The role of CBCT in the field of dental implantology

As radiology rapidly and continuously develops, dental radiological devices are becoming integral to dental practice. CBCT enables a precise three-dimensional image of the orofacial region. The wider use of CBCT devices is further encouraged by the flaws of two-dimensional radiological methods, especially concerning dental implantology. This paper aims to describe the advantages and disadvantages of using CBCT devices in planning and placing dental implants. It offers an insight into artifacts and radiation doses and their influence on the quality of the resulting image. The generation of multiplanar slices of the area of interest, the possibility of 3D reconstruction, the reduction of the magnification error, and the radiation dose are some of the important advantages of the CBCT device. A Limited FOV and volume of the screening, a low range of contrasts, measuring of bone density and shades of grayscale, as well as possible artifacts of movement are some of its disadvantages. Not only did the CBCT device find a purpose in the processes of planning and placement of dental implants, but also in postoperative assessments of healing and possible complications. CBCT balances the price and radiation dose and the quality of clinical information. It is used in oral surgery, orthodontics, periodontology, and endodontics. Due to its precision and quality, the CBCT device is the foundation of dental implantology

The investigation of plant species Alchemilla vulgaris L. and Satureja hortensis L: phytochemical profile and biological activity under in vitro and in vivo conditions : Ph. D. Thesis

REZIME: Predmet ove doktorske disertacije bila su fitohemijska i farmakološka ispitivanja biljnih vrsta Alchemilla vulgaris L. (familija Rosaceae) i Satureja hortensis L. (familija Lamiaceae), koje su prepoznate kao lekovite u tradicionalnoj medicini, ali su eksperimentalni podaci o njihovom hemijskom sastavu i biološkoj aktivnosti oskudni. Ciljevi ove studije bili su da se pomenute biljne vrste hemijski okarakterišu i da se procene njihovi biološki odgovori u in vitro i in vivo uslovima. Primenom hromatografije visokih performansi (UHPLC-DAD/(-)HESI-MS/MS) pokazano je da su metanolni ekstrakti nadzemnog dela i korena A. vulgaris i nadzemnog dela S. hortensis bogati fenolnim jedinjenjima, pre svega fenolnim kiselinama i flavonoidima. Elaginska kiselina predstavlja dominantno jedinjenje u ekstraktu nadzemnog dela A. vulgaris, dok je najzastupljenija komponenta ekstrakta korena iste biljke katehin-galat. Ruzmarinska kiselina, prisutna u koncentraciji 24,9 mg/g suvog ekstrakta, je jedinjenje u najvećem procentu prisutno u ekstraktu S. hortensis, u odnosu na ostala identifikovana jedinjenja iz grupe polifenola. Pored ovih jedinjenja, u analiziranim ekstraktima identifikovane su i veće količine flavona, flavanona, flavanola i njihovih derivata. Putem spektrofotometrijskih analiza, u ekstraktima je određen sadržaj ukupnih fenolnih jedinjenja, kao i pojedinih klasa polifenola. Rezultati pokazuju da su ispitivani ekstrakti veoma bogati ukupnim fenolnim jedinjenjima i da, aproksimativno, čine skoro više od trećine ekstrakata. Posebno se izdvajaju količine kondenzovanih tanina i fenolnih kiselina, dok je sadržaj monomernih i ukupnih antocijana u sva tri ekstrakta bio veoma nizak. U cilju procene antioksidativne aktivnosti, primenjeno je više različitih antioksidativnih testova u in vitro uslovima. Dobijeni rezultati pokazali su da se ekstrakti odlikuju visokom ukupnom antioksidantivnom aktivnošću. Uz to, ova tri ekstrakta su pokazala visok stepen neutralizacije DPPH i OH radikala, ABTS radikal katjona i inhibicije stvaranja lipidnih peroksida pri IC50 vrednostima nešto nižim ili u rangu onih dobijenih za dobro poznate prirodne (elaginska kiselina i katehin) i sintetske antioksidante (butilovani hidroksitoluen (BHT)). Pored toga, ekstrakti su pokazali i sposobnost redukcije feri jona, Fe3+, do fero oblika gvožđa, Fe2+. Međutim, ni jedan od tri analizirana uzorka ne pokazuje sposobnost heliranja jona metala.ABSTRACT: The aim of the presented Ph.D. thesis was to phytochemically and pharmacologically characterize two plants - Alchemilla vulgaris (family Rosaceae) and Satureja hortensis (family Lamiaceae), which have been applied as therapeutics in traditional medicine, but reports on their biological activity and chemical profile are scarce. Considering the mentioned, the main subjects of this Ph.D. thesis are a chemical analysis of the main compounds presented in these plants as well as their biological potential under both in vitro and in vivo conditions. The results obtained from high-performance liquid chromatography showed that methanol extracts of aerial parts and roots of A. vulgaris and aerial parts of S. hortensis are rich in phenolic compounds, especially in the phenolic acids and flavonoids contents. Ellagic acid has been identified as a main component in the aerial parts extract of A. vulgaris, while catechin-gallate was the major compound in the roots extracts from the same plant. Rosmarinic acid, presented in a high amount in the extract of aerial parts of S. hortensis (249 mg/g dry weight of extract) was the main active component of this extract. Among these compounds, other classes of phenolics, such as flavonols, flavones, flavanones, and their derivatives were also identified in all extracts. By spectrophotometric determinations, it can be concluded that the investigated extracts are rich in phenolic compounds – approximately one-third of all compounds in extracts were measured as polyphenols. Especially, the extracts possessed a significant number of condensed tannins and phenolic acids, while the content of anthocyanins (both monomeric and total) was negligible. Several methods have been applied in order to assess the antioxidant activity of A. vulgaris and S. hortensis extracts. High total antioxidant capacity was observed for all extracts. Besides, all tested extracts were found to possess strong ability to neutralize DPPH• и •OH radicals, ABTS•+ radical cation and to inhibit the lipid peroxidation process at IC50 concentrations similar or even lower than those obtained for well-known antioxidants from natural origin (ellagic acid and catechin) or synthetic antioxidants (butylated hydroxytoluene). Moreover, extracts showed pronounced ferric ion reducing power. However, the extracts did not show the ability to chelate transition metals

Insulin replacement therapy

Šećerna je bolest jedna od najkompleksnijih bolesti sadašnjice zbog svojih brojnih komplikacija te stalnog porasta oboljelih. Oboljeli od tipa 1 šećerne bolesti ne luče vlastiti endogeni inzulin te je nužno nadomjestiti ga terapeutski. Do otkrića inzulina, ova je bolest bila neizlječiva. Svrha je ovoga rada prikazati nadomjesno inzulinsko liječenje. Opisane su dostupne vrste inzulina, načini primjene te režimi doziranja. Inzulini se klasificiraju prema vremenu i načinu djelovanja. Primjenjuju se putem injekcija odnosno prijenosnih (pen) štrcaljki ili inzulinskih pumpi. U radu se opisuje razvoj umjetne gušterače koja djeluje obećavajuće za olakšavanje budućeg liječenja šećerne bolesti tipa 1. U novije vrijeme radi se i na razvoju alternativnih metoda primjene kao što su: oralni, transdermalni, nazalni, te inhalacijski. Poseban je naglasak stavljen na nadomjesno liječenje inzulinom intenziviranim režimom primjene. Prikazano je praktično izračunavanje bazal-bolus doze inzulina u intenziviranom režimu doziranja inzulina. Dan je kratak osvrt na pokušaje liječenja transplantacijom gušterače i Langerhansovih otočića te liječenje matičnim stanicama koje bi omogućile ponovno uspostavljanje endogenog lučenja inzulina u oboljelih. Takve vrsta liječenja sa sobom nosi posljedice zbog podvrgavanja kirurškom postupku te imunosupresivnog liječenja. Može se zaključiti kako je zlatni standard liječenja tipa 1 šećerne bolesti nadomjesno intenzivirano liječenje inzulinom. Provodi se bazal -bolus liječenje multiplim injekcijama inzulina ili uređajima s kontinuiranom supkutanom inzulinskom infuzijom takozvanim inzulinskim pumpama koje su za sada najrazvijeniji te najpovoljniji sustav liječenja. Najčešća je komplikacija intenziviranog inzulinskog liječenja hipoglikemija, no ona se najčešće može prevenirati te njezine posljedice umanjiti temeljitom i stalnom edukacijom pacijenta o praktičnoj primjeni inzulina. Ovakav tip nadomjesnog liječenja inzulinom s obzirom na inzulinske pripravke te način primjene zasada je zasigurno najbolji, ali nije u potpunosti zadovoljavajući te se i dalje se traga za pripravcima poboljšanih svojstava i razvoju novih pripravaka koji bi bili pogodni za nove načine primjene.Diabetes mellitus is one of the most complex diseases nowadays because of its many complications and permanent increase in number of patients. Patients who suffer from type 1 diabetes do not secrete endogenous insulin by their own and it is necessary to replace it therapeutically. Until the discovery of insulin, this disease was incurable. The aim of this paper is to present insulin replacement therapy. Available types of insulin, routes of administration and dosage regimes are described. Insulin is classified according to the time and mode of action. Insulin is administered by an injection or notebook (pen) syringe or insulin pumps.This paper describes the development of an artificial pancreas, which seems promising for the future treatment of type 1 diabetes.More recently alternative methods of administration have been developed, such as: oral, transdermal, nasal, and inhalation. Special emphasis was placed on the insulin replacement therapy by intensified regimen. The practical calculation of basal-bolus insulin dose is shown in the intensified regimen insulin dosing. There is a brief review of modern attempts of treatment by the transplantation of the pancreas and islets and stem cell treatment. Those methods would enable the re-establishment of endogenous insulin secretion in patients. This kind of treatment has consequences due to undergoing the surgical procedure and the immunosuppressive treatment.It can be concluded that the gold standard for treatment type 1 diabetes is replacement intensified insulin therapy. Basal-bolus therapy is conducted with multiple insulin injections or devices with continuous subcutaneous insulin infusion so-called insulin pumps, which are so far the most developed and the most suitable treatment system. The most common complication of intensive insulin therapy is hypoglycemia.This type of insulin replacement therapy with respect to insulin preparations and the method of administration is so far certainly the best, but is not fully satisfactory. Preparations with improved properties and the development of new compositions that would be suitable for new ways of administration are still being looked for

Path Analysis of Familial Resemblance in Blood Pressure in Middle Dalmatia, Croatia

The familial resemblance in blood pressure in Middle Dalmatia, Croatia, has been analyzed using the Path-analytic approach. The sample consisted of 1,126 examinees (526 males and 600 females, aged 17 to 87), inhabitants of the Middle Dalmatia’s islands of Bra~, Hvar, Kor~ula and the Pelje{ac peninsula. The Path analysis was performed with the assumption that each family member (father, mother, offspring 1 and 2) has a latent variable (C) that influences both the blood pressure values (P) and the morphological dimensions significantly correlated with blood pressure (Q). According to the estimates revealed from the most parsimonious models, the diastolic blood pressure has a more pronounced genetic component (h2 = 30–32%) than the systolic blood pressure (h2 = 15%). In contrast to the low intergenerational influences, the members of the same generation showed pronounced effects of shared environment. Common (non-transmitted) offsprings’ environment (B) explains 44% of variance of the individual offspring’s environment (C) in systolic and 33–35% in diastolic blood pressure. The correlation of father’s and mother’s environment (u2) was high in the case of diastolic blood pressure (33–44%) but for the systolic blood pressure it was not significantly different from zero. According to the presented results in insular/peninsular population of Middle Dalmatia, family resemblance of systolic and diastolic blood pressure differs. The resemblance is higher in diastolic blood pressure with stronger additive genetic component and stronger environmental and/or genetic component related with morphology. The sources of high heritability of diastolic blood pressure in Middle Dalmatia as well as the sources of high prevalence of hypertension in the same population are the phenomena that might be connected and thus deserve to be further explored in incoming analyses

Cost Management at Higher Education Institutions – Cases of Bosnia and Herzegovina, Croatia and Slovenia

Higher education expenditures persistently rise due to various economic, demographic and socio-cultural reasons. This caused repeated calls for reforms of the economic model in the higher education sector and dramatically increased the importance of the economic evaluations in the last decades due to concerns for efficiency. The above academic challenges led us to pioneering an attempt to evaluate the capabilities of financial management tools for three Western Balkan countries, i.e. Bosnia and Herzegovina, Croatia and Slovenia. The precondition for successful reform processes is certainly a comprehensive and high-quality accounting information system that meets not only the requirements of external reporting but also the requirements of internal users, especially the management of HEIs. In that context, the main aim of this paper is to overview the legal and organizational accounting systems' characteristics focusing on external and internal reporting requirements, and study the level of development and usage of cost accounting at HEIs in selected countries. Therefore, our paper employs research methodology based on the survey conducted. The results show great differences in legal and organizational characteristics of accounting systems among the countries as well as in the development stages of cost accounting systems, which mainly focus on inconsistent overhead allocation as well as different accounting basis usage. The research results confirm poorly conceptualised and structured reporting of accounting information for management purposes, offering several applicable platforms for creation of performance management approaches and strategies in the public sector

Javno zdravstvo i primarna zdravstvena zaštita: mogućnosti i izazovi

Public health and primary health care are two vital components of the sustainability of healthcare systems. Although their collaboration is crucial, their integration remains a major challenge for many countries worldwide. Public health primarily aims to prevent diseases and injuries at the population level, while primary health care provides basic healthcare system services to individuals, with health promotion at the very core of both. Although it is difficult today to draw clear boundaries between public health and primary health care, as there is much overlap, there is an obvious gap between them. The path to successful collaboration between public health and primary health care requires an understanding of their respective roles and responsibilities, communication and coordination strategies, and the development of shared goals and values, and only through such successful collaboration is it possible to achieve their integration. By leveraging their respective strengths and working together, public health and primary health care can optimise resource utilisation, enhance health outcomes, and foster health equity, ultimately leading to universal health coverage, which is the first path to sustainability. One key connecting element between public health and primary health care is disease prevention, which can serve as their bridge. Through collaborative efforts, these fields can develop comprehensive strategies to address the social determinants of health, promote healthy behaviours, and ensure equitable access to high-quality healthcare system services. By adopting an integrated approach, this collaborative effort can enhance health outcomes, mitigate disease burdens, and advances health equity for both the population and individuals.Javno zdravstvo i primarna zdravstvena zaštita dvije su ključne sastavnice održivosti zdravstvenih sustava. Iako je njihova suradnja ključna, njihova integracija i dalje je velik izazov za mnoge države diljem svijeta. Javno zdravstvo prvenstveno ima za cilj sprječavanje bolesti i ozljeda na razini stanovništva, dok primarna zdravstvena zaštita pruža osnovne usluge zdravstvenog sustava pojedincima, pri čemu oboje u svojoj samoj srži imaju promicanje zdravlja. Iako je danas teško povući jasnu granicu između javnog zdravstva i primarne zdravstvene zaštite jer se uveliko preklapaju, očit je jaz između njih. Put do uspješne suradnje između javnog zdravstva i primarne zdravstvene zaštite zahtijeva razumijevanje njihovih uloga i odgovornosti, komunikacijske i koordinacijske strategije te razvoj zajedničkih ciljeva i vrijednosti, a samo takvom uspješnom suradnjom moguće je ostvariti njihovu integraciju. Iskorištavanjem svojih snaga i zajedničkim radom, javno zdravstvo i primarna zdravstvena zaštita mogu postići najbolju iskoristivost dobara, poboljšati zdravstvene ishode te poticati zdravstvenu pravednost, što u konačnici dovodi do sveopće zdravstvene pokrivenosti koja je prvi korak na putu ka održivosti. Jedna od ključnih poveznica između javnog zdravstva i primarne zdravstvene zaštite jest sprječavanje bolesti, što može poslužiti kao njihov most. Kroz zajedničke napore, ova područja mogu razviti sveobuhvatne strategije za rješavanje društvenih odrednica zdravlja, promicanje zdravog ponašanja i osiguranje ravnopravnog pristupa visokovrsnim uslugama zdravstvenog sustava. Primjenom integriranog pristupa, ovaj zajednički napor može poboljšati zdravstvene ishode, ublažiti opterećenje bolestima te poboljšati zdravstvenu jednakost kako za stanovništvo tako i za pojedince

Morfološke i hemodinamske karakteristike vertebralnih arterija kod muškaraca i žena

Introduction: Men and women differ in diameters and MBFVs in VAs. Aim: to compare morphology and hemodynamics of VAs between sexes. Patients and methods: We examined 155 subjects using a linear 7.5 MHz probe (Aloka Prosound SSD-5500). Measurements were obtained at the V2 segment of VAs. Criteria: VA diameter of 2-4mm, systolic MBFVs of 0.35-0.70m/s, normal resistance pattern. Investigated parameters: diameters of VAs, MBFVs in VAs, sum of VA diameters, sum of MBFVs in VAs, diameter of the narrower and wider VA, and age. Results: 68 men and 87 women; 88 with a dominant left VA (56% of men and 58% of woman), 11 (7%) showed no dominance. Group differences: men had both VAs wider, and a larger diameter of the “wider” VA. There were no differences in MBFVs between men and women. Conclusion: Left VA is dominant in both sexes. There was no difference in MBFVs among sexes. Men have a wider VA than women.Uvod: Muškarci i žene se razlikuju u promjerima i srednjim brzinama strujanja krvi (SBSK) u vertebralnim arterijama (VA). Cilj: usporediti morfologiju i hemodinamiku VA među spolovima. Ispitanici i metode: Pregledali smo 155 osoba upotrebom linearne sonde 7,5 mHz (Aloka Prosound SSD-5500). Mjerenja su vršena u V2 segmentu VA. Kriteriji: VA dijametar 2-4mm, sistoličke SBSK 0,35-0,70m/s, normalan otpor. Mjereni parametri: promjeri VA, SBSK u VA, ukupni promjeri VA, ukupne SBSK u VAs, promjeri “uže” i šire VA, i dob. Rezultati: 68 muškaraca i 87 žena; 88 dominantnih lijevih VA (56% muškaraca i 58% žena), 11 (7%) bez dominacije. Razlike među grupama: muškarci imaju šire obje VA i promjer “šire” VA. Nije bilo razlika u sbsk među spolovima. Zaključak: Lijeva VA je dominantna u oba spola, nema razlika u SBSK među spolovima. Muškarci imaju šire VA od žena

Zdravstveno rizična ponašanja i zdravlje stanovništva Hrvatske starijeg od 50 godina

Recent data indicate that self-rated health among Croatians is substantially lower, and the gender gap more pronounced, than the EU28. Thus, our study aims to test the sex-specific associations of various health-risk characteristics with subjective and objective health in the Croatian population aged 50 and older (2,436 individuals, cross-sectional SHARE Wave 6 dataset). The logistic regression analyses were performed on health-risk behaviours (nutrition, physical activity, smoking, and alcohol consumption), together with the selected socioeconomic variables and the quality of life scale (CASP-12). The study revealed the importance of vigorous physical activity and the CASP score as being consistently relevant for objective and subjective health in both sexes. Univariate associations of the majority of health- -risk behaviours and health have disappeared from the multivariate model; we have thus concluded that they are often a proximate reflection of underlying economic and psychosocial factors. Furthermore, our findings support the necessity of country-specific health-risk research since the relevance of particular health risks can be considered culturally specific.Noviji podaci pokazuju da je samoprocjena zdravlja stanovnika Hrvatske značajno niža i da je razlika po spolu naglašenija nego u EU28. Stoga je cilj ove studije bio ispitati odnos raznih karakteristika povezanih sa zdravljem sa dva pokazatelja zdravlja (subjektivnog i objektivnog) u stanovništvu Hrvatske starijem od 50 godina (2436 osoba, presječno istraživanje studije SHARE, 6. val). Analize logističke regresije napravljene su primjenom značajki ponašanja (prehrana, tjelesna aktivnost, pušenje, konzumacija alkohola), uz uključivanje odabranih društvenih i ekonomskih varijabli, te skale procjene kvalitete života (CASP-12). Nalazi upućuju na važnost intenzivne tjelesne aktivnosti i samoprocjene kvalitete života (CASP skala) kao dva obilježja koja su se konzistentno pokazala važnima za objektivno i subjektivno zdravlje u oba spola. Kako je univarijatna povezanost većine ispitivanih elemenata ponašanja i zdravlja nestala u multivarijatnom modelu, zaključujemo da je takva povezanost samo neposredan odraz ekonomskih i psihosocijalnih čimbenika koji stoje u podlozi određenoga zdravstveno rizičnog ponašanja. Rezultati ove studije pružaju dodatni argument za potrebu provedbe istraživanja zdravstvenih rizika unutar svake države posebno, jer je važnost određenih obilježja očito kulturno specifična

DEMOGRAFSKO STARENJE U ŠIBENSKO-KNINSKOJ ŽUPANIJI

U radu se razmatra demografska dinamika na prostoru Šibensko-kninske županije s posebnim osvrtom na demografsko starenje. Na temelju posljednjeg popisa stanovništva 2011. godine analizira se više demografskih pokazatelja: dobno-spolna struktura, prosječna starost, indeks starenja, koefi cijent starosti, koefi cijent dobne ovisnosti i koefi cijent feminiteta, te stupanj ostarjelosti stanovništva županije. Podatci se analiziraju i na razini gradova i općina Šibensko-kninske županije u razdoblju 1971.-2011. godine, te se razmatra projekcija demografskih promjena do 2030. godine. Stanovništvo Šibensko-kninske županije ima obilježje vrlo duboke demografske starosti, što je posljedica kombiniranih utjecaja pada nataliteta/fertiliteta, dugotrajnog iseljavanja, te izravnog i neizravnog utjecaja Domovinskog rata. Prema demografskim projekcijama, Šibensko-kninska županija pokazuje trend daljnjeg smanjivanja broja stanovnika, te daljnje starenje stanovništva. Istodobno, prema procjenama se očekuje daljnje demografsko pražnjenje ruralnih naselja