Transdental Implants in the Case of Wider Indications for Apicotomy of the Median Upper Incisor

Načela klasične mehaničke retencije primjenjuju se i danas u modernoj medicini i stomatologiji, a primjer tomu su i transdentalni usadci modificirani iz igličastih usadaka, tj. triplantata. Zamisao njihove primjene potječe od Scialoma godine 1962., iako se u literaturi spominju i prije. Zbog široka izbora indikacija i biokompatibilnosti, transdentalni usadci imaju danas svoje mjesto u stomatologiji. Prikazan je slučaj četrnaestogodišnje pacjentice u koje je zbog recidiva ostitičkoga periapikalnog procesa na središnjem lijevom gornjem sjekutiću nakon ponovljene apikotomije primijenjena terapija transdentalnim endoosealnim usadkom. Klinički i radiološki nalaz pokazao je velik gubitak koštanoga i zubnoga tkiva, što je za posljedicu imalo pomičnost zuba u svim smjerovima. Zbog takve indikacije odabrana terapija osigurala je stabilnost i produljila uzdužnu osovinu zuba. Kao transdentalni usadak upotrijebljena je nehrđajuća čelična žica promjera 0,9 mm ukucana u kost pod kontrolom oka. Slučaj je praćen i dokumentiran u razdoblju od godine 1990. do danas što je omogućilo dokazati opravdanost terapije. Ovaj primjer pokazuje kako “izgubljeni zub” ne mora uvijek to i biti.The principles of classic mechanical retention are still applied today in modern medicine and dental medicine. Examples of this are transdental implants, modified from needle implants, i.e. triplants. The concept of their application originates from Scialoma in 1962, although in the literature they were mentioned even earlier. Because of the wide selection of indications and biocompatibility transdental implants have their place today in dental medicine. The case of a fourteen year-old girl is presented, in whom therapy with a transdental endoosseous implant was applied, because of a recurrence of an ostitic periapical process on the median left upper incisor following repeated apicotomy. The clinical and radiographic finding showed considerable loss of bone and dental tissue, which had resulted in the movement of the tooth in all directions. Because of the indications the therapy chosen ensured stability and lengthened the longitudinal axis of the tooth. Stainless steel wire, 0.9 mm in diameter, was used for the transdental implant, driven into the bone with the control of the naked eye. The case was monitored and documented during the period from 1990 until today, and proves the justification of the therapy. This example shows how a “lost tooth” does not always have to be that

Parisian Cycle

Prikazani radovi nastali su u jednom trenutku za vrijeme Sederova boravka u Parizu 1988. godine. Premda u kontekstu cjeline djela predstavljaju samo isječak, u njima se ipak iskazuju sve velike karakteristike Sederova slikarstva.The displayed works came about during Seder\u27s stay in Paris in 1988. Even though the works in the context of a whole present only a segment, all of the wider characteristics of Seder\u27s painting can be seen in them

Relationship between the names of people and enterprises with plant origin with phytotoponyms in five Croatian regions

In this study, the first and last names of people (FN and LN), enterprises (EN) (with plants’ species roots in their names) and phytotoponyms (PT) in five Croatian regions are analyzed, in their relationships. The goals of the study were: to determine the correlations between FN, LN, EN and PT; to determine the latent structure of these variables; to forecast number of PT (criterion) on the base of predictors (FN, LN, EN); to determine grouping of the places (within certain regions) as cases by two plants’ categorizations; to determine grouping of the plants as cases by regions. We have analyzed 15 places, grouped in five regions, with 39 different plant species. The results revealed that the only principal component highly positively correlated with the variables last name and office name, while the projections for the variables first name (moderate high) and phytotoponyms (low size) were negative. Prediction of the criteria phytotoponyms is satisfactorily good, using three predictors: last name, first name and the office name. First cluster analysis revealed that phytotoponyms are mostly related with trees and deciduous plants, while names are related with trees, deciduous and herbaceous plants. Second cluster analysis obtained clear distinction between regions in dominant PTs, based on certain plants’ names. The results indicate clear association between phytotoponyms and names of people

Data Quality in the Context of Longitudinal Research Studies

This paper discusses the concept of data quality in the context of longitudinal research. By deconstructing quality assurance process and data collection strategies through a case study of the “Croatian Birth Cohort Study“, we try to define causes and sources of poor data quality in the context of longitudinal studies. Besides the problems discussed throughout the known literature (panel conditioning, sample attrition, recall bias, temporal and financial demands), we introduce singlesource problems, multi-source problems, security problems, design questionnaire problems and QA workflow problems as important aspects in the domain of the possible sources of errors. Additionaly we propose models for eliminating the errors through prevention and detection in order to improve data quality

Nefarmakološko liječenje osteoartritisa utemeljeno na dokazima

Osteoarthritis (OA ) is the most common rheumatic joint disease, but also a disease that affects the entire joint and all structures surrounding the joint (periarticular structures). Literature dealing with this topic most commonly includes results related to the treatment of knee osteoarthritis (OA ), while other localisations of degenerative changes of the joints are not researched in such a detailed way. In addition to that, these degenerative changes exhibit less evidence strength, so the same will be used in this review. According to the latest 2019 ESCEO guidelines for the treatment of OA , non-pharmacological treatment (NPT) has an important role in OA treatment and it is a part of all OA treatment algorithms, and it has to be a part of evidence-based medicine (EBM). With technological progress in rehabilitation medicine, new solutions have appeared, as well as new forms of NPT aimed at helping patients, relieving pain, increasing the patients’ functional ability and improving their quality of life. Due to this, in this literature review, which was accessed through the Cochrane library, PEDro database and PubMed search, we mostly found discussions about new technologies in OA treatment. During that search, we can easily conclude that results of many systematic reviews and meta-analyses about the use of conventional methods of physical therapy did not change much compared to the methods used 10 years ago. When it comes to all of these methods, medical exercise is considered to be the most effective one, with the highest evidence strength. Nowadays, as opposed to literature sources in the past, in most literature we are able to find a significantly more accurate and precise definition of the term “physical activity”. It is defined as an activity performed during an individual’s stay at their workplace, during transport, while doing one’s chores or housework, and during leisure time. We believe that the newest, modern technologies in rehabilitation medicine, such as the following ones: high-intensity laser therapy (HILT ), extracorporeal shock wave therapy (ESWT), radio frequency (RF) and electromagnetic therapy super inductive system (SIS ), present the biggest challenge in the NPT of OA today. These treatment methods, according to the available EBM data, have shown outstanding efficiency in the treatment of OA by reducing the patients’ pain, improving patients’ functional ability as well as their quality of life, with minimal adverse effects. Today, the general opinion is that we should give advantage to modern technologies in combination with already well- known and defined medical exercises with implementing preventive activitieOsteoartritis (OA ) najčešća je reumatska bolest zgloba i svih okolozglobnih struktura. U literaturi su najčešće zastupljeni rezultati vezani uz liječenje OA koljena, a ostale lokalizacije degenerativnih promjena zglobnih struktura manje su istraživane. Pritom su i dokazi manje snage pa će tako biti i u ovome preglednom članku. Prema ažuriranim smjernicama ESCEO-a iz 2019. g., bitnu ulogu u liječenju bolesnika s OA ima i nefarmakološko liječenje (NFL) – dio svih algoritama liječenja OA , uz preporuku da mora biti utemeljeno na dokazima (EBM). Tehnološki napredak u rehabilitacijskoj medicini nudi neka nova rješenja, nove oblike NFL-a radi pomoći bolesnicima, uklanjanja boli i povećanja funkcionalnih mogućnosti, čime se poboljšava i kvaliteta života. Zbog toga se u literaturi koja je dostupna pregledom Cochraneove knjižnice, baze PEDro i tražilice PubMed danas najčešće raspravlja o novim tehnologijama u liječenju OA . Primjećujemo da se rezultati brojnih sustavnih pregleda i metaanaliza o primjeni konvencionalne fizikalne terapije nisu bitno promijenili u odnosu prema onima u sličnim analizama i prije 10-ak godina. Najučinkovitijom metodom, uz najkvalitetniju snagu dokaza, smatra se medicinska vježba. No, za razliku otprije, danas u literaturi nalazimo znatno točniju i precizniju definiciju pojma tjelesne aktivnosti: to je aktivnost tijekom boravka na radnome mjestu, za vrijeme transporta, tijekom obavljanja kućanskih poslova i u slobodno vrijeme. Najveći izazov u NFL-u OA danas jesu moderne tehnologije u rehabilitacijskoj medicini, a to su terapije laserom visokog intenziteta (HILT ), udarnim valom (ESWT), radiofrekvencijom (RF) i elektromagnetskim poljem visokog intenziteta (SIS ). Te metode liječenja, prema dostupnim podatcima EBM-a, pokazale su izrazitu učinkovitost u liječenju OA : reduciranu bol kod ispitanika, poboljšane funkcionalne sposobnosti i kvalitetu života bolesnika. Sve to uz izrazito malo neželjenih događaja. Danas je uvriježeno mišljenje da treba davati prednost modernim tehnologijama, dobro definiranim medicinskim vježbama i provođenju preventivnih aktivnosti

Ocjena zdravstvenog stanja stanovnika u neposrednoj blizini aerodroma Bourgas u Bugarskoj

The aim of this follow-up performed in a period of three years (1997-1999) was to assess the morbidity rate among children (0-17 years) and adults (18 years and above) from housing estates Sarafovo, Izgrev, Zornitsa and partly Slaveykov, located close to the airport of Bourgas and compare it to population living at more distance from the airport (town centre). It was found that the prevalence of all diseases in children and the incidence in adults were higher in populations living close to the airport than in matching population living in the town centre. Specific groups of diseases which may be considered more closely associated with the adverse health effects of noise included diseases of the nervous system and of the sense organs, mental disorders, cardiovascular diseases, particularly arterial hypertension, and diseases of the digestive system. It is worth noting, however, that some diseases whose relationship with the effects of aircraft noise was not expected to be that of cause and effect were also found in higher prevalence or incidence rate in exposed populations. This indicates that other factors, which were not sufficiently analysed in this study, deserve full consideration in the evaluation of the results obtained.U razdoblju od 3 godine (1997 – 1999) analiziran je morbiditet u djece (0 - 17 godina) i u odraslih (18 god. i više) u naseljima Sarafovo, Izgrev, Zornica koja se nalaze u blizini zračne luke Bourgas. Grad Bourgas važan je turistički centar Bugarske. U ispitivanje su uključeni i stanovnici naselja Slaveykov koje je udaljeno oko 5 km od završetka aerodromske piste ili se nalazi u smjeru slijetanja – uzlijetanja aviona. Morbiditet je u tim dijelovima grada Bourgasa uspoređen s morbiditetom centra grada koji je izvan dometa buke proizvedene avionskim prometom. Podaci o morbiditetu dobiveni su iz rutinske zdravstvene statistike koja se temelji na evidencijama u poliklinikama u kojima se provodi izvanbolnička zdravstvena zaštita pučanstva. Za djecu su podaci prikazani kao ukupni zbroj bolesti registriranih u navedenome trogodišnjem razdoblju, a za odrasle kao godišnja incidencija bolesti. Rezultati su pokazali da je i u djece i u odraslih prevalencija odnosno incidencija bolesti bila veća u naseljima blizu zračne luke u usporedbi s onima koji žive u centru grada Bourgasa. Evidentirane razlike u pojedinim skupinama bolesti, poput bolesti živčanog sustava, bolesti osjetnih organa, mentalnih poremećaja, bolesti cirkulacije – posebno arterijske hipertenzije te bolesti probavnih organa mogle bi se dijelom povezati sa štetnim učincima buke uzrokovane avionskim prometom. Ali i u vezi s tim bolestima, kao i nekim drugim koje su bile češće u stanovnika naselja u blizini zračne luke, a u učestalosti kojih se ne može pretpostaviti uloga izloženosti buci, upozorava se na to da su očito u igri i drugi čimbenici koji u provedenom ispitivanju nisu dovoljno uzeti u obzir odnosno nisu bili kontrolirani. U zaključku se ističe da, uza sva ograničenja koja se moraju uzeti u obzir pri interpretiranju prikazanih podataka i razlika u morbiditetu uspoređenih skupina stanovnika u Bourgasu, ne treba podcijeniti štetne učinke buke na zdravlje. Uz mjere usmjerene na učinkovitiju kontrolu aerodromske buke potrebno je provoditi zdravstveni nadzor potencijalno ugroženih stanovnika, ali uz korištenje selektivnijih metoda

Current and novel percutaneous epicardial access techniques for electrophysiological interventions: A comparison of procedural success and safety

Accessing the pericardial space safely and efficiently is an important skill for interventional cardiac electrophysiologist. With the increased recognition of the complexity of the 3-dimensional arrhythmogenic substrate due to advances in imaging and mapping technologies there has been an expansion of epicardial procedures in recent years. Equally, minimally invasive implantation of epicardial pacing, cardiac resynchronization, or defibrillation leads is expanding in specific patients where transvenous systems are contraindicated or their long term sequelae should be ideally avoided. Selective delivery of intrapericardial pharmacological antiarrhythmic therapy is yet another potential indication, albeit still investigational. The expanding indications for percutaneous epicardial procedures is contrasted by the still substantial risk and challenges associated with accessing the pericardial space. Myocardial perforation, coronary artery laceration, and damage to the surrounding organs are all recognized and feared complications. A number of innovative epicardial access techniques have been proposed to overcome the difficulties and risks of traditional dry subxiphoid punctures and may allow for more widespread use of epicardial access in the future. We review 10 different established and novel subxiphoidal epicardial access techniques describing procedural success rates, safety profile and overall experience. The technical aspects as well as access times and costs for extra equipment will be reviewed. Finally, an outlook of reported preclinical techniques awaiting in-human feasibility studies is provided

Određivanje optimalne veličine vertikalnog izmjenjivača topline u tlu

The heat pumps coupled to the borehole heat exchangers (BHE) can serve for heating and/or cooling of buildings. Optimal sizing of BHE is important because of high drilling costs and importance of matching borehole thermal capacity with the capacity of the heat pump. Proper design of such systems is usualy based on complex mathematical simulations that have to be performend not only for peak building loads, but also for building loads that are calculated throughout the whole year. For this reason the building loads have to be analysed in more detail than for sizing of a conventional system. Designers of heat pump systems coupled to the BHE should also take into acount the long-term temperature changes in the ground surrounding the BHE, which would influence the overall efficiency of the system during its life cycle. The required BHE length is substantially influenced by the thermal conductivity of the ground, which can be only roughly estimated from local geological data. Experimental thermal response tests provide a good estimate of the ground thermal conductivity and borehole thermal resistance. The high cost of the thermal response test reduces its application to commercial and institutional premises with the large number of BHE. In this work, the overview of calculation methods for the heat pumps coupled to the BHE is presented, with suggestions for optimal sizing of BHE.Dizalice topline koje su povezane s izmjenjivačima topline u vertikalnim bušotinama u tlu (ITVB) mogu služiti za grijanje i/ili hlađenje zgrada. Određivanje optimalnih dimenzija ITVB je važno zbog visoke cijene bušenja i zbog usklađivanja toplinskog učinka ITVB s učinkom dizalice topline. Ispravno projektiranje takvih sustava je obično temeljeno na složenim matematičkim simulacijama koje treba provesti ne samo za vršna toplinska opterećenja zgrade nego i za promjene opterećenja zgrade koje su izračunate za cijelu godinu. Zbog toga toplinska opterećenja zgrada treba analizirati detaljnije nego je to potrebno kod projektiranja konvencionalnih sustava. Projektanti sustava s dizalicama topline koje su povezane s ITVB trebaju također uzeti u obzir dugoročne promjene temperature tla koje okružuje ITVB, a koje će utjecati na ukupnu djelotvornost sustava u njegovom životnom vijeku. Potrebna duljina ITVB bitno ovisi o toplinskoj vodljivosti tla, vrijednost koje se može samo grubo procijeniti na temelju lokalnih geoloških podataka. Eksperimantalno ispitivanje toplinskog odziva bušotine pruža dobru procjenu toplinske vodljivosti tla, a također i toplinskog otpora bušotine. Visoka cijena provedbe ispitivanja toplinskog odziva bušotine ograničava primjenu takvih ispitivanja samo na velike poslovne i institucionalne zgrade, kod kojih se izvodi veliki broj bušotina. U ovom je radu prikazan pregled metoda proračuna dizalica topline koje su povezane s ITVB, s preporukama za optimalno dimenzioniranje ITVB