Background There has been a lack of a standardized protocol for collection of patient reported outcomes (PRO) and detection of and indication for psychological treatment in cleft care. The objectives of this paper was to translate Cleft Hearing Appearance and Speech Questionnaire (CHASQ) into eight European languages, to investigate whether levels of PRO in patients with cleft lip and/or cleft palate (CL/P) were comparable across countries and to investigate clinician experience of the instrument. Methods The PRO measure-CHASQ-was translated into Bulgarian, Estonian, Greek, Latvian, Macedonian, Romanian, Serbian and Swedish and implemented with patients in the respective countries. A focus group discussion was conducted to investigate health care professional experience on the use of CHASQ in their clinics. Data was analysed in accordance with the principles of thematic analysis. Results Analysis showed statistically significant differences between countries and groups of diagnosis in CHASQ scores. CHASQ helped clinicians gain patient information and informed on treatment decisions, broadened the clinicians' role as caregivers and was perceived as short and easy to use. Limited time and resources in clinics were limitations in implementing the instrument. Conclusions Translation and utilization of CHASQ facilitated international comparison and cooperation. Linguistically, valid replicas of CHASQ are now available in many European languages. Results from this study show that CHASQ may be used for collection of PRO on patient satisfaction and to spark conversation between clinicians, patients and families. Level of evidence: Not rateable.

Background and objectives: Due to the fact that the mandible is the only movable bone in the face, it is often exposed to the influence of external forces. The incidence of trismus and posttraumatic pain in unilateral mandibular corpus fractures may be related to the occurrence of complications. There is a decrease in the quality of life of these patients. The aim was to study the relationship of the preoperative pain and trismus with the incidence of complications, as well as to investigate the quality of life. Materials and Methods: A prospective study on 60 patients with isolated mandibular fractures was performed, with a follow-up period of six months. The level of preoperative pain was measured on a 0–10 scale, while the mouth opening was measured with a caliper. All patients were treated surgically on the third day after the fracture. The University of Washington Quality of Life (UW-QOL v4) questionnaire was used to analyze the quality of life. Results: The most common types of complications were the occlusal derangement and facial asymmetry. The majority of complications were treated with counseling and physical therapy. The degree of preoperative pain was significantly positively related to the onset of complications (rs = 0.782, p = 0.004). The interincisal distance showed a significant inverse relation with the incidence of complications (rs = −0.722, p < 0.001). The patients regarded the pain, appearance and mood issues as the most important issues during the first postoperative month. Conclusions: The degree of inflammatory symptoms may be positively related to the onset of complications occurring after the rigid fixation of mandibular fractures. The postoperative health-related and overall quality of life was unsatisfactory in nearly half of the patients.

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This study aimed to determine the effectiveness of airbags and seatbelts in the prevention of facial fractures and slight facial injuries in relation to the speed and kinetic energy experienced in frontal collisions. All cases of vehicle occupants who had been in frontal collisions and had subsequently been examined in the Institute for Emergency Medical Assistance and the Clinical Center of Montenegro in 2017 were analyzed. There were 29 cases of facial fractures (Group 1), 35 cases of slight facial injuries (including nondisplaced nasal fractures) (Group 2), and 26 cases of occupants who had suffered no facial injuries (control Group 3). In all assessed cases all of the subjects had been wearing a seatbelt and the airbag had deployed at the time of impact. A frontal collision is defined as a collision in which the principal force acts within a range of 90° from the longitudinal axis of the vehicle. Using the mass and the speed of the vehicles, the total kinetic energy (KE) of all frontal collisions being analyzed was calculated. The cut-off value of total KE in frontal collisions that were associated with either facial fractures or slight facial injury was estimated using a receiver operating characteristic (ROC) curve. The cut-off amounts of KE were then used to calculate the barrier equivalent velocity (BEV). The BEV for a vehicle of average mass was estimated to be 55.7 km/h (34.6 mph) in Group 1, and 49.2 km/h (30.6 mph) in Group 2. Airbags and seatbelts are effective in preventing facial injuries in vehicles of average mass that are traveling at speeds under 49.2 km/h (30.6 mph) at the point of impact, but they do not protect from facial fractures when the vehicle speed exceeds 55.7 km/h (34.6 mph).

Introduction/Aim: Anemia is the commonest complication in patients on a chronic hemodialysis program and is the cause of reduced quality of life. The aim of this study was to identify the factors that contribute to the better control of anemia with the help of recombinant erythropoietin in persons undergoing hemodialysis. Methods: The cross-sectional study was conducted in 2017 and it included 52 persons on hemodialysis at the Clinical Center of Montenegro. The participants were divided into those, in whom hemoglobin values increased to satisfactory values (110 g/l or more) after three months of application of recombinant erythropoietin (group 1), and those, in whom hemoglobin values were lower than 110 g/l (group 2). Data were collected from the medical history of all participants. T-test was used for the statistical analysis of data. Results: After the three-month administration of erythropoietin, the target value of hemoglobin of 110 g/l or more (group 1) was achieved in only 21 patients (40.4%), while hemoglobin values were below 110 g/l in 59.6% of patients. Participants, in whom target values of hemoglobin were not achieved, received significantly higher average doses of erythropoietin and they had higher body mass index in comparison to participants, in whom the target values were achieved. There was no significant difference between the examined groups regarding the response to erythropoietin, duration of erythropoietin therapy, duration of hemodialysis, participants' age, skin-fold thickness, upper arm width, transferrin values, number of erythrocytes, value of albumin, hemoglobin, hematocrit and iron. Conclusion: Possible factors that contribute to worse control of anemia are higher doses of erythropoietin and greater level of nutritional status estimated according to the body mass index. Further research is necessary aimed at finding factors that would contribute to the elimination of anemia in persons on hemodialysis, because non-treated anemia may lead to numerous unfavorable outcomes (poor quality of life, cardiovascular diseases, cerebrovascular insult, decreased survival rate etc.).