27 research outputs found
Prisutnost bakterije helicobacter pylori u želucu i sluznici grkljana kod bolesnika s karcinomom grkljana
Helicobacter (H.) pylori is the cause of one of the most common chronic bacterial infections in humans. Risk factors for the development of laryngeal cancer are cigarette smoke, alcohol, and human papillomavirus. Several papers report on H. pylori isolated in tooth plaque, saliva, middle ear and sinuses. Many articles describe the presence of H. pylori in laryngeal cancer cases, however, without noting the possible source of infection, i.e. stomach or oral cavity. The aim of this study was to determine which patients and to what extent simultaneously developed H. pylori colonization in the stomach and the larynx. Prospective examinations were performed in 51 patients with laryngeal squamous cell carcinoma. The study group included patients with laryngeal squamous cell carcinoma histopathologically confirmed by two independent pathologists. The patients underwent fiber esophagogastroduodenoscopy with tumor tissue biopsy. Laryngeal and gastric biopsies were examined by histologic staining technique for histopathologic detection of H. pylori and with DNA analyses using the standardized fluorescent ABI Helicobacter plus-minus PCR assay. Laryngeal carcinoma patients showed positive H. pylori test results simultaneously in the laryngeal and stomach areas, implying H. pylori transmission from the stomach to the laryngeal area. In addition, H. pylori positive test results along with negative H. pylori results in the stomach region were also recorded, suggesting a possible bacteria migration from the oral cavity. In conclusion, H. pylori was found in the area of laryngeal carcinoma, and its migration appeared likely to occur both upwards (from the stomach to the mouth) and downwards (from the oral cavity to the stomach).Helicobacter (H.) pylori uzroÄnik je jedne od najÄeÅ”Äih kroniÄnih bakterijskih infekcija u ljudskoj populaciji, prisutne u svim zemljama u svijetu. Incidencija infekcije bakterijom H. pylori teÅ”ko se može izravno utvrditi, jer akutna infekcija ima vrlo malo karakteristiÄnih simptoma ili ih uopÄe nema. Planocelularni karcinom je najÄeÅ”Äi karcinom grkljana koji Äini 95% svih karcinoma grkljana. U Äimbenike rizika za razvoj karcinoma grkljana ubrajaju se cigaretni dim i alkohol te infekcija humanim papilomavirusima. H. pylori je dokazan kao jedan od uzroÄnika karcinoma grkljana, ali nigdje nije jasno opisan rezervoar te bakterije s obzirom na to da je u nekoliko Älanaka dokazano nepostojanje bakterije H. pylori u zdravoj sluznici grkljana. Svrha naÅ”ega rada bila je ispitati istodobnu prisutnost bakterije H. pylori u karcinomu grkljana i želucu. Kod 51 bolesnika s karcinomom grkljana uÄinjena je ezofagogastroskopija s uzimanjem uzoraka sluznice iz antruma i korpusa želuca te iz podruÄja karcinoma grkljana za analizu na H. pylori pomoÄu lanÄane reakcije polimeraze i patohistoloÅ”kom metodom. U tkivu karcinoma grkljana dobiveni su pozitivni rezultati testova na H. pylori istodobno s pozitivnim testom na H. pylori u podruÄju želuca, Å”to upuÄuje na migraciju bakterije iz želuca u podruÄje grkljana. U odreÄenom broju ispitanika dobiveni su pozitivni rezultati testova na H. pylori u podruÄju karcinoma grkljana s negativnim testom na H. pylori u sluznici želuca, Å”to upuÄuje na moguÄu migraciju bakterije iz usne Å”upljine. Iz nalaza se može zakljuÄiti da je H. pylori prisutan u podruÄju karcinoma grkljana te da je njegov prijenos moguÄ i uzlaznim i silaznim putem iz usne Å”upljine i želuca
Logical Notations on Chess
Namjena je rada pokuÅ”ati prikazati Å”ahovska pravila kao logiÄke iskaze te ljudsko (ne raÄunalno) Å”ahovsko razmiÅ”ljanje kao postupak koji se može rekonstruirati pomoÄu klasiÄnih logiÄkih shema kao Å”to su istinitosno stablo i deduktivni postupak u Fitchevu stilu. Å ahovska pravila mogu se prevoditi na jezik logike prvoga reda, iako je mjestimiÄno potrebno primjenjivati i operatore deontiÄke logike. Ciljevi se u Å”ahovskoj igri mogu prikazati pomoÄu logiÄkog kvadrata. MoguÄnosti jakih poteza opÄenito se mogu logiÄki promiÅ”ljati. NesavrÅ”enost ljudske procjene kvalitete odreÄenih poteza otvara moguÄnost primjene elemenata trovrijednosnih logika. Ipak, rad je u veÄini posveÄen moguÄnostima primjene elementarne logike na osnove Å”ahovske igre.This paper aims to present the rules of chess as logical statements and human (non-computer) chess reasoning as a decision procedure that can be reconstructed using classical logic methods such as tableaux and Fitch-style natural deductions. Chess rules can be represented in first-order logic terms with the occasional application of deontic logic operators. A consideration of chess game objectives can be offered by the tableaux method. In general terms, possible strong moves can be assessed with logical reasoning. Human imperfection in the quality assessment of certain moves opens up the possibility of applying three-valued logic parameters. However, the main focus of this paper is to examine the possibilities of applying elementary logic to the basics of chess play
Connection between knowledge of oral hygiene and dental status of the elderly in PožeŔko-slavonska County
Timely visits to the dentist are extremely important for the preservation of dental health. Given the biological predisposition of teeth decay with age, it is important to act preventively in order to minimize the adverse effects of age on dental health.
Aim: The aim of this study is to establish the correlation between the various factors related to oral health and dental status in older age and to examine the differences in dental status between retirement home residents and those living at home.
Materials and methods: The data were collected through a survey consisting of 39 questions. The sample consisted of 110 participants located in the Požega HPP and the Home for the Elderly and Infirm in Požega, 42.7% of which were men and 57.3% women. The study used the selection criterion of persons over the age of 65. The average age in the sample was 77.35 years (SD = 7.18) ranging from 65 to 97 years of age. The data were collected in the period from January 2018 to July 2018. The participants were divided into two groups, those living in the Požega Nursing Home and those living in their own household but were hospitalized once in the Požega County Hospital.
Results: The obtained results showed that participants have different dental problems that were partially related to their knowledge of oral hygiene. This paper emphasizes the importance of additional training and education for the elderly population in order to preserve and improve the quality of their dental health.
Conclusion: The results of this study suggest that participants, in average, were less concerned about their dental health, which was confirmed by the small number of healthy teeth. There was a partial correlation between the knowledge about oral hygiene and the dental status of elderly people in Požega-Slavonia County, i.e. their knowledge was related only to some aspects of their dental status. According to the results obtained, it is important to organize training for the elderly about the importance of timely interventions when dental health is in question, as well as to further educate them about the harmful factors when it comes to the preservation of their dental health
Neuro-fuzzy inference systems approach to decision support system for economic order quantity
Supply chain management (SCM) has a dynamic structure involving the constant flow of information, product, and funds among different participants. SCM is a complex process and most often characterized by uncertainty. Many values are stochastic and cannot be precisely determined and described by classical mathematical methods. Therefore, in solving real and complex problems individual methods of artificial intelligence are increasingly used, or their combination in the form of hybrid methods. This paper has proposed the decision support system for determining economic order quantity and order implementation based on Adaptive neuro-fuzzy inference systems - ANFIS. A combination of two concepts of artificial intelligence in the form of hybrid neuro-fuzzy method has been applied into the decision support system in order to exploit the individual advantages of both methods. This method can deal with complexity and uncertainty in SCM better than classical methods because they it stems from expertsā opinions. The proposed decision support system showed good results for determining the amount of economic order and it is presented as a successful tool for planning in SCM. Sensitivity analysis has been applied, which indicates that the decision sup- port system gives valid results. The proposed system is flexible and can be applied to various types of goods in SC
New Analytic Solutions of Queueing System for Shared-Short Lanes at Unsignalized Intersections
Designing the crossroads capacity is a prerequisite for achieving a high level of service with the same sustainability in stochastic traffic flow. Also, modeling of crossroad capacity can influence on balancing (symmetry) of traffic flow. Loss of priority in a left turn and optimal dimensioning of shared-short line is one of the permanent problems at intersections. A shared-short lane for taking a left turn from a priority direction at unsignalized intersections with a homogenous traffic flow and heterogeneous demands is a two-phase queueing system requiring a first in-first out (FIFO) service discipline and single-server service facility. The first phase (short lane) of the system is the queueing system M(p lambda)/M(mu)/1/infinity, whereas the second phase (shared lane) is a system with a binomial distribution service. In this research, we explicitly derive the probability of the state of a queueing system with a short lane of a finite capacity for taking a left turn and shared lane of infinite capacity. The presented formulas are under the presumption that the system is Markovian, i.e., the vehicle arrivals in both the minor and major streams are distributed according to the Poisson law, and that the service of the vehicles is exponentially distributed. Complex recursive operations in the two-phase queueing system are explained and solved in manuscript
Association between oxidative stress biomarkers and concentrations of some metal ions in the blood of patients with brain tumors and hydrocephalus
Introduction
Any substance that induces production of free radicals can be a potential cause of brain damage. The aim of our study was to investigate the relationship between some metal ions and oxidative stress biomarkers in the blood of patients with brain tumor and hydrocephalus.
Material and methods
Our study included 27 control subjects, 24 patients with brain tumor and 21 patients with hydrocephalus. The activities of superoxide dismutase (CuZn SOD), catalase (CAT), glutathione peroxidase (GSH-Px), glutathione reductase (GR), glutathione S-transferase (GST) and acetyl cholinesterase (AChE), as well as concentrations of reduced glutathione (GSH), lipid peroxides (TBARS) and sulfhydryl groups (SH) were analyzed in the plasma and red blood cells (RBCs) of patients. We also determined the concentrations of Mn, Ni, Co, Cu, Zn, As, Se, Cd, Hg and Fe.
Results
The higher activity of SOD and concentration of GSH in both investigated groups could indicate higher oxidative stress. We also observed decreased levels of SH groups in both groups of patients. In both groups of patients we detected decreased concentrations of Ni, Co, Zn and Fe (and Mn in brain tumor patients) and increased concentrations of As, Se and Cd in the blood. Interestingly, we observed a higher concentration of Cd in both plasma and RBCs of hydrocephalus patients compared to the patients with brain tumor.
Conclusions
There are strong correlations between some metal ion concentrations and certain oxidative stress biomarkers in the blood of patients, which supports our hypothesis, but the observed trend needs to be further investigated
Divovska kavernozna malformacija s neuobiÄajeno agresivnim kliniÄkim tijekom: prikaz sluÄaja
Giant cavernomas (GC) are rare lesions, with less than 50 cases reported so far. Clinical presentation usually involves epileptic seizures and less typically focal neurological deficit, due to repeated hemorrhages and GC mass effect and consequentially increased intracranial pressure. Although individual cases have been reported, due to the rarity and variable imaging appearance, GCs are usually not considered in the differential diagnosis of large hemorrhagic lesions, especially when significant mass effect is present. A 17-year-old boy presented due to severe headache, right-sided weakness, and slurred speech. Symptoms started three days before with occasional headaches, which intensified gradually. Emergency computed tomography revealed a left frontal massive heterogeneous lesion. Soon after, right-sided hemiparesis and speech impairment progressed, and the patient became drowsy with the slightly dilated left pupil. Emergency surgery was performed, and the lobed grayish lesion was entirely removed. Based on the macroscopic appearance, the surgeon assumed it was a metastasis of melanoma. Histopathologic analysis result was cavernoma. GC should be considered as an option in hemorrhagic lesions, especially in the young age population. Emergency surgery for mass lesions is not uncommon in neurosurgery; however, bleeding cavernomas are usually planned for elective surgery due to the specific approach and complications.Divovski kavernomi (DK) su rijetke lezije s manje od 50 dosad opisanih sluÄajeva. UobiÄajena simptomatologija su epileptiÄni napadaji, a rjeÄe se manifestiraju žariÅ”nim neuroloÅ”kim deficitom koji je uzrokovan ponavljanim hemoragijama i posljediÄnim poveÄanjem intrakranijskog tlaka. Iako su objavljeni pojedini sluÄajevi, zbog rijetke pojavnosti i raznovrsne radioloÅ”ke prezentacije DK se obiÄno ne razmatraju u diferencijalnoj dijagnostici velikih hemoragiÄnih ekspanzivnih lezija,
pogotovo kada je prisutan znaÄajan kompresivni uÄinak. SedamnaestogodiÅ”nji djeÄak se javio lijeÄniku zbog jake glavobolje, blaže desnostrane slabosti i nerazgovijetnog govora. Simtpomi su se javili 3 dana ranije u vidu blagih glavobolja koje su se postupno pojaÄavale. Hitna kompjutorizirana tomografija je pokazala masivnu hemoragiÄnu leziju frontalno lijevo. Nedugo zatim desnostrana slabost i nerazgovijetan govor su se pogorÅ”ali i bolesnik je postao pospan s blago proÅ”irenom lijevom zjenicom. UÄinjena je hitna operacija, kružna sivkasta lezija je u cijelosti uklonjena. Na osnovi makroskopskog izgleda kirurg je pomislio da se radi o metastazi melanoma. HistopatoloÅ”ka analiza je pokazala da se radi o kavernomu. DK bi trebalo razmatrati kao moguÄnost kod hemoragiÄnih lezija, pogotovo kod mlaÄih bolesnika. Hitna operacija kod kompresivnih lezija nije rijetkost u neurokirurgiji, meÄutim, krvareÄi kavernomi se obiÄno planiraju za elektivnu operaciju zbog specifiÄnog pristupa i moguÄih komplikacija
Functional dizziness in the light of the newly-established entity ā Persistent postural-perceptual dizziness
Funkcionalne vrtoglavice istiÄu se svojom uÄestaloÅ”Äu i drugi su najÄeÅ”Äi uzrok vrtoglavica u opÄoj populaciji, dok su u dobnoj skupini od 30 do 50 godina i najÄeÅ”Äi. KlasiÄni dijagnostiÄki proces usmjeren je na pronalaženje medicinske ili kirurÅ”ke dijagnoze, a ako se ona ne pronaÄe, obiÄno kažemo da je uzrok bolesti āpsihogenā. Posljednjih desetljeÄa, napuÅ”tanjem uvriježenoga dihotomnoga dijagnostiÄkog pristupa i primjenom novog, integrativnog naÄina dijagnostiÄkog razmiÅ”ljanja doÅ”lo se do spoznaje o postojanju funkcionalnih vestibularnih poremeÄaja. Oni su uvijek posljedica loÅ”e readaptacije posturalnog sustava na neku vestibularnu, neuroloÅ”ku, strukturnu ili psihijatrijsku bolest. Uzrok tomu leži u uskoj povezanosti živÄanih projekcija u mozgu odgovornih za kontrolu pokreta i položaja tijela u prostoru s onima odgovornima za opasnost i strah. Odbor za klasifikaciju vestibularnih poremeÄaja BĆ”rĆ”nyjeva druÅ”tva nedavno je utemeljio dijagnostiÄke kriterije za perzistentnu posturalno-percepcijsku vrtoglavicu (PPPD). RijeÄ je o najÄeÅ”Äem funkcionalnom vestibularnom poremeÄaju, koji obuhvaÄa prije uspostavljene entitete: fobiÄnu posturalnu vrtoglavicu, vizualnu i kroniÄnu subjektivnu vrtoglavicu. Dominantni simptomi PPPD-a jesu: vrtoglavica koja kontinuirano traje najmanje 3 mjeseca i uvijek je povezana s držanjem tijela, a nije kružnog tipa. Javljaju se preosjetljivost na pokretne podražaje, ukljuÄujuÄi i vlastite pokrete, ali i kretanje velikih vizualnih objekata ili kompleksnih vizualnih podražaja u Å”irokome vidnom polju, kao i teÅ”koÄe pri izvoÄenju preciznih vizualnih radnja. Kod blažih i umjerenih smetnja poželjno je provesti vestibularnu rehabilitaciju, jer veÄina pacijenata ima provokativne Äimbenike vezane uz vid i kretanje. Indicirano je i farmakoterapijsko lijeÄenje selektivnim inhibitorima ponovne pohrane serotonina i noradrenalina. Dobri rezultati postižu se i primjenom kognitivno-bihevioralne psihoterapije, mijenjanjem negativnih automatskih misli, refokusiranjem pažnje, reatribucijom, sustavnim i postupnim izlaganjem ili, pak, izlaganjem odjedanput i dr. Prognoza bolesti znatno je bolja kod pacijenata bez komorbiditeta u odnosu prema onima s njime.Functional dizziness is noted for its frequency and is the second most common cause of dizziness in the general population, most prevalent in the age group of 30ā50 years. The classic diagnostic process is aimed
at finding a medical or surgical diagnosis, and in case it is not found, it is said to be caused by a āpsychogenicā disease. In recent decades, using a new, integrative way of thinking, there has been a discovery of functional vestibular disorders. They have always been overcome by acute or back vestibular disease due to poor readout of the postural system. The reason for this lies in a close connection to the brain of nerve projections responsible for controlling motion and position of the body in space with those responsible for danger and fear. The Nomenclature and Classification Committee of Baranyās Vestibular Disorders recently established diagnostic criteria for persistent postural-perceptive dizziness (PPPD). This is the most common functional vestibular disorder, which includes the previously established: persistent postural dizziness, visual and chronic subjective dizziness. The dominant symptom of PPPD is non-rotatory dizziness that lasts for at least three months continuously and is always associated with the condition of the body. The hypersensitivity to moving stimuli occurs, including the movements of large visual objects or complex visual stimuli in a wide field of vision and the difficulty of performing precision visual actions. For mild and moderate interferences it is advisable to conduct vestibular rehabilitation, as most patients have provocative factors related to vision and movement. Individually tailored exercises are used to reduce susceptibility to provocative movements, and conditioning exercises are very useful for repairing disturbed body posture. Pharmacotherapeutic treatment with selective serotonin or serotonin and norepinephrine reuptake inhibitors is also indicated. Good results are achieved by the use of cognitive-behavioural psychotherapy, changing of negative automatic thoughts, refocusing attention, re allocation, systematic and gradual exposure or exposure at once, biofeedback etc. The prognosis of the disease is better in patients without comorbidity, while in those with comorbidity it is significantly worse
Rare Diseases of the Vestibular System
Vrtoglavica je jedna od najÄeÅ”Äih tegoba na koju se pacijenti žale lijeÄniku. Može se reÄi da poremeÄaj ravnoteže tijekom života doživi oko treÄina cjelokupne ljudske populacije pa otuda njegov veliki javnozdravstveni znaÄaj. Ne radi se o jednoj bolesti, veÄ se u sluÄaju vrtoglavice radi o sindromu koji ukljuÄuje stotine razliÄitih uzroka. LijeÄniku kliniÄaru to može na prvi pogled djelovati zastraÅ”ujuÄe, ali nakon dublje analize shvaÄamo da ogromnu veÄinu vrtoglavica Äini deset najÄeÅ”Äih uzroka, dok se svi ostali mogu svrstati u rijetke bolesti prema važeÄoj definiciji koja kaže da se svaka bolest koja zahvaÄa < 5 : 10 000 ljudi smatra rijetkom. Ovo nas upuÄuje na zakljuÄak da ovakve bolesti nikako ne bi trebalo zanemariti u procesu diferencijalno-dijagnostiÄkog promiÅ”ljanja. Može se reÄi da su rijetke bolesti rijetke, ali da su oboljeli od njih vrlo brojni. Otprilike 5000 - 8000 razliÄitih rijetkih bolesti pogaÄa 6-8 % stanovniÅ”tva Europske unije, odnosno izmeÄu 27 i 36 milijuna ljudi. U ovom tekstu pozornost smo posvetili onim rijetkim vestibularnim poremeÄajima koji su važni za svakodnevno dijagnostiÄko, posebice diferencijalno-dijagnostiÄko promiÅ”ljanje. Neki od ovih poremeÄaja, iako po naÅ”em miÅ”ljenju imaju veliku diferencijalno-dijagnostiÄku važnost, joÅ” uvijek nisu uvrÅ”teni na listu rijetkih entiteta ORPHA, dok su s druge strane uvrÅ”teni dobro nam poznati i etablirani poremeÄaji ili pak oni potpuno beznaÄajni za svakodnevnu lijeÄniÄku praksu zbog svoje enormno niske uÄestalosti.Dizziness is one of the most common symptoms that patients complain about to their doctors. It can be said that around one third of the entire human population experiences dizziness during their lifetime, and hence its great public health significance. It is not a single disease, however: in the case of dizziness, it is rather a syndrome, which involves hundreds of different causes. It may seem scary to a clinician, but we might realize subsequent to an in-depth analysis that ten dizziness causes are most common, while the remaining ones might be classified as rare diseases, according to the current definition. Consequently, they should not be ignored in a differential-diagnostic process. Actually, any disease that affects < 5:10.000 people is considered rare. It can be said that rare diseases are infrequent, but the patients suffering from them are numerous. Five to eight thousand different rare diseases affect 6-8% of the European Union (EU) population--that is, between 27 and 36 million people. In this article, we have paid attention to those rare vestibular disorders that are significant for quotidian diagnostics, especially with regard to a differential-diagnostic excogitation method. In spite of their major differential-diagnostic importance, some of these disorders are still not included in the ORPHA list of rare entities. On the other hand, the well-known and established disorders, or those that are completely insignificant for everyday medical practice, are enlisted due to their enormously low frequency