Oralne komplikacije zračenja glave i vrata

Almost all patients (90-100%) who have undergone radiation treatment (RT) of head and neck region develop at least one oral complication. Oral complications of head and neck RT can be acute and chronic. Acute complications occur during RT and include oral mucositis, dry mouth and taste sensation disorder. Chronic complications occur several weeks, months or years after RT cessation, and include radiation caries, osteoradionecrosis and trismus.Gotovo svi pacijenti (90-100%) koji su podvrgnuti terapijskom zračenju u području glave i vrata razviju neku od komplikacija u usnoj šupljini. Oralne komplikacije terapijskog zračenja glave i vrata mogu biti akutne i kronične. Akutne komplikacije nastaju tijekom zračenja i u njih ubrajamo oralni mukozitis, suhoću usta i poremećaj okusne osjetljivosti. Kronične komplikacije nastaju nekoliko tjedana, mjeseci ili godina po završetku zračenja, i podrazumijevaju radijacijski karijes, osteoradionekrozu i trizmus

Salivary and Serous Values of Interleukin 6 and Basic Growth Factor of Fibroblasts in Patients with Planocellular Carcinoma

U literaturi postoje podatci o ulozi interleukina 6 (IL-6) i bazičnoga čimbenika rasta fibroblasta (bFGF) u bolesnika s oralnim karcinomima, ali nema podataka o salivarnom IL-6 i bFGF u tih bolesnika. Svrha ovoga ispitivanja bila je odrediti vrijednosti salivarnog i serumskog IL-6 i bFGF u 35 bolesnika s planocelularnim karcinomom usne šupljine, dobi od 40-73 godine, prosječne dobi 54 godine. Kontrolna se je skupina sastojala od 23 zdrava sudionika, u dobi od 25 godina. Dobiveni podatci analizirani su Mann-Whitney U testom i vrijednosti manje od 0,001 smatrale su se statistički znatnima. Serumske vrijednosti IL-6 i bFGF nisu se znatno razlikovale između ispitne i kontrolne skupine. Povišene vrijednosti salivarnog IL-6 i bFGF ustanovljene su u oboljelih od planocelularnoga karcinoma u usporedbi s kontrolnom skupinom (p<0,001). Možemo zaključiti da povišene vrijednosti salivarnog IL-6 i bFGF u oboljelih od planocelularnoga karcinoma potječu od lokalne proizvodnje.Data can be found in the literature on the roles of interleukin 6 (IL-6) and basic growth factor of fibroblasts (bFGF) in patients with oral carcinomas, although there are no data on salivary IL-6 and bFGF in such patients. The aim of this study was to determine the values of salivary and serum IL-6 and bFGF in 35 patients with planocellular carcinoma of the oral cavity, aged 40 - 73 years (mean age 54 years). A control group consisted of 23 healthy participants, aged 25 years. The data obtained were analysed by Mann-Whitney U test and values of less than 0.001 were considered statistically significant. Serum values IL-6 and bFGF did not significantly differ between the examined and the control group. Increased values of salivary IL-6 and bFGF were determined in the patients with planocellular carcinoma compared with the control group (p<0.001). We can conclude that the increased values of salivary IL-6 and bFGF in patients with planocellular carcinoma originated from local production

Salivary Peroxidase Levels in Patients With Oral Lichen Planus

Oralni lihen planus (OLP) je kronična upalna bolest kojoj etiologija još nije identificirana, ali je karakterizirana s imunoreaktivnošću koj je usmjerena protiv bazalnih keratinocita i koja je posredovana s T-limfocitima. U zdravih osoba salivarna peroksidaza zajedno s drugim salivarnim antimikrobnim enzimima održava ekološku ravnotežu u usnoj šupljini. Svrha ovog istraživanja bila je odrediti vrijednosti salivarne peroksidaze u bolesnika s OLP-om. U 30 bolesnika s OLP-om određene su vrijednosti salivarne peroksidaze u ukupnoj nestimuliranoj slini, a tako i u 28 kontrolnih ispitanika. Svaki je ispitanik izbacivao skupljenu slinu u kalibrirane epruvete tijekom pet minuta u vremenu od 8-11 ujutro. Uzorci sline zatim su centrifugirani na 800 okretaja tijekom deset minuta i supernatanti su smrznuti na -70°C sve do početka raščlambe. Vrijednosti salivarne peroksidaze određene su po metodi Putter i Beckera. Statistička je raščalmba napravljena uz upotrebu Studentova t-testa i p-vrijednost manja od 0,05 smatrala se statistički znatnom. Nije bilo znatnih razlika između bolesnika s OLP-om i kontrolne skupine s obzirom na količinu izlučene sline i s obzirom na vrijednosti salivarne peroksidaze. Možemo zaključiti da vrijednosti salivarne peroksidaze u bolesnika s OLP-om nemaju utjecaj na promjene koje se vide u usnoj šupljini tih bolesnika.Oral lichen planus (OLP) is a chronic inflammatory disease whose etiology has not yet been identified. It is characterizied by immunoreactivity directed against basal keratinocytes and mediated by T-lymphocytes. In health, salivary peroxidase together with other salivary antimicrobial enzymes maintains the ecological balance in the oral cavity. The aim of this study was to evaluate salivary peroxidase levels in patients with OLP. In 30 patients with OLP, salivary peroxidase levels in whole unstimulated saliva were determined and compared to 28 healthy controls. Each participant collected saliva using the simple method of spitting while sitting unstimulated whole saliva into calibrated tubes during five minutes between 8-11 A.M. Salivary samples were then centrifuged on 800 turns during ten minutes and supernatans were frozen at -70°C until analysis. Salivary peroxidase levels were determined according to Putter and Becker. Statistical analysis was performed using Student t-tes and p-values below 0.05 were considered statistically significant. No significant differnces between patients with OLP and controls in salivary flow rate, as well as in salivary peroxidase levels were found. We can conclude that salivary peroxidase levels in patients with OLP did not have an impact on changes seen in the oral cavity of these patients

GEOECOLOGICAL EVALUATION OF LOCAL SURROUNDINGS FOR THE PURPOSES OF RECREATIONAL TOURISM

The paper presents geoecological evaluation of the city of Loznica for the purposes of sports and recreational tourism based on quantitative method of diversity, V-Wert Method. Using the GIS tool by the quantitative method, the criteria of natural components (relief, forest, water surface and climate) are evaluated for the analyzed area. In the proposed method, the climate factor was supplemented by the analysis of the bioclimatic index Universal Thermal Climate Index (UTCI). When the evaluation was completed, the final results were obtained based on which the degrees of convenience of different parts of the analyzed area have been presented. Out of the total analyzed surface, which amounts to 705 km2, favorable surfaces comprise 21 km2 (2.98%), and very favorable surfaces comprise 33 km2, i.e. 4.68% of the territory. The largest area consists of conditionally favorable terrains — 333 km2 (47.23%). Since one of the basic strategic priorities of the City of Loznica is improvement and development of sports and recreational tourism, the aim of this analysis is to emphasize the potential of the mentioned area in terms of general suitability of the terrain for the development of this type of tourism

Oralne komplikacije zračenja glave i vrata

Almost all patients (90-100%) who have undergone radiation treatment (RT) of head and neck region develop at least one oral complication. Oral complications of head and neck RT can be acute and chronic. Acute complications occur during RT and include oral mucositis, dry mouth and taste sensation disorder. Chronic complications occur several weeks, months or years after RT cessation, and include radiation caries, osteoradionecrosis and trismus.Gotovo svi pacijenti (90-100%) koji su podvrgnuti terapijskom zračenju u području glave i vrata razviju neku od komplikacija u usnoj šupljini. Oralne komplikacije terapijskog zračenja glave i vrata mogu biti akutne i kronične. Akutne komplikacije nastaju tijekom zračenja i u njih ubrajamo oralni mukozitis, suhoću usta i poremećaj okusne osjetljivosti. Kronične komplikacije nastaju nekoliko tjedana, mjeseci ili godina po završetku zračenja, i podrazumijevaju radijacijski karijes, osteoradionekrozu i trizmus

Idiopathic Exposed Bone Lesions of the Jaw

Introduction: Osteonecrosis of the jaw is defined as exposed bone in the oral cavity that does not heal longer than eight weeks after identification. The two most common predisposing factors for osteonecrosis of the jaw are medication-related and radiotherapy. Rarely, exposed bone in the maxillofacial region can occur due to other causes and represents a clinical and therapeutic challenge for the dentist because there is no universally accepted treatment protocol. Case presentation: We report a case of a patient with two idiopathic lesions of exposed bone which have healed after systemic antibiotic therapy, seven weeks after the first examination. Conclusion: Exposed bone lesions of the jaw are a rare entity and are poorly documented in the literature. It is necessary to exclude possible local or systemic contributing factors. Surgical and conservative therapy (antibiotics) are the treatment of choice

Sepsis and septic shock - an observational study of the incidence, management, and mortality predictors in a medical intensive care unit

Aim: To prospectively determine the number of patients with sepsis and septic shock in a medical intensive care unit (ICU) using the Sepsis-3 definition; to analyze patients' characteristics, clinical signs, diagnostic test results, treatment and outcomes; and to define independent risk factors for ICU mortality. ----- Methods: This prospective observational study enrolled all patients with the diagnosis of sepsis treated in the medical ICU of "Sestre Milosrdnice" University Hospital Center, Zagreb, between April 2017 and May 2018. ----- Results: Out of 116 patients with sepsis, 54.3% were female. The median age was 73.5 years (IQR 63-82). The leading source of infection was the genitourinary tract (56.9%), followed by the lower respiratory tract (22.4%). A total of 35.3% of the patients experienced septic shock. Total ICU mortality for sepsis was 37.9%: 63.4% in patients with septic shock and 24.0% in patients without shock. Independent risk factors for ICU mortality were reduced mobility level (odds ratio [OR] 11.16, 95% confidence interval [CI] 2.45-50.91), failure to early recognize sepsis in the emergency department (OR 6.59, 95% CI 1.09-39.75), higher Sequential Organ Failure Assessment score at admission (OR 2.37, 95% CI 1.59-3.52), and inappropriate antimicrobial treatment (OR 9.99, 95% CI 2.57-38.87). ----- Conclusion: While reduced mobility level and SOFA score are predetermined characteristics, early recognition of sepsis and the choice of appropriate antimicrobial treatment could be subject to change. Raising awareness of sepsis among emergency department physicians could improve its early recognition and increase the number of timely obtained specimens for microbial cultures

Sepsis and septic shock – an observational study of the incidence, management, and mortality predictors in a medical intensive care unit

Aim To prospectively determine the number of patients with sepsis and septic shock in a medical intensive care unit (ICU) using the Sepsis-3 definition; to analyze patients’ characteristics, clinical signs, diagnostic test results, treat - ment and outcomes; and to define independent risk fac - tors for ICU mortality. Methods This prospective observational study enrolled all patients with the diagnosis of sepsis treated in the medical ICU of “Sestre Milosrdnice” University Hospital Center, Za - greb, between April 2017 and May 2018. Results Out of 116 patients with sepsis, 54.3% were fe - male. The median age was 73.5 years (IQR 63-82). The lead - ing source of infection was the genitourinary tract (56.9%), followed by the lower respiratory tract (22.4%). A total of 35.3% of the patients experienced septic shock. Total ICU mortality for sepsis was 37.9%: 63.4% in patients with sep - tic shock and 24.0% in patients without shock. Indepen - dent risk factors for ICU mortality were reduced mobility level (odds ratio [OR] 11.16, 95% confidence interval [CI] 2.45-50.91), failure to early recognize sepsis in the emer - gency department (OR 6.59, 95% CI 1.09-39.75), higher Se - quential Organ Failure Assessment score at admission (OR 2.37, 95% CI 1.59-3.52), and inappropriate antimicrobial treatment (OR 9.99, 95% CI 2.57-38.87). Conclusion While reduced mobility level and SOFA score are predetermined characteristics, early recognition of sep - sis and the choice of appropriate antimicrobial treatment could be subject to change. Raising awareness of sepsis among emergency department physicians could improve its early recognition and increase the number of timely ob - tained specimens for microbial cultures