There is much evidence that microvascular free flaps are successfully used in the reconstruction of the head and neck defects in cancer patients. It has become evident that proportional with ageing population, there is an increase in the number of elderly patients requiring microvascular reconstruction after radical excision of tumors in the head and neck region. The aim of this study is to estimate the correlation between the application of a microvascular free flap for defect reconstruction in elderly patients based on ASA (American Society of Anesthesiology) classification and postoperative surgical and medical morbidity. Study included 31 patients older than 70 years hospitalized in the period from 1996 to 2010 at the Clinic for Maxillofacial Surgery, Zagreb, Croatia. Base of reference for every patient included data about: gender, age, date and length of surgical procedure, basic diagnosis, chronic illneses, ASA (American Society of Anesthesiology) clasiffication, type of surgical procedure, type of microvascular free flap, postoperative complications, length of hospitalization and treatment results. Based on the data analysis it is estimated that morbidity was significantly higher in the number of male patients than the number of female patients (61% : 38.7%). Average age was 76 years and the oldest patient was 87 years old. According to ASA clasiffication patients were mostly ASA III (60,87%) and then ASA II 26.08%. Overall, the success rate of microvascular free flap was 94%. Moreover, postoperative medical complications were in the correlation with ASA status 19.45%. The study shows that the successs rate of microvascular free flap reconstruction of cancer in the head and neck region with elderly patients is directly related to ASA and the length of surgical procedure, as significant predictors in postoperative surgical and medical morbidity.

Development of a civil society and social systems for protection of different groups is directly related to well functioning political and economic systems. If the level of economic development or political stability is not continuous the implementation of antidiscrimination laws would most likely be at a very low level. In this case development of social rights along with implementation of antidiscrimination rights may be marginalized due to three factors: lack of cooperation among political and economic spheres, lack of knowledge about antidiscrimination laws and absence of political will for adoption and implementation of antidiscrimination laws. Therefore, we focus on the examination of specific issues concerning the three aforementioned factors primarily focusing on EU and divergence in the level of political and economic development among the member states.We will argue that antidiscrimination laws are not welcome in new member states, especially since they increase political and economic costs for the governments of respective countries. Level of political development has much to do with the acceptance and inclusion of AD laws in the decision making process. Economic development has much to do with social and living standards within a country which is directly related to the general perception of the population on AD laws. Therefore, one could say that implementation of AD laws heavily depends on the preparedness of people, economic and political system and their will to cope with costs and benefits of implementing those laws

Head and neck neoplasia can affect certain fundamental functions, including eating, drinking, speaking and respiration. One overriding factor in deciding on treatment policy is the tendency for head and neck malignancy to be limited to the primary site and regional lymph nodes with surgery and chemotherapy and radiotherapy. The aim of the study was to analyze the occurrence of Head and Neck tumours operated at ENT clinic Tuzla, University Clinical Center Tuzla, Bosnia and Herzegovina. Medical records of patients with histopathologically confirmed head and neck malignancies over a 5 year period (2003-2007) were analyzed. Eight hundred and eight one (881) cases, made up of 519 (58,8%) males and 362 (41,1%) females were found. The most common sites for head and neck malignancies were found to be in the larynx (26,1%), oral cavity (21,7%), the thyroid gland (14,64 %) and the neck (8,51%). A total of 230 patients were diagnosed with laryngeal carcinoma (M:173; F:57), showing the increasing number of female patients. The histopathological tumour types found in this work were mostly squamous cell carcinoma (72,09%), papillary carcinoma (12,2%), while many other minor histopathological variants accounted for 13%. The most patients were presented with stage I and stage III of disease (27% and 28,3%), and 19,9% with stage IV. About 40% of patients did not have data about smoking habit and alcohol drinking. The incidence of head and neck tumours seems to be relatively high, but without significant increase during investigated period. More investigation concerning risk factors, diagnostic procedures, and management strategies should be done in future.

Background: The most comon patohistologi-cal finding in primary hyperparathyroidism is adenoma of the parathyroid gland, followed by hyperplasia and the rarest is carcinoma. However, hyperplasia of the parathyroid glands (PTG) is most commonly found in secondary and tertiary hyperparathyroidism. Objective: To determine the relationship between the localization of the parathyroid glands and pathological diagnosis, as well as the prevalence of individual pathological diagnosis after surgery in patients with hyperparathyroidism. Methods: Analysis of retrospective-prospective database of 79 patiens who underwent parathyreoid-ectomy for hyperparathyroidism in the 7-year study period. Diagnostic methods were used to identify enlarged parathyroid glands as well as to determine their localization: ultrasound examination, scintigraphy and operative finding. Standard hematoxylin eosin staining was used for pathohistological diagnosis. A correlation analysis between parathyroid gland localization and pathohistological diagnosis was performed. Results: The median age of the patients were 51 age (range 20-73) and 67,1% of the patients were female. In the total number of surgically removed parathyroid glands (182), the most common pathohistological diagnosis was hyperplasia. Parathyroid adenoma was found in 21 cases. Other diagnoses (thyroid nodule / tissue, lymph node, thymus, cancer) were found in 11 cases, while a normal finding was found in 12 glands. Pathohistological diagnosis of hyperplasia and adenoma were more common in the lower parathyroid glands. Using the chisquare test, no association was found between pathohistological diagnosis and localization of enlarged parathyroid glands. Conclusion: The most common pathohistological diagnosis in hyperparathyroidism was hyperplasia and was most commonly found in the inferior parathyroid glands. Adenoma as pathohistological diagnosis is also most commonly found in the lower parathyroid glands, but without statistical significance.