Crosstalk between dietary patterns, obesity and nonalcoholic fatty liver disease

The prevalence of nonalcoholic fatty liver disease (NAFLD) is rising worldwide, paralleling the epidemic of obesity. The liver is a key organ for the metabolism of proteins, fats and carbohydrates. Various types of fats and carbohydrates in isocaloric diets differently influence fat accumulation in the liver parenchyma. Therefore, nutrition can manage hepatic and cardiometabolic complications of NAFLD. Even moderately reduced caloric intake, which leads to a weight loss of 5%-10% of initial body weight, is effective in improving liver steatosis and surrogate markers of liver disease status. Among dietary patterns, the Mediterranean diet mostly prevents the onset of NAFLD. Furthermore, this diet is also the most recommended for the treatment of NAFLD patients. However, clinical trials based on the dietary interventions in NAFLD patients are sparse. Since there are only a few studies examining dietary interventions in clinically advanced stages of NAFLD, such as active and fibrotic steatohepatitis, the optimal diet for patients in these stages of the disease must still be determined. In this narrative review, we aimed to critically summarize the associations between different dietary patterns, obesity and prevention/risk for NAFLD, to describe specific dietary interventions’ impacts on liver steatosis in adults with NAFLD and to provide an updated overview of dietary recommendations that clinicians potentially need to apply in their daily practice

Etika i marketing u estetskoj stomatologiji

Contemporary dentistry is, first of all, characterized by diverse accelerated development, owing to improvements of information and other technologies, as well as the development of dental materials (shape-memory biomaterials, nanomaterials, biomaterials for application in tissue engineering, etc.). Expert doctrinaire attitudes move from the direction of operative interventions, whereby disease and acute symptoms are primarily treated, towards the strengthening of oral health by minimally invasive procedures. A particular place in patients’ total rehabilitation belongs to numerous esthetic procedures which, to a large extent, make up a wants-based service, led by the patients’ needs and affinities. This paper deals with differences between cosmetic and esthetic dentistry. The complexity of esthetic dentistry, which favors therapy with the change of function parameters in care for the patient, is emphasized. On the other hand, more attention is paid to the need to know and respect ethical and marketing principles that follow any activity of dentists, starting from the first contact with the patient, the selection of certified materials, to the implementation of the appropriate treatment plan. Well-directed communication and comprehensive awareness of the patient, the use of the visual analog scale, consideration of realistic resources in therapy, and the acceptance of de Bono model of adopted parallel thinking are determinants which help dentists define a problem adequately, find quality solutions, open alternative solutions, and reduce the potential risks in patients’ therapy.Današnju stomatologiju karakteriše ubrzani razvoj zahvaljujući unapređenju informacionih i drugih tehnologija, kao i razvoju dentalnih materijala (biomaterijali sa memorisanim oblikom, nanomaterijali, biomaterijali za primenu u tkivnom inženjeringu i dr.). Stručni doktrinarni stavovi kreću se iz pravca operativnih intervencija, kojima se primarno saniraju bolest i akutni simptomi, ka jačanju oralnog zdravlja malo invazivnim postupcima. Posebno mesto u sveukupnoj rehabilitaciji bolesnika pripada brojnim estetskim procedurama, koje u velikoj meri čine praksu vođenu potrebama i afi- nitetima bolesnika. U radu se diskutuje o razlikama u poimanju kozmetske i estetske stomatologije. Naglašena je složenost estetske stomatologije, koja daje prednost terapiji sa promenom funkcijskih parametara u zbrinjavanju bolesnika. S druge strane, akcenat se stavlja na potrebu poznavanja i poštovanja etičkih i marketinških načela koja prate svaku aktivnost lekara, počev od prvog kontakta sa bolesnikom, odabira sertifikovanog materijala do realizacije odgovarajućeg terapijskog plana. Dobro usmerena komunikacija i sveobuhvatna informisanost bolesnika, upotreba VAS skale, kao i sagledavanje realnih resursa u terapiji odrednice su koje pomažu stomatologu da definiše problem na pravi način, iznađe kvalitetna rešenja, otvori alternativne solucije i smanji moguće rizike u terapiji bolesnika

Uloga okluzije u nastanku temporomandibularnih disfunkcija

Introduction. The influence of occlusal condition at the onset of temporomandibular disorders (TMD) has been strongly debated for many years and still is the source of controversy. Up to the eighties in the last century, the occlusal factors such as the presence of uncured malocclusions, discrepancies between intercuspal position and retruded contact position greater than two millimeters, retrusive and nonworking side interferences and loss of posterior teeth were considered to be the primary causes of TMD. Objective. The aim of this study was to estimate the role of occlusal factor in the etiology of craniomandibular dysfunction and therapeutic effects of irreversible occlusal therapy (occlusal equilibration) in patients with TMD. Methods. In the investigation we studied a group of 200 men and women. The average age of the selected patients was between18 and 25 years. The purpose of TMD signs and symptoms was confirmed in every patient using a special functional analysis and evaluating the craniomandibular index (CMI) according to Fricton and Schiffman. The value of craniomandibular index was determined in the group of 15 patients with signs and symptoms of temporomandibular dysfunction. In the study groups occlusal equilibration (selective grinding) was performed according to Okeson using the central position of the mandible as the referent position in the occlusal therapy. The value of CMI was determined before and 30 days after occlusal equilibration. Results. The results of this study confirmed the significant reduction in the signs and symptoms of TMD after occlusal equilibration. The statistical elaboration of the differences between the values of CMI I (before treatment) and CMI II (30 days after treatment) revealed highly significant differences. The CMI I values in the group ranged between 0.076 and 0.346 with the mean value of 0.188±0.082.The values of CMI II ranged between 0.038 and 0.19 with the mean value of 0.038±0.053. Conclusion. The study conformed the validity of irreversible occlusal therapy (selective grinding) in patients with TMD.Uvod. Uloga okluzivnih disharmonija u nastanku temporo-mandibularnih disfunkcija (TMD) i dalje je pitanje u stručnoj literaturi i kliničkoj praksi koje ostaje bez odgovora. Do osamdesetih godina dvadesetog veka okluzivni faktori, kao što su određene malokluzije, razlike između retrudovanog kontaktnog položaja i interkuspalnog položaja veće od 2 mm, okluzivne smetnje (posebno mediotruzijske i retruzijske) i gubitak bočnih zuba, smatrali su se glavnim etiološkim faktorima u nastanku TMD. Cilj rada. Cilj rada je bio da se utvrdi uloga okluzivnih faktora u razvoju TMD i oceni uspeh primene ireverzibilne okluzivne terapije (selektivno brušenje) kod osoba sa TMD. Metode rada. U svrhu istraživanja pregledano je 200 osoba oba pola uzrasta 18-25 godina. Znaci i simptomi TMD su vrednovani na osnovu posebne funkcionalne analize i izraženi kraniomandibularnim indeksom (CMI) po Friktonu (Fricton) i Šifmanu (Schiffman). Na osnovu ovoga indeksa formirana je studijska grupa koju je činilo 15 ispitanika sa znacima i simptomima TMD. Kod njih je urađeno selektivno uklanjanje okluzivnih smetnji brušenjem prema metodi Oksona (Okeson) korišćenjem centralnog položaja kao referentnog položaja tokom okluzivne terapije. Vrednovanje CMI je ponovljeno trideset dana nakon okluzivnog uravnoteženja. Rezultati. Rezultati istraživanja su pokazali značajno smanjenje znakova i simptoma TMD posle okluzivnog uravnoteženja. Statističkom analizom je utvrđeno da između vrednosti CMI pre lečenja (CMI I) i trideset dana kanije (CMI II) postoji statistički značajna razlika. Vrednost CMI I bila je između 0,076 i 0,0346, dok je srednja vrednost bila 0,188±0,082. Vrednost CMI II bila je između 0,038 i 0,19, a srednja vrednost 0,038±0,053. Zaključak. Ova studija je potvrdila značaj ireverzibilne okluzivne terapije (selektivno brušenje) kod osoba sa TMD

Korelacija stepena konverzije i količine oslobođenih supstanci iz dentalnih kompozitnih cemenata

This study examined the possible correlation between the degree of conversion (DC) and the amount of substances eluted from three commercial cured resin-based cements. The DC of the various resin-based cements was measured by Raman spectroscopy, while the quantity of unreacted monomers released from the cement matrix (triethylene glycol dimethacrylate, TEGDMA, urethane dimethacrylate, UDMA, 2-hydroxyethyl methacrylate, HEMA and bisphenol A) was determined by high pressure liquid chromatography (HPLC). The obtained results, after multiple statistical evaluation (one way ANOVA, LSD post hoc test), showed no significant differences in the DC values between the resin cements. On the contrary, the results of the HPLC analysis depicted statistically significant differences between the three materials with respect to the amount of leached monomers. In addition, no correlation between the DC and the amount of eluted substances from the tested cured composite cements was found.Rad istražuje moguću korelaciju stepena konverzije (DC) i količine oslobođenih monomernih supstanci iz tri komercijalna preparata kompozitnih dentalnih cemenata. Stepen konverzije kompozitnih cemenata određen je metodom Raman spektroskopije, dok je količina neizreagovalih i oslobođenih monomera iz cementnog matriksa detektovana pomoću HPLC metode. Rezultati dobijeni nakon višestruke statističke evaluacije (one way ANOVA, LSD past hoc test) ne pokazuju značajne razlike u stepenu konverzije različitih preparata kompozitnih cemenata. Nasuprot tome, rezultati HPLC analize beleže značajne razlike u količini i vrsti monomernih supstanci otpuštenih iz kompozitnih cemenata. Takođe, statistička analiza u okviru ove studije nije pokazala korelaciju stepena konverzije ispitivanih kompozitnih dentalnih cemenata i količine oslobođenih supstanci iz ovih materijala

Protokoli u klasifikaciji krezubosti

This paper shall discuss the importance of protocol application in modern dentistry. Literature data that include recommendations and consensuses in dental practice point out to their presence in available literature, printed papers, reviewed journals and supplements in the form of expert group conclusions. It should be noted that the protocols most commonly rely on valid postulates of different branches of medicine, supported by specific conditions of the environment in which they are implemented. Additionally, in our settings, applicable dentistry protocols are the result of requirements that institutions and practices should fulfill according to renewable accreditation, as well as following recommendations given in the good clinical practice guidelines with different binding obligations levels. Certain protocols offer therapeutic modalities categorized into classes intended to help users to select appropriate treatments. The second part of this paper shall address one such protocol which classifies partially edentulous patients. The emphasis is on the partial edentulism classification recommended by The American College of Prosthodontists (ACP), which relies on four diagnostic criteria essential for therapeutic decision. Edentulous areas location and extent, abutment teeth health, occlusion model, and residual ridge characteristics represent the parameters which have defined the four classes of partial edentulism of different complexity. In this way, comprehensive approach to the clinical status of the patients has, for the first time been offered to the dental practitioners assuring, among others, higher uniformity of professional attitudes in selection of therapeutic modalities.U radu se diskutuje o značaju primene protokola u savremenoj stomatologiji. Literaturni podaci koji obuhvataju preporuke i konsenzuse u stomatološkoj praksi govore o njihovoj prisutnosti u dostupnim knjigama, štampanim radovima u recenziranim časopisima, i dodacima časopisa kao zaključci ekspertskih grupa. Treba primetiti da su protokoli najčešće oslonjeni na validne postulate različitih medicinskih grana, pomognuti specifičnim uslovima sredine u koju se implementiraju. Dodatno, u našim uslovima, protokoli u stomatologiji su rezultat zahteva koje institucije i prakse moraju da ispunjavaju shodno obnovljivoj akreditaciji, kao i poštovanja preporuka koje su date u vodičima dobre kliničke prakse različitog nivoa obaveznosti. Pojedini protokoli nude terapijske modalitete koji se kategorizuju u klase, pomažući korisnicima u izboru pravog tretmana. O jednom od takvih protokola koji klasifikuje krezube pacijente govori drugi deo rada. Akcenat je na primeni klasifikacije krezubosti koju je preporučio Američki koledž protetičara, a koja se oslanja na četiri dijagnostička kriterijuma, bitna za terapijsku odluku. Lokalizacija i veličina bezubih polja, stanje zdravlja zuba nosača, model okluzije i karakteristike rezidualnog grebena su parametri koji su definisali četiri klase krezubosti različite složenosti. Tako je, prvi put, stomatološkoj praksi ponuđen ozbiljan, sveobuhvatni pristup kliničkom statusu bolesnika, koji obezbeđuje, između ostalog, i uniformnije stručne stavove u izboru terapijskih modaliteta

Higher degree of dysfunctional attitudes and beliefs and higher scores of frustration intolerance in women with unsuccessful weight loss

Background/Aim. Obesity is a chronic and relapsing condition, and since recently, it has been considered a global epidemic. Current guidelines for tripartite treatment of obesity emphasize a program of lifestyle modifications such as medical nutrition therapy, aerobic exercise, and behavioral intervention. The aim of the study was to evaluate whether specific psychological factors (general attitudes and beliefs and frustration tolerance) could be predictors of successful weight loss, i.e., factors that can be further addressed as part of the integrated therapy approach. Methods. A total of 84 consecutive overweight and obese female participants who were apparently healthy and homogeneous in age, level of education, and marital or employment status were prescribed the same medical nutrition therapy protocol as a single six-month therapeutic intervention. Prior to starting the therapy, the General Attitude and Belief Scale (GABS) and the Frustration Discomfort Scale (FDS) were administered. The participants were divided into two groups: successful (group A) and unsuccessful (group B). Group A, or the successful group [with the mean body mass index (BMI) ± standard deviation (SD) of 24.1 ± 5.81 kg/m2], consisted of 40 participants who have reached the corresponding loss, i.e., they lost ≥ 10% of the starting body weight (BW). Group B, or the unsuccessful group (with the mean BMI ± SD of 28.51 ± 2.74 kg/m2), consisted of 44 participants who have not reached the corresponding loss, i.e., they lost < 10% of the starting BW. Results. Participants in group B had significantly higher scores (p < 0.05) on the GABS subscales for the Need for Approval, Need for Comfort, and Other Downing. A statistically significant difference between groups (p < 0.05) was shown for FDS subscales of Emotional Intolerance, Entitlement, and Achievement Frustration. Conclusion. Results of our study showed that participants who were unsuccessful in medical nutrition therapy had a higher degree of dysfunctional attitudes and beliefs and higher scores of frustration intolerance when compared to successful participants. The recommendation, based on our results, would be to include psychotherapeutic techniques in the integrative obesity treatment, aimed at cognitive changes and increasing frustration tolerance

Liver disease and COVID-19: The link with oxidative stress, antioxidants and nutrition

Varying degrees of liver injuries have been reported in patients infected with the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). In general, oxidative stress is actively involved in initiation and progression of liver damage. The liver metabolizes various compounds that produce free radicals. Maintaining the oxidative/antioxidative balance is important in coronavirus disease 2019 (COVID-19) patients. Antioxidant vitamins, essential trace elements and food compounds, such as polyphenols, appear to be promising agents, with effects in oxidative burst. Deficiency of these nutrients suppresses immune function and increases susceptibility to COVID-19. Daily micronutrient intake is necessary to support anti-inflammatory and antioxidative effects but for immune function may be higher than current recommended dietary intake. Antioxidant supplements (βcarotene, vitamin A, vitamin C, vitamin E, and selenium) could have a potential role in patients with liver damage. Available evidence suggests that supplementing the diet with a combination of micronutrients may help to optimize immune function and reduce the risk of infection. Clinical trials based on the associations of diet and SARS-CoV-2 infection are lacking. Unfortunately, it is not possible to definitively determine the dose, route of administration and best timing to intervene with antioxidants in COVID-19 patients because clinical trials are still ongoing. Until then, hopefully, this review will enable clinicians to understand the impact of micronutrient dietary intake and liver status assessment in COVID-19 patients

Thermographic Properties of Up-conversion Emission of Y2O3:Yb, Er Nanophosphors Obtained through Hydrothermal Synthesis

Thermographic phosphors are oxides doped With rare-earth or transition metal ions that will emit visible, Infrared, or UV light upon excitation from an external energy source This materials have received significant attention due to the potential application as optical temperature sensor In this report, we have investigated yttrium oxide co-doped with changeable ytterbium to erbium ratio (Y1.94YbO.05Er001 and Y1 97YbO 02ErO 01) fabricated through hydrothermal synthesis Process conditions (2h, 200 'C) and additional thermal treatment (3h, 1100 'C) allows obtaining nanoparticles of appropriate composition and morphology which further affect on improved photoluminescent characteristics. The fluorescence Intensity ratio (FIR) technique is used to examine potential usage of samples as low temperature sensors. This optical method is based on ratio between two emission lines or areas In photoluminescence spectrum which show temperature dependence. Photoluminescent measurements (PL) are recorded In the temperature range from 10K to 300 K under 978 nm exciting wavelength Observing changes In following transitions blue 2H912~4115/2, green (2H1112, 4S3/2) ~ 411512 and red 4F912~4115/2 Obtained experimental results imply that the fluorescent intensity ratio of the blue, green and red lines and areas show significant temperature sensitivity and can be used as low temperature sensor

Dilemmas in zirconia bonding: A review

This article presents a literature review on the resin bond to zirconia ceramic. Modern esthetic dentistry has highly recognized zirconia, among other ceramic materials. Biocompatibility of zirconia, chemical and dimensional stability, excellent mechanical properties, all together could guarantee optimal therapeutical results in complex prosthodontic reconstruction. On the other hand, low thermal degradation, aging of zirconia as well as problematic bonding of zirconia framework to dental luting cements and tooth structures, opened the room for discussion concerning their clinical durability. The well known methods of mechanical and chemical bonding used on glass-ceramics are not applicable for use with zirconia. Therefore, under critical clinical situations, selection of the bonding mechanism should be focused on two important points: high initial bond strength value and long term bond strength between zirconia-resin interface. Also, this paper emphases the use of phosphate monomer luting cements on freshly air-abraded zirconia as the simplest and most effective way for zirconia cementation procedure today