Background and objectives: Recurrent herpes simplex keratitis (HSK) is the most common cause of corneal blindness in the developed world. A relationship between host gene polymorphisms and the recurrence of herpes simplex virus (HSV) infection has previously been proposed. Thus, the aim of this study was to investigate a potential association between the IL28B host genotype and recurrent HSK. Materials and Methods: Eighty patients older than 18 years of age of both genders with a history of recurrent herpes simplex labialis (HSL) were considered for inclusion. Seventy-five of these patients were found to be seropositive for HSV-1 and were subsequently enrolled in the study. Twenty-four of the enrolled patients also had a history of recurrent HSK associated with severe corneal scarring and visual acuity deterioration. Total DNA was isolated from whole blood samples. A single-nucleotide polymorphism (SNP) rs12979860 near the IL28B gene on chromosome 19 was genotyped. Results: A significant association was observed between recurrent HSK and two SNPs of the IL28B genotype (CCrs12979860 and CTrs12979860, p < 0.01). The variation CCrs12979860 showed a significantly greater association with HSK (16 out of 26 patients) compared with CTrs12979860 (8 out of 34 patients). Conclusion: Seropositive individuals with a history of recurrent HSK are likely to have the CC IL28B genotype. This genotype may be related to incomplete control of the infection and more frequent periodical viral shedding along the first nerve branch of the trigeminal ganglion, which clinically manifests as recurrent herpes keratitis. The clinical manifestation of recurrent HSV-1 infection seems to be influenced by polymorphism of the IL28B genotype.

Primary teeth play a crucial role in a child’s development, particularly in maintaining space for permanent teeth. The premature loss of a primary tooth can lead to orthodontic issues, making the use of space maintainers essential to ensure proper growth and development of permanent teeth. To preserve space, the fabrication of a space maintainer is necessary. Since conventional space maintainers do not restore masticatory function, this study presents an innovative solution for space preservation following the extraction of the first primary molar through the design of the functional space maintainer KOS&MET (Key Orthodontic System and Materials Enhanced Therapy). The space maintainer was designed using the 3Shape Dental Designer 2023 version software tool and manufactured via additive 3D printing, utilizing a metal alloy with high resistance to masticatory forces. The crown is supported by the primary canine, while an intraoral window is created to monitor the eruption of the successor tooth. This design does not interfere with occlusion and enables bilateral chewing. Masticatory performance was assessed using two-color chewing gum, and the results showed improvement after cementing the space maintainer. This innovative approach not only preserves space for permanent teeth but also enhances masticatory function, contributing to the proper growth and development of the jaws and teeth.

The trigeminocardiac reflex (TCR) is defined as sudden onset of parasympathetic dysrhythmias including hemodynamic irregularities, apnea, and gastric hypermotility during stimulation of sensory branches of the trigeminal nerve. Back in 1999 when TCR was first described as such, a clinical discussion on the establishment of terminology is ongoing. We present a case of a 31-year-old male patient who was admitted to the Emergency Department due to traumatic brain injury who died with clinical manifestations of TCR. TCR can be a red flag for neurosurgeons when treating patients with traumatic brain injury.

In the trauma of craniofacial junction, frontal sinus wall fractures take up 5-15% of all facial bone fractures. The most common mechanism of their occurrence comes as a result of the action of high-energy impact force on the frontal area. Treatment of the injuries in frontal-orbital-ethmoidal regions largely depends on the responsible experts (otolaryngologist, maxillofacial surgeon or neurosurgeon) in all cases, because of the implementation of diverse surgical technics in order to achieve the best possible outcome for the patient. Bearing in mind the complex anatomical features of this region, it is clear that these procedures are often accompanied by series of possible complications, all of which are certainly neurosurgical. These can be expressed as early or late complications, and could be characterized by diverse clinical manifestations. Mucocele is formed, either due to partial obstruction of the sinus mucosa or due to the obstruction of the frontal sinus. The long term existence of mucocele and its progressive growth will result in strong pressure on the adjacent bones, and lead to their destruction followed by the process-propagation into surrounding tissues and spaces. In the further development if a bacterial contamination is detected, it will lead to the purulent inflammatory process and clinical picture of mucopyocele. In most clinical cases with complications proptosis and diplopia are dominant ophthalmic manifestations. In this paper we will present our experience in the treatment of proptosis and diplopia, as well as the ways of diagnostic evaluation in order to achieve timely diagnosis and assure swift healing of patients.

Introduction/Aim: Patients, who stay long in hospitals, nursing homes, and especially in intensive care units, are exposed to the risk of developing chronic wounds. The term "chronic wound" refers to wounds that do not heal despite all treatment measures taken in the period of six to eight weeks. The aim of this retrospective cohort study was to analyze data on chronic pressure ulcers that were collected in intensive care units (ICU) of the Urgent Care Center of the Clinical Center of Serbia during the five-year period, with the aim of determining the factors that influence their occurrence and healing. Methods: The retrospective cohort study was conducted from January 1st, 2018 to April 1st, 2023 at the Urgent Care Center of the University Clinical Center of Serbia in the intensive care units in polytrauma, neurosurgical and surgical patients. The study included 74 patients diagnosed with chronic pressure ulcers. Data for all participants were obtained from medical history and list of discharge. Results: During in-hospital treatment in ICU, pressure ulcers were found in all 74 patients (56.8% of women and 43.2% of men), while combined chronic wounds were found in 57 (77.0%) patients. The largest number of these patients were elderly (70 and older) (31.1%) and with non-traumatic injuries (62%). All patients were tracheotomized with a gastrostomy tube placed. The localization of pressure ulcers was most often in the lumbosacral region (44.6%), followed by the trochanteric region (23.0%). The majority of patients had hypertension (90.5%), diabetes (79.7%) and chronic obstructive pulmonary disease (82.4%), while 28 patients (37.8%) died. 38 patients were underweighted (51.4%), while 11 (14.9%) patients were overweight and obese. Conclusion: Risk factors for the occurrence of pressure ulcers should be evaluated at the moment of the first contact of the doctor with the immobile patient because this is the only prerequisite for timely prevention. Special emphasis should be placed on the elderly, underweight and people with comorbidities.

Introduction: Pituitary tumors represent 10-15% of all intracranial tumors. Clinical manifestations depend on the size of the tumor such as microadenoma, macroadenoma or giant adenoma, and type of the tumor (secreting or non-secreting). Surgical treatment of pituitary adenoma can be managed via transcranial or transsphenoidal approach. Depending on the approach, there is a possibillity of postoperative complications such as meningitis, pneumocephalus, liquorrhea, transient diabetes insipidus and ect. Aim: The aim of this study was to establish the frequency of newly discovered pituitary tumors in the Emergency Center, University Clinical Center Of Serbia, during the COVID-19 pandemic in Serbia, and early postoperative complications in patients treated with an endoscopic and microscope transsphenoidal approach. Material and methods: During the time period during the pandemic, the study contains 119 patients, from January 1, 2020 to March 1, 2023, of which 64 are male (53.8%) and 55 are female (46.2%), age range is 14 to 85 years with a mean of 52.10. As for statistical analysis, assessment of frequency rate and relative numbers were used as methods of descriptive statistics. Results: Macroadenoma was present in 95 patients (79.83%), microadenoma in 22 patients (18.49%), and giant adenoma in 2 patients (1.69%). Transient DI developed postoperatively in 11 patients (9.24%). The average duration of hospitalization after surgery was 8 days. Conclusion: The duration of hospitalization depends on numerous factors where the COVID-19 pandemic can serve as an example for future similar crisis situations so that better organization and preoperative preparation of patients can be implemented.