Different therapeutic modalities in a patient with multiple spontaneously developed keloids: a case report

Keloids are benign tumors that usually develop as an excessive healing response to injury. They remain a challenging therapeutic problem to this day. Numerous treatment approaches are available, yet therapeutic results are often not satisfactory. A female patient with multiple spontaneously developed keloids on her trunk is presented. In this patient, four different therapeutic options were employed at different sites, with variable responses. The first option included cryotherapy, with poor effect. Slight flattening was observed after intralesional corticosteroid therapy. Treatment with excision followed by radiotherapy resulted in recurrence after 3 months. The best effect was noticed when excision and injection of corticosteroids into surgical margins were followed by radiotherapy. To the authors' knowledge, this is the first report of three-modal therapy in the management of keloids, which resulted in no recurrences over a 3-year follow-up

Evolution and Current Status of the Competitive Environment in the Serbian Banking Sector: Concentration Indices Analysis

This paper analyzes the degree of concentration and competition in the Serbian banking sector during the 2010-2017 period and in its current state, by considering the financial statements of banks for the years 2016 and 2017. For this purpose, both traditional concentration indicators (concentration ratio CRn and the Herfindahl-Hirschman index), and the relatively rarely used Linda indices have been used. The degree of concentration has been calculated based on five variables: total assets, deposits, capital, operating income of banks, and loans. The degree to which these indicators are compliant with the basic antitrust regulations has been illustrated. It has been demonstrated that in the current case of a relatively large number of banks operating in Serbia, the existing degree of concentration is relatively low. This provides suitable conditions for the development of healthy competition among them. However, the approximation of the indices to moderate concentration within the period analyzed warns of the appearance of oligopoly

New management practice in the hotel business – The case of the hotel Excelsior

The paper analyses the new management practice in the hotel industry. Over recent years, the environment for hotel management in Croatia has changed radically. Difficult business conditions require the transformation of management in the hotel industry. From the old-style business model, in which hotel managers were focused inwards on the hotel and its operation, a new paradigm encompassing a more externally oriented focus is now required. The current transformation of socially-owned hotels into capital-based and market-oriented business enterprises will accelerate the general process of privatisation and promote incentive management strategies. The article gives the research results of the new management practice in the case of the hotel "Excelsior" in Dubrovnik. It is one of the most successful hotels on the Croatian coast, which practises modern management. The research referred to management level, sex, age and educational structure of managers, their continuing education, knowledge, skills and characteristics of management, main functions of management, delegation of authorities and responsibilities, management system, decision-making, styles of leading and governing of managers by their time. The received results have been compared with the earlier management approach of the above-mentioned hotel. The objective of the paper is to point out the importance of the new management practice and its contribution to the successful hotel business

Incarcerated Diaphragmatic Hernia – Differential Diagnoses

The incarceration of diaphragmatic hernia is very rare. We present a case of a four-year old girl who developed the incarceration of left-sided diaphragmatic hernia, who, until then, was completely asymptomatic. This incarceration of the hernia represented a surgical emergency presenting as obstructive ileus and a severe respiratory distress which developed from what appeared to be full health. During a brief pre-operative examination a number of differential diagnoses were suggested. Along with the laboratory blood analysis (complete blood count and acid-base balance) a plain thoracic and abdominal radiography was done (babygram). After that, through an inserted nasal-gastric tube, barium meal of the upper gastrointestinal tract was done, showing abdominal organs in the left half of the thorax and a signifi cant shift of the mediastinum to the right. With an urgent upper medial laparotomy we accessed the abdominal cavity and made the correct diagnosis. An opening was shown in the rear part of the left hemi-diaphragm with thickened and edematous edges, approx. 6 cm in diameter with incarcerated content. The incarcerated abdominal organs (stomach, transversal colon, small intestine and spleen) gradually moved into the abdominal cavity. The opening was closed with nonresorptive sutures (TiCron) size 2-0 with a previous control and ventilated expansion of the well-developed left lung. In postoperative course the acid-base balance quickly recovered, as well as the general state of the patient and radiography showed a good expansion and lucency of the lung parenchyma and a return of the mediastinum into the middle part of the thorax

Korektivna dermatologija danas

The field of corrective dermatology has gained remarkable development in the past two decades. New heights in techniques and the growing interest in rejuvenation procedures have resulted in an increase in the number of corrective procedures all over the world. Here we present the most frequently performed corrective procedures in dermatology today: lasers, intense pulsed light, fillers, botulinum toxin, chemical peeling, radiofrequency, and dermabrasion. Currently, the most preferable procedures are those with early visible results, short ‘down-time’ and minimal risk of unwanted effects. Therefore, ablative resurfacing has been mostly replaced by nonablative and fractional resurfacing, while fillers and botulinum toxin have been ever more employed. The best cosmetic results can be achieved with combination of different corrective procedures.U posljednja dva desetljeća zabilježen je znatan razvoj u području korektivne dermatologije. Nova vrhunska postignuća u tehnikama i sve veće zanimanje za postupke podmlađivanja doveli su porasta broja korektivnih zahvata širom svijeta. U radu se prikazuju korektivni postupci koji se danas najčešće primjenjuju u dermatologiji, a to su laseri, intenzivno pulsno svjetlo, fileri, botulinski toksin, kemijski piling, radiofrekvencija i dermabrazija. Danas se prednost daje onim zahvatima kod kojih se razultati najbrže vide, koji imaju kratko vrijeme zastoja i minimalan rizik od neželjenih učinaka. Stoga je ablativno “presvlačenje” (resurfacing) uglavnom zamijenjeno neablativnim i frakcijskim “presvlačenjem”, dok se fileri i botulinski toksin rabe sve više. Najbolji kozmetski rezultati postižu se kombinacijom različitih korektivnih postupaka