Evaluation of Periodontal Parameters in Patients with Early Stage Chronic Lymphocytic Leukemia

Svrha rada: Procjenjivao se parodontni status ispitanika s KLL-om u ranom stadiju i uspoređivao s parodontnim statusom zdravih ispitanika u kontrolnoj skupini te analizirala veza između parodontoloških i hematoloških parametara bolesnika s KLL-om. Materijali i metode: Pregledano je 60 ispitanika: 30 oboljelih od KLL-a – u stadiju Rai 0 (ispitna skupina) te 30 zdravih osoba iste životne dobi (kontrolna skupina). Kriteriji za isključivanje bili su: postojanje neke druge sistemske bolesti ili stanja (npr. dijabetes), već provedena parodontna terapija, liječenje antibioticima tijekom posljednja tri mjeseca i uzimanje lijekova. Socijalno-demografski podatci prikupljeni su upitnikom. Ispitanicima s najmanje osam zuba obavljen je kompletan parodontološki pregled i određeni su API, PBI, PPD, REC i CAL. Medicinski podatci oboljelih od KLL-a preuzeti su iz njihove medicinske dokumentacije, a hematološki parametri očitani su iz nalaza krvne pretrage. Rezultati: Skupine su se međusobno razlikovale s obzirom na dob, broj zuba i učestalost odlazaka stomatologu (p 0,05), nego samo za REC (F = 4,601; p 0,05). Zaključak: Rezultati ovog istraživanja pokazali su da su oboljeli od KLL-a imali lošiji parodontni status negoli zdravi ispitanici. Uzročno-posljedična veza između parodontoloških i hematoloških parametara nije dokazana.Objective: To assess periodontal conditions in patients with early stage CLL and to compare it with the periodontal status of age matched healthy controls and to analyze the relationship between periodontal and hematological parameters in CLL patients. Materials and Methods: 60 subjects were examined: 30 patients with CLL Rai 0 (test group) and 30 age-matching healthy individuals (control group). The exclusion criteria were: presence of other systemic disease or condition (e.g. diabetes), history of treatment for periodontitis, use of antibiotics during the last 3 months, use of medications. Socio-demographic data were obtained by means of a questionnaire. Participants with at least 8 teeth underwent a full mouth examination assessing API, PBI, PPD, REC and CAL. Medical data for CLL patients were collected from the patients’ records, while hematological data were obtained from the hemogram. Results: Difference between groups was statistically significant for age, number of teeth and frequency of dental checkups (p0.05), only for REC (F=4.601; p0.05). Conclusion: The results of this study showed that patients with CLL had worse periodontal status compared to healthy subjects. Causal relationship between periodontal and hematological parameters was not proved

Aspect of nursing care for patients undergoing surgery for infective endocarditis

Infektivni endokarditis ostaje rijetko stanje, ali ono s visokim povezanim morbiditetom i smrtnošću. Sa starenjem stanovništva i sve većom upotrebom implantabilnih srčanih uređaja i srčanih zalistaka, epidemiologija infektivnog endokarditisa se promijenila. Rana klinička sumnja i brza dijagnoza ključni su kako bi se omogućio pristup ispravnim putovima liječenja i smanjila stopa komplikacija i smrtnosti. Klinička prezentacija infektivnog endokarditisa vrlo je promjenjiva i može predstavljati akutno, subakutno ili kronično stanje koje odražava promjenjive uzročne mikroorganizme, temeljna srčana stanja i već postojeće komorbiditete. Kod većine bolesnika prisutno je s vrućicom, noćnim znojenjem, umorom te gubitkom težine i apetita. Dijagnozu infektivnog endokarditisa kod kardiokirurških bolesnika treba pažljivo razmotriti kod onih koji imaju predisponirajuće čimbenike rizika, šum na srcu, vaskularne i emboličke pojave povezane s infektivnim endokarditisom Antimikrobna terapija općenito se ne bi trebala započinjati dok se ne uzmu tri skupa krvnih kultura. Aspekti sestrinske skrbi vežu se dobroj procijeni, detaljnoj sestrinskoj anamnezi te pravovremenom reagiranju na sve patološke promijene nakon kardiokirurškog zahvata. Izradom plana zdravstvene njege sestra prevenira moguće neželjene događaje koji mogu ugroziti život bolesnika i osigurava oporavak bolesnika.Infective endocarditis remains a rare condition, but one with high associated morbidity and mortality. With the aging of the population and the increasing use of implantable cardiac devices and heart valves, the epidemiology of infective endocarditis has changed. Early clinical suspicion and rapid diagnosis are crucial to enable access to the correct treatment pathways and reduce the rate of complications and mortality. The clinical presentation of infective endocarditis is highly variable and may present as an acute, subacute, or chronic condition that reflects changing causative microorganisms, underlying cardiac conditions, and preexisting comorbidities. In most patients, it is present with fever, night sweats, fatigue, and loss of weight and appetite. The diagnosis of infective endocarditis in cardiac surgical patients should be carefully considered in those with predisposing risk factors, heart murmurs, vasculitis and embolic events associated with infective endocarditis Antimicrobial therapy should generally not be initiated until three sets of blood cultures have been obtained. Aspects of nursing care are related to good assessment, detailed nursing anamnesis and timely response to all pathological changes after cardiac surgery. By creating a health care plan, the nurse prevents possible unwanted events that may threaten the patient's life and ensures the patient's recover

Aspect of nursing care for patients undergoing surgery for infective endocarditis

Infektivni endokarditis ostaje rijetko stanje, ali ono s visokim povezanim morbiditetom i smrtnošću. Sa starenjem stanovništva i sve većom upotrebom implantabilnih srčanih uređaja i srčanih zalistaka, epidemiologija infektivnog endokarditisa se promijenila. Rana klinička sumnja i brza dijagnoza ključni su kako bi se omogućio pristup ispravnim putovima liječenja i smanjila stopa komplikacija i smrtnosti. Klinička prezentacija infektivnog endokarditisa vrlo je promjenjiva i može predstavljati akutno, subakutno ili kronično stanje koje odražava promjenjive uzročne mikroorganizme, temeljna srčana stanja i već postojeće komorbiditete. Kod većine bolesnika prisutno je s vrućicom, noćnim znojenjem, umorom te gubitkom težine i apetita. Dijagnozu infektivnog endokarditisa kod kardiokirurških bolesnika treba pažljivo razmotriti kod onih koji imaju predisponirajuće čimbenike rizika, šum na srcu, vaskularne i emboličke pojave povezane s infektivnim endokarditisom Antimikrobna terapija općenito se ne bi trebala započinjati dok se ne uzmu tri skupa krvnih kultura. Aspekti sestrinske skrbi vežu se dobroj procijeni, detaljnoj sestrinskoj anamnezi te pravovremenom reagiranju na sve patološke promijene nakon kardiokirurškog zahvata. Izradom plana zdravstvene njege sestra prevenira moguće neželjene događaje koji mogu ugroziti život bolesnika i osigurava oporavak bolesnika.Infective endocarditis remains a rare condition, but one with high associated morbidity and mortality. With the aging of the population and the increasing use of implantable cardiac devices and heart valves, the epidemiology of infective endocarditis has changed. Early clinical suspicion and rapid diagnosis are crucial to enable access to the correct treatment pathways and reduce the rate of complications and mortality. The clinical presentation of infective endocarditis is highly variable and may present as an acute, subacute, or chronic condition that reflects changing causative microorganisms, underlying cardiac conditions, and preexisting comorbidities. In most patients, it is present with fever, night sweats, fatigue, and loss of weight and appetite. The diagnosis of infective endocarditis in cardiac surgical patients should be carefully considered in those with predisposing risk factors, heart murmurs, vasculitis and embolic events associated with infective endocarditis Antimicrobial therapy should generally not be initiated until three sets of blood cultures have been obtained. Aspects of nursing care are related to good assessment, detailed nursing anamnesis and timely response to all pathological changes after cardiac surgery. By creating a health care plan, the nurse prevents possible unwanted events that may threaten the patient's life and ensures the patient's recover

Aspect of nursing care for patients undergoing surgery for infective endocarditis

Infektivni endokarditis ostaje rijetko stanje, ali ono s visokim povezanim morbiditetom i smrtnošću. Sa starenjem stanovništva i sve većom upotrebom implantabilnih srčanih uređaja i srčanih zalistaka, epidemiologija infektivnog endokarditisa se promijenila. Rana klinička sumnja i brza dijagnoza ključni su kako bi se omogućio pristup ispravnim putovima liječenja i smanjila stopa komplikacija i smrtnosti. Klinička prezentacija infektivnog endokarditisa vrlo je promjenjiva i može predstavljati akutno, subakutno ili kronično stanje koje odražava promjenjive uzročne mikroorganizme, temeljna srčana stanja i već postojeće komorbiditete. Kod većine bolesnika prisutno je s vrućicom, noćnim znojenjem, umorom te gubitkom težine i apetita. Dijagnozu infektivnog endokarditisa kod kardiokirurških bolesnika treba pažljivo razmotriti kod onih koji imaju predisponirajuće čimbenike rizika, šum na srcu, vaskularne i emboličke pojave povezane s infektivnim endokarditisom Antimikrobna terapija općenito se ne bi trebala započinjati dok se ne uzmu tri skupa krvnih kultura. Aspekti sestrinske skrbi vežu se dobroj procijeni, detaljnoj sestrinskoj anamnezi te pravovremenom reagiranju na sve patološke promijene nakon kardiokirurškog zahvata. Izradom plana zdravstvene njege sestra prevenira moguće neželjene događaje koji mogu ugroziti život bolesnika i osigurava oporavak bolesnika.Infective endocarditis remains a rare condition, but one with high associated morbidity and mortality. With the aging of the population and the increasing use of implantable cardiac devices and heart valves, the epidemiology of infective endocarditis has changed. Early clinical suspicion and rapid diagnosis are crucial to enable access to the correct treatment pathways and reduce the rate of complications and mortality. The clinical presentation of infective endocarditis is highly variable and may present as an acute, subacute, or chronic condition that reflects changing causative microorganisms, underlying cardiac conditions, and preexisting comorbidities. In most patients, it is present with fever, night sweats, fatigue, and loss of weight and appetite. The diagnosis of infective endocarditis in cardiac surgical patients should be carefully considered in those with predisposing risk factors, heart murmurs, vasculitis and embolic events associated with infective endocarditis Antimicrobial therapy should generally not be initiated until three sets of blood cultures have been obtained. Aspects of nursing care are related to good assessment, detailed nursing anamnesis and timely response to all pathological changes after cardiac surgery. By creating a health care plan, the nurse prevents possible unwanted events that may threaten the patient's life and ensures the patient's recover

Political Role of Women in the Left-wing and Right-wing Parties in Croatia

Od osnutka neovisne Republike Hrvatske žene se bore s niskom stopom zastupljenosti na najvišim političkim položajima. O tome govori podatak da je 1990. godine bilo manje od 5% žena u tada tri predstavnička tijela. Na zadnjim parlamentarnim izborima bilo ih je manje od 15%. Udio žena u tom razdoblju raste, međutim još je uvijek ispod praga ravnopravnosti. Potpuno, razvijena demokracija trebala bi osigurati zastupljenost svih interesa te tako i ženskih. Kako političke stranke biraju kandidate odnosno kandidatkinje za političke položaje, uzroci podzastupljenosti žena mogu se tražiti upravo u njima. Bitan čimbenik kod selekcije kandidata je ideologija političkih stranaka. Desnica zbog konzervativne ideologije najvjerojatnije postavlja manje žena na kandidatske liste od liberalne ljevice koja podupire participaciju žena u politici. Utjecaj ideologije političkih stranaka desnice i ljevice kod selekcije žena u Republici Hrvatskoj nije zanemariv. Razlike među udjelima kandidiranih i izabranih žena desnice i ljevice postoje, međutim, i kod desnice i kod ljevice još su uvijek ispod praga ravnopravnosti. Iako desnica kandidira manje žena od ljevice, u razdoblju od 1990. do 2016. godine u Hrvatskoj i desnica i ljevica na stranačkim listama većinom kandidira veći udio žena nego li ih je bilo izabrano.Since the establishment of the independent Republic of Croatia, women have been struggling with the low levels of representation in top political positions. This is evidenced by the fact that in 1990 there were less than 5% of women in the then three representative bodies. Moreover, there were less than 15% of women in the last parliamentary elections. The proportion of women during this period was increasing, however, it is still below the equality threshold. Fully developed democracy should ensure that all interests, including women, are represented. As political parties select candidates for political positions, the causes of women's low representation may be sought precisely in them. An important factor in the selection of candidates is the ideology of political parties. The right-wing parties' conservative ideology most likely places fewer women on the candidate list than the liberal left-wing parties, which supports women's participation in politics. The influence of the ideology in the selection of women in Croatia is not negligible. The differences between the proportions of candidates and elected women of the right-wing and left-wing parties exist. However, the proportions of women at both are still below the equality threshold. Although the right-wing were running fewer women than the left-wing parties, from 1990 to 2016 in Croatia, both party lists mostly run a larger proportion of women that were elected

Association between periodontitis and liver disease

Recent clinical and scientific evidence confirms the negative impact of long-term periodontitis on the clinical course and progression of various liver diseases. Periodontitis is a chronic, slow-progressing infectious disease of the tooth supporting tissues caused mainly by the gram-negative bacteria Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola and Tannerella forsythia. These specific pathogens can be easily translocated from oral cavity to the intestine. Disruption of the intestine microbiota composition by orally derived periodontal pathogenic bacteria has recently been suggested to be a causal mechanism between periodontitis and liver disease. Furthermore, both diseases have the ability to induce an inflammatory response and lead to the creation of inflammatory mediators through which they may influence each other. Recent epidemiologic studies have demonstrated that individuals with liver cirrhosis have considerably poorer periodontal clinical parameters than those without cirrhosis. Periodontal therapy in cirrhosis patients favorably modulates oral and gut microbiome, the course of systemic inflammation, cirrhosis prognostic factors, and cognitive function. Therefore, future clinical researches should be focused on detailed examination of the biological mechanisms, strength and direction of the association between advanced liver disease and periodontitis