Prevalence and severity of TMD in orthodontic patients

Introduction Temporomandibular disorder (TMD) is a collective term for numerous symptoms, with the most common being masticatory muscle pain, pain in temporomandibular joints, limited mouth opening, irregular jaw movements, headaches and sound effects in TMJ. The aim was to determine the prevalence and severity of TMD in orthodontic patients determining whether the type of malocclusion affects the prevalence and severity of TMD. Material and Methods The study was conducted in the form of Fonseca Anamnestic Index, which classifies TMD severity among examinees (no TMD, mild, moderate and severe TMD). The experimental group consisted of orthodontic patients with confirmed malocclusions, while the control group consisted of dental students with a Class I occlusion and no need for orthodontic treatment. Orthodontic patients were classified into the three subgroups based on malocclusions. Results In the experimental group, 45.03% of orthodontic patients had some degree of TMD, while among students, that percentage was 56.41%. Compared to Class I, higher percentage of TMD was found among patients with distal and mesial occlusion in experimental group. In the experimental and control groups, the greatest percentage of participants showed mild TMD. The prevalence of TMD was greater in females than in males in the experimental group. Conclusion The high prevalence of TMD in the control group speaks in favor of its complex etiology, with stress having an important role. Malocclusion is one of many factors which can contribute to the occurrence and severity of TMD, but it cannot be considered the most significant

Prevalenca i izraženost TMD kod ortodontskih pacijenata

Uvod: Temporomandibularna disfunkcija (TMD) manifestuje se kao skup simptoma od kojih su najčešći bol u regiji mastikatornih mišića ili temporomandibularnih zglobova, ograničeno otvaranje usta, neregularne kretnje donje vilice, glavobolje i zvučni efekti u TMZ. Cilj rada: Utvrditi prevalencu i izraženost TMD kod ortodontskih pacijenata na Klinici za ortopediju vilica, i ispitati da li vrsta malokluzije utiče na učestalost i izraženost TMD. Materijal i metode: Istraživanje je sprovedeno u vidu Fonseka upitnika, koji ispitanike klasifikuje u odnosu na izraženost TMD (bez TMD, blaga, umerena i izražena TMD). Eksperimentalnu grupu činili su pacijenti Klinike za Ortopediju vilica sa potvrđenim ortodontskim nepravilnostima, dok su kontrolnu grupu činili studenti Stomatološkog fakulteta u Beogradu sa okluzijom prve klase po Englu, bez nepravilnosti zagrižaja i potrebe za ortodontskim tretmanom. Ortodontski pacijenti su klasifikovani u tri grupe na osnovu sagitalnih nepravilnosti zagrižaja. Rezultati: U eksperimentalnoj grupi 46,96% ortodontskih pacijenata pokazalo je neku formu TMD, dok je među studentima taj procenat bio 54,29%. Pacijenti sa manje ili više izraženom malokluzijom druge klase pokazali su veću učestalost TMD u odnosu na prvu i treću klasu, kao i kontrolnu grupu (64,71%). I u eksperimentalnoj i u kontrolnoj grupi, najčešće su bile zastupljene blage forme TMD. U eksperimentalnoj grupi učestalost TMD bila je veća kod žena nego kod muškaraca. Zaključak: Pacijenti sa distookluzijom su u najvećem procentu pokazali učestalost TMD. Visok procenat zastupljenosti TMD u kontrolnoj grupi govori u prilog jako složenoj etiologiji TMD i tome da su ortodontske nepravilnosti samo jedan od brojnih faktora koji mogu uticati na njen nastanak i izraženost, ali da se ne smeju smatrati najznačajnijim. Fonseka upitnik na vrlo jednostavan način može utvrditi postojanje i stepen izraženosti TMD

Architectural Sublime: Dome Above Dome

The European concept of the architecture of sky oscillates between the differences of the two worlds. In the period of classical antiquity, that was a leap forward from the perfect towards the unique, on a course set by the philosophy which began with the thought of nature (physics) and progressed towards the reflection of the essence of matter (metaphysics). The poiesis of the whole, as an architectural potential for the range of a higher scale, was born from the projection of cosmopolitan tendencies, but only after this perception of the world had included universality. For antique thought, whose boundaries and geometry were linked to the sphere, universality referred to the shape of the Universe, thus the geometric sky expressed the ideal One. Parthenon and Pantheon, unified through the thematisation of the geometric dome, uncovered possibilities for sublime architectural worlds. One world offers pure geometry, while the other one is ruled by the visual presentation. One projects the depth of the sky, while the other sees the sky only as its illusion. The sky is an absolute category for the architecture of both worlds, it is placed out of reach, and its symbolic sublimity is achieved through spatial opening, outwards. Sublimity is a constant metaphysical challenge in European architecture. It connects aesthetics with the spatial secret: the idea that it takes more than perfect technique to bring matter to life. In that sense, the connection between the antique ability to reduce the Universe to an object using weight, and the modernist antigravity which leaves the orbit of the Earth, may be interpreted today only if the limits of the visibility of architecture were expanded to reach the esthetic dimension of digital infinity, the same infinity which is stamped by pictures of Voyager on its journey of no return. That proves that only those who abandon their own position may come close to that which has remained sublime

Inhaler technique training of community pharmacists and common errors

Introduction: Pharmacists have a significant role in improving patient inhaler technique (HK. Reddel, et al. Eur Respir J 2008;32: 812; Alismail A, et al. Respir Care 2016;61:593). Hence, it is crucial for pharmacists to develop skills in educating patients on the correct use of inhalers. Aims: The aim of the study was to evaluate the effectiveness of an educational intervention on the pharmacists’ inhaler technique demonstration skills. Methods: The study was performed during the community pharmacists’ training classes in 2019. Demonstration of correct inhaler technique was performed for metered-dose (MDI), dry powder (DPI) and soft mist inhalers (SMI). All participants were instructed about correct technique and given placebo inhalers. After the demonstration, they were assessed on the use of each of these devices. The pharmacists were given a 1-point score for each step (1-preparation, 2-expiration, 3-inhalation, 4-holding breath) performed correctly. Results: All participants (108) showed improved inhaler technique after training (3.8±0.5 points). Friedman test showed a significant difference in achieved score depending on the type of the inhaler (p<0.05) and the lowest was with MDI. After education, 29.6% of participants had a problem with coordination of dose release and inhalation using MDIs. Only 4.6% made an error in step 3 for DPIs (strong and fast inhalation). None of the participants made an error in the same step for SMI (slow and deep inhalation). Conclusion: This method of inhaler technique training is sufficient to provide the skills to the pharmacist in educating patients about the correct use. However these results indicate that there was a difference in the ability to use different inhalers.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”