Mortality trend of cutaneous melanoma in Montenegro from 1990-2018.

OBJECTIVE: Every year, melanoma claims over 20,000 lives in Europe. In Montenegro, as in Europe, numerous campaigns have been initiated to raise public awareness about the importance of melanoma prevention and its early detection. Thus, accompanying current diagnostic and therapeutic protocols, new methods of melanoma diagnosis and treatment have been implemented. Studying the trend enables the identification of the groups most burdened by mortality and assesses whether there has been a change in trends based on interventions aiming to reduce mortality. The objective of this study is to evaluate the mortality trend from cutaneous melanoma in Montenegro for the period 1990-2018. MATERIALS AND METHODS: We have utilized national data on the causes of death from melanoma, code 179 from the ninth and C43 from the tenth revision of the International Classification of Diseases, categorized by gender and age groups. The study utilized various regression techniques, including Joinpoint regression in the Joinpoint Program, Poisson regression, and linear regression in the SPSS 26th Program, to describe the trend. RESULTS: In Montenegro, during the period from 1990 to 2018, a total of 281 individuals died (51.6% male and 48.4% female). This ranks as the 13th leading cancer in terms of mortality among all cancers. The average age-standardized rate was 1.1 deaths per 100,000 (1.2 for males and 1.0 for females).  The number of death cases has been increasing on average by 3.3% annually [average annual percentage change (AAPC) (95% CI) = 3.3 (1.7-4.9); p<0.001] on an overall level and by 5.4% annually among males [AAPC (95% CI) = 5.4 (3.6-7.3); p<0.001] due to the rises in the age groups 55-64 years and 65-74 years with an average annual percent change of respectively 3.2% [AAPC (95% CI) = 3.2 (0.8-5.8); p=0.012] and 5.4% [AAPC (95% CI) = 5.4 (2.7-8.1); p<0.001] overall level, and 4.8% [AAPC (95% CI) = 4.8 (2.4-7.3); p<0.001] and 7.5% [AAPC (95% CI) = 7.5 (4.9-10.2); p<0.001] among males. For females, an increase of 1.1% was recorded, which was not statistically significant [AAPC (95% CI) = 1.1 (-0.8-3.0); p=0.255]. Furthermore, there was a noted increase in the rates at an overall level [ß (95% CI) = 0.027 (0.008-0.046); p=0.007] and in the age group 65-74 years [ß (95% CI) = 0.249 (0.090-0.407); p=0.003], as well as among males at an overall level [ß (95% CI) = 0.052 (0.025-0.079); p<0.001] and for age groups 45-54 years [ß (95% CI) = 0.102 (0.011-0.193); p=0.030] and 65-74 [ß (95% CI) = 0.410 (0.144-0.676); p=0.004]. In contrast, the rates for females remained constant. The three age groups most burdened by melanoma skin cancer mortality are 65-74 years (23.5%), 55-64 years (21.7%) and 75-84 years  (19.2%). CONCLUSIONS: The results of regression analyses indicate a significant rise in both the number of death cases and mortality rates overall, specifically among males in Montenegro. In females, however, the increase in the number of death cases and rates is not statistically significant. Preventive campaign activities should be redirected towards the most vulnerable groups in terms of mortality, namely males and the elderly population.

Complications in patients with facial bone fractures before and after conservative and surgical treatment, their comparison and correlation with different factors.

OBJECTIVE: This study aims to determine the occurrence of complications before and after the treatment of facial fractures, as well as the impact of the factors on the treatment results and evaluation of their relationships. PATIENTS AND METHODS: This is a prospective case-control study comprising 90 patients aged between 18 and 65 with facial fractures. Depending on the treatment method, patients were divided into three groups: those treated surgically using a transcutaneous approach, those treated surgically using a transmucosal approach, and those treated conservatively (control group). Following complications before and after treatment were compared: malocclusions, paresthesias, facial asymmetry, diplopia, and limited mouth opening. The follow-up period after the treatment of choice was six months. RESULTS: There was a significant reduction in complications after treatment: malocclusion, paresthesia, facial asymmetry, and limited mouth opening. Regarding the transcutaneous approach, there is a substantial reduction in the number of complications after treatment, such as malocclusions (p=0.008), paresthesias (p=0.004), and facial asymmetries (p<0.001). Similar results were obtained for the transmucosal approach. Pain intensity positively correlated with preoperative complications: malocclusion, paresthesias, and facial asymmetry. The range of mouth opening had a negative interdependence with malocclusion before and after treatment with infection, fractura male sanata, malocclusion, paresthesias, postoperative level of mouth opening, and damage to the facial nerve. CONCLUSIONS: There is no difference in the reduction of preoperative and postoperative complications related to surgery when an incision is made through the skin or mucosa. Malocclusions, paresthesias, and facial asymmetry are reduced through surgical methods.

Descriptive body composition profile in female olympic volleyball medalists defined using multichannel bioimpedance measurement: rio 2016 team case study / Perfil descriptivo de la composición corporal en medallistas femeninos de voleibol olímpico definido mediante medición de bioimpedancia multicanal: estudio del equipo Rio 2016

The subject of this paper was the study of the morphological status of top elite women volleyball players, Rio 2016 Olympic medal winners, with the aim of obtaining reliable quantitative data, used to determine the morphological model and to control the morphological status of top elite women volleyball players. This study tested 12 top elite women volleyball players who participated in the 2016 Rio Olympic Games and won the silver medal. Measurements of body composition were conducted one day before departing for the Rio Olympic Games, on 25th June, 2016, using electrical bioimpendance analysis (BIA), with the InBody 720 Tetrapolar 8-Point Tactile Electrode System analyzer. The study included 29 variables: 17 original variables, four voluminosity-dependent variables, six longitudinality-dependent variables, and two combined index variables. The results showed that average height of the women players was 188.93±6.49 cm, the overall mean BM value for the Serbian team was 75.56±6.97, the overall mean BMI value for the team was 21.08±1.30 kg•m-2, while the mean values for percent skeletal muscles and body mass were 48.95±1.78 % and 13.43±2.70 %, respectively. Upon a thorough analysis of the results of the study, it can be argued that in all measured anthropomorphological characteristics the top elite women volleyball players from the tested sample had a body type of remarkable basic longitudinality, i.e., BH, and a body composition mainly characterized by very high muscle mass but such a low amount of body fat that it bordered on the biological minimum for women.

El objetivo de este trabajo fue estudiar el estado morfológico de las jugadoras de voleibol de élite, ganadoras de la medalla olímpica Rio 2016 y obtener datos cuantitativos confiables para determinar el modelo morfológico y controlar el estado morfológico de las mejores jugadoras de voleibol de elite. Este estudio estudió a 12 jugadoras de voleibol de élite que participaron en los Juegos Olímpicos de Rio 2016 y ganaron la medalla de plata. Las mediciones de la composición corporal se realizaron un día antes de partir para los Juegos Olímpicos de Río, el 25 de junio del año 2016. Se realizó un análisis de bioimpedancia eléctrica (ABI), con el analizador de sistema de electrodos táctiles Tetrapolar 720 de 8 puntos. El estudio incluyó 29 variables: 17 variables originales, cuatro variables dependientes de voluminosidad, seis variables dependientes de la longitud y dos variables de índice combinadas. Los resultados mostraron que la estatura promedio de las jugadoras fue de 188,93 ± 6,49 cm, el valor medio general de MC para el equipo serbio fue de 75,56 ± 6,97, el valor medio total de IMC para el equipo fue de 21,08 ± 1,30 kg • m-2, mientras que los valores medios para el porcentaje de músculos esqueléticos y la masa corporal fueron 48.95 ± 1.78 % y 13.43 ± 2.70 %, respectivamente. Tras un análisis exhaustivo de los resultados del estudio, se puede argumentar que en todas las características antropomorfológicas medidas, las jugadoras de élite de voleibol femenino, de la muestra analizada, tenían un tipo corporal de notable longitudinalidad básica, por ejemplo, AC y una composición corporal caracterizada principalmente por una masa muscular muy alta, pero una cantidad tan baja de grasa corporal que limita con el mínimo biológico para las mujeres.

[Problems with organization and operation of emergency medical services in the post-war period in districts with a population of up to 60,000 inhabitants]. / Problemi organizacije i rada SHMP u poslijeratnom periodu u opcini do 60.000 stanovnika.

Demographic characteristics of Gracanica municipality:--Organization of the municipality on 15 local communities that are 5-20 km away from the centre of municipality.--Road conditions--Starting of industry within Gracanica municipality and social status of the employed population.--There are two main roads that are passing through the territory of municipality--These highways are passing through densely inhabited areas and traffic is heavy. Distance of Tuzla Clinical centre. Services of Gracanica Outpatient Department organize their work although lacking professional staff and equipment. Significance of Emergency Medical Service (EMS) for the municipality and broader community under these circumstances. Present EMCS organization in Gracanica is the following: EMS in Gracanica is organized as a separate service with three permanent teams and temporary engagement of 2 doctors who are on specialization in pediatrics and lungs diseases. A team comrising of a specialist of emergency medicine, three medical technicians and one driver works from 7.00 to 15.00 on regular working days and other doctors work at EMCS from 15.00 to 7.00 and on weekend as well. EMS doesn't examine patients outside the EMS rooms. EMS equipment consists of one ECG, one defibrillator, two aspirators, one oxygen concentrator and a resuscitation set. The Japanese Government donated equipment. Lack of intravenous solutions, drugs and other material for the emergency treatment is notified as permanent problem in emergency care service. Next problem is unsuitable and non-functional space with difficult access and lack of ambulances because the whole rolling stock was destroyed by shelling in 1992. In any case, all these circumstances diminish a team efficiency in providing emergency care. Even under these circumstances EMS had 10,415 examinations during the first sixth months in 2000, provided 45,265 services and treated 912 injuries out of which 64 were traffic injuries. Concerning the complicity of work in EMS Gracanica, standards and norms related to emergency medical care, which have been proposed by the Federal Ministry of Health couldn't be met. By these standards one team covers 20,000 inhabitants and EMS from 19.00 one day until 7.00 the next day and Saturdays and Sundays as well. The question is what to do between 15.00 and 19.00, when every Outpatient Department is closed? For normal functioning of EMS in Gracanica municipality we should do more work on the prevention and work organization in the surgeries of General Medicine in a distant local communities. In that way, EMS wouldn't be a surgery of General Medicine after 15.00. It's necessary to ensure an adequate space, professional staff (at least 4 teams with their leaders) new equipment, ambulances, medicaments, disposable material and furniture. It is necessary:--to develop a system of communication tha could cover municipality and Clinical Centre area,--make educational plan and to respect it,--to establish a cooperation with EMS in neighboring municipalities,--to discuss EMS role in relation to family medicine organization within General hospital in Gracanica.