Epidemiologija and etiologija pločastog karcinoma glave i vrata

Introduction: It was expected at least in Western countries that incidence of head and neck cancers (HNSCC) should become lower due to the propaganda against smoking. However, the expected decrease in HNSCC was not achieved in many countries. Tobacco and alcohol consumption are known as a major risk factors for development of HNSCC. It is well known that 15-20% of HNSCC are linked to HPV infection, however, some authors reported coexistence with other viruses as well. In the Eastern countries paan (betel nut), ghutka, that have been also linked to the development HNSCC. However, lately HNSCC have been linked to the low vegetable and fruit intake, vitamin defi ciencies, coinfection with other viruses, certain genetic syndromes and occupational exposure. Therefore, the aim of this study is to review recent literature regarding epidemiology and other risk factors in the development of HNSCC. Methods: Pubmed was searched in the past two years in order to fi nd out novelties regarding epidemiology and aetiology for HNSCC and 34 papers were included. Results and Conclusion: The results of this review paper show that smoking is a major contributing factor especially with alcohol both being dosed and time dependent in the development of HNSCC. Unhealthy diet, decrease in vitamin intake especially folate, C and E vitamin and occupational exposure were seen in the diseased. In about one fourth of the patients infection with HPV has been noticed, and in some coinfection with other viruses such as Epstein Barr, cytomegalovirus and HIV. Obviously genetic predisposition exists but also correlation with certain genetic syndromes such as Fanconi’s anaemia and Bloom syndrome.Uvod: Očekivalo se barem u Zapadnim zemljama kako će incidencija karcinoma glave i vrata biti manja uslijed propagande protiv pušenja. Ipak, očekivano smanjenje u incidenciji karcinoma glave i vrata nije postignuto u mnogim zemljama. Pušenje i konzumacija alkohola su glavni faktori rizika za nastanak karcinoma glave i vrata. Dobro je poznato da je 15-20% karcinoma glave i vrata povezao s HPV infekcijom, doduše, neki autori su izvijestili i o koegzistenciji s drugim virusima također. U istočnim zemljama paan (betel nut), ghutka su također povezani s nastankom carcinoma glave i vrata. Ipak, nedavno je karcinom glave i vrata povezan s rijetkim unosom povrća i voća, defi citom vitamina, koinfekcijom s drugim virusima, određenim genetskim sindromima i radnim okolišem. Stoga je cilj ovog istraživanja bio pregledati noviju literature s obzirom na epidemiologiju i druge rizične faktore u nastanku karcinoma glave i vrata. Metode: Pubmed je pretražen u zadnje dvije godine kako bi se ustanovilo novosti vezane uz epidemiologiju i etiologiju karcinoma glave i vrata te su 34 rada uključena. Rezultati i zaključci: Rezultati ovog preglednog rada pokazuju kako je pušenje najvažniji faktor koji doprinosi nastanku karcinoma glave i vrata uz konzumiranje alkohola, a što ovisi o dozi i vremenu izloženosti. Nezdrava prehrana,smanjeni unos vitamina, posebice folata, C i E vitamina i radni okoliš se ustanove u oboljelih. U oko četvrtine pacijenata je ustanovljena infekcija s HPV virusom, a u nekih i koinfekcija s drugim virusima poput Epstein Barrovog, citomegalovirusa i HIV-a. Očito genetska predispozicija postoji ali i korelacija sa određenim genetskim sindromima poput Fankonijeve anemije i Bloomovog sindroma

Mandibular osteonecrosis due to the pulpal-periodontal syndrome: a case report and review of the literature

OBJECTIVE: Ishemic bone disease has multifactorial etiologies. Cronic dental infections should be eliminated to prevent osteonecrosis of the jaw. ----- CASE REPORT: We report an unusual case of osteonecrosis due to the pulpal-peridontal syndrome and subsequent pulp necrosis. A case of 38 year old woman who presented with exposed bone, 8 mm in diameter, in the lingual area of the right lower third molar. The patient was otherwise healthy and was not taking any medications. A detailed medical history showed no previous diseases. Patient denied any type of local trauma. A complete blood count showed no abnormalities. The panoramic radiograph revealed a deep periodontal pocket between teeth 47 and 48. The CBCT revealed a deep periodontal pocket between molars and bone sequestrum of the lingual plate. Topical treatment consisted of adhesive periodontal dressing based on the cellulose and bethamethasone oitnment together with orabase, without improvement. Therefore, peroral amoxycillin was prescribed for a week. Since there was no improvement, the third molar was removed as well as necrotic bone; the alveolar bone was remodelled and sutures were placed. After suturing, the whole area was covered using intraoral resorbable bandage. Microbial swab of the wound aspirate did not reveal polymorphonuclears or the presence of microorganisms. Microbial swab of the biopsy specimen of the necrotic bone particle and sequestrum showed a large amount of gram-positive coccae, however, polymorphonuclears were not found. Histopathological analysis revealed acute chronic inflammation. One week after the surgery, the area healed completely. ----- CONCLUSION: This case highlights the fact that in some patients bone exposure might develop due to the pulpal-periodontal syndrome i.e. pulp necrosis

Usporedba stabilnosti dentalnih implantata ugrađenih imedijatnom i odgođenom tehnikom u gornjoj čeljusti analizom rezonantne frekvencije – klinička studija

The purpose of this study was to objectively evaluate the stability of dental implants by use of resonance frequency analysis (rfA). In this study, 60 nobel replace tapered Groovy implants were placed in the premolar region of the maxilla in 60 patients. Thirty implants were placed immediately after tooth extraction and 30 implants were placed in healed bone sites. Implant stability quotient (ISq) was obtained by use of the Osstell mentor device and was recorded at the time of implant placement (t1) and 20 weeks after placement, at the time of implant loading (t2). All implants were not functionally loaded during the follow up period. data were analyzed using simple linear regression. no implant failures were reported in the 6-month follow up period. The mean ISqvalue for immediate implant placement was 61.43 at t1 and 66.23 at t2. The implants placed in healed bone showed higher ISq values compared to the immediately placed implants (mean ISqvalue was 64.17 at t1 and 68.83 at t2). differences in the mean ISqvalues were statistically significant (p<0.001). After the completed period of osseointegration, the mean ISqvalue was 4.8 for immediately placed implants compared to 4.67 for implants placed in delayed sites.Svrha ovoga rada bila je objektivno procijeniti stabilnost dentalnih implantata ugrađenih imedijatno nakon ekstrakcije zuba u odnosu na odgođenu tehniku ugradnje u formiranu alveolarnu kost pomoću analize rezonantne frekvencije. Praćeno je 60 pacijenata kojima je gubitak jednog zuba u premolarnoj regiji gornje čeljusti nadomješten ugradnjom dentalnog implantata nobel replace tapered Groovy. Pacijenti su bili podijeljeni u dvije skupine: prvu skupinu činilo je 30 pacijenata odnosno 30 implantata ugrađenih imedijatno nakon ekstrakcije zuba, dok je drugu skupinu činilo 30 implantata ugrađenih odgođenom tehnikom u formiranu alveolarnu kost. mjerenje stabilnosti implantata učinjeno je uređajem Osstell mentor za mjerenje rezonantne frekvencije koji rezultate interpretira u vidu vrijednosti kvocijenta stabilnosti implantata (implant stability quotient, ISq). Prvo mjerenje je učinjeno neposredno nakon ugradnje implantata, dok je drugo provedeno 20 tjedana nakon ugradnje, odnosno prije postavljanja konačne protetske suprastrukuture. Implantati tijekom mjerenja nisu bili funkcionalno opterećeni. nije zabilježen niti jedan gubitak implantata. Prosječne vrijednosti ISq kod imedijatne tehnike su bile 61,43 za prvo te 66,23 za drugo mjerenje u usporedbi sa 64,17 za prvo i 68,83 za drugo mjerenje kod odgođene tehnike ugradnje dentalnih implantata. Srednji porast vrijednosti ISq bio je 4,8 za imedijatnu i 4,67 za odgođenu tehniku

Smart capacitive moisture sensor calibration in mineral wool and green roof soil substrate

The environmental benefits of green roofs have been widely recognized. In recent years, increasing attention has been paid to moisture management in the green roof systems. The moisture in the green roof has an influence on its thermal and hydrological performances. An accurate measurement of water content in green roof substrate is important for irrigation monitoring, optimal irrigation management, and plant growth. Knowing the performance and characteristics of the sensor for the chosen substrate layer in a green roof system is essential. This paper presents laboratory calibration of the capacitive moisture sensor in two types of the green roof substrate layer. The volumetric water content of several mineral wool and soil samples, with the water content from low until saturated, were measured using the gravimetric method and related to frequency obtained by the sensor. The results have shown that the capacitive moisture sensor has a good response to water content variation

Insulin mimetički efekat niskih koncentracija amonijum dekavanadata na izolovane adipocite pacova

In this study, the insulin mimetic activity of ammonium decavanadate (DV) (in concentration 0.1 and 1.0 mM) dissolved in saline (0.9 % w/v of NaCl) or dimethyl sulfoxide, DMSO (2% v/v) was evaluated by means of in vitro measurements of the glucose uptake (GU) and inhibition of free fatty acids release (IFFAR) using isolated epinephrine-pretreated white adipocytes from Wistar rats. Our data showed strong insulin mimetic effect of DV (> 80 %) in both concentration and independently of the solvent were used. Having in mind satisfactory pharmacological effect of DMSO as well as its capability of penetration enhancer it would be reasonable to continue in vivo testing of dose-dependent insulin mimetic effect of decavanadate in DMSO. It is also necessary to examine toxicity of decavanadate in order to estimate its therapeutic index as potential antidiabetic agent.Ispitana je insulin mimetička aktivnost amonijum dekavanadata (DV), in vitro merenjem preuzimanja glukoze (GU) i merenjem inhibicije oslobađanja slobodnih masnih kiselina (IFFAR) na modelu izolovanih belih adipocita Wistar pacova. Ovaj biološki efekat dekavanadata (u koncentracijama od 0,1 i 1,0 mM) koji je rastvoren u fiziološkom rastvoru (0.9 % NaCl) ili u dimetil sulfoksidu (2% DMSO) ispitan je na adipocitima koji su prethodno tretirani adrenalinom. Prema dobijenim rezultatima dekavanadat pokazuje snažan insulin mimetički efekat (> 80 %) i to u obe koncentracije i nezavisno od vrste rastvarača. Na osnovu ovog in vitro eksperimenta može se zaključiti da bi bilo opravdano dozno-zavisno ispitivanje insulin mimetičkog efekta dekavanadata u DMSO-u kao rastvaraču u in vivo uslovima. Takođe, neophodno je ispitati i toksičnost ovog jedinjenja kako bi se što bezbednije iskoristio njegov insulin mimetički efekat

Applications of Low Level Laser Therapy

Principles of biostimulation via therapeutic lasers was introduced more than 20 years ago when they were used in dermatology for wound healing. According to Genovese, biological effects caused by low level lasers are due to low energy deposited into tissues where deposited energy results in primary, secondary and general therapeutic effects. This results in the analgesic and anti-inflammatory effects as well as in improvement in healing. LLLT acts according to the Arndt-Schulz principle which states that if the stimulus is too weak, no effect is seen. Increased stimulation and optimal dose leads to the optimal effect ; while, further dose increase leads to a decreased effect. Additional stimulation leads to the inhibition of stimulation. It seems that LLLT act analgesically since they improve endorphin release and therefore inhibit nociceptive signals and control pain mediators. They can also act analgesically by inhibiting pain signals which partially leads to the transient varicosities along the neurons which decrease impulse transmission

Evaluation of Sentinel Node Biopsy in Oral Carcinomas

It is still a matter of debate whether sentinel node biopsy might replace neck dissection in patients with clinically negative neck lymph nodes who suffer from oral squamous cell carcinoma. In 30 patients (26 male, 4 female, average age 59.4 years) with oral squamous cell carcinoma we performed ultrasound guided punction of the lymph nodes which were lymphoscintigraphically seen together with histopatological analysis of the dissected node. Sentinel lymph node was seen in 93% cases. By use of lymphoscintigraphy sentinel node was verified in 23 patients. Ultrasound guided punction showed presence of regional disease in 10% of cases, whereas sentinel biopsy revealed 23 of the converted necks. Histopathological findings were positive in 33% of our patients. The results of this study revealed that sentinel biopsy did not reveal 27% of the patients with positive neck histopathology. In conclusion, sentinel node biopsy should be performed in selective cases as in some localizations it is easier to perform neck dissection in comparison to the sentinel node biopsy

Evaluacija inovativno digitalno kontroliranog Er:YAG lasera u liječenju leukoplakije - probno istraživanje

The use of lasers for treatment of oral leukoplakia has gained a lot of interest in the past years, however, data on the use of Er:YAG laser are scarce. The aim of this study was to compare the efficacy of Er:YAG laser and 1% topical isotretinoin in the treatment of 27 oral leukoplakia patients. Er:YAG laser (LightWalker AT, Fotona, Slovenia) was used in 27 patients with 27 leukoplakia lesions. Postoperative pain was assessed by use of visual analog scale (VAS), and the impact of laser treatment on the quality of life was assessed by the OHIP-14 questionnaire (Croatian version). Control group consisted of the same 27 patients previously treated with 1% topical isotretionin three times a day during the period of one year. No improvement in the size of leukoplakia lesions was observed after treatment with topical isotretinoin. There were significant differences between men and women according to leukoplakia localization, number of laser sessions and VAS (p<0.05). At follow-up after six months and one year, there was no recurrence of lesions. Er:YAG laser is a successful treatment for oral leukoplakia. Topical isotretionin treatment is unsuccessful in patients with oral leukoplakia.Posljednjih godina postoji veliko zanimanje za upotrebu lasera u liječenju oralne leukoplakije, ali su podatci o upotrebi Er:YAG lasera malobrojni. Cilj ovoga istraživanja bio je usporediti učinak Er:YAG lasera i 1%-tnog topikalnog izotretinoina u liječenju 27 bolesnika s oralnom leukoplakijom. Er:YAG laser (LightWalker AT, Fotona, Slovenia) je korišten u 27 bolesnika s 27 leukoplakičnih lezija. Poslijeoperacijska bol je određena uz pomoć vizualne analogne ljestvice (visual analog scale, VAS), a utjecaj na kvalitetu života mjeren je pomoću upitnika OHIP-14 (hrvatska verzija). Kontrolna skupina se sastojala od istih 27 bolesnika koji su prije toga liječeni 1%-tnim topikalnim izotretioninom tri puta na dan tijekom tri mjeseca. Nije bilo poboljšanja u veličini lezija leukoplakije nakon topikalno primijenjenog izotretinoina. Utvrđene su značajne razlike između muškaraca i žena s obzirom na lokalizaciju leukoplakije, broj laserskih zahvata i rezultata VAS (p<0,05). Šest mjeseci i godinu dana od laserskog zahvata nije bilo recidiva oralne leukoplakije. Er:YAG laser je uspješna terapija u liječenju oralne leukoplakije. Topikalna primjena izotretionina nije uspješna u liječenju oralne leukoplakije