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Low - grade chondrosarcomas are primary malignant bone tumors that are resistant to chemo- and radiotherapy and are treated surgically. Sacral localization makes surgical resection technically difficult due to position, anatomic structures involved, and large tumor size at detection. The risk of complications is high. We present the introduction of a novel surgical technique in our country, sacrectomy with ilio-lumbar stabilization. This was performed on a 67-year-old man with low-grade chondrosarcoma of the sacrum with sacroiliac joint involvement. The procedure was performed via an antero-posterior approach in two stages. Ilio-lumbar fixation with a mesh cage bridge was used to obtain spinopelvic continuity and stability. Sacrectomy is a technically demanding procedure that requires careful preoperative planning and a multidisciplinary approach, as well as high level of surgical experience.

Aim: To investigate the association between maternal post-traumatic stress disorder (PTSD) during pregnancy and offspring DNA methylation and cortisol levels. Materials & methods: Blood genome-wide DNA methylation and cortisol was measured in the youngest child of 117 women who experienced sexual violence/torture during the Kosovo war. Results: Seventy-two percent of women had PTSD symptoms during pregnancy. Their children had higher cortisol levels and differential methylation at candidate genes ( NR3C1, HTR3A and BNDF) . No methylation differences reached epigenome-wide corrected significance levels. Conclusion: Identifying the biological processes whereby the negative effects of trauma are passed across generations and defining groups at high risk is a key step to breaking the intergenerational transmission of the effects of mental disorders.

Maternal stress during pregnancy is associated with differential DNA methylation in offspring and disrupted cortisol secretion. This study aimed to determine methylation signatures of cortisol levels in children, and whether associations differ based on maternal post-traumatic stress disorder (PTSD). Blood epigenome-wide methylation and fasting cortisol levels were measured in 118 offspring of mothers recruited from the Kosovo Rehabilitation Centre for Torture Victims. Mothers underwent clinically administered assessment for PTSD using Diagnostic and Statistical Manual of Mental Disorders. Correlations between offspring methylation and cortisol levels were examined using epigenome-wide analysis, adjusting for covariates. Subsequent analysis focussed on a priori selected genes involved in the hypothalamic–pituitary–adrenal (HPA) axis stress signalling. Methylation at four sites were correlated with cortisol levels (cg15321696, r = −0.33, cg18105800, r = +0.33, cg00986889, r = −0.25, and cg15920527, r = −0.27). In adjusted multivariable regression, when stratifying based on prenatal PTSD status, significant associations were only found for children born to mothers with prenatal PTSD (p

In this article, we present, as participants and observers, an analysis of the social and political impact of the 2015 art installation “Mendoj Për Ty” [Thinking of You], dedicated to survivors of wartime sexual violence in Kosovo. We argue that art possesses an extraordinary power to unveil the “public secret” of wartime rape, as well as produce a “reparative” reading of the past, creating solidarity for, and recognition of, survivors, which simultaneously empowers them and their advocates. We also confirm the crucial role of women’s networks and subjectivity to the inclusion of women’s perspectives for effective transitional justice.

Purpose The purpose of this paper is to explore the association between the quality of prison life and mental health among prisoners and the occurrence of violence. Design/methodology/approach In total, 203 prisoners from Dubrava Correctional Center in Kosovo participated. Data on background characteristics of the prisoners, quality of prison life, mental health symptoms and exposure to physical, psychological and sexual violence were collected through interviewer-administered questionnaires. Data were analyzed using general linear models (GLM) and manual backwards model search with step-wise exclusion. Findings The GLM analysis showed a significant negative association between anxiety symptom load (−1.4), physical violence (−1.5) and psychological violence (−1.9), and quality of prison life. Furthermore, it appeared that prisoners rating of quality of life (QoL) increased with time among prisoners not exposed to violence, while this was not seen among prisoners exposed to violence. Finally, there was an inverse association between the dimensions of respect, fairness, humanity and good staff/prisoner relations, and the proportion of prisoners exposed to violence. Originality/value An environment with higher levels of respect, fairness, humanity and good relations between staff and prisoners was associated with lower levels of violence. Hence, a prison that focuses on promoting QoL and good mental health among prisoners will show lower levels of violence, thereby making the prison a more tolerable place for the prisoners and a better working environment for prison staff.

The goal of the current study was to examine types of exposure to traumatic events and affective and anxiety disorders of 81 civilian war survivors seeking treatment for war-related stress almost one decade following the war in the area of former conflict. Furthermore, the study investigated changes in symptoms of mental health and in well-being amongst these individuals during a treatment period of 6 months. The results indicated that civilian war survivors seeking treatment reported multiple war-related traumatic events and high levels of psychiatric morbidity. Individuals assessed at follow-up (n = 67) reported no change in post-traumatic stress symptoms or psychological well-being, but improvement in symptoms of depression, overall psychiatric distress and quality of life. The only significant difference between participants classified as achieving clinically significant improvement as compared with those who did not achieve such change was in less symptom severity of depression, post-traumatic stress, general distress and higher psychological well-being at the time of first assessment. Neither the assessment of initial diagnoses nor war or post-war trauma types emerged as significantly different amongst the two groups.

Liposarcoma is a neoplasm of mesodermic origin derived from adipose tissue and represents the most frequent histopathological variety of the retroperitoneum. Retroperitoneal liposarcoma may grow to a large size without symptoms. Approximately 20% of the tumours are10 cm at the time of diagnosis and may reach extremely giant dimensions.We present the case of a 58-year-old woman with a giant retroperitoneal liposarcoma. The patient presented at our clinic with diffuse abdominal pain and enormous abdominal distension. She had swellings and redness of the right leg. CT scan revealed a 50×25 cm sized enhancing soft mass. Ultrasound guided biopsy was negative for the presence of malignant cells. A double "J" ureteral stent was placed in the right ureter. We performed surgery with complete resection of the tumorous mass without multiorgan resection and with macroscopic free margins. A well differentiated, lipoma-like subtype of retroperitoneal liposarcoma, weighing 13.4 kg, was diagnosed in the histopathological report. At 6 months after surgery a new CT scan was done and there was no evidence of recurrence. Currently, after 12 months of follow-up, the patient is asymptomatic and disease free.Surgery is the gold standard for treatment of retroperitoneal liposarcomas, well differentiated retroperitoneal liposarcomas, that have a minimal metastatic potential. It is preferable to place a ureteral stent before surgery for minimizing the risk of intraoperative lesions of ureters. Symptoms in lower extremities, such as swelling, redness and others, that are due to compression in the retroperitoneum by giant tumours, can disappear after their surgical removal.

The substantial impact of the war in Kosovo has been documented by earlier research performed shortly after the war, but only limited data on the long term mental health impact have been published so far, mostly limited to posttraumatic stress (PTSD). The present study is aimed at extending the focus to a major question so far neglected in most post-conflict zones, namely that of depression and suicidal ideation.The present study was based on a representative country-wide survey (n=1161) , using subscales for suicidal behaviour in the General Health Questionnaire (GHQ), comparing results with the corresponding Hopkins Symptom Checklist (HSCL-25) items and the Harvard Trauma Questionnaire (HTQ) to assess war related experiences and PTSD symptomatology. Irrespective of age, gender or education, subjects in rural areas had higher suicide ideation scores, 41.7% of respondents met criteria for moderate to severe depressive symptomatology, 41.6% for clinical anxiety. Unemployment (83.7%), and high PTSD scores were associated with suicidal ideation scores, the last contingent on depressive mood. It is concluded, that suicidal ideation linked to both past stressful experience and present social stressors is a question to be considered in mental health care plans in post-conflict zones. Under-recognition could be expected to result in increasing suicidal behaviour. Ideation also indicates, especially in the context of high post-traumatic stress and depression rates, exhaustion and despair that need to be addressed by more general interventions than individual Psychotherapeutic treatment.