Archives: Specijalnosti

Gastroenterology

Gastroenterology focuses on the diagnosis and treatment of diseases of the digestive system. Gastroenterologists deal with diseases such as gastritis, inflammatory bowel diseases, bile ducts, and colon cancer. Through endoscopic procedures (gastroscopy to colonoscopy), ultrasound and other diagnostic methods, gastroenterologists gain insight into the state of the patient’s digestive organs.

Gastroenterology deals with the diagnosis and treatment of diseases of the digestive organs, which include: esophagus, stomach, gall bladder, liver, pancreas, spleen, small intestine, large intestine and rectum.

The most common gastroenterological diseases are: gastritis, ulcer, reflux esophagitis (gerd), enteropathies, diverticulosis, polyps, colon tumors, irritable colon syndrome, inflammatory bowel diseases.

The main diagnostic method in gastroenterology is endoscopies, i.e. gastroscopy and colonoscopy. Due to the preparation for the examination and the actual performance, patients avoid and postpone them. However, as far as gastroenterology is concerned, endoscopies represent the gold standard in diagnostics, and in most cases are superior to other methods (ultrasound, magnetic resonance and MSCT) for several reasons. By placing an endoscope (a thin, flexible instrument with a camera), the gastroenterologist during one examination can see the condition of the mucosa, see live movements and function of all organs, and can also take tissue samples for biopsy as well as perform minor interventions.

Gastroenterological diagnostic methods:

  • Gastroscopy
  • Colonoscopy
  • Ultrasound examination
  • Magnetic resonance
  • MSCT

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Rheumatology

Rheumatology is a branch of medicine dedicated to the diagnosis and treatment of rheumatic diseases that affect muscles, bones, joints and connective tissues. Rheumatologists deal with diseases such as rheumatoid arthritis, osteoarthritis, lupus and gout. Through careful evaluation of symptoms and the use of various diagnostic techniques, rheumatologists provide specific therapies to improve patients’ quality of life.

The most common rheumatic disease is rheumatoid arthritis. Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, this disorder can damage various parts of the body, including the skin, eyes, lungs, heart, and blood vessels.

Rheumatoid arthritis is an autoimmune disorder that occurs when your immune system mistakenly attacks your own body tissues.

Unlike the wear and tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing painful swelling that can eventually lead to bone erosion and joint deformity. If therapy is not started on time, after 10 years 80% of sufferers become severely disabled.

The inflammation associated with rheumatoid arthritis can also damage other parts of the body. Although new types of drugs have greatly improved treatment options, severe rheumatoid arthritis can still cause serious damage.

Correct diagnosis of rheumatic diseases may require:

  • examination by a rheumatologist
  • lab analysis of blood and urine
  • x-ray
  • DEXA osteodensitometry
  • ultrasound examination of the joints
  • MRI

Dermatology

Dermatology is a branch of medicine dedicated to the diagnosis and treatment of diseases of the skin, hair and nails. Dermatologists treat conditions such as acne, dermatitis, psoriasis, allergies and malignant skin changes. Through dermatological examination, dermoscopy, skin smear and various therapeutic approaches, dermatologists provide specific care for skin health, often in collaboration with other branches of medicine.

See a dermatologist if you notice any skin changes that worry you, or if you have specific skin problems or symptoms. Here are some situations in which you should consider visiting a dermatologist:

Changes on skin:
If you notice new skin changes, including changes in the color, shape, size, or texture of moles, freckles, or any other lesions.
Suspected skin cancer:
If you are suspicious of signs that may indicate skin cancer, such as unusual birthmarks, sores that do not heal, or changes that look atypical.
Acne problems:
In case of acne problems that are not adequately controlled by conventional treatments.
Skin infections:
When you notice symptoms of skin infections, such as redness, itching, swelling or purulent discharge.
Chronic skin problems:
If you suffer from chronic skin conditions such as eczema, psoriasis or dermatitis, and need professional assessment and therapy management.
Changes in hair and nails:
When you notice changes in the health of your hair or nails that seem unusual or worrisome.
Allergic skin reactions:
In case of allergic skin reactions that cause itching, redness, swelling or rash.
Anti aging:
If you would like a consultation regarding the prevention of skin aging or treatments to preserve skin health.
Mole check:
Periodically check moles, especially if you have a large number of moles or if you have a family history of skin cancer.
Specific skin problems:
If you have specific skin problems such as vitiligo, alopecia, hidradenitis suppurativa or other rare skin diseases.

It is important not to delay a visit to the dermatologist if you notice something unusual or if you are concerned about the health of your skin. Early diagnosis and treatment can significantly improve the outcome of various skin problems.

Urology

Urology is a medical discipline that deals with the diagnosis and treatment of diseases of the urinary tract in men and women, as well as the reproductive system in men. Urologists deal with problems such as bladder infections, kidney stones, benign prostatic hyperplasia (BPH) and malignant tumors of the urogenital system. With the help of various diagnostic methods, urologists provide comprehensive care for the health of the urinary and reproductive systems.

In men, the most common problems with the prostate are: bacterial inflammation of the prostate, benign enlargement (hyperplasia) of the prostate and prostate cancer. In Serbia, about 1,250 new cases of prostate cancer are discovered every year, and it is the second most common malignant tumor in men in the world, including in Serbia, after lung cancer. In order to detect this cancer at an early stage and effectively treat it, all men over the age of 40 are recommended to undergo preventive examinations by a urologist on an annual basis.

Bacterial infections of the urinary tract are the most common in women. The most common causative agent is Escherichia coli (E. coli), which normally inhabits the intestines. In women, due to the anatomical characteristics of the female urogenital system, i.e. short urethras, it easily gets into the urinary tract and causes infection.

The most common symptoms of urological diseases:

  • Frequent urination
  • Intermittent stream of urine
  • Burning sensation when urinating
  • The appearance of blood in the urine
  • Lower back pain
  • Pain in the lower abdomen
  • Pain during intercourse

PSA, or prostate-specific antigen, is a biomarker often used in the context of prostate health monitoring. Increased levels of PSA in the blood can indicate problems in the prostate, including possible cancer. Regular monitoring of PSA levels helps doctors detect potential prostate problems early. Men with increased risk factors for prostate cancer, such as a family history of prostate cancer, may be recommended for a PSA test even before age 50.

The most common urological diseases:

  • Urinary tract infections (including sexually transmitted infections)
  • Enlargement of the prostate (benign prostatic hyperplasia)
  • Prostate cancer
  • Stones in the kidney and urinary tract
  • Erectile dysfunction
  • Bladder dysfunction

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Ultrasound and mammography

Ultrasound examination, mammography and MRI are the basic breast exams. None of these methods is superior to the others, but they represent complementary methods that can provide additional information about the structure of the breast or possible changes in it. When the examination will be done depends on the age of the patient, the structure of the breast, as well as the presence of breast cancer in the family. And depending on those factors, the radiologist will make a plan and schedule of examinations.

Depending on your age, breast tissue structure and family history, the radiologist will determine the method and schedule of the examination. It is important to always consult with your radiologist. It is also very important that the radiologist knows all the methods in order to choose the best one, as well as to avoid possible unnecessary examinations.

In standard cases where there is no breast cancer in the family, ultrasound examinations begin in the twenties, on annual basis.

The initial mammographic examination is recommended from the age of 40, and from the age of 50 to the age of 70 it is done regularly every 2 years. In cases where there is a history of illness in the family, examinations start earlier and are done more often. genetic testing of the patient and other female family members is also recommended in these cases in order to determine the risk and plan further examinations.

Tomosynthesis mammography is an advanced breast imaging method that allows the creation of three-dimensional images of the breast, which can improve the accuracy of diagnosis compared to traditional two-dimensional mammography. This procedure helps to reduce tissue overlap in the image, giving doctors a better view of the structure of the breast. Tomosynthesis mammography is often used for early detection of cancer and other changes.

It is important to note that mammography with tomosynthesis is part of a comprehensive approach in the diagnosis of breast cancer, along with clinical examination and other modalities, such as ultrasound or magnetic resonance, depending on the needs and specificity of the patient.

MRI of the breast is performed: as a screening examination in high-risk patients, to determine the extent of the disease, to assess the results of therapy, as an additional method to assess the condition of implants.

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Neurology

Neurology is a branch of medicine that deals with the diagnosis and treatment of disorders of the nervous system. Neurologists deal with conditions such as migraine, epilepsy, multiple sclerosis, Parkinson’s disease and stroke. Through a neurological examination, radiological methods such as MRI and MSCT scans and other diagnostic procedures, neurologists diagnose neurological disorders

After heart attack, stroke is the leading cause of death worldwide. In Serbia, one case of stroke is recorded every 15 minutes. That is, about 23,000 people a year in Serbia experience an acute stroke, of that number, about 7,500 lose their lives, the same number remain disabled, while approximately 8,000 successfully recover. Preventive measures can significantly reduce the negative consequences, especially if a person seeks professional help and receives thrombolytic therapy within the first hour of the onset of symptoms.

The most common symptoms of neurological diseases are: mental problems, muscle weakness, muscle tremors, loss of feeling in the extremities, unexplained pain, confusion, vision problems, headaches

The most common neurological diseases are: headaches and migraines, head and spine injuries, brain tumors, stroke, dementia, Alzheimer’s disease, multiple sclerosis, Parkinson’s disease.

Diagnostics of neurological diseases includes the application of various methods for identifying and monitoring damage in the nervous system:

1. Magnetic resonance imaging (MRI): Uses a strong magnetic field and radio waves to create detailed images of the brain and spinal cord. It is especially useful for diagnosing tumors, stroke, multiple sclerosis and other structural damage.

2. Computed tomography (CT): Uses X-rays to create layered images of the brain and spine. It is fast and effective for detecting bleeding, aneurysms, tumors, skull fractures and strokes, especially in emergency situations.

3.Electroencephalography (EEG): is a neurological diagnostic method that provides data on brain activity, that is, on brain functioning, which cannot be obtained in any other way.
EEG recording is painless, safe and harmless. Electrodes are placed on the patient’s scalp and record the electrical activity of the brain. The computer of the EEG machine converts this information into a graphic record that is interpreted by a doctor, an electroencephalographer.
EEG is important in the process of diagnosing epilepsy, loss of consciousness, confused states, sleep disorders. Also, EEG can provide useful information to the neurologist during the monitoring of the condition after a head injury, cerebrovascular insult, dementia, intoxication, tumor processes in the brain, brain infections. Simultaneous recording of EEG and video recordings of the patient is important in the diagnostic process of epilepsy and other sudden, short-term, repeated behavioral and movement disorders, because it allows them to be analyzed simultaneously with the recording of electrical activity of the brain.
Standard EEG recording is performed in the awake state, and if it is clinically significant, EEG recording is also performed after partial sleep deprivation with the aim of registering the EEG record during sleep.

As part of the preparation for a standard EEG recording, it is necessary:
• Take a light meal 2 hours before the scheduled recording time.
• Wash your hair the day before or on the day of the examination, but do not use conditioner/balm, hair masks, hairspray and gel, as they can affect the quality of the recording.
• On the day of the recording, do not consume alcohol or caffeinated beverages (coffee, tea, coke) because they can affect the test results.
• Take your regular, prescribed therapy as usual.
As part of preparation for EEG recording after partial sleep deprivation, it is necessary to:
• Fall asleep two hours later than the usual rhythm the night before, and wake up two hours earlier in the morning, no later than 4 a.m.
• During the morning, be active, do not nap or sleep, have lunch and then come to the recording.

4. Electromyoneurography (EMNG): This method evaluates muscle and peripheral nerve function. It is used for the diagnosis of muscle diseases, neuropathies, radiculopathy and similar conditions.

These methods are often used complementary in order to make a precise diagnosis and enable adequate treatment.

 

MSCT – CT Scan

Multislice computed tomography (MSCT) is an advanced CT scanning technology that enables faster and more accurate images of internal organs. With the ability to simultaneously display multiple layers of tissue, MSCT provides important information about anatomy and pathology. This technique is often used in the diagnosis of cardiovascular problems, lung diseases, traumatic injuries and many other conditions.

CT (computed tomography) is a type of radiological imaging. Similar to an X-ray, it shows the structures inside your body. However, instead of creating a flat, two-dimensional image, a CT scan takes dozens or even hundreds of images. To get these images, the CT machine takes X-rays as it rotates around the patient.

Doctors use CT scans to see things that plain X-rays can’t show. For example, body structures overlap on plain X-rays and many things are not visible. A CT scan shows the details of each of your organs for a clearer and more accurate view.

MSCT is used to examine the lungs and chest, enlargement of blood vessels (aneurysms), abdomen, urinary tract, internal bleeding, skeletal system, intestines, spine, brain.

Low-dose MSCT or LDCT (low-dose CT) has a key role in lung cancer screening. Lung cancer screening is the detection of lung cancer at a very early stage, when the probability of cure is incomparably higher. Unfortunately, due to the lack of nerve endings and pain receptors in the lungs, lung cancer is usually detected in the late stages of the disease when the chances of cure are quite low. By the time lung cancer signs and symptoms appear, it’s usually too late. Studies show that screening for lung cancer drastically reduces the risk of dying from this form of cancer.

Who should consider screening?

Lung cancer screening is usually recommended for people at highest risk for lung cancer, including:

  • Older adults who currently smoke or have smoked in the past. Lung cancer screening is usually offered to smokers and ex-smokers who are 50 years of age or older. Persons who have smoked in large quantities for many years. Lung cancer screening may be considered if you have a smoking history of 20 years or more. Pack-years are calculated by multiplying the number of packs of cigarettes you smoke per day by the number of years you have smoked. For example, a person with a 20 pack-year smoking history might have smoked a pack a day for 20 years, two packs a day for 10 years, or half a pack a day for 40 years.
  • People who used to smoke heavily, but have stopped. If you have been a heavy smoker for a long period of time and have stopped within the last 15 years, you may want to consider screening for lung cancer.
  • People with a history of lung cancer. If you were treated for lung cancer more than five years ago, you may consider lung cancer screening.
  • People with other risk factors for lung cancer.
  • People who have other risk factors for lung cancer may include those with chronic obstructive pulmonary disease, those with a family history of lung cancer, and those who have been exposed to asbestos in the workplace.

If you are doing a CT scan of the abdomen and/or small pelvis, you should not eat 4 hours before the examination, and you should drink a couple of glasses of water half an hour before the examination. If the examination requires the use of a contrast dye, it is necessary to perform blood tests – urea and creatinine.

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MRI

Magnetic resonance imaging (MRI) is a sophisticated diagnostic method that uses strong magnetic fields and radio waves to create detailed images of internal organs and tissues. This safe and non-invasive method allows doctors a precise insight into the structure of the brain, spine, joints, soft tissues and other vital organs. Magnetic resonance imaging is often used to diagnose a variety of medical conditions, including injuries, tumors, infections, and neurological disorders. Unlike CT scanners and X-ray machines, magnetic resonance does not use ionizing radiation in its work, so there is no negative radiation and it can be done as often as you like.

The strong magnetic field created by an MRI causes the atoms in your body to align in the same direction. Radio waves are then sent from the MR machine and move these atoms from their original position. When the radio waves are turned off, the atoms return to their original position and send back radio signals. These signals are received by a computer and converted into an image of the part of the body being examined. This image is displayed on the preview monitor.

MRI can be used instead of computed tomography (CT) when studying organs or soft tissues. Magnetic resonance imaging is better at differentiating between types of soft tissue compared to CT, which usually images bones better.

Because no ionizing radiation is used, there is no risk of radiation exposure during an MRI scan.

New applications for MR have contributed to the development of additional magnetic resonance technology. Magnetic resonance angiography (MRA) is a procedure used to assess blood flow through the arteries. MRA can also be used to detect aneurysms in the brain and vascular malformations—abnormalities of blood vessels in the brain, spinal cord, or other parts of the body.

When you call to make an appointment, it is extremely important that you let us know  if any of the following apply to you: You have a pacemaker or have had heart valve replacement; You have any type of implantable pump, such as an insulin pump; You have coils, filters, stents or clips; You are pregnant or think you are pregnant; Have you ever worked with metal (for example, as a grinder or welder); You have metal fragments anywhere in your body; You are unable to lie down for longer than 20 minutes; You have kidney problems or have previously had an allergic reaction to contrast media;

If you are doing an MRI of the abdomen and/or pelvis, you should not eat 4 hours before the examination, and if you are doing an MR enterography 8 hours before the examination (for enterography, there is also additional preparation). If the examination requires the use of a contrast medium, it is necessary to perform blood tests for urea and creatinine.

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