Nutritional Status and Quality of Life in Patients with Oral Squamous Cell Carcinoma Before and After Surgical Oncological Treatment: A Single-Center Retrospective Study.

BACKGROUND Oral squamous cell carcinoma (OSCC) is the most common of head and neck malignancies in well-developed countries. In most cases, patients with OSCC experience a degree of nutritional status disturbances and decreased quality of life (QoL). This study aimed to compare nutritional status and QoL in 51 patients before and after surgery for OSCC. MATERIAL AND METHODS Fifty-one eligible patients with OSCC were followed during a 3-year period (2019-2022). For all patients, we determined body mass index (BMI), serum albumin (ALB), prognostic nutritional index, and nutritional risk index before and after treatment. Also, all patients completed a standardized QoL questionnaire before and after treatment. The obtained data were compared between the groups by using the t test and multivariate Cox regression. RESULTS The values of BMI and NRI were statistically significantly different between the preoperative and postoperative measurements (24.1 kg/m² vs 21.1 kg/m², and 103 vs 100.1, respectively, P=0.001), while values of ALB and prognostic nutritional index did not differ significantly (41.35 g/L vs 39.1 g/L, and 48.5 vs 46.2, respectively). Dysphagia (P=0.03) and chewing problems (P=0.04) were found to be the 2 most important factors decreasing the QoL of patients. CONCLUSIONS Based on our results, BMI and NRI were the most sensitive parameters of nutritional status. Dysphagia and chewing problems were the 2 most important factors affecting the QoL in patients with OSCC.

Comparison of the Fractured and Non-Fractured Orbit Before and After Surgery Using a Titanium Implant or a Resorbable Poly-d,l-lactic Acid (PDLLA) Implant: A Study from a Single Center in Nis, Serbia of 58 Patients with Unilateral Orbital Floor Fracture Using Volumetric Measurement.

BACKGROUND A fracture of the orbital floor can lead to complications such as enophthalmos, impaired eye motility, or diplopia, which is why it is necessary to reconstruct the bony walls of the orbit. This study from a single center in Nis, Serbia, included 58 patients with unilateral orbital floor fracture and aimed to use volumetric measurement to compare the fractured and non-fractured orbit before and after surgery using a titanium implant or a resorbable poly-d, l-lactic acid (PDLLA) implant. MATERIAL AND METHODS From 2018 to 2022, a total of 58 patients with unilateral orbital floor fractures were treated at the Clinic of Dental Medicine, Nis. Computed tomography examination was used for volumetric measurement of the fractured and non-fractured (contralateral) orbit before and after the surgical procedure. A titanium implant was used in 31 patients, and a PDLLA implant was used in 27 patients. RESULTS Orbital volume ratio did not differ statistically significantly in relation to the type of implant (P=0.591). The postoperative volume did not differ statistically significantly from the volume of the contralateral side (titanium, P=0.212; PDLLA, P=0.232). There was a significant correlation between orbital volume and enophthalmos both before and after surgery (P=0.012, P=0.018, respectively). CONCLUSIONS Measuring the preoperative volume of the injured orbit is sufficient data for an indication because reconstruction depends primarily on the correlation between the volume and enophthalmos. The findings from this study showed that preoperative orbital volumetry using computed tomography evaluated enophthalmos and provide data to assist orbital floor reconstruction.

Early Neanderthals in contact: The Chibanian (Middle Pleistocene) hominin dentition from Velika Balanica Cave, Southern Serbia.

Neanderthals are Eurasian fossil hominins whose distinctive morphology developed in the southwestern corner of Europe and later spread throughout the continent, reaching Southwest Asia before the Late Pleistocene and spreading into Central Asia by 59-49 ka. The timing, tempo, and route of the Neanderthal movements eastward are poorly documented. The earliest probable evidence of Neanderthals in Asia comes from Karain E Cave (Anatolia, Turkey), dated to 250-200 ka. We present four Chibanian (Middle Pleistocene) hominin specimens, representing at least two individuals, from Velika Balanica Cave (Serbia): a permanent upper third molar (BH-2), a deciduous upper fourth premolar (BH-3) refitted to a poorly preserved maxillary fragment with the permanent first molar in the alveolus (BH-4), and a permanent upper central incisor (BH-5). We provide descriptions of the teeth, as well as a comparative analysis of the well-preserved M1 (BH-4), including assessments of cusp angles, relative occlusal polygon area, relative cusp base areas, two- and three-dimensional enamel thickness, and taurodontism. Morphology of both the occlusal surface and the enamel dentine junction of the M1 indicates that the maxillary fragment and associated dP4 belonged to an early Neanderthal child. The heavily worn I1 and M3 are consistent with the Neanderthal morphology, although they are less distinct taxonomically. These Chibanian remains with provenance from layer 3a are constrained by two thermoluminescence dates: 285 ± 34 ka and 295 ± 74 ka. They represent the earliest current evidence of Neanderthal spread into the Eastern Mediterranean Area. We discuss these findings in light of recent direct evidence for cultural connections between Southwestern Asia and Southeast Europe in the Chibanian.

Connections between the Levant and the Balkans in the late Middle Pleistocene: Archaeological findings from Velika and Mala Balanica Caves (Serbia).

Major changes in the technological, economic, and social behavior of Middle Pleistocene hominins occurred at the onset of the Middle Paleolithic, 400-200 ka. However, until recently it was not possible to establish when, where, and how certain forms of Middle Paleolithic behavior appeared and spread into Southeastern Europe, mainly owing to gaps in the Paleolithic record. Here we report new results of dating, material culture, and the archaeological context of finds from the Balanica Cave Complex in Sicevo (Serbia). Two methods-thermoluminescence and electron spin resonance-were used to date the sequence. The geoarchaeological context was examined through sedimentology, micromorphology, and spatial analysis. Microfaunal remains were used to constrain the dates within an ecological zone, whereas macrofauna was analyzed for taxonomy and taphonomy to examine the source of accumulation and hominin behavior. Technological and typological features of the lithic assemblage were used to characterize lithic production at the site. Materials recovered from Layer 3 in Velika Balanica and from Layer 2 in Mala Balanica, both dated to MIS 9-7, include a distinctive set of archaeological assemblages which resemble contemporaneous Yabrudian assemblages from the Levant in important ways, and which are unlike contemporary material from the surrounding regions. In Velika Balanica, the lithic assemblages are associated with a large fireplace containing evidence of human activities similar to those from Qesem Cave (Israel). Dental remains uncovered in the same layer are consistent with Neanderthals. These findings suggest that the end of the Middle Pleistocene (before 300-240 ka) saw population movement and/or cultural transmission between Southwest Asia and the Balkans, which led eventually to a transfer of technology between Middle Eastern and European hominin populations and contributed to the shaping of Neanderthal behaviors throughout the eastern and northern Mediterranean.

Homo bodoensis and why it matters.

In our original paper, we proposed a new species, Homo bodoensis, to replace the problematical taxa Homo heidelbergensis and Homo rhodesiensis, with the goal of streamlining communication about human evolution in the Chibanian. We received two independent responses. Given their substantial overlap, we provide one combined reply. In this response: (1) we are encouraged that the primary proposal in our paper, to discontinue the use of H. heidelbergensis (as a junior synonym to Homo neanderthalensis) due to its' nomenclatural problems, is acknowledged. (2) we provide additional clarification about the rules governing taxonomic nomenclature as outlined by the International Code of Zoological Nomenclature and join the growing calls for a revision to these rules. (3) we discuss further why H. rhodesiensis should be abandoned, particularly in light of the current sensitivity to using culturally inappropriate names. We conclude that H. bodoensis is a better solution than the proposed alternatives.

Resolving the "muddle in the middle": The case for Homo bodoensis sp. nov.

Recent developments in the field of palaeoanthropology necessitate the suppression of two hominin taxa and the introduction of a new species of hominins to help resolve the current nebulous state of Middle Pleistocene (Chibanian) hominin taxonomy. In particular, the poorly defined and variably understood hominin taxa Homo heidelbergensis (both sensu stricto and sensu lato) and Homo rhodesiensis need to be abandoned as they fail to reflect the full range of hominin variability in the Middle Pleistocene. Instead, we propose: (1) introduction of a new taxon, Homo bodoensis sp. nov., as an early Middle Pleistocene ancestor of the Homo sapiens lineage, with a pan-African distribution that extends into the eastern Mediterranean (Southeast Europe and the Levant); (2) that many of the fossils from Western Europe (e.g. Sima de los Huesos) currently assigned to H. heidelbergensis s.s. be reassigned to Homo neanderthalensis to reflect the early appearance of Neanderthal derived traits in the Middle Pleistocene in the region; and (3) that the Middle Pleistocene Asian fossils, particularly from China, likely represent a different lineage altogether.

The first Neanderthal specimen from Serbia: Maxillary first molar from the Late Pleistocene of Pesturina Cave.

Neanderthals were the only human group in Europe throughout the Late Pleistocene until the arrival of modern humans, and while their presence has been confirmed in the surrounding regions, no Neanderthal fossils are known to date from the Central Balkans. Systematic excavations of Pesturina Cave (Serbia) resulted in the discovery of a permanent right M1 (Pes-3). The specimen was recovered from stratigraphic Layer 4b with an estimated age of 102.4 ± 3.2 ka, associated with Mousterian artifacts. The exceptional state of preservation and minimal wear of the molar enabled a detailed description and comparative analysis of the inner and outer dental structure, including non-metric dental traits and morphometric features of the crown, roots, and dental tissues. The results of this study strongly support the identification of Pes-3 as Neanderthal. Non-metric traits of the occlusal surface of the crown, enamel-dentine junction, and roots are consistent with Neanderthal morphology. The crown shows morphometric features typical for Neanderthal M1, such as a buccolingually skewed crown shape, internally compressed cusps, and a relatively large hypocone. The specimen also shows Neanderthal-like dental tissue proportions, characterized by relatively thin enamel and large coronal dentine and coronal pulp volumes. The discovery of the Pes-3 molar therefore confirms the presence of Neanderthals in the territory of Serbia and the Central Balkans at the end of Marine Isotope Stage (MIS) 5c.

First record of a fossil monkey (Primates, Cercopithecidae) from the Late Pliocene of Serbia.

The cercopithecid fossil record of the Balkan Peninsula extends from the Late Miocene to the Early Pleistocene, but to date no fossils of non-human primates have been identified in Serbia. Here we report the identification of two primate teeth from Ridjake, a rich paleontological site in western Serbia. NHMBEO 042501 is an upper third molar with heavy occlusal wear and taphonomic weathering. NHMBEO 042502 is a well-preserved lower third molar with only minor damage to the cusps and root apices. We performed an analysis of non-metric traits and made bivariate comparisons of crown linear measurements in order to assess the taxonomic affinity of the molars. Both show typical papionin occlusal patterns and relatively large overall sizes. In combination with the early Villafranchian (MN16) age of the site, we attribute both Ridjake primate fossils to cf. Paradolichopithecus sp. This represents the first identification of a non-human primate in Serbia, and the first identification of any primate in the Neogene period of Serbia. Along with recent hominin discoveries, the Ridjake fossils contribute to the growing primate fossil record in Serbia, and indicate the need for increased research into fossil primates in the country.

A re-examination of the human fossil specimen from Backi Petrovac (Serbia).

A fragmented human calotte was discovered during the early 1950s near Backi Petrovac (Serbia), in association with Palaeolithic stone tools. After its initial publication, the fossil specimen remained largely unknown outside of the Serbian academe and no detailed comparative study has ever been carried out. Since the whereabouts of the fossil itself are currently unknown, and given its potential significance for the Pleistocene human evolution, we re-examine the data published by Zivanovic (1966, 1975). Using the original measurements, mostly taken on the frontal bone, and a wide comparative sample of 68 fossil specimens, the fossil was compared and analyzed by statistical multivariate methods. We also conducted a visual examination of the morphology based on the available photographic material. Our analysis reveals phenetic similarity with Middle Pleistocene archaic Homo from Africa and anatomically modern Homo sapiens. However, the absence of primitive cranial traits in Backi Petrovac indicates a clear modern Homo sapiens designation. Although lost at the moment, there is a chance for the re-discovery of the fossil in the years to come. This would give us an opportunity to acquire absolute dates and to study the specimen in a more detailed manner.

[Macroglossia and Beckwith-Wiedemann syndrome].

INTRODUCTION: In 1963 Beckwith presented a report on the first patient with extreme cytomegaly of adrenal cortex, hyperplasia of kidneys and pancreas and Leydig cell hyperplasia. Wiedemann completed description of the new syndrome by adding umbilical hernia and macroglossia. The diagnosis is made based on the clinical signs of omphalocele or some other umbilical deformity, macroglossia, congenital asymmetry, visceromegaly (liver, pancreas, and kidneys). CASE OUTLINE: A 16-month-old male child was admitted for examination because of macroglossia. He underwent examination on several occasions by an endocrinologist due to recurrent hypoglycaemic crisis. The patient was observed by a paediatric neurophysicatrist for disorders of mental development. Hypoglycaemia, muscular hypotonia of the anterior abdominal wall with umbilical hernia and macroglossia were observed by clinical examination. Inratraoral examination revealed macroglossia with microstomia, suckling and swallowing difficulties, hypotonia of the perioral muscles with increased salivation. It was therefore decided to perform surgical reduction of the prominent tongue and develop good condition for nutrition, speech function and the development of orofacial system. CONCLUSION: The diagnosis of macroglossia is based on subjective clinical criteria such as the morphology and amount of protrusion of the tongue, difficulty in articulating sounds, breathing, and hypersalivation. Some authors have suggested that the tongue size may be analyzed radiographically with a cephalogram. Treatment of macroglossia is controversial because of the absence of objective clinical criteria.

[MALT lymphoma of the parotid salivary gland].

BACKGROUND: Mucosa-associated lymphoid tissue (MALT) lymphoma was described for the first time in 1983 by Isaacson and Wright. It was classified into extranodal non-Hodkin's lymphomas of B-cell lymphocytes of the marginal zone of reactive lymphe follicles. It is characterized by both hyperplasia and colonization of plasmocytic, centrocytoid and monocytoid cells, by the infiltration of interfollicular and parafollicular parts of interstitium, as well as by the invasion of clusters of neoplastic lymphoid cells of the glandular epithelium, forming the pathognomic lymphoepithelial MALT limphoma lesions. CASE REPORT: In this paper we presented the two female patients, 59 and 75 years of age, with MALT lymphomas, associated with Miculicz's and Sjögren's syndromes. The paper also underlined rather many-month-long, indolent clinical course, evalution of both tumors, massive in size, as well as two-sided localization in the case of the Miculicz's syndrome. After the subtotal parotidectomy, using conservation of nerve facialis, the tissue blocks were fixed in 10% formaldehyde. The paraffine sections were stained by routine histochemical and an immunohistochemical method by using monoclonal antibodies for both B-cell and T-cell lymphomas, due to the verification of lymphoepithelial lesions. The MALT lymphoma diagnosis was based on the histological criteria and confirmed by an immunohistochemical method. After the surgical therapy accompanied by chemotherapy, the patients were controlled at regular intervals, and residual MALT lymphoma did not appear. CONCLUSION: MALT lymphoma is a rare tumor of the salivary glands, with the most frequent localization in the parotide gland. It had a slow clinical course, without metastases in both patients. The diagnosis was made pathohistologically and confirmed immunohistochemically. The surgical therapy was accompained by adjuvant chemotherapy.