Browsing by Author "Jovanović, Milan (57210477379)"

Introduction/Objective Alcohol abuse influence on developing thyroid cancer is controversial. While some studies consider it a protective factor, others deny any impact on thyroid cancer. The objective of the paper was to establish a possible link between alcohol abuse and certain types of thyroid cancers. Methods The retrospective study included 502 patients with thyroid cancer and a control group of 600 patients with benign forms of thyroid diseases (e.g. nodular, multinodular, and toxic nodular goiter). Thyroid cancer patients were divided into four groups: I – papillary, II – medullary, III – anaplastic, and IV – follicular carcinoma, and grouped by sex, age (< 30 years; > 30 years) and alcohol abuse, as defined by the World Health Organization. Results Thyroid cancer patients were predominantly male of younger age. This distribution difference was statistically significant in groups I and II (p < 0.001). Of total 10 (0.9%) patients with chronic alcohol abuse, eight (1.6%) had thyroid cancer, while two (0.3%) belonged to the control group (p < 0.001). In thyroid cancer patients, chronic alcohol abuse was absent from groups III and IV. Distribution in groups I and II was six (1.6%) and two (2%), respectively (p < 0.001). Conclusion Alcohol abuse deserves to be considered as a risk factor for papillary and medullary forms of thyroid cancer, while it does not stay the same for anaplastic and follicular thyroid cancers. © 2021, Serbia Medical Society. All rights reserved.

Introduction/Objective The development of safer cosmetic medical procedures has lead to an increase in the number of minimally invasive esthetic procedures. The main aim of the current paper is to examine the connection of the number/location of esthetic procedures with the overall body image dissatisfaction, affective temperament traits, and the index of self-esteem in persons who have undergone several minimally invasive cosmetic procedures for esthetic reasons. The subsidiary aim is to compare the predominance of the above-mentioned traits in the sample with the results in the general population. Methods The study included 228 participants, aged from 21 to 73 years, who had multiple minimally invasive cosmetic procedures, purely for esthetic reasons. Data were collected using a socio-demographic questionnaire, medical documentation, the Body Image Assessment Scale-Body Dimensions, TEMPS-A temperament scale, and Rosenberg Self-Esteem Scale. Results Overall body image dissatisfaction was moderate in our patients (11.56 ± 11.877). With an increase of dissatisfaction, the number of procedures did not grow (r = 0.075, p = 0.263); however, the number of body parts on which the procedures had been performed did. The patients who had their body parts altered most were found to have deeper dissatisfaction with their overall body image (F(2,225) = 4.963, p = 0.008, η 2 = 0.04), and the most prominent temperament was wound to be hyper-thymic (F(2,225) = 3.408, p = 0.035, η 2 = 0.03), similar to the Serbian general population. Conclusion Through establishing potential relations between physical, social, and psychological variables, like body image dissatisfaction, temperament, and self-esteem, we could provide a better insight into a mental state of individuals who frequently undergo minimally invasive cosmetic procedures. © 2019, Serbia Medical Society. All rights reserved.

Introduction Silicone implants have been used ever since the second half of the 20th century. Over that period, several generations of implants have been developed that differed in thickness of the shell and viscosity of the silicone gel. Development of these generations of implants was accompanied with different complication rates. The first-generation implants had the lowest tendency to rupture, but were more prone to capsular contracture and calcification formation. Case outline An 81-year-old female patient had her silicone implants placed in 1983. After a chest injury in 2015, on the lateral aspect of the left breast a tumefaction becomes palpable and she complains of pain. She denied any subjective problems before the injury. After pertinent diagnostic procedures and clinical examination, silicone implant rupture was suspected. Surgical findings confirmed ruptures of both implants so that they were extracted, capsulectomy was performed and the surrounding tissue imbibed with silicone removed. Samples were sent for histopathological examination. Conclusion Implant rupture is one of late complications of breast augmentation. The incidence of ruptures has changed with development of newer generations of silicone implants. We believe that our patient had the first-generation silicone implants, knowing the time of their placement to the occurrence of symptoms and macroscopic appearance of the shell after extraction. The fact is that these implants have proved to be very durable, but regardless of the lack of symptoms, current guidelines recommend regular screening for rupture, while possible preventive extraction, particularly in case of so old implants should be considered. © 2021, Serbia Medical Society. All rights reserved.

Purpose: This split-face study aimed to see whether different types of local anesthetics or their buffered/nonbuffered combinations produce lower pain scores in upper eyelid blepharoplasty. Methods: The study involved 288 patients, randomly divided into 9 groups: 1) 2% lidocaine with epinephrine - Lid + Epi; 2) 2% lidocaine with epinephrine and 0.5% bupivacaine (1:1) - Lid + Epi + Bupi; 3) 2% lidocaine with 0.5% bupivacaine (1:1) - Lid + Bupi; 4) 0.5% bupivacaine - Bupi; 5) 2% lidocaine - Lid; 6) 4% articaine hydrochloride with epinephrine - Art + Epi; 7) buffered 2% lidocaine/epinephrine with sodium bicarbonate (SB) in a 3:1 ratio - Lid + Epi + SB; 8) buffered 2% lidocaine with SB in a 3:1 ratio - Lid + SB; 9) buffered 4% articaine hydrochloride/epinephrine with SB in a 3:1 ratio - Art + Epi + SB. Following the injection of the first eyelid and a 5-minute period of soft pressure on the injection site, patients were asked to rate their pain level on the Wong-Baker Face Pain Rating Visual Analogue Scale. Rating of the pain level was repeated 15 and 30 minutes following anesthetic administration. Results: The lowest pain scores at the first time point were observed in Lid + SB when compared with all of the other groups (p < 0.05). At the final time point, significantly lower scores were also observed in Lid + SB, Lid + Epi + SB, and Art + Epi + SB when compared with the Lid + Epi group (p < 0.05). Conclusion: These findings could help surgeons select an appropriate combination of local anesthetics, particularly in patients with lower pain threshold and tolerance because buffered combinations of local anesthetics produce significantly lower pain scores compared with nonbuffered solutions. © 2023 Lippincott Williams and Wilkins. All rights reserved.

Introduction Full-thickness burns pose a significant challenge in terms of surgical management, particularly when concurrent trauma of other organs is involved. Traditional treatment of deep burns includes early excision or debridement of necrotic tissue, followed by skin grafting or flap reconstruction. There are numerous challenges such as poor overall general condition, polytrauma, questionable wound bed viability, limited donor sites. Thus, we have to consider skin substitutes. INTEGRAR is an acellular dermal substitute which creates a native dermis. The aim of this case was to share our experience of the treatment by skin substitutes in a polytraumatized burn patient. Case outline We present a case report of a 46-year-old man with severe work-related contact burn wounds associated with multiple rib and vertebral fractures, as well as lungs contusion with localized bilateral hemothorax. Patient suffered from third-degree burns to the lower extremities, extending to scrotal and gluteal area, which included 15% of the total body surface area. The patient underwent early excision of necrotic tissues with subsequent skin autografting on the right leg; however, due to partial failure of autografts, we had to perform allografting followed by autografting because of limited local donor sites and poor general condition. Successive debridement and partial osteotomy resulted in the left knee defect with exposed patella. Therefore, in order to reconstruct the consequent defect and prevent joint contracture, the defect was finally covered by INTEGRAR. Conclusion Our experience has highlighted that INTEGRAR prevents functional disability and furthermore, it leads to optimal aesthetic results. © 2023, Serbia Medical Society. All rights reserved.

Introduction/Objective Epidemiology of melanoma including the number of new cases and mortality have been established in most developed countries, but data on pathohistological features are mostly missing. The objective of the study was to investigate epidemiological, clinical, and pathohistological features of melanoma patients and compare the results with trends in other countries. Methods Our sample comprised patients surgically treated for skin melanoma at the Hospital for Burns, Plastic and Reconstructive Surgery during the 2015–2017 period. Pathohistological, clinical, and demo-graphic features of melanoma were studied. Results The retrospective study comprised 201 patients (109 men and 92 women) aged 25–87 years. Melanoma was more common in men than in women (54.2% vs. 45.8%). Melanoma in male population most commonly presented on the trunk, while in females presentation on the trunk and lower extremities was almost equal. Superficial spreading melanoma was the most common type of melanoma (68.7%), without correlation to the sex. No correlation was observed in relation to the stage of the disease and the patient’s sex (p = 0.294). A statistical difference was observed in relation to the type of melanoma and the Breslow classification (p < 0.001). Breslow’s thickness correlated with neither age nor sex. In relation to tumor invasiveness, 12.4% of the lesions were classified as in situ lesions, while 87.6% of the lesions were invasive. The majority of patients were identified as stage pT1a. Conclusion This study can help to identify patients at high risk for melanoma and contribute to optimize screening efforts in a defined target population. © 2022, Serbia Medical Society. All rights reserved.

Background and Objectives: Upper eyelid blepharoplasty is a surgical procedure that addresses both aesthetic and functional concerns, offering transformative potential for patients’ overall well-being. This study systematically evaluates the comprehensive impact of upper eyelid blepharoplasty on patients’ quality of life, employing rigorous methodologies and standardized assessment protocols. Materials and Methods: A prospective, randomized controlled trial was conducted, involving 348 patients aged 49 to 87 years. Patients were randomly assigned to receive either continuous or intradermal sutures following upper eyelid surgery. Validated FACE-Q questionnaires were used to assess various outcomes, including early-life impact, expectations, satisfaction with eyes, overall face satisfaction, satisfaction with the outcome, psychological function, social function, and adverse effects. Results: Results indicate significant improvements in multiple domains of patient-reported outcomes following upper eyelid blepharoplasty, including satisfaction with eyes, overall face satisfaction, satisfaction with the outcome, psychological function, and social function. Notably, no significant differences were observed between suturing techniques regarding patient satisfaction and well-being. Adverse effects were minimal and improved over time. Conclusions: The study underscores the transformative nature of upper eyelid blepharoplasty in enhancing patients’ quality of life, addressing both cosmetic and functional concerns. Utilizing standardized assessment tools like the FACE-Q questionnaire facilitates a comprehensive understanding of treatment outcomes and enables patient-centered care. Overall, this research contributes to the growing evidence supporting the positive impact of upper eyelid blepharoplasty on patients’ well-being, emphasizing the importance of continued research and standardized assessment protocols in advancing patient care in cosmetic surgery. © 2024 by the authors.

Most skin tumors are not fatal, but if not treated in a timely manner, they can lead to significant morbidity. Due to the COVID-19 pandemic and in order to create more capacities for the treatment of COVID-19-positive patients as well as to contain the spread of the virus, the healthcare system was reorganized worldwide, leading to decreased access to preventive screening programs. The aim of this study was to evaluate the impact of the pandemic on healthcare accessibility to cutaneous squamous cell carcinoma patients in Serbia. This retrospective study was conducted at the Clinic for Burns, Plastic, and Reconstructive Surgery, University Clinical Center of Serbia in Belgrade. Patient demographics and pathohistological findings of tumors of patients living in and outside the capital in the period before, during, and after the pandemic were compared. The two groups did not show any differences regarding the largest tumor diameter prior and during the pandemic; however, this difference became extremely noticeable after the pandemic (15 mm vs. 27 mm; p < 0.001). While cSCCs are commonly slow-growing tumors, the impact of the COVID-19 pandemic is not negligible. This study found a population at a significant risk of cSCC metastasis, with additional evidence likely to emerge in the upcoming years. © 2023 by the authors.

Most skin tumors are not fatal, but if not treated in a timely manner, they can lead to significant morbidity. Due to the COVID-19 pandemic and in order to create more capacities for the treatment of COVID-19-positive patients as well as to contain the spread of the virus, the healthcare system was reorganized worldwide, leading to decreased access to preventive screening programs. The aim of this study was to evaluate the impact of the pandemic on healthcare accessibility to cutaneous squamous cell carcinoma patients in Serbia. This retrospective study was conducted at the Clinic for Burns, Plastic, and Reconstructive Surgery, University Clinical Center of Serbia in Belgrade. Patient demographics and pathohistological findings of tumors of patients living in and outside the capital in the period before, during, and after the pandemic were compared. The two groups did not show any differences regarding the largest tumor diameter prior and during the pandemic; however, this difference became extremely noticeable after the pandemic (15 mm vs. 27 mm; p < 0.001). While cSCCs are commonly slow-growing tumors, the impact of the COVID-19 pandemic is not negligible. This study found a population at a significant risk of cSCC metastasis, with additional evidence likely to emerge in the upcoming years. © 2023 by the authors.

Introduction/Objective Hair transplantation is one of the fastest evolving procedures in aesthetic surgery and is accompanied by continuous improvement of new techniques. Hairline planning is one of the most important steps in hair transplantation. The shape of the hair also varies depending on the variation of facial shape so it is very important when determining hair direction and making holes for future grafts. Methods We used ordinary 18 gauge injection needles whose number was the same as the number of micrographs we planned for transplantation. Needles are administered in pile growth direction and angle, starting from the first row, and then proceeding to the second one and so on, until we insert all prepared needles. We insert them one in front of the other with a precision ease for future follicles. Results In all 56 patients, we obtained natural hair growth. Inserting the needles reduced bleeding and the average time of the operation was three hours. The success of grafting was 95%. We only had one infection in one patient. Hair growth corresponded to the needle insertion. After a year of transplantation at the last control, the patient’s satisfaction was 100%. Conclusion By using the same number of needles as the number of grafts we reduced operating time, we had a better determination of the direction of hair growth, we can prevent follicular extraction that can be caused by new needle insertion, and this technique achieved a good aesthetic result. © 2019, Serbia Medical Society. All rights reserved.

Rationale, aims, and objective: There is limited information about the comparative effectiveness of the START/STOPP (Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment) criteria and the Ghent Older People's Prescriptions community Pharmacy Screening tool (GheOP3S tool) for the screening of potentially inappropriate prescribing (PIP) in the geriatric population. Considering this, the aim of this study was to compare the ability of the START/STOPP criteria and GheOP3S tool to identify the PIP and potential prescribing omissions (PPOs) among elderly patients visiting their primary care physician. Methods: This is a retrospective observational study where a total of 422 subjects were included. The Charlson Co-morbidity Index (CCI) and the Medicines Co-morbidity Index (MCI) for older people were used to determine the co-morbidity status. The user's diagnosis and medications prescribed were analysed with the START/STOPP criteria and GheOP3S tool. The Wilcoxon signed rank test was used to compare these criteria. The statistical relationship between the occurrence of PIP and users' age, the number of medication prescribed, the number of diagnoses, CCI, and MCI was determined with one-tailed bivariate correlation. Results: The START/STOPP criteria detected 843 PIPs and 1067 PPOs, while the GheOP3S tool detected 936 PIPs and 202 PPOs. The GheOP3S tool detected significantly more PIPs than did the STOPP criteria (P = 0.003). A significantly higher number of PPOs were detected with the START criterion (P < 0.0001). The results obtained with the START/STOPP criteria positively correlated with mentioned variables. Oppositely, there is a negative correlation between the results obtained with the GheOP3S tool and age. Still, the positive correlation could be found with the rest of the variables. Conclusion: The results of this study indicate that both tested tools demonstrated efficiency to detect PIPs and PPOs. The GheOP3S tool detected significantly more PIPs than did the STOPP criteria. On the other hand, the START criteria performed much better for the screening of PPOs. © 2019 John Wiley & Sons, Ltd.

Early melanoma diagnosis plays a key role in ensuring best prognosis with good survival rates. The ongoing global COVID-19 pandemic has greatly impacted global and national healthcare systems, thus making it a real challenge. The aim of this study was to evaluate the impact of the pandemic on diagnostic delay in melanoma patients in Serbia. In this retrospective study, we included patients treated at the university hospital in Serbia’s capitol over a period of five years and three months. We compared the prepandemic (01/JAN/17-14/MAR/20) and pandemic periods (15/MAR/20-31/MAR/22) by evaluating patient demographic data, melanoma subtype, Breslow thickness, Clark level, ulceration status, mitotic index rate and pT staging. We observed a significant reduction in the number of diagnosed patients (86.3 vs. 13.7%; p = 0.036), with melanomas having an increased median Breslow thickness (1.80 vs. 3.00; p = 0.010), a higher percentage of Clark IV–V level lesions (44.0% vs. 63.0%; p = 0.009), an increase in median mitotic index rate (2 vs. 5; p < 0.001) and a trend of increase in lesions thicker than 2 mm (37.8% vs. 53.7%; p = 0.026). We believe that this study can be a useful scenario guide for future similar events, highlighting the importance of preventive measures and timely diagnosis for the best patient outcomes. © 2022 by the authors.

Early melanoma diagnosis plays a key role in ensuring best prognosis with good survival rates. The ongoing global COVID-19 pandemic has greatly impacted global and national healthcare systems, thus making it a real challenge. The aim of this study was to evaluate the impact of the pandemic on diagnostic delay in melanoma patients in Serbia. In this retrospective study, we included patients treated at the university hospital in Serbia’s capitol over a period of five years and three months. We compared the prepandemic (01/JAN/17-14/MAR/20) and pandemic periods (15/MAR/20-31/MAR/22) by evaluating patient demographic data, melanoma subtype, Breslow thickness, Clark level, ulceration status, mitotic index rate and pT staging. We observed a significant reduction in the number of diagnosed patients (86.3 vs. 13.7%; p = 0.036), with melanomas having an increased median Breslow thickness (1.80 vs. 3.00; p = 0.010), a higher percentage of Clark IV–V level lesions (44.0% vs. 63.0%; p = 0.009), an increase in median mitotic index rate (2 vs. 5; p < 0.001) and a trend of increase in lesions thicker than 2 mm (37.8% vs. 53.7%; p = 0.026). We believe that this study can be a useful scenario guide for future similar events, highlighting the importance of preventive measures and timely diagnosis for the best patient outcomes. © 2022 by the authors.

Background and objectives: Bullous pemphigoid (BP), the most common subepidermal autoimmune skin blistering disease (AIBD) has an estimated annual incidence of 2.4 to 42.8 new cases per million in different populations, designating it an orphan disease. Characterized by disruption of the skin barrier combined with therapy-induced immunosuppression, BP could pose a risk for skin and soft tissue infections (SSTI). Necrotizing fasciitis (NF) is a rare necrotizing skin and soft tissue infection, with a prevalence of 0.40 cases per 100,000 to 15.5 cases per 100,000 population, often associated with immunosuppression. Low incidences of NF and BP classify them both as rare diseases, possibly contributing to the false inability of making a significant correlation between the two. Here, we present a systematic review of the existing literature related to the ways these two diseases correlate. Materials and methods: This systematic review was conducted according to the PRISMA guidelines. The literature review was conducted using PubMed (MEDLINE), Google Scholar, and SCOPUS databases. The primary outcome was prevalence of NF in BP patients, while the secondary outcome was prevalence and mortality of SSTI in BP patients. Due to the scarcity of data, case reports were also included. Results: A total of 13 studies were included, six case reports of BP complicated by NF with six retrospective studies and one randomized multicenter trial of SSTIs in BP patients. Conclusions: Loss of skin integrity, immunosuppressive therapy, and comorbidities commonly related to BP patients are risk factors for necrotizing fasciitis. Evidence of their significant correlation is emerging, and further studies are deemed necessary for the development of BP-specific diagnostic and treatment protocols. © 2023 by the authors.

Introduction: Aesthetic surgery procedures are generally done in a relatively healthy population and carry a rather low risk compared to other surgical specialties. The incidence of complications in aesthetic surgery varies greatly depending on the type, wound cleanliness regarding the anatomical site, complexity of the surgery, patient’s age, and comorbidities but is generally considered low. The overall incidence of surgical site infections (SSIs) in all aesthetic surgical procedures is around 1% in most of the literature while cases of necrotizing soft tissue infections are mostly found as individual reports. In contrast, treating COVID-19 patients is still challenging with many diverse outcomes. Surgical stress and general anesthesia are known mediators of cellular immunity impairment while studies regarding COVID-19 infection unquestionably have shown the deterioration of adaptive immunity by SARS-CoV-2. Adding COVID-19 to the modern surgical equation raises the question of immunocompetence in surgical patients. The main question of the modern post-lockdown world is: what could be expected in the postoperative period of perioperatively asymptomatic COVID-19 patients after aesthetic surgery? Case report: Here, we present a purulent, complicated, necrotizing skin and soft tissue infection (NSTI) after gluteal augmentation most likely triggered by SARS-CoV-2-induced immunosuppression followed by progressive COVID-19 pneumonia in an otherwise healthy, young patient. To the best of our knowledge, this is the first report of such adverse events in aesthetic surgery related to COVID-19. Conclusion: Aesthetic surgery in patients during the incubation period of COVID-19 or in asymptomatic patients could pose a significant risk for surgical complications, including severe systemic infections and implant loss as well as severe pulmonary and other COVID-19-associated complications. © 2023 by the authors.

Introduction/Objective Frostbite is a cold-induced injury of the tissue caused by the freezing of intra-and extracellular water, and characterized by thrombosis and ischemic necrosis. Although individual, socioeconomic, and environmental factors are all considered fundamental determinants of human health in general, their role in the occurrence of frostbite remains largely unknown. The aim of this study was to examine the associations among these factors and frostbite for patients in Belgrade, Serbia. Methods We investigated a total of 24 patients that were hospitalized and treated for frostbites at the Clinic for Burns, Plastic, and Reconstructive surgery, Clinical Center of Serbia, 2008–2017. Results The majority (88%) of the patients were male, 58% were long-term alcohol consumers, 46% were long-term smokers, and one patient was drug addict. Of the patients, 14 (58%) had no income and depended on government support, 10 (42%) were employed in physical labor or work on the field, and three (13%) of the patients were homeless. Of the 24 frostbite patients identified, deep frostbite accounted for 18 (75%), of whom 17 (70.8%) had an operative outcome. A majority of patients (42%) sustained frostbite when the temperature was in the range of-5–0°C on the date of occurrence. Conclusion The results of our study showed that individual, social, and environmental factors were important determinants of frostbite. Our results will contribute to existing evidence for risk factors related to frostbite and will allow for comparisons across countries where these factors have been examined. © 2019, Serbia Medical Society. All rights reserved.

Background and Objectives: The careful selection of adequate SLNB candidates not only aims at reducing the surgical risk while identifying SLN metastasis, but also plays a crucial role in identifying the patients eligible for adjuvant therapy. Objectives: The purpose of our study was to investigate the clinical and histologic aspects of primary melanomas that correlate with the likelihood of a positive SLNB result. Materials and Methods: A total of 101 primary melanoma patients who underwent sentinel lymph node biopsies were included in the study. General patient demographics were obtained as well as localization and melanoma-specific characteristics of primary melanoma from histologic reports in addition to data derived from SLNB melanoma histopathology reports. Results: The patients with positive SLN results had a statistically significant increased Breslow thickness (3.8 mm vs. 1.97 mm, p = 0.002), higher mitotic index rate (5/mm2 vs. 2/mm2, p = 0.009), as well as the presence of ulceration (68.4% vs. 31.6%, p = 0.007). Univariate regression analysis showed the Breslow thickness (p = 0.008), the mitotic index rate (p = 0.054), the presence of ulceration (p = 0.009), as well as the pT3-4 stage (p = 0.009) to be significant predictors of SLN positivity. The optimal cut-off values for Breslow thickness and the number of mitoses scores were determined based on ROC curve analysis. Using the Breslow thickness, mitotic index rate, presence of ulceration, and pT3-4 stage significant coefficients from the univariate regression model, a chance prediction score was developed. Conclusions: The newly developed and proposed scoring system can aid in patient selection for SLN biopsy by facilitating a more efficient risk assessment in the detection of lymph node metastases in melanoma patients. © 2023 by the authors.

Background and Objectives: Before the introduction of griseofluvin, the use of X-ray radiation was the treatment of choice for tinea capitis. More than half a century later various types of tumors have been found to be associated with childhood irradiation due to tinea capitis, most commonly cancers of the head and neck, as well as brain tumors. The often unusually aggressive and recurrent nature of these tumors necessitates the need for repeated surgeries, while the atrophic skin with an impaired vascular supply due to radiation often poses an additional challenge for defect reconstruction. We present our experience in the surgical treatment of such patients. Materials and Methods: This is a retrospective cohort study. In this study, 37 patients treated for acquired defects of the scalp with a history of irradiation therapy due to tinea capitis in childhood were included in this study, 24 male and 13 female patients. The mean age at the first appointment was 60.6 ± 7.8, with the youngest included patient being 46 and the oldest being 75 years old. Patients’ characteristics, surgical treatment, and complications were analyzed and a reconstructive algorithm was developed. Results: Local flaps were used for reconstruction in 34 patients, direct sutures were used in 10 patients and 20 patients received split-thickness skin grafts for coverage of both primary and secondary defects for reconstruction of flap donor sites. One regional flap and one dermal substitute covered by an autologous skin graft were also used for reconstruction. Complications occurred in 43.2% of patients and were significantly associated with the presence of comorbidities (p = 0.001), aseptic bone necrosis (p = 0.001), as well as skin atrophy in frontal, occipital, and parietal region (p = 0.001, p = 0.042 and p = 0.001, respectively). A significant correlation between major complications and moderate skin atrophy was found only in the parietal region (p = 0.026). Conclusions: Unfortunately, many protocols developed for scalp reconstruction are not applicable in the setting of severe or diffuse scalp skin atrophy associated with high tumor recurrence rate and radiation-induced vascular impairment, such as in tinea capitis patients in Serbia. An algorithm has been developed based on the authors’ experience in managing these patients. © 2023 by the authors.

Introduction/Objectives The objective of our study was to investigate the structure of the cosmetic procedures’ acceptance attitudes and differences in acceptance between persons who had undergone minimally invasive cosmetic procedures and those who had not. Methods The study included 245 subjects (treatment group), 21–73 years old (42.02 ± 12.12). The control group included 250 subjects who had not previously undergone cosmetic procedures, also 21–73 years old (40.19 ± 11.71). The control group was balanced with the treatment group according to category distribution of demographic variables. The Acceptance of Cosmetic Surgery Scale, adjusted for cosmetic procedures in general, was used for the evaluation of participants’ attitudes towards these procedures. Results Internal consistency of the scale was α = 0.963, the split-half coefficient of validity was 0.861/0.810, and test–retest correlation coefficient was 0.892. The treatment group has shown overall higher acceptance (t(478) = 27.024, p < 0.001, η2 = 0.6), and higher scores in all three dimensions. No demographic variable has shown significant differences in total or individual factor scores in either group. Conclusion Subjects from both groups had scored higher on items dealing with the advantages of cosmetic procedures on a personal level (Intrapersonal Factor). © 2019, Serbia Medical Society. All rights reserved.

The aim of this study was to investigate the mechanisms and etiologic factors of forearm nerve injuries. This retrospective survey included all patients treated surgically in Clinical Department of Neurosurgery, Clinical Center of Serbia, from January 1, 2000 to December 31, 2010. All relevant data were collected from medical records. Statistical procedures were done using the PASW 18 statistical package. Our study included 104 patients that underwent surgery after forearm nerve injury. The majority of admitted patients were male (n=84; 80.8%) and only 20 (19.2%) were female. Ulnar nerve injury predominated with 70 cases, followed by median nerve with 54 (51.9%) cases and radial nerve with only 5 cases. Transection was the dominant mechanism of injury and it occurred in 84.6% of cases. Injury by a sharp object was the most frequent etiologic factor and it occurred in 62 (59.6%) patients, while traffic accident and gunshot injuries were the least common etiologic factor of forearm nerve injury, occurring in 7 (6.7%) and 6 (5.8%) cases, respectively. Associated injuries of muscles and tendons, bones and blood vessels occurred in 20 (19.2%), 16 (15.4%) and 15 (14.4%) patients, respectively. The etiology and mechanism of peripheral nerve injury are of great importance when choosing the right course of treatment in each individual patient because timing and type of treatment are closely related to these factors.