The hyomental distance ratio (HMDR) is the ratio between the hyomental distance (HMD) (the distance between the hyoid bone and the tip of the chin) at the extreme of head extension (HMDe) and the one in the neutral position (HMDn). The objective of the study was to examine the predictive value, sensitivity, and specificity of HMDe, HMDn, and HMDR in predicting difficult endotracheal intubation (DI). A prospective study included 262 patients that underwent elective surgical operations. The following parameters were observed as possible predictors of DI: HMDR, HMDe, HMDn, Mallampati score, and body mass index (BMI). The cut-off points for the DI predictors were HMDe <5.3 cm, HMDn ≤5.5 cm, and HMDR ≤1.2. The assessment that DI existed was made by the anesthesiologist while performing laryngoscopy by applying the Cormack-Lehane classification. DI was present in 13 patients (5%). No significant difference was observed in the frequency of DI with regard to the sex, age, and BMI of the patients. Our research indicated HMDR as the best predictor of DI with a sensitivity of 95.6% and specificity of 69.2%. HMDR can be used in the everyday work of anesthesiologists because HMDR values ≤1.2 may reliably predict DI.

Background: Follicular thyroid carcinoma (FTC) is categorized into three groups: minimally invasive FTC (MIFTC), encapsulated angioinvasive FTC (EAIFTC), and widely invasive FTC (WIFTC). FTC is the second most common type of thyroid tumor, though it remains relatively rare in the general population. This study aimed to examine the prognosis and prognostic factors in patients with follicular thyroid carcinoma. Methods: Data were obtained from a tertiary referral center for 130 FTC patients, covering the period from 1995 to 2020. Clinical data included demographic characteristics, tumor features, type of surgery, tumor recurrence, and vital status. Descriptive statistical methods, Kaplan–Meier survival curves, and Cox proportional hazard regression were used for statistical analysis to identify independent predictors. Results: Distant metastases occurred in 12 patients during the follow-up period. The 5-year, 10-year, 15-year, and 20-year cancer-specific survival (CSS) rates were 98.1%, 92.3%, 83.5%, and 79.8%, respectively. Independent unfavorable prognostic factors for CSS included widely invasive tumor type (hazard ratio [HR] 3.63, 95% CI 1.29–10.18), multifocality (HR 6.7, 95% CI 1.37–32.72), and presence of distant metastases (HR 2.29, 95% CI 1.08–4.84). When disease-free interval (DFI) was considered, the 5-year, 10-year, 15-year, and 20-year rates were 92.3%, 85.3%, 82.0%, and 76.6%, respectively. Independent unfavorable prognostic factors for DFI were widely invasive tumor type (HR 2.53, 95% CI 1.02–6.28) and tumor multifocality (HR 7.69, 95% CI 1.07–55.17). Conclusions: The 10-year survival rate for patients with FTC is relatively favorable. Factors associated with poorer prognosis include the presence of distant metastases, WIFTC, and multifocality. Factors linked to disease recurrence are WIFTC and multifocality.

Background: Many European countries’ epidemiological data on burns were analyzed. This research aimed to analyze the key epidemiological characteristics of hospitalized burn patients in Serbia’s major burn unit over 10 years, as well as to create the very first national epidemiological dataset with the basic requirements for future epidemiological studies. Methods: A retrospective cross-sectional study was conducted, and demographic, clinical, and burn characteristics, as well as predictors of mortality, were analyzed. Results: A total of 996 patients were included. The mean age of the population was 54.65 ± 27.15 years. Regarding etiology, flame was the most common (49.0%). Patient comorbidities were noted on admission in 50.1% of cases. The mean % of total burn surface area (TBSA) was 16.89 ± 18.72%. Inhalation injury was confirmed in 7.5% of patients, and a total of 10.3% of patients required mechanical ventilation during hospitalization. The requirement for mechanical ventilation support was the strongest independent predictor of mortality, while other independent predictors of mortality were male gender, higher %TBSA, deep burns, mechanism of injury, an extended total length of stay (LOS), the occurrence of complications during hospitalization, and conservative treatment modalities. Conclusion: Burn injury mortality remains high, and %TBSA, burn depth, mechanical ventilation requirement, inhalation injury, and the presence of comorbidities on admission unfavorably influence mortality rates.

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.

Objective: Thyroid dysfunction is a common cause of atrial fibrillation (AF). Incidence of AF is high in patients with both expressed and subclinical hyperthyroidism. The aim of our study was to determine the incidence and predictors of new onset atrial fibrillation (NOAF) in euthyroid patients undergoing thyroid surgery. Subject and Methods: The study included 1,252 euthyroid patients with American Society of Anesthesiologists (ASA) physical status ASA 2 and ASA 3, who were 18 years and older and were in sinus rhythm. Patients without comorbidity and patients with persistent AF were excluded. We investigated the influence of the following preoperative characteristics on the occurrence of NOAF: age, sex, body mass index, ASA score, admission diagnoses, and comorbidity. We noted the influence of difficult intubation of trachea, type and duration of surgery, and time under general anaesthesia. Univariate and multivariate logistic regression were used to determine predictors of occurrence of NOAF. Results: NOAF was noted in 0.72% of patients. Patients with NOAF were older (63.11 vs. 56.81 years) than patients without NOAF, but this was not statistically significant. Significantly more patients from the NOAF group had preoperative heart rhythm disturbance and a history of angina pectoris, in contrast to patients without registered NOAF (p = 0.001; p = 0.017). Multivariate analysis showed that a history of heart rhythm disturbance was an independent predictor of NOAF. Conclusions: Incidence of NOAF during thyroid surgery is similar to the other type of surgery, if the values of thyroid hormones are normal.