Katarina Janković

Background: Blood-accessible biomarkers may support future personalization of prostate cancer radiotherapy, but their interpretation depends on sampling timing relative to radiotherapy, androgen deprivation therapy, and post-treatment recovery. We mapped clinical evidence for selected biomarker domains beyond prostate-specific antigen: γ-H2AX/DNA damage response, IL-6/inflammatory mediators, testosterone/endocrine recovery and a prespecified galectin-1/3 immune–stromal domain evaluated as a potential evidence gap. Methods: We conducted a PRISMA-ScR scoping review of PubMed, Scopus, and Web of Science searched on 7 January 2026. Eligible original human studies evaluated soluble serum/plasma analytes or peripheral blood cell-based assays in prostate RT pathways. Data were charted by biomarker domain, treatment context, RT modality/fractionation, assay reporting, sampling schedule, and endpoint linkage. Results: Of 3499 records, 45 studies were included. No eligible study reported repeated circulating galectin-1/3 kinetics anchored to prostate radiotherapy, identifying a distinct clinical evidence gap. The remaining evidence was dominated by testosterone studies (n = 28), followed by IL-6/inflammatory mediators (n = 12) and γ-H2AX/DDR (n = 5). Testosterone studies were mapped as separate RT-only endocrine kinetics and ADT-anchored recovery streams. IL-6 studies mainly used during-RT or early post-RT sampling and linked trajectories to acute toxicity, fatigue, symptoms or inflammatory phenotypes; no included study directly validated serial IL-6/inflammatory trajectories against biochemical control, metastasis-free survival, or overall survival. γ-H2AX studies were characterized by ultra-acute, fraction-anchored sampling. Across domains, baseline definition and sampling timing limited interpretability more than assay platform alone. Conclusions: Evidence maturity was unequal across the selected domains. Testosterone provided the comparatively more developed longitudinal clinical literature, whereas IL-6/inflammatory mediators remained exploratory and were linked mainly to acute toxicity, fatigue, symptoms, and inflammatory phenotypes. γ-H2AX remained predominantly a translational and biodosimetry-oriented marker, while galectin-1/3 represented a hypothesis-generating clinical evidence gap. None of these biomarkers currently supports routine biomarker-guided prostate RT personalization. Future biomarker-embedded studies may benefit from domain-specific sampling considerations, explicit RT/systemic-therapy context stratification, standardized assay reporting, and clinically relevant endpoints.

Objectives: To analyze the structure of direct treatment costs for FUO and identify key cost-driving factors. Methods: A retrospective pharmacoeconomic analysis using a bottom-up approach was conducted on 71 patients treated for FUO at the Clinic for Infectious Diseases, University Clinical Centre Kragujevac, between 2016 and 2022. Treatment cost data were extracted from the electronic medical records. Results: The total direct cost was €81,655.20, with a mean of €1,150.07 ± 3,434.60 per patient with a median of €549.55 (IQR=€512.62). Major cost components included pharmacotherapy (49.40 %; €40,337.26), diagnostic procedures (30.52 %; €24,923.44), and hospitalisation (10.32 %; €8,324.00). Significant cost determinants were the following: gender, the Charlson comorbidity index, hospital stay duration, number of medications administered per patient, and number of specialist consultations. Conclusions: Pharmacotherapy, especially broad-spectrum antibiotics and antifungals, along with diagnostics and hospitalisation, are the main contributors to FUO treatment costs. Patient-specific factors, particularly comorbidities and service utilisation, play a significant role in determining overall healthcare expenditure.

Background/Objectives: Ultra-low-dose radiotherapy (ULD-RT), an ultra-low-dose regimen delivering 4 Gy in two fractions, has emerged as a promising treatment for indolent ocular adnexal lymphoma (OAL), offering disease control with minimal toxicity. However, the clinical outcomes and safety profile of ULD-RT remain inconsistently reported across studies. Methods: We conducted a systematic review of peer-reviewed studies evaluating ULD-RT in patients with OAL, including prospective, retrospective, and comparative cohorts published between 2000 and 2025. A comprehensive search was performed in PubMed, Embase, and Scopus. Eligible studies reported clinical outcomes (e.g., response rates, local control, progression-free survival) and safety data (acute and late toxicities). Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). Results: Ten studies comprising 591 patients met the inclusion criteria. The overall response rate to ULD-RT ranged from 88% to 100%, with complete response rates of 50% to 95%. Local control rates ranged from 63% to 100%, and 2-year progression-free survival exceeded 85% in most studies. Importantly, no grade ≥ 3 toxicities were observed following the regimen of 4 Gy in two fractions. Acute toxicities occurred in up to 42% of patients, typically grade 1 dry eye or conjunctivitis. Late toxicities were uncommon (16–33%), with cataracts rarely requiring surgery. All included studies were rated as good quality (NOS score ≥ 7), indicating low risk of bias. Conclusions: ULD-RT is a highly effective and safe treatment modality for OAL, providing excellent local control with a favorable toxicity profile. These findings support the adoption of ULD-RT as a first-line radiotherapy strategy for indolent OAL. Future prospective trials with longer follow-up and standardized toxicity reporting are warranted to confirm and refine its clinical role.

Isotretinoin is an oral medicine prescribed for the management of severe acne that is insensitive to conventional therapy, including systemic antibiotics. Acute psychosis refers to a severe mental illness characterized by a loss of touch with realism, visions, delusions, confused thinking, and abnormal behaviors. The study aims to analyze and document these cases to better understand the potential relationship between isotretinoin use and the development of acute psychosis, as well as to find out which therapy is best for treating this problem. We searched the following electronic databases independently with no linguistic or date limit: PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and Serbian Citation Index (SCIndeks). Our results included 14 studies (13 case reports and 1 cohort study) with 18 individual cases. The oldest patient was 27 years old, and the youngest was 13 years old. Both genders were represented with 9 individuals each. We can conclude that, in addition to discontinuation of isotretinoin, therapy with olanzapine and eventually risperidone could improve the symptoms of psychosis caused by isotretinoin.