14 research outputs found
Periodontal disease and chronic kidney disease
Cilj istraživanja: Parodontalna bolest (PB) jedna je od najrasprostranjenijih bolesti danas. RijeÄ je o stanju kroniÄne upale niske razine koja može aktivirati sistemski upalni odgovor organizma i na taj naÄin dodatno opteretiti bolesnika s drugim sistemskim bolestima i oslabljenim imunoloÅ”kim sustavom. Istraživanja su o povezanosti parodontalne bolesti s drugim sistemskim bolestima brojna, a do sada je najbolje istražena povezanost parodontalne bolesti i dijabetesa melitusa. Cilj naÅ”eg istraživanja bio je istražiti moguÄu povezanost parodontalne bolesti i kroniÄne bubrežne bolesti (KBB) preko sistemskih razina proupalnih citokina. Ispitanici i metode: U ovo presjeÄno kohortno istraživanje ukljuÄeno je ukupno 80 bolesnika podijeljenih u dvije skupine ovisno o stupnju kroniÄne bubrežne bolesti od kojeg boluju. U prvu skupinu uvrstili smo ispitanike s 5.stupnjem kroniÄne bubrežne bolesti koji se lijeÄe hemodijalizom, a u drugu ispitanike s 3.i 4.stupnjem kroniÄne bubrežne bolesti. Svima su uzeti podatci iz anamneze i medicinske dokumentacije, uÄinjena je opsežna laboratorijska analiza i ELISA analiza razine citokina: interleukin 6 (IL-6), interleukin 17A (IL-17A) i tumorski faktor nekroze alfa (TNF-Ī±) u serumu. Svim ispitanicima uÄinjen je kompletan parodontoloÅ”ki pregled i uzet kompletan parodontalni status. Podatci su meÄusobno analizirani i usporeÄeni meÄu skupinama. Rezultati: Rezultati su pokazali da nije bilo statistiÄki znaÄajne razlike u parodontalnom statusu meÄu skupinama. Razine IL-6 bile su znaÄajno viÅ”e u skupini ispitanika koji su na hemodijalizi (P=0,004) i bile su povezane s loÅ”ijim parodontalnim statusom. Razine preostala dva citokina nisu pokazale statistiÄki znaÄajnu razliku. LoÅ”iji parodontalni status takoÄer su imali i dijabetiÄari, te puÅ”aÄi. ZakljuÄak: PoviÅ”ene razine interleukina 6 u skupini ispitanika na hemodijalizi koje su i povezane s loÅ”ijim parodontalnim statusom govore da je moguÄe da loÅ”iji parodontalni status svojim dodatnim upalnim optereÄenjem može pogorÅ”ati stanje kroniÄne bubrežne bolesti.Objectives: Periodontal Disease (PD) is one of the most common diseases today. It is believed that low-grade level of chronic inflammation and release of bacterial toxins and inflammatory mediators in the bloodstream aggravate a chronic systemic disease. Numerous studies have shown the association of periodontal disease and various chronic systemic diseases, such as diabetes mellitus and cardiovascular disease. The purpose of our research was to investigate the possible association of periodontal disease and chronic kidney disease (CKD) via the inflammatory cytokines path. Subjects and methods: In this cross-sectional study, we surveyed a total of 80 subjects divided into two groups. First group included subjects with CKD stages 3 and 4, and the second group included patients with CKD stage 5, who are treated with hemodialysis. We compared the periodontal status among the groups, as well as the serum levels of different cytokines: interleukin 6, interleukin 17A and tumor necrosis factor Ī±. Results: The results showed no significant differences in the periodontal status among groups, but interleukin 6 levels were significantly higher in the hemodialysis group of patients (P=0,004) and were also associated with a poorer periodontal status. Diabetic patients and smokers also had poorer periodontal status. Conclusion: Elevated interleukin 6 levels in the hemodialysis group associated with poorer periodontal status indicate that it may be possible that a worse periodontal status can deteriorate chronic disease such as CKD with additional inflammatory burden
Frenulectomy - When and Why?
Podatci iz literature Äesto su dijametralno suprotni Å”to se tiÄe potrebe da se izvede kirurÅ”ki zahvat kod perzistentnoga frenuluma, bilo da se radilo o njegovoj izravnoj povezanosti s dijastemom medijanom ili ne.
RazliÄita su miÅ”ljenja o najpovoljnijem vremenu za zahvat ili na redoslijed intervencije kirurga, odnosno ortodonta. VeÄina se autora slaže u tome da je zahvat potreban, ali i da se s njim ne treba žuriti. Pojedini autori smatraju kako treba priÄekati da iznikne trajni oÄnjak, a drugi upozoravaju i na moguÄnost spontanoga zatvaranja dijasteme joÅ” i u vrijeme nicanja drugoga trajnog molara. Prema navodima u literaturi frekvencija tektolabijalnoga frenuluma djece je 7,3%, a odraslih samo l,3%, Å”to upuÄuje na neopravdanost ranih kirurÅ”kih tretmana.
NaÅ”e istraživanje pokazuje sukladne podatke, jer je najveÄa zastupljenost frenulektomija (80%) u dobi do 20 godina. Od svih lokalizacija koje zahvaÄa hipertrofiÄni frenulum njih 90% je u podruÄju gornje usne. Upravo ta povezanost izmeÄu dobi i lokalizacije govori nam da se radilo o ortodontskoj indikaciji, zapravo o dijastemi medijani. NajveÄi broj dijastema zatvara se u vrijeme nicanja lateralnih sjekutiÄa, pa ako dijastema i dalje perzistira, a popraÄena je hipertrofiÄnim frenulumom, postoje male moguÄnosti kasnijeg spontanog zatvaranja. Zato operativni zahvat izvodimo ne ÄekajuÄi da niknu trajni oÄnjaci.
Sve operativne intervencije za uklanjaje abnormalno razvijenog frenuluma svode se na inciziju, eksciziju ili transpoziciju tkiva u podruÄju frenuluma, odnosno kombinaciji svih triju postupaka. Operativne metode koje se najÄeÅ”Äe preporuÄuju zbog zadovoljavajuÄeg postoperativnog rezultata, brzine samog zahvata i jednostavnosti tehnike jesu āVā ekscizija, te horizontalna incizija interdentalnoga tkiva i dijela papile incizive. Nakon toga kirurÅ”koga tretmana moguÄe je uÄiniti i kortikotomiju na tome podruÄju ako je to potrebno.
Svrha je ovoga istraživanja prikazati indikacije za frenulektomiju, s posebnim osvrtom na vrijeme kirurŔkoga zahvata.Data from the literature are often diametrically contradictory with regard to the need to carry out a surgical procedure in the case of a persistent frenulum, either when it is a case of its direct connection with the diastema median or not.
Opinions vary on the most suitable time to perform the operation, or on the chronology of the intervention of the surgeon or orthodontist. The majority of authors agree that the operation is necessary but that there is no need for urgency. Some authors consider that one should wait until the eruption of the permanent molar, while others warn of the possibility of spontaneous closing of the diastema at the time of the eruption of the second permanent molar. According to reports in the literature the frequency of tectolabial frenulum in children is 7.3%, and in adults only 1.3%, which indicates that early surgical treatment is unjustified.
Our investigation shows consistent data, because the greatest incidence of frenulectomia (80%) occurred up to the age of 20 years. Of all the sites affected by a hypertrophic frenulum, 90% were in the area of the upper lip. The connection between age and the localisation indicates orthodontic indication, of just the diastema median. Most diastema close during eruption of the lateral incisors, but if the diastema persists, and is accompanied by hypertrophic frenulum, the possibility of later spontaneous closing is slight. Thus the operative procedure can be carried out without waiting for the eruption of the canines.
All operations for removal of abnormally developed frenulum comprise incision, excision or transposition of tissue in the region of the frenulum, i.e. a combination of all three procedures. The operative methods most frequently recommended because of the satisfactory postoperative result, speed of procedure and simple technique are āVā excision and horizontal incision of the interdental tissue and part of the papilla incisiva. After such surgical treatment it is possible to carry out corticotomy in the area if necessary.
The aim of this study was to present indications for frenulectomy, with special reference to the time of the surgical procedure
Debljina sloja živÄanih vlakana mrežnice u glaukomskih bolesnika LijeÄenih multiplim intravitrealnim injekcijama anti-vegf-a (bevacizumaba)
Over the past decade, intravitreal injections of anti-VEGF agents have been widely used and intensively developed as a treatment option for many ophthalmological indications. Due to its availability and low cost, the most frequently used anti-VEGF agent is bevacizumab. This type of therapy is often indicated in patients with exudative age-related macular degeneration (ARMD) and diabetic macular edema (DME). If, in addition to these two conditions, patients have a diagnosis of primary open angle glaucoma (POAG), they also present with optic nerve head (ONH) retinal nerve fiber layer (RNFL) thinning. The aim of this prospective study was to establish whether administering bevacizumab to patients with POAG leads to additional reduction of RNFL thickness. The study included 60 patients divided into two groups. First group comprised the eyes of patients with exudative ARMD and POAG, whereas second group comprised the eyes of patients with DME and POAG, all treated with bevacizumab. Control group comprised the fellow eye of each involved patient, which was not treated with bevacizumab. In a period of one year, all patients underwent optical coherence tomography (OCT) measurements of ONH RNFL thickness. The results of all patients were compared between the two study groups and then with control group results. Study results showed a decrease of RNFL in both groups of patients. Comparison of these two groups of patients after one year revealed a statistically more significant decrease in RNFL thickness in the second group (DME + POAG).Intravitrealna aplikacija anti-VEGF agenasa za razliÄite indikacije jedna je od najprimjenjivanijih i najbrže razvijajuÄih terapijskih moguÄnosti posljednih godina u oftalmologiji. NajÄeÅ”Äe se zbog svoje dostupnosti i cijene koristi bevacizumab. Eksudativna senilna makularna degeneracija (SMD) i dijabetiÄki makularni edem (DME) meÄu najÄeÅ”Äim su indikacijama za ovu vrstu terapije. Ako uz ove dijagnoze bolesnici imaju i primarni glaukom otvorenog kuta (engl. primary open angle glaucoma, POAG), imaju i stanjenje sloja živÄanih vlakana PNO (lat. papilla nervi optici). U ovom prospektivnom istraživanju ispitivali smo dolazi li kod bolesnika s POAG koji moraju primati bevacizumab do dodatnog stanjenja debljine RNFL (engl. retinal nerve fi ber layer). U istraživanje je bilo ukljuÄeno 60 bolesnika podijeljenih u dvije skupine. Prvu skupinu su Äinile oÄi bolesnika koji imaju eksudativnu SMD i POAG, a drugu oni koji imaju DME i POAG te su lijeÄeni bevacizumabom. Kontrolnu skupinu Äinilo je drugo oko u koje nije apliciran bevacizumab. Kod svih bolesnika mjerila se debljina sloja živÄanih vlakana PNO pomoÄu optiÄke koherentne tomografi je kroz godinu dana, a dobivene vrijednosti su usporeÄene s kontrolnim skupinama te meÄusobno. Rezultati su pokazali da su nakon godinu dana sve skupine imale stanjenje RNFL, ali dok u prvoj skupini nije bilo statistiÄki znaÄajne razlike izmeÄu lijeÄenog i nelijeÄenog oka, u drugoj skupini je ta razlika ipak bila statistiÄki
znaÄajna. UsporeÄujuÄi ove dvije skupine bolesnika dobiveno je statistiÄki veÄe stanjenje RNFL nakon godinu dana u drugoj skupini bolesnika (DME + POAG)
KirurÅ”ki aspekti lijeÄenja blefarospazma: prikaz sluÄaja
Blepharospasm is an idiopathic condition characterized by involuntary eyelid closure mainly caused by bilateral tonic-clonic contractions of the orbicularis oculi muscle. It results in patient inability to open their eyes, thus significantly impairing their ability to perform activities of daily living. First-line treatment for blepharospasm are primarily botulinum toxin type A injections. However, surgical procedure as a treatment option can also be taken in consideration. In this overview, we present a case of a 75-year-old female patient who received surgical treatment as per Andersonās method after being treated with botulinum toxin type A for 3 years. This form of therapy proved to be an extremely successful permanent solution in the treatment of severe cases of refractory blepharospasm, without any long-term complications, especially ectropion and lagophthalmos.Blefarospazam je idiopatska bolest kod koje dolazi do nekontroliranog stiskanja oÄnih vjeÄa zbog najÄeÅ”Äe obostranih toniÄko kloniÄkih kontrakcija kružnog oÄnog miÅ”iÄa. Takvo stanje kod bolesnika rezultira nemoguÄnoÅ”Äu otvaranja oÄiju i znatno ograniÄava obavljanje svakodnevnih aktivnosti. Terapija prvog izbora su injekcije botulinum toksina A, no u obzir dolazi i kirurÅ”ko lijeÄenje. Ovaj osvrt prikazuje sluÄaj bolesnice u dobi od 75 godina, kirurÅ”ki lijeÄene Andersonovom
metodom nakon 3 godine lijeÄenja botulinum toksinom A. Takav oblik terapije pokazao se veoma uspjeÅ”nim trajnim rjeÅ”enjem u lijeÄenju težih sluÄajeva refraktornog blefarospazma uz izostanak dugoroÄnih komplikacija, osobito ektropiona i lagoftalmusa
The Radiomorphometric Indices of the Mandible as a Screening Method for Early Detection of Osteoporosis in Postmenopausal Women
The aim of the study was to compare radiomorphometric indices measured on panoramic radiographs: mandibular cortical width (MCW), panoramic mandibular index (PMI) and mandibular cortical index (MCI) with the densitometric values of skeletons in postmenopausal women, as well as and to determine the possibilities of their use in screening for early detection of osteoporosis in risky populations. Radiomorphometric indices were measured on panoramic radiographs of 146 postmenopausal patients, mean age 66.3 (Ā±9.7) years, mean menopausal age 16.3 (Ā±10.6) years. By dual energy X-ray absorptiometry (DXA) method were measured bone mineral density of the femur and the lumbar vertebrae (L1āL4). The Receiver Operating Characteristic (ROC) curve analysis was used to determine the changed densitometric finding, and to distinguish osteopenia and osteoporosis. The examinees with lower densitometric values had significantly lower MCW (3.60 mm) and PMI (0.36 mm) than those with regular densitometric values (p 1 (p<0.001). For early detection of osteopenia and osteoporosis in postmenopausal women in everyday clinical practice, panoramic radiograph as a screening method can be of help
The Importance of Thorough Preoperative Diagnostics of Maxillary Ameloblastoma: Report of Three Cases
Ameloblastoma, especially maxillary, is a rare benign neoplasm of odontogenic origin. Diagnosis of significant number of lesions is usually established postoperatively, because ameloblastoma, especially the unicystic form, mimics wide range of more frequent jaw lesions. From January 1993 to December 2005, three cases of the maxillary ameloblastoma were surgically treated at our Department. The authors present clinical, radiological and pathohistological features of the ameloblastomas in this rare localization with special attention to need of accurate preoperative diagnostics
Periodontal disease and chronic kidney disease
Cilj istraživanja: Parodontalna bolest (PB) jedna je od najrasprostranjenijih bolesti danas. RijeÄ je o stanju kroniÄne upale niske razine koja može aktivirati sistemski upalni odgovor organizma i na taj naÄin dodatno opteretiti bolesnika s drugim sistemskim bolestima i oslabljenim imunoloÅ”kim sustavom. Istraživanja su o povezanosti parodontalne bolesti s drugim sistemskim bolestima brojna, a do sada je najbolje istražena povezanost parodontalne bolesti i dijabetesa melitusa. Cilj naÅ”eg istraživanja bio je istražiti moguÄu povezanost parodontalne bolesti i kroniÄne bubrežne bolesti (KBB) preko sistemskih razina proupalnih citokina. Ispitanici i metode: U ovo presjeÄno kohortno istraživanje ukljuÄeno je ukupno 80 bolesnika podijeljenih u dvije skupine ovisno o stupnju kroniÄne bubrežne bolesti od kojeg boluju. U prvu skupinu uvrstili smo ispitanike s 5.stupnjem kroniÄne bubrežne bolesti koji se lijeÄe hemodijalizom, a u drugu ispitanike s 3.i 4.stupnjem kroniÄne bubrežne bolesti. Svima su uzeti podatci iz anamneze i medicinske dokumentacije, uÄinjena je opsežna laboratorijska analiza i ELISA analiza razine citokina: interleukin 6 (IL-6), interleukin 17A (IL-17A) i tumorski faktor nekroze alfa (TNF-Ī±) u serumu. Svim ispitanicima uÄinjen je kompletan parodontoloÅ”ki pregled i uzet kompletan parodontalni status. Podatci su meÄusobno analizirani i usporeÄeni meÄu skupinama. Rezultati: Rezultati su pokazali da nije bilo statistiÄki znaÄajne razlike u parodontalnom statusu meÄu skupinama. Razine IL-6 bile su znaÄajno viÅ”e u skupini ispitanika koji su na hemodijalizi (P=0,004) i bile su povezane s loÅ”ijim parodontalnim statusom. Razine preostala dva citokina nisu pokazale statistiÄki znaÄajnu razliku. LoÅ”iji parodontalni status takoÄer su imali i dijabetiÄari, te puÅ”aÄi. ZakljuÄak: PoviÅ”ene razine interleukina 6 u skupini ispitanika na hemodijalizi koje su i povezane s loÅ”ijim parodontalnim statusom govore da je moguÄe da loÅ”iji parodontalni status svojim dodatnim upalnim optereÄenjem može pogorÅ”ati stanje kroniÄne bubrežne bolesti.Objectives: Periodontal Disease (PD) is one of the most common diseases today. It is believed that low-grade level of chronic inflammation and release of bacterial toxins and inflammatory mediators in the bloodstream aggravate a chronic systemic disease. Numerous studies have shown the association of periodontal disease and various chronic systemic diseases, such as diabetes mellitus and cardiovascular disease. The purpose of our research was to investigate the possible association of periodontal disease and chronic kidney disease (CKD) via the inflammatory cytokines path. Subjects and methods: In this cross-sectional study, we surveyed a total of 80 subjects divided into two groups. First group included subjects with CKD stages 3 and 4, and the second group included patients with CKD stage 5, who are treated with hemodialysis. We compared the periodontal status among the groups, as well as the serum levels of different cytokines: interleukin 6, interleukin 17A and tumor necrosis factor Ī±. Results: The results showed no significant differences in the periodontal status among groups, but interleukin 6 levels were significantly higher in the hemodialysis group of patients (P=0,004) and were also associated with a poorer periodontal status. Diabetic patients and smokers also had poorer periodontal status. Conclusion: Elevated interleukin 6 levels in the hemodialysis group associated with poorer periodontal status indicate that it may be possible that a worse periodontal status can deteriorate chronic disease such as CKD with additional inflammatory burden