion cell/inner plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (pRNFL), and macular thickness of PD and dopa responsive dystonia (DRD) patients with healthy controls (HC), to investigate whether DRD patients, as a distinctive model of genetically induced dopamine deficiency, have reduced retinal thickness in comparison with PD, and to analyze correlation between retinal thickness and various PD clinical parameters. Methods: We analyzed 86 patients with PD, 10 patients with DRD, and 96 age- and sex-matched HC. Results: GCIPL, pRNFL, and central macula thickness (CMT) are statistically significantly thinner in PD patients compared to HC (p < 0.001, all). GCIPL and CMT are also statistically significantly thinner in DRD patients compared to HC (p = 0.012, p = 0.001, respectively). GCIPL thickness correlates positively with the daily dose of levodopa (r = 0.244, p < 0.01). The thickness of GCIPL and pRNFL correlate negatively with current age (r = −0.219; p < 0.01 and r = −0.358; p < 0.05, respectively). All retinal parameters are statistically significantly thinner in females than in males (p < 0.05). Conclusions: Patients with PD and DRD did not differ in GCIPL and pRNFL thickness when compared to one another. These results, supported by positive correlation of levodopa dose and GCIPL thickness in PD patients, emphasize the importance of dopamine in maintaining retinal thickness.

The peer review process remains a cornerstone of scientific integrity, ensuring that research findings are critically evaluated before entering the scientific record. With the growing integration of artificial intelligence (AI) and the widespread adoption of large language models (LLMs) such as ChatGPT, the research and publishing landscape is undergoing rapid transformation. While AI offers considerable advantages ? enhancing efficiency in manuscript drafting, editing, and preliminary evaluation ? it also introduces significant risks, particularly when used beyond its optimal scope. This viewpoint underscores the limitations of generative AI, including the phenomenon of ?hallucinated? references and the inability to perform genuine critical thinking. These shortcomings raise serious concerns about the validity of scientific content when AI is used without appropriate human oversight. Emphasis is placed on preserving the human-centered nature of peer review, which is vital to safeguarding scientific credibility. In doing so, this article reinforces the necessity of evolving editorial and publishing policies, such as Elsevier?s updated guidelines on the use of generative AI, to ensure responsible integration of these technologies into the research ecosystem.

We present the case of a 49-year-old female of Caucasian European descent with chest tightness, fatigue, and palpitations, ultimately diagnosed with primary intracardiac angiosarcoma. Initial echocardiography revealed a significant mass within the right atrium, infiltrating the free wall. Surgical intervention included tumor excision and partial resection of the superior vena cava. Histopathological examination confirmed a high-grade angiosarcoma. Postoperative imaging identified a recurrent mass in the right atrium, suggestive of thrombus, alongside Takotsubo cardiomyopathy. Considering the elevated surgical risks and the presence of cardiomyopathy, management included anticoagulation therapy with Warfarin and adjuvant chemotherapy with Paclitaxel. Follow-up cardiac magnetic resonance imaging demonstrated a recurrent angiosarcoma with superimposed thrombus. This case presents the complex diagnostic and therapeutic landscape of angiosarcoma, highlighting the critical importance of early surgical intervention, advanced imaging techniques, and vigilant postoperative monitoring.

There is no definitive consensus about the cost-effectiveness of minimally invasive aortic valve replacement (AVR) (MI-AVR) compared to conventional AVR (C-AVR). The aim of this study was to compare the rate of postoperative complications and total hospital costs of MI-AVR versus C-AVR overall and by the type of aortic prosthesis (biological or mechanical). Our single-center retrospective study included 324 patients over 18 years old who underwent elective isolated primary AVR with standard stented AV prosthesis at the Institute for Cardiovascular Diseases “Dedinje” between January 2019 and December 2019. Reintervention, emergencies, combined surgical interventions, and patients with sutureless valves were excluded. In both MI-AVR and C-AVR, mechanical valve implantation contributed to overall reduction of hospital costs with equal efficacy. The cost-effectiveness ratio indicated that C-AVR is cheaper and yielded a better clinical outcome with mechanical valve implantation (67.17 vs. 69.5). In biological valve implantation, MI-AVR was superior. MI-AVR patients had statistically significantly higher LVEF and a lower Euro SCORE than C-AVR patients (Mann–Whitney U-test, p = 0.002 and p = 0.002, respectively). There is a slight advantage to MI-AVR vs. C-AVR, since it costs EUR 9.44 more to address complications that may arise. Complications (mortality, early reoperation, cerebrovascular insult, pacemaker implantation, atrial fibrillation, AV block, systemic inflammatory response syndrome, wound infection) were less frequent in the MI-AVR, making MI-AVR more economically justified than C-AVR (18% vs. 22.1%).