Association of masticatory efficiency with deep carious lesions in children.

PURPOSE: Masticatory efficiency is defined as an individual ability to grind and pulverize food material, and can be influenced by many factors. This research aimed to investigate the association between masticatory efficiency and deep carious lesion. METHODS: The research included 48 children (24 male, 24 female) aged from 3 to 14 years. Participants were allocated to two groups; children with no or with only incipient carious lesions were included in the first group (ICDAS levels 0, 1, or 2), and children with bilateral deep carious lesions that are ICDAS levels 4, 5, and 6 were included in the second group. Information on dental parameters (dental status, ICDAS level of each carious lesion), and level of pain (Wong-Baker scale) were collected from each participant. Participants chewed Optosil® test food for 20 masticatory cycles, and chewed particles were analyzed by the optical scanning method. RESULTS: There is a significant difference in masticatory efficiency variables (number of chewed particles, minimal and maximal Feret diameter, Sauter mean diameter, a mean and total surface of particles) between groups. A positive significant correlation is observed between WBS level and time needed for masticatory performance in a group of children with deep carious lesions. CONCLUSION: Deep carious lesions in children are associated with a decrease in masticatory efficiency. Moreover, children with carious lesions that provoke a higher level of pain take more time for masticatory cycles.

Masticatory efficiency in children with cerebral palsy.

PURPOSE: The purpose of this investigation was to compare quality of chewing in children with CP to the healthy controls, and determine whether the functional capacity of chewing units and overall dental health affect the quality of chewing. METHODS: A total of 86 were included in the investigation: 43 children with CP and 43 controls (13 girls aged 7-16 years and 30 boys aged 9-16 years) residents of the institutions for the children with special needs. Control group included the same number of children matched by age and gender for every child from the test group according to the pairing principle. The number of functional masticatory units was expressed through the number of healthy teeth and teeth with cavities which the patients could use for chewing. Masticatory efficiency assessment was determined by the method of chewed almond transparency after ten chewing cycles. The particles were passed through 12 sieves with diameter range from 0.6 to 7.2 mm. The masticatory efficiency was expressed with the number of sieves needed to pass 50% of the total almond mass. RESULTS: Healthy children had significantly more teeth in occlusal contact, while the DMF index did not differ significantly. Both groups had the same number of functional masticatory units. Children with CP had significantly poorer quality of chewing. CONCLUSION: Children with CP had significantly poorer quality of chewing which is not affected by tooth functionality, but rather the primary condition.

Knowledge about emergency procedure in case of dental trauma among paediatricians in Croatia.

AIM: The aim of this study was to investigate paediatricians' actual attitudes towards emergency management of dental injuries, need for potential improvement in their knowledge and motivation for further education. MATERIALS METHODS: This study was a questionnaire-based cross-sectional survey on a sample of 84 respondents from four Croatian counties. A questionnaire of 24 questions was divided into four parts: personal and professional profile; self-assessed perceived knowledge and experience with dental injuries; specific questions on the management of dental injuries and specific questions regarding education about dental injuries. The questionnaires were collected during a 2-month period. RESULTS: A larger percentage (95%) of surveyed paediatricians have at least once encountered trauma in the practice and in this case 90% of them contacted the dentist. Three quarters of participants (76%) would correctly hold completely extruded tooth. In case of tooth or fragment preservation 60% of the subjects would place the tooth in the saline solution, and only 12% of the respondents would use milk as a transport medium. The 19% of the paediatricians considered that the permanent tooth should not be replanted. Two tirds (62%) of participants did not get any information regarding dental trauma during their past education, but most of them (90%) consider that education about traumatic dental injuries is important, and 86% of the respondents are willing to be educated on the subject in the future. There is no difference in procedures (recommended vs. non-recommended) undertaken during management of detal injuries, according to the participants working place, experience in emergency department or their personal experience of dental trauma. CONCLUSION: The results revealed insufficient paediatricians' knowledge about emergency procedures in case of dental trauma, but they also point out high awareness of the importance of dental trauma, and willingness for further education.

What general medicine students of University of Rijeka know about dental avulsion?

INTRODUCTION: Injuries of decidouos and premanent teeth can be rather hard, esspecially in combinatin if they involve adjacent supportive tissue. Among all injuries, the loss of the teeth is considered the most stressful for both a child and its parents. Tooth injury usually involves soft tissue damage, which means severe bleeding. As parents often look for help from their family general practitioners, it is very important that general practitioner is acquainted with the first aid in order to preserve the tooth and enable further skeletal development. MATERIALS AND METHODS: This study was carried out in the form of a questionnaire, which was distributed among general medical students at the Medical studies of the Faculty of Medicine of the University of Rijeka, Croatia. The study included 86 pre-doctoral students of the 3rd, 4th and 5th years of studies. The questionnaire consisted of 23 questions, which were related to demographics, personal experience in treating dental injuries, theoretical knowledge about dental injuries and their interest in additional training on the subject. RESULTS: The results showed that only 32.6% of the students heard of 'tooth avulsion'. Replacement of the avulsed tooth in its original position in the jaw was considered by 77.6% of the students. In their entire education, 84.9% students didn't acquire any knowledge about dental injuries. CONCLUSION: The study showed that medical students have very poor knowledge about dental injuries. Also, the vast majority of the students were neither informed nor educated about it during their studies.

Activation transcription factor-3 activation and the development of spinal cord degeneration in a rat model of amyotrophic lateral sclerosis.

It has been reported that an early activation of glial fibrillary acid protein (GFAP) in astroglial cells occurs simultaneously in peripheral nerves and spinal cord from the G93A SOD1 mouse model of amyotrophic lateral sclerosis (ALS), an invariably fatal neurodegenerative disorder. In ALS, the contribute to the pathological process of different cell types varies according to the disease stage, with a florid immune response in spinal cord at end stage disease. In this study, we have mapped in different anatomical sites the process of disease-induced functional perturbation from a pre-symptomatic stage using a marker of cellular distress expressed in neurons and glial cells, the activating transcription factor 3 (ATF-3), and applied large-scale gene expression analysis to define the pattern or transcriptional changes occurring in spinal cord from the G93A SOD1 rat model of ALS in parallel with ATF-3 neuronal activation. From the disease onset onward, transgenic lumbar spinal cord displayed ATF-3 transcriptional regulation and motor cells immunostaining in association with the over-expression of genes promoting cell growth, the functional integrity of cell organelles and involved in the modulation of immune responses. While spinal cord from the pre-symptomatic rat showed no detectable ATF-3 transcriptional regulation, ATF-3 activation was appreciated in large size neurofilament-rich, small size non-peptidergic and parvalbumin-positive neurons within the dorsal root ganglia (DRG), and in ventral roots Schwann cells alongside macrophages infiltration. This pattern of peripheral ATF-3 activation remained detectable throughout the disease process. In the G93A SOD1 rat model of ALS, signs of roots and nerves subtle distress preceded overt clinical-pathological changes, involving both glial cells and neurons that function as receptors of peripheral sensory stimuli from the muscle. In addition, factors previously described to be linked to ATF-3 activation under various experimental conditions of stress, become switched on in spinal cord from the end-stage transgenic rat model of ALS.

[Identification of sentinel lymph nodes in thyroid carcinoma]. / Provera strazarskih limfnih nodusa kod tiroidnog karcinoma.

Sentinel lymph node (SLN) was defined as the first lymph node that the tumor would drain to, within that tumors regional lymphatic basin. In 1998, Kelemen and coworkers have published the first results on SLN lymphonodectomy in thyroid carcinomas. Different methods have been used in a goal of lymphatic mapping (application of vital blue dye and/or radiocolloid). In a period from 2001 to 2003 we have performed SLN biopsy in 64 patients with thyroid tumors. There were 12 cases of thyroid carcinoma. SLN identification rate was 73.44%. We found no false positive or negative results on definitive histopathology. The impact of lymph node metastases in differentiated thyroid carcinoma is still controversial. The management of cervical lymph nodes varies from berry picking to modified radical neck dissection. There is a significant disproportion in percentage of pre and intraoperatively enlarged lymph nodes (27-45%) and histologically confirmed lymph node metastases (80-90%) in papillary thyroid carcinoma. In the current literature the average rate of SLN identification is 91% (66-100%) and when identified, the SLN accurately predicts the disease status of the neck in most patients (80-100%). The SLN biopsy for thyroid carcinoma is good and feasible technique for estimating the cervical lymph node status.

[Physical manifestations of anxiety during group psychotherapy]. / Tjelesne manifestacije tjeskobe tijekom grupne psihoterapije.

Anxiety is always accompanied by certain somatic sensations related to certain organs. The author, using the results obtained in the course of the median group sessions, exceptionally anxiogenic in their very nature, measures the intensity of somatizations of anxiety by means of v. Zerssen questionnaire at the beginning and at the end of the sessions. He also observes the distribution of somatizations, according to organic systems (cardiovascular, respiratory, urogenital, gastrointestinal, locomotor and sensorium). What is interesting is the distribution of significantly pronounced somatizations, which indicates that the most frequently pronounced discomforts are related to sensorium. This was to be expected in view of the fact that the population of neurotic patients was being observed while other systems are approximately equally represented. The results shown indicate that the median group situation leads to an increase of anxiety, resulting in subsequent homeostasis disruptions, and to somatizations of anxiety. In such circumstances, it is locomotion that is most inhibited by group situation itself.

Prophylactic administration of ranitidine after sclerotherapy of esophageal varices.

The present trial was carried out to determine the usefulness of H2-receptor antagonist drug therapy for the prevention of esophageal bleeding and esophageal varices in patients who underwent sclerotherapy. According to randomization, out of the 58 patients, 28 received, along with the usual standard therapy, ranitidine and 30 received placebo. Ranitidine, 50 mg, was administered intravenously over a period of 3 days every 8 hours, and then 150 mg of ranitidine was given per os in the evening for one month. For improvement of hemostasis and during the elective sclerotherapies, 1% polidocanol was used as the sclerosant. During each puncture, 2 ml was injected. Injections were paravasal and intravasal. After sclerotherapy, endoscopic examinations were carried out on the third day and one month later. Necrosis was noted in 42% of the patients and esophageal mucosal inflammation in 26%. Esophageal ulcers did not occur. There was no statistically significant difference between the two groups in terms of age, sex ratio, cause of liver cirrhosis, and the Child's classification. The size of the esophageal varices had no effect on the development of esophageal mucosal changes in correlation with the quantity of sclerosant. The comparison of the two groups of patients, sclerosed for hemorrhage and sclerosed electively, showed no statistically significant difference regarding esophageal mucosal changes. No differences between the ranitidine and placebo groups of patients were observed in this indication. It can be concluded that esophageal mucosal changes probably arise as a consequence of the sclerosant, its concentration, quantity and mode of application.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of (DesGly9-Arg8) vasopressin on cognitive processes in alcoholic patients.

The effect of intranasally administered (DesGly9-Arg8) vasopressin (DGAVP) on certain aspects of cognitive functions of alcoholic patients was studied. The investigation was carried out in 103 chronic alcoholic patients. None of the patients suffered from Korsakoff's syndrome, portal encephalopathy or brain damage of other etiology. The trial was double-blind, placebo controlled. Psychological testing, which included certain aspects of attention, short-term and long-term memory and spatial orientation, was carried out on the day before (baseline measurements), on the last day (II), and seven days after the last administration of DGAVP (III). No treatment effect of DGAVP was observed. The results show that investigations with humans are infinitely more complex than those with animals, since a number of physiological and socio-psychological factors must be controlled. In this study of alcoholics two such factors: 1) duration of abstinence and 2) adaptation to test situation were identified.

Controlled trial of the prophylactic administration of antibiotics in sclerotherapy of esophageal varices.

The aim of this controlled trial was to determine the usefulness of chemoprophylaxis in sclerotherapy of ruptured esophageal varices. Sixty patients bleeding from esophageal varices, without signs of infection at admission, were included in a randomized open trial of one-year duration. Thirty patients received, along with the usual standard therapy (infusions, transfusions) 4x1 g ampicillin intravenously over 3 days, and 30 patients received the standard therapy only. Bleeding varices of the esophagus were sclerosed transendoscopically intravenously using 1% polidocanol solution. Body temperature, general condition, white blood count, differential blood count and sedimentation rate were followed-up over three days. There were no statistically significant differences between the groups in the mean values of the mentioned parameters. There was no correlation between the dose of sclerosant used and body temperature or leukocyte count. Chemoprophylaxis proved to have no effect in this indication.

[Incorporation of 3H-cortisol into the dental pulp and the induced changes]. / Incorporation du 3H-cortisole dans la pulpe dentaire et changements induits.

The incorporation of labelled hydrocortisone (3H-cortisol) in the dental pulp of Wistar rats has been tested using autoradiography. Light microscopy showed that an hour after injection the hormone is incorporated in the nuclei of the odontoblasts, subodontoblastic and endothelial cells of the dental pulp. It was also demonstrated at the ultrastructural level that a 4 week-treatment with high rates of hydrocortisone (16 and 32 mg/kg) at the time of rat intensive growth induces degeneration of the odontoblasts, pulp connective tissue cells and capillaries. High rates of hydrocortisone thus induces a decrease in the protective and reparative responses of rat molar pulp.