Introduction: Smoking tobacco results in the death of more than 8 million people every year. Our study aims to explore a new approach for smoking cessation by analyzing body composition differences between smokers and non-smokers, focusing on potential variations in biological and chronological...

Background: Children with Down syndrome (DS) lag behind typical children in the acquisition of developmental milestones, which could differ depending on body proportionality. We aimed to determine the difference in the acquisition of developmental milestones in children with DS with a disproportionate cephalization index (CI) compared to a proportionate CI. We created a motor development model that predicted milestone acquisition times. Methods: In this 20-year prospective cohort study, 47 children with DS aged 3 months to 5 years, followed up to 2020, were grouped according to the ratio of head circumference to birth weight (HC/BW) or CI into proportionate (CI < 1.1) and disproportionate (CI ≥ 1.1). We used a modified Munich Functional Developmental Diagnostic Scale that was assessed for reliability and content validity (Levene’s test and discriminant analysis) to determine 28 motor milestones. Linear regression was used to predict time to milestone acquisition, controlling for sex, maternal age, and birth weight. Results: Compared to proportionate CI, children with disproportionate CI were delayed in the milestone acquisition of a prone position by 2.81 months, standing before walking by 1.29 months, and a supine position by 1.61 months. Both groups required more time to reach standing after the acquisition of independent walking, but children with disproportionate CI reached those milestones later (4.50 vs. 4.09 months, p < 0.001). Conclusion: Children with disproportionate CI acquired milestones in a predictable order but slower than those with a proportionate CI. Our findings support the need to classify the degree of motor developmental delay in children with DS into unique functional groups rather than rely on clinicians’ arbitrary descriptions of the timing of developmental delays in children with DS.

Background and Objectives: Hip fracture surgery is considered a major operation due to the risk of complications and increased mortality. COVID-19 is a newly recognized risk factor for increased mortality in regard to various diseases. Materials and Methods: The aim of this retrospective observational study, conducted from January 2018 to April 2022, was to analyze mortality among rehabilitation ward patients after surgical treatment of acetabular or femoral fractures in both the COVID-19 and pre-COVID-19 periods. The association between mortality and age, gender, comorbidity status, and number of complications during hospital stay was also examined. Results: Higher mortality was observed in the COVID-19-period group during all analyzed periods: cumulative three-year mortality was 2.3 times higher (14.2% vs. 6.2%, p = 0.013); two-year mortality was 3.7 times higher (9.2% vs. 2.5%, p = 0.005); and first-year mortality was 8.3 times higher (5.0% vs. 0.6%, p = 0.006). The Charlson Comorbidity Index (CCI) and admission during the COVID-19 period were strong predictors of mortality, while the number of complications, age, and gender did not significantly influence the mortality rate. An increase of one point in CCI resulted in a 42% increase in the likelihood of mortality, while hospitalization during the COVID-19 period was associated with an odds ratio of 2.44 for death compared to the pre-COVID-19 period (p = 0.013, 95% CI [1.19, 4.94]). Conclusions: The excess mortality may be attributed to the COVID-19 pandemic because the groups were comparable in all other aspects (Barthel index, CCI, complications, age, and gender). Additional five-year mortality data will be useful for analyzing mortality dynamics, as pre-COVID-19 patients will enter the COVID-19 period and COVID-19 patients will enter the post-COVID-19 period.

Ravno stopalo je stopalo s većom dodirnom površinom s podlogom zbog smanjenje visine ili potpune odsutnosti medijalnog svoda. Pedijatrijsko ravno stopalo se najčešće dijeli na patološko, kruto ravno stopalo i fiziološko, fleksibilno ravno stopalo. Patološko spušteno stopalo pokazuje određeni stupanj ukočenosti i značajno ograničenje pokreta subtalarnog zgloba. Često uzrokuje poteškoće i obično zahtijeva konzerativno ili kiruško liječenje. Fiziološko fleksibilno ravno stopalo je pomično i mekano, predstavlja više kozmetički nego funkcionalni problem. Ono čini ∼95% slučajeva ravnih stopala u djece i pretežno je asimptomatsko. U asimptomatskih pacijenata, nema dokaza koji bi poduprli preventivnu ulogu uložaka, ortoza ili operacija s ciljem odgađanja ili uklanjanja eventualnih budućih simptoma. Rano postavljanje uložaka, koji podržavaju svod stopala ne utječe na njegovu visinu u kasnijoj dobi. Teški oblici fleksibilnog ravnog stopala tijekom vremena mogu izazivati bolove i funkcionalne probleme i tada zahtijevaju liječenje. Općenita preporuka za prevenciju ravnog stopala je podržavanje prirodnih obrazaca kretanja u dojenačkoj dobi koji će omogućiti pravilan razvoj svodova te hodanje bez obuće i reguliranje tjelesne težine. Unatoč širokoj rasprostranjenosti, u literaturu nema usuglašenih klasifikacija i smjernica za liječenje dječjeg ravnog stopala te je potrebno provesti daljnja istraživanja sa ciljem postavljanja univerzalnih smjernica za klasifikaciju, dijagnozu, prevenciju i liječenje ravnih stopala u djece.

Bell’s palsy, or idiopathic peripheral facial nerve palsy is a neurologic condition characterized by unilateral weakness of facial muscles. The evidence-based guidelines mostly consider the acute treatment of Bell’s palsy. However, chronic cases of Bell’s palsy are not supported by strong evidence regarding treatment options, except for a weak recommendation to utilize physical therapy. This case report has presented an application of a combination of physical therapy modalities (Mirror Book Therapy, High Inten-sity Laser Therapy, and Acupuncture) within 10 weeks, to treat a patient with long-term sequelae. This combination of therapies has resulted in a significant improvement in the level of recovery measured by facial grading scales. However, further research is necessary to provide stronger evidence regarding the benefits of this treatment option.