Introduction: The number of newly diagnosed skin cancers per year is greater than the sum of the four most common cancers: breast, prostate, lung, and colon. The implementation of primary and secondary prevention measures, over the last 2 to 3 decades, has made a major contribution to successful treatment. Aim: Evaluate the accuracy and reliability of teledermoscopic versus clinical diagnosis for skin cancers when diagnostic algorithms are used, and when GPs and surgical specialties are involved in the clinical procedure. Methods: Digital dermoscope (TS-DD, by Teleskin company) was used for the acquisition of teledermoscopic photographs and specialized teledermoscopic software was used for clinical examination and teledermoscopic consultation. The teledermoscopic procedure itself was performed in two steps. The first step was a clinical examination using the ABCDE rule with digital dermoscopic photography of the suspected lesion. The second step was a 2-step dermoscopic evaluation using the second step ABCD algorithm for the second step. Accuracy and diagnostic reliability were calculated for: teledermoscopic diagnosis versus histopathological diagnosis; clinical diagnosis versus histopathological diagnosis and teledermoscopic diagnosis versus clinical diagnosis. Results: The study included 120 patients with 121 Pigmented Skin Lesions, of which 75 (62%) were benign and 46 (38%) were malignant lesions (6 melanomas and 40 NonMelanoma Skin Cancers). Diagnostic accuracy between teledermoscopic and histopathologic diagnosis was 90.91% and reliability k=0.81; between clinical and histopathological diagnosis the diagnostic accuracy was 82.64% and the reliability k=0.64 and between the clinical and teledermoscopic diagnosis the diagnostic accuracy was 81.82% and the reliability k=0.62. Conclusion: The achieved diagnostic accuracy between clinical and teledermoscopic diagnosis, when using diagnostic algorithms, establishes a feasible screening path for skin cancers and indicates that general practitioners and specialized surgeons may equally be involved in prevention.

Zusammenfassung Hintergrund Im Rahmen des ELF der ESPRAS wurde die Notwendigkeit standardisierter Richtlinien zur Brustrekonstruktion auf europäischer Ebene definiert. Ziel dieser Studie ist es, zunächst einen Überblick über den aktuellen Status, Entwicklungen und mögliche regionale Unterschiede der Brustrekonstruktion in Europa zu geben, wobei ein Schwerpunkt auf dem Angebot, der Verteilung und dem Zugang zur Brustrekonstruktion liegt. Materialien und Methoden Es erfolgte eine internetbasierte Befragung von in der Brustrekonstruktion spezialisierten Plastischen Chirurgen, welche zusätzlich die nationalen Versorgungsstrukturen ihrer jeweiligen Länder überblicken. Geeignete Teilnehmer wurden über das ExCo der ESPRAS und nationale Delegierte von ESPRAS identifiziert. Die Ergebnisse wurden mit aktueller evidenzbasierter Literatur verglichen. Ergebnisse 33 Teilnehmer aus 29 europäischen Ländern nahmen an der Studie teil. Im Vergleich zur Gesamtzahl durchgeführter Mastektomien war die Inzidenz der Brustrekonstruktionen in Europa relativ gering, vergleichbar mit anderen großen geografischen Regionen, wie z. B. Nordamerika. Die Verfügbarkeit und der Zugang zur Brustrekonstruktion war innerhalb Europas gleichmäßig verteilt, allerdings kann die geografische Region das Verfahren der Brustrekonstruktion (Eigengewebe vs. Implantat) beeinflussen. Deutliche Differenzen zeigten sich bezüglich Brustrekonstruktionen bei bestrahlten Patientinnen. Schlussfolgerung Die Studie identifizierte ein ausgeprägtes Maß an Inkohärenz in den internationalen Standards zwischen den europäischen Ländern. Es besteht großer Bedarf für kohärente europäische Leitlinien. Europäische, multizentrische klinische Studien sollten initiiert werden, um eine evidenzbasierte Grundlage zu schaffen.

Introduction: Injuries to the radial nerve can occur at any point along its anatomical route, and the etiology quite varies. A particular entity are war injuries of the extremities, which have high morbidity but low mortality. After irreparable radial nerve injury, the only treatment is tendon transfer (if we neglect arthrodesis) with over then 40 methods. Four tendon transfers are considered as better than the other and two of them are the subject of our article flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU). Aim: To evaluate the ultimate functional results of forearm tendon transfers for irreparable radial nerve damage caused by war injuries and indicate the better operative treatment choice in accordance with the evaluation schemes. Methods: This retrospective research included 40 patients with isolated irreparable radial nerve damage. Patients were operated from 1993 to 1996. The follow-up period is from 3.5 to 11.5 years (until 2007). Twenty patients were operated using FCR tendon transfer method and twenty patients were operated using FCU tendon transfer method. The surgery was performed at the Clinic for Reconstructive and Plastic Surgery, Clinical Center University of Sarajevo. Three score evaluation schemes were used: Zachary, Neumann Pertecke and Tajima scheme, along with subjective evaluation of treatment. Results: Measured by the Zachary Evaluation Scheme, the overall score in patients undergoing FCR tendon transfer is 92.25%. In patients undergoing FCU tendon transfer, the total score was 82.20%. The total result of all 40 operated patients was 87.25%. The Zachary evaluation scheme showed a significant difference between FCR and FCU results by tendon transfer (p <0.05) in favor of the FCR tendon transfer. Tajima scheme proved a statistically significant difference between the two tendon transfers (p = 0.024), also in favor of FCR tendon transfers. Conclusion: Forearm tendon transfer is a relevant method to compensate for the loss of function of the wrist, fingers and thumb extensions as a result of irreparable damage to the radial nerve. FCR tendon transfer provides better functional results than FCU tendon transfer in irreparable radial nerve damage. The time elapsed from the injury to the performed surgery of the tendon transfer has no effect on the final functional result. There is no surgical tendon transfer procedure that can be recommended as a standard for any patient. Practically, the surgeon must tailor the surgery to the patient's needs. It is necessary to develop a unique and generally accepted evaluation scheme for the results of tendon transfers that will enable comparisons of results achieved. Both methods can be used for irreparable damage of radial nerve due to any etiology.

The graft length, level of injury and denervation time significantly influenced the functional outcome in both motor and sensory recovery. Better results were in the patients in which the autograft length was up to 5 cm, in patients who were operated within six months from the injury and in patients with distal lesions.

Introduction: Laparoscopic cholecystectomy is now considered the procedure of choice that achieves a shorter recovery period after the surgery and reduction in the cost of treatment. Aim: The aim of the study is to prove which method: early or delayed laparoscopic cholecystectomy is the method of choice in the treatment of acute cholecystitis by examining: duration of hospitalization, conversion rate, duration of surgery, postoperative complications, and total cost. Methods: The study was conducted at the University Clinical Center of Republika Srpska as a retrospective-prospective study from May 1 st 2013 until December 31 st 2019. Patients diagnosed with acute cholecystitis were divided into two groups: Patients designated for early laparoscopic cholecystectomy within 72 hours of admission (group A-42 patients), Patients designated for initial conservative treatment followed by a delayed interval of 6-12 weeks until surgery (group B-42 patients). Results: In both groups, there were statistically significantly more female respondents. The results showed that the average cost of treatment in the early treated group was statistically significantly lower than the cost of treatment in the delayed treatment group. The patients in the early group had shorter hospitalization times (an average of 2.8 days and 5.6 days in the delayed group of patients), a smaller percentage of conversions (4.8% in the early and 16.7 in the delayed group of patients), the total cost of in the early group it was 1300.83 KM, while in the delayed group it was 1645.43 KM. Conclusion: Early laparoscopic cholecystectomy is a method to be preferred in surgical treatment.