Upravljanje dišnim putom tijekom izvođenja laparoskopske kolecistektomije - usporedna analiza

In this study, we aimed to compare supraglottic airway devices (Supreme and i-gel laryngeal mask) with tracheal tube with respect to airway control and efficiency in ventilation and oxygenation. The study included 325 patients of ASA I-II who underwent laparoscopic cholecystectomy. In group 1, the airway was secured using endotracheal intubation (115 patients). In group 2 (103 patients), LMA Supreme was applied, whereas i-gel mask was used for airway management in group 3 (107 patients). Monitoring parameters were recorded and compared using t-test, analysis of variance (ANOVA), Tukey’s test and χ2-test. The following parameters were monitored: insertion time, number of attempts for device placement, oropharyngeal seal pressure, etc. Insertion time was longest in group 1 (14.7±1.65 s) as compared to group 2 (15.5±1.05 s) and group 3 (14.1±1.27 s); ANOVA test yielded a statistically significant difference (p<0.01). Insertion success rate was almost identical in all three groups (p=0.907, χ2-test). Comparison of oropharyngeal seal pressure between group 2 (35.95±2.92 cm H2O) and group 3 (36.47±1.43 cm H2O) yielded no statistical difference (p=0.314, t-test). Endotracheal tube, Supreme and i-gel laryngeal masks were shown to be equally efficient in airway management in laparoscopic cholecystectomy. All three devices enabled efficient ventilation and oxygenation despite certain pathophysiological changes associated with laparoscopy.Ova studija je imala za cilj pružiti usporedbeni prikaz primjene supraglotičnih uređaja (laringealne maske Supreme i i-gel) s endotrahealnom intubacijom u kontroli dišnih putova, učinkovitosti ventilacije i oksigenacije tijekom izvođenja kirurških laparoskopskih operacija. Istraživanje je obuhvatilo 325 bolesnika, ASA klasifikacije I.-II. U prvoj skupini (115 bolesnika) dišni sustav je bio opskrbljen endotrahealnom intubacijom. U drugoj skupini (103 bolesnika) primijenjena je laringealna maska tipa Supreme, dok je maska i-gel korištena za kontrolu dišnih putova u trećoj ispitivanoj skupini (107 bolesnika). Promatrani parametri zabilježeni su i uspoređeni primjenom t-testa, ANOVA testa, Tukeyjeva testa i χ2-testa. Tijekom praćenja zabilježeno je vrijeme postavljanja, broj pokušaja, orofaringealnog tlaka zaptivanja itd. Vrijeme postavljanja bilo je najduže u prvoj (14,7±1,65s), zatim u drugoj (15,5±1,05s) i najkraće u trećoj skupini bolesnika (14,1±1,27s). Usporedba testom ANOVA pokazala je statistički značajnu razliku (p<0,01). Izvedba postavljanja bila je gotovo jednaka u sve tri ispitane skupine (p=0,907, χ2-test). Usporedba orofaringealnog tlaka zaptivanja između druge (35,95±2,92 cm H2O) i treće skupine (36,47±1,43 cm H2O) nije dala statističku značajnost (p=0,314, t-test). Endotrahealna cijev, laringealne maske Supreme i i-gel bile su podjednako učinkoviti uređaji za upravljanje dišnim putovima u laparoskopskim intervencijama. Omogućuju učinkovitu ventilaciju i oksigenaciju bez obzira na bilo kakve specifične patofiziološke promjene koje prate laparoskopsku kolecistektomiju

Analiza mineralnog sastava hipomineralizovanih prvih stalnih molara

Background/Aim. Hypomineralization of molars and incisors (molar-incisor hypomineralization - MIH) is defined as enamel hypomineralization of systemic origin of one or more of the four first permanent molars, which may be associated with changes in the maxillary, and less frequently in the permanent mandibular incisors. The aim of this study was to investigate the mineral content in hypomineralized teeth as a contribution to under-standing the origin of these changes, which will be important for effective restorative approach. Methods. A total of 10 extracted first permanent molars diagnosed with MIH were used in the study as the experimental group, and intact first premolars extracted for orthodontic reasons were used as the control group. A certain surface of hypomineralized and healthy enamel and dentin was analyzed using a scanning electron microscope equipped with an energydispersive spectrometer (SEM/EDS). Results. By conducting quantitative chemical analysis of the distribution of the basic chemical elements, it was found that the concentration of calcium (Ca) and phosphorus (P) was significantly higher in healthy enamel (Ca = 28.80 wt%, and P = 15.05 wt%) compared to hypomineralized enamel (Ca = 27.60 wt% and P = 14.32 wt%). Carbon (C) concentration was statistically significantly higher in hypomineralized enamel (C = 11.70 wt%) compared to healthy enamel (C = 10.94 wt%). Hypomineralized and healthy enamel did not differ significantly regarding the ratio of calcium and phosphorus concentrations whereas the ratio of calcium and carbon concentrations was statistically significantly higher in healthy enamel compared to hypomineralized enamel. Conclusion. Concentration of the main chemical elements, primarily calcium and phosphorus, is significantly reduced in hypomineralized enamel whereas carbon concentration is increased compared to healthy enamel.Uvod/Cilj. Hipomineralizacija molara i sekutića (molar-incisor hipomineralisation - MIH) definiše se kao hipomineralizacija sistemskog porekla jednog ili više od četri prva stalna molara, koja može biti udružena sa promenama na maksilarnim, a nešto ređe na mandibularnim sekutićima. Cilj ovog rada bio je da se istraži mineralni sadržaj hipomineralizovanih zuba kao doprinos razumevanju nastanka ovih promena, što će biti od značaja za efikasniji restaurativni pristup. Metode. U istraživanju je korišćeno 10 izvađenih prvih stalnih molara sa dijagnozom MIH, kao eksperimentalna grupa, a kao kontrolna grupa zuba korišćeni su prvi intaktni premolari izvađeni iz ortodonskih razloga. Određena površina hipomineralizovane i zdrave gleđi i dentina analizirana je pomoću elektronskog mikroskopa opremljenog energetskim disperzionim spektrometrom (SEM/EDS). Rezultati. Kvantitativnom hemijskom analizom raspodele osnovnih hemijskih elemenata, utvrđeno je da je koncentracija kalcijuma (Ca) i fosfora (P) bila statistički značajno veća u zdravoj gleđi (Ca = 28,80% tež. i P = 15,05% tež) u odnosu na hipomineralzovanu gleđ (Ca = 27,60% tež. i P = 14.32% tež). Koncentracija ugljenika (C) bila je statistički značajno veća u hipomineralizovanoj gleđi (C = 11,70% tež) u odnosu na zdravu gleđ (C = 10,94% tež). Zdrava i hipomineralizovana gleđ nisu se statistički značajno razlikovale u odnosu koncentracija kalcijuma i fosfora, dok je odnos koncentracija kalcijuma i ugljenika statistički bio značajno veći u zdravoj gleđi u odnosu na hipomineralizovanu gleđ. Zaključak. Koncentracija osnovnih hemijskih elemenata, pre svega kalcijuma i fosfora, značajno je snižena u hipomineralizovanoj gleđi, a koncentracija ugljenika povišena u poređenju sa zdravom gleđi

Stomatitis herpetica: The importance of early diagnosis

Herpetic stomatitis as well as many other infections of the orofacial region in everyday practice represent an important percentage of pathology. These diseases can be a major problem for therapists in terms of early diagnosis and, consequently, in determining the correct treatment. The disease belongs to a group of droplet infection, caused by the herpes simplex virus, with characteristic changes in the skin and mucous membrane in children and adults. A relatively small percentage, 10-15% of primary infections are manifested with clinically distinct symptoms. At the oral mucosa occurs triad of symptoms: generalized catarrhal gingivitis, coated tongue and erosions dispersed all over oral epithelium of the oral cavity

Analysis of the mineral composition of hypomineralized first permanent molars

Background/Aim. Hypomineralization of molars and incisors (molar-incisor hypomineralization - MIH) is defined as enamel hypomineralization of systemic origin of one or more of the four first permanent molars, which may be associated with changes in the maxillary, and less frequently in the permanent mandibular incisors. The aim of this study was to investigate the mineral content in hypomineralized teeth as a contribution to under-standing the origin of these changes, which will be important for effective restorative approach. Methods. A total of 10 extracted first permanent molars diagnosed with MIH were used in the study as the experimental group, and intact first premolars extracted for orthodontic reasons were used as the control group. A certain surface of hypomineralized аnd healthy enamel and dentin was analyzed using a scanning electron microscope equipped with an energydispersive spectrometer (SEM/EDS). Results. By conducting quantitative chemical analysis of the distribution of the basic chemical elements, it was found that the concentration of calcium (Ca) and phosphorus (P) was significantly higher in healthy enamel (Ca = 28.80 wt%, and P = 15.05 wt%) compared to hypomineralized enamel (Ca = 27.60 wt% and P = 14.32 wt%). Carbon (C) concentration was statistically significantly higher in hypomineralized enamel (C = 11.70 wt%) compared to healthy enamel (C = 10.94 wt%). Hypomineralized and healthy enamel did not differ significantly regarding the ratio of calcium and phosphorus concentrations whereas the ratio of calcium and carbon concentrations was statistically significantly higher in healthy enamel compared to hypomineralized enamel. Conclusion. Concentration of the main chemical elements, primarily calcium and phosphorus, is significantly reduced in hypomineralized enamel whereas carbon concentration is increased compared to healthy enamel

Analysis of the mineral composition of hypomineralized first permanent molars

Background/Aim. Hypomineralization of molars and incisors (molar-incisor hypomineralization - MIH) is defined as enamel hypomineralization of systemic origin of one or more of the four first permanent molars, which may be associated with changes in the maxillary, and less frequently in the permanent mandibular incisors. The aim of this study was to investigate the mineral content in hypomineralized teeth as a contribution to under-standing the origin of these changes, which will be important for effective restorative approach. Methods. A total of 10 extracted first permanent molars diagnosed with MIH were used in the study as the experimental group, and intact first premolars extracted for orthodontic reasons were used as the control group. A certain surface of hypomineralized and healthy enamel and dentin was analyzed using a scanning electron microscope equipped with an energydispersive spectrometer (SEM/EDS). Results. By conducting quantitative chemical analysis of the distribution of the basic chemical elements, it was found that the concentration of calcium (Ca) and phosphorus (P) was significantly higher in healthy enamel (Ca = 28.80 wt%, and P = 15.05 wt%) compared to hypomineralized enamel (Ca = 27.60 wt% and P = 14.32 wt%). Carbon (C) concentration was statistically significantly higher in hypomineralized enamel (C = 11.70 wt%) compared to healthy enamel (C = 10.94 wt%). Hypomineralized and healthy enamel did not differ significantly regarding the ratio of calcium and phosphorus concentrations whereas the ratio of calcium and carbon concentrations was statistically significantly higher in healthy enamel compared to hypomineralized enamel. Conclusion. Concentration of the main chemical elements, primarily calcium and phosphorus, is significantly reduced in hypomineralized enamel whereas carbon concentration is increased compared to healthy enamel.Uvod/Cilj. Hipomineralizacija molara i sekutića (molar-incisor hipomineralisation - MIH) definiše se kao hipomineralizacija sistemskog porekla jednog ili više od četri prva stalna molara, koja može biti udružena sa promenama na maksilarnim, a nešto ređe na mandibularnim sekutićima. Cilj ovog rada bio je da se istraži mineralni sadržaj hipomineralizovanih zuba kao doprinos razumevanju nastanka ovih promena, što će biti od značaja za efikasniji restaurativni pristup. Metode. U istraživanju je korišćeno 10 izvađenih prvih stalnih molara sa dijagnozom MIH, kao eksperimentalna grupa, a kao kontrolna grupa zuba korišćeni su prvi intaktni premolari izvađeni iz ortodonskih razloga. Određena površina hipomineralizovane i zdrave gleđi i dentina analizirana je pomoću elektronskog mikroskopa opremljenog energetskim disperzionim spektrometrom (SEM/EDS). Rezultati. Kvantitativnom hemijskom analizom raspodele osnovnih hemijskih elemenata, utvrđeno je da je koncentracija kalcijuma (Ca) i fosfora (P) bila statistički značajno veća u zdravoj gleđi (Ca = 28,80% tež. i P = 15,05% tež) u odnosu na hipomineralzovanu gleđ (Ca = 27,60% tež. i P = 14.32% tež). Koncentracija ugljenika (C) bila je statistički značajno veća u hipomineralizovanoj gleđi (C = 11,70% tež) u odnosu na zdravu gleđ (C = 10,94% tež). Zdrava i hipomineralizovana gleđ nisu se statistički značajno razlikovale u odnosu koncentracija kalcijuma i fosfora, dok je odnos koncentracija kalcijuma i ugljenika statistički bio značajno veći u zdravoj gleđi u odnosu na hipomineralizovanu gleđ. Zaključak. Koncentracija osnovnih hemijskih elemenata, pre svega kalcijuma i fosfora, značajno je snižena u hipomineralizovanoj gleđi, a koncentracija ugljenika povišena u poređenju sa zdravom gleđi

A Comparative Study of Antioxidative Activity of Saliva in Children and Young Teenagers with and without Gingivitis

Objectives: The aim of this study was to compare the values of total antioxidant capacity (TAC), catalase (CAT) and glutathione peroxidase (GPX) in the saliva of children and young teenagers with and without gingivitis. Materials and Methods: A total of 120 children and young teenagers of the mean age of 12.2 participated in the research. Gingival condition was assessed using the Löe and Silness Gingival Index. The subjects were divided into groups of those without gingivitis and those with gingivitis. Samples of unstimulated saliva were collected, and TAC, CAT and GPX were determined spectrophotometrically. Results: By comparing the values of TAC, CAT and GPX in subjects with and without gingivitis, significantly lower values of TAC (p &lt; 0.001) and CAT (p &lt; 0.001) were observed in the group of subjects with gingivitis. The correlation analysis of these values showed a positive correlation in groups of subjects not suffering from gingival inflammation and those with gingival inflammation. Conclusions: The study showed significantly lower values of TAC and CAT in the saliva of subjects with gingivitis. This indicates their possible role as a potential biomarker in the early diagnosis and expression of periodontal disease in children and young teenagers

The incidence of dental caries and gingivitis in school-aged children

Frequent occurrence of dental caries and periodontal diseases, especially gingivitis, in school-aged children, is becoming one of the most important problems in oral pathology, although they all can be brought under control through health education and implementation of preventive and prophylactic measures. The aim of this study was to determine the incidence of dental caries and gingivitis in children, aged 12 years, attending primary schools in Kosovska Mitrovica, as an urban area, and schools in Gračanica and Laplje Selo, as rural areas. The study included 227 schoolchildren, aged 12 years, divided into two groups. One group, 129 of them, consisted of children from primary schools in Kosovska Mitrovica, as urban areas. The other group, 98 of them, consisted of children from primary schools in Gračanica and Laplje Selo, as rural areas. Klein-Palmer DMFT system (D-Decayed, M-Missing, F-filled) was used to estimate the prevalence of dental caries, while Silness-Löe plaque index, Löe-Silness gingival index and Muhlemann sulcus bleeding index were used to estimate the level of oral hygiene, gingival status and severity of gingival inflammation. The average number of permanent teeth with caries per respondent (DMFT) was 4.6 in total, for all children. The average value of DMFT in children from urban areas was 3.8, and 5.3 in children from rural areas. SiC Index was 7.9. The average value of the plaque index (PI) was 1.53±0.61, of the gingival index (GI)1.05±0.58 and of the bleeding index (BI) 0.64±0.59. The established state of oral health and periodontium in examined children points to the necessity of applying modern preventive and prophylactic measures in order to improve the oral health and increase the motivation for the overall health care

Periodontal health evaluation of the residents on Kosovo and Metohia

According to numerous studies conducted here and abroad, ailments of the bone support surrounding teeth are common among humans. Pathological symptoms occur with gingiva inflammation which later on spreads and leads towards the changes of deeper periodontal tissues. This paper deals with the current conditions of oral hygiene and its influence on prevalence as well as health risks of Kosovo and Metohija residents from periodontal and gingivitis. Research has been conducted on 120 subjects of the age from 20 to 60 years with slightly more male participants. After the examination of all subjects, 9.7 % males and 44.8% females had healthy gingiva. Results show notably better gingiva condition with females. 11.66% subjects had healthy periodontals while 40% had early symptoms of gingiva inflammation. Periodontal pockets with 4 to 5 mm depth were found on 15% of examinees, while the most serious symptoms of periodontal disease were found only on 3.33% of male examinees. Compared statistical results show that, according to CPITN index, periodontal disease is significantly less common among female participants than among males. According to approximately- spatial Plaque index, high oral hygiene is found only among non-smokers or precisely among 13% of all examinees. Low oral hygiene was recorded with 21.67% smokers and 14% non-smokers. According to results we can conclude that gingiva health condition as well as health condition of the whole support surrounding teeth apparatus among the northern part Kosovska Mitrovica residents, is on the higher level among females than among males. Also, considering the same examinees, results show that oral health is higher among non-smokers than among smokers. These results show the need for further activity of preventive services in raising consciousness on oral health importance as well as for the conducting appropriate measures concerning oral hygiene with northern part of Kosovska Mitrovica residents

Detection and distribution of Actinobacillus actinomycetemcomitans in patients with aggressive parodontopathy

Parodontopathy is a complex disease of periodontal tissues. The patological changes that occure here are destructive and lead to gradual or progressive periodontium disease and its anatomical and functional desintegration. The aim of the research was to use the PCR method (Polimerase Chain Reaction) to identify the presence and spreading of the oral pathogen Actinobacillus actinomycetemcomitans in subgingival plaque in patients suffering from the aggressive parodontopathy and then compare it to qualitative-quantitative structure of dental plaque in patients suffering from chronic parodontopathy. The study included 70 patients, average age of 45. The identification of microorganisms in subgingival plaque was determined by PCR method. In order to confirm the diagnosis and determine the extent of destruction of periodontal tissue the standard epidemiological criteria were used: plaque index (Silness-Lӧe), gingival index (Lӧe-Silness), SBI index (Mühleman-Son) and DPP. Extremely high statictical significance of presence of A. actinomycetemcomitans was obtained in patients with aggressive parodontopathy. The presence of A. actinomycetemcomitans and P. gingivalis showed the difference in distribution in patients with chronic as well as in patients with aggressive pardontopathy. In our sample A.a was detected in a high percentage of younger patients with the diagnosis of aggressive parodontopathy. Higher rate of A. actinomycetemcomitans in subgingival plaque has a direct impact on the course of parodontopathy. Its detection may be a useful marker for identifying the increased risk for developing aggressive parodontopathy in patients of younger population

Significance of echotomography in the diagnostic algorithm for acute pyelonephritis and glomerulonephritis

Introduction: Dental caries is the most common oral disease in all age groups. Being more and more frequent in preschool and school-age children, it has become one of the most important problems in oral pathology. The aim of this study was to determine the incidence of dental caries in schoolchildren aged 12 and 15 years in the northern part of Kosovo and Metohija, as well as to inform them about the importance of oral health. Materials and Methods: The study included 626 schoolchildren of both sexes from five schools from the municipalities of Kosovska Mitrovica, Zvečan and Leposavić. Klein-Palmer DMFT system (D-Decayed, M-Missing, F-filled) was used to estimate the prevalence of dental caries the following indices were also used: Person Caries Index, Teeth Caries Index, Average Caries Index and DMFT structure. All the selected children were examined using standard dental diagnostic agents. Tooth surfaces were examined dry under artificial lighting. Results: The average value of DMFT index for children aged 12 and 15 years was 4.2. On average, 92.3% of the examined children had caries. The mean value of caries index was 15.11%.Conclusion: After these new epidemiological studies, it can be concluded that the state of children's oral health, considering the high levels of untreated caries and all other features of DMFT index, is not satisfactory. This situation points to the necessity of applying modern preventive and prophylactic measures to preserve and improve the population oral health