Endodontic pathology is a bacterial disease. It is well established that periapical disease is the result of bacteria, their product, and the host response to them. Periradicular disease will occur after microorganisms and their metabolic products affect the periradicular tissue. Aim of using antibiotics as part of a treatment regimen is to achieve, within the periodontal environment, a concentration of the drug that is sufficient either to kill (bactericidal) or arrest the growth (bacteriostatic) of pathogenic microorganisms. There are two possible approaches to improve the drug action: sustained and controlled drug release to reduce or eliminate side effects by improving the therapeutic index and site-specific drug delivery to minimize systemic effects. These two strategies have been explored by the association of drugs with different vehicles, either naturals or synthetics. A wide variety of specialized local delivery systems (i.e.intrapocket devices) have been designed to maintain the antibiotic in the GCF (gingival crevicular fluid) at a concentration higher than the MIC (minimum inhibitory concentration). Fibres, films, strips and microparticles made of biodegradable or non-biodegradable polymers have been reported as effective methods to administer antibacterial agents for periodontal therapy. Together with these solid devices, semisolid adhesive or non-adhesive formulations have also been proposed.
The endodontium and periodontium are closely related and disease of one may lead to secondary disease in the other. The differential diagnosis of endodontic and periodontal disease is of vital importance, so that the appropriate treatment can be done. Microorganisms play a primary role in endodontic and periodontal infections. The magnitude of the host response will be directly proportional to the virulence and the number of microbial cells present. Tissue damage caused by bacteria is mediated by either direct or indirect mechanisms. Direct harmful effects caused by bacteria involve their products, such as enzymes (collagenase, hyaluronidase, condroitinase, acid phosphatase), exotoxins and metabolites (bytrate, propionate, ammonium polyamines, sulphured compounds). In addition, bacterial components such as peptidoglycan, teichoic acid, fimbriae, outer membrane proteins, capsule, and lypopolysaccharide, stimulate the development of host immune reaction capable of causing severe tissue destruction.
An exposure to extreme trauma events leads to posttraumatic stress disorder (PTSD) in up to 14-50% of war survivors. Recent findings suggest that genetic factors could play a certain role in PTSD development. In order to illustrate this possibility, we present results of a pilot study on gender specific sample of Sarajevo civilians immediately after the war cessation. During the period 1992-1995, Sarajevo civilians experienced continuous life threatening events with a great risk of developing PTSD in such conditions. Our study included 100 women adjusted to same socio-demographic characteristics. All women were interviewed using Harvard Trauma Questionnaire (HTQ) and divided into two groups (domestic and returnees) according to exposure length to extreme war life events of six or forty-three months. Above 50% of total analysed sample fulfilled criteria for PTSD. Regarding duration in trauma exposure no significant difference between these two groups were found. The only significant predictor found was physical abuse (p>0.01) that still cannot explain why some women develop PTSD while others not. Several years after the war, PTSD frequencies are decreased and disorder became chronic and more severe. However, the PTSD prevalence remains high when compared to general population rates. Therefore, Sarajevo population being exposed for almost four years to extreme war life events represents unique model for comparative research on PTSD etiology within the light of latest findings in molecular genetics of PTSD.
Neonatal BCG vaccination reduces the risk of tuberculosis and provides protection higher than 80% against the development of meningeal and miliary tuberculosis in newborns. Tuberculosis meningitis remains a major problem and also an important cause of death in some countries. In countries with high and moderate incidence of tuberculosis, prevention from the most severe complications of tuberculosis can be achieved only with a high coverage of the universal BCG neonatal immunization, being higher than 98% in the cohort of newborns. The decrease in BCG immunization coverage within immunization program during the year 2003 in Bosnia and Herzegovina influenced the increase in tuberculous meningitis. During 2002, when coverage with BCG vaccination in cohort of newborns was 90%, the incidence rate of tuberculous meningitis was 19. 04%oo. With the 68% decrease in BCG immunization coverage in the cohort of newborns in Bosnia and Herzegovina during the year 2003, the incidence of tuberculous meningitis raised to 33 33%oo. It has been proven that the 22% decrease of the neonatal BCG immunization coverage in the cohort of newborns /vaccination program of children/ caused 175 times higher number of the tuberculous meningitis cases. Newborns affected by the tuberculous meningitis were not BCG vaccinated. BCG vaccine provided effective protection against tuberculous meningitis, as well against the death of newborns caused by tuberculosis.
Microscopic demonstration of chlamydial inclusions within cells offered the first laboratory procedure supporting the clinical diagnosis of chlamydial infection. Our aim is to evaluate the usefulness of different endocervical staining methods in diagnosis of Chlamydia trachomatis (CT) infection within exfoliated cells of the endocervix. The cytological test for the detection of chlamydial inclusions in genital tract infection, though not as sensitive and specific as isolation in the cell culture monolayers, is still of the diagnostic value. The present study discusses the collection of clinical smears for microscopic examination, their preparation; fixation and staining of slides by a variety of staining methods that have been used to detect Chlamydia in clinical smears and biopsies. Most of these methods such as Giemsa stain, Papanicolaou, iodine, and immunofluorescence (IF) using monoclonal antibodies, are based on the combination of dyes designed to obtain optimum differentiation of the various structures. The utilization of different endocervical smear stains together with the clinical information can be used to identify women at high risk for CT infection.
BACKGROUND AND PURPOSE Developmental process that leads to final forebrain shaping is a result of complex histogenetic and morphogenetic events. Comprehensions about brain development are based on observations carried out on onthogenetic successive stages. Microscopic analysis of brain together with analysis of serial sections gives information about shape the of some forebrain parts and basic relations between them. The aim of this study was to analyse morphogenesis in the earliest stages of rat's forebrain development. MATERIAL AND METHODS Rat brains used in this study were obtained from Fisher inbred rats with accurately timed pregnancies. The investigation was carried out on serial frontal sections of rat embryonic heads from the 12th (E12) to the 16th (E16) day of gestation. Gestation was considered to have begun early in the morning when sperm was found in the vaginal smear. Histological paraffin and plastic sections were systematically inspected with regard to morphogenetic changes of the forebrain parts telencephalon and diencephalon. RESULTS E12: neural tube is completely closed in its cranial part. Rostral part of forebrain shows telencephalons vesicles origins as slightly paired enlargements of neuroepithelial wall. Between telencephalic vesicles origin and in direction to caudal there is an origin of diencephalon. E13: rostral part of forebrain shows well expressed and divided areas of telencephalons vesicles as basal, basolateral, dorsal and medial telencephalon. Central area between paired vesicles is a telencephalon impar. In diencephalon optic vesicles appeared. Epithalamus, thalamus and hypothalamus origins are slight enlargements of its neuroepithelial wall. E14: telencephalic vesicles spread above telencephalon impar into rostral direction and above diencephalon in rostrodorsal direction. Their basolateral parts of are very thickened and become folded. Sulcus telodiencephalicus appears. E15: the main event is the appearance of the origins of plexus choroideus in the area of telencephalon impar as fingerlike processes. E16: all forebrain parts, especially telencephalic vesicles-origin of brain hemispheres and processes of plexus choroideus, are progressively growing and shaping. CONCLUSIONS Our morphologic analysis describes significant morphogenetic changes in the forebrain shape. The forebrain changes from a relatively simple tubular structure with thin walls surrounding a large ventricular system to a thick-walled brain with a highly convoluted but reduced ventricular system.
INTRODUCTION Without sufficient insulin treatment, acceptable level of glycoregulation, avoidance of dislipoproteinaemia and maintenance of body mass is difficult to achieve in patients with type 1 diabetes mellitus (DM). On the other hand sometimes it is difficult to prevent weight gain, endogenous hyperlipidemia and iatrogenic insulin resistance. AIM To compare metabolic control indicators in patients with type 1 DM in patients treated conventionally to those on intensified insulin regimen. MATERIAL AND METHODS A sample of 52 persons with type 1 DM, without late complications and long duration of the disease, was selected. Among them 19 (36.5%) persons were treated with insulin in 4 or 5 doses, and 33 (63.5%) conventionally, in 2 doses. All the participants had biochemical indicators of metabolic control determined (glycosylated Hb , fasting and postprandial glycaemia, total cholesterol, triglycerides as well as lipoprotein fractions, HDLC and LDLC), body height (BH) and weight (BW) measured, body mass index calculated (BMI) and blood pressure measured (BP). RESULTS In the group treated conventionally we found significantly higher mean values of BMI as compared to those on intensified insulin treatment (23.2 +/- 2.0 kg/m2, and 21.2 +/- 1.2 kg/m2 respectively, p%<0.01) and proportion of those with overweight was as well significantly higher (27.3% versus 0%, p =0.012). We noted higher mean values of systolic (134.2 +/- 17.6 mmHg, versus 123.4 +/- 12.7. p<0.05) and diastolic (83.2 +/- 10.1, versus 74.0 +/- 9.7, p<0.01) BP. Biohemical indicators of glycoregulation were significantly worse with, at the same time, higher total dose of applied insulin ( 55.9 +/- 8.5 IU, versus 46.3 +/- 10.0 IU, p<0.01), and insulin units per kg of body weight (0.84 +/- 0.11 IU/kg versus 0.77 +/- 0.15 IU/kg, p<0.05). CONCLUSION Results indicate that intensified insulin treatment is more favourable variant of treatment, by which the certain level of insulin resistance, which might be present in patients treated with two higher insulin doses, is probably reduced. Therefore it improves metabolic outputs, blood pressure values and body mass index but also may have beneficial impact to economic aspect of insulin treatment as well.
UNLABELLED Cardiovascular diseases are the major cause of mortality in uraemic patients treated by hemodialysis. Left ventricular hypertrophy (LVH) is considered to be a major cardiac risk factor. AIM To investigate the presence of some potential adverse risk factors in hemodialysis patients with developed LVH echocardiography verified and determine their relative contribution to the LVH in comparison with patients with normal LV. METHOD The study included 50 patients with end-stage renal disease in the first 2 years of hemodialysis treatment, who were followed up during one year. All participants have the echocardiography performed as well as serial measurements of potential modifiable cardiovascular risk factors. RESULTS This investigation showed that LVH is present in high percentage (72%) in uraemic patients, even at the beginning of hemodialysis treatment. This LV morphological abnormality is statistically significantly related to anaemia (p<0,001), systolic (p<0,001) and diastolic hypertension (p<0,001)), elevated mean arterial pressure (p<0,001) and hyperparathyroidism (p=0,002). CONCLUSION Modification of existing risk factors in uraemic patients could contribute to prevention and treatment of LV hypertophy and thus reduce cardiovascular morbidity and mortality.
Cervical and breast cancer are usually type of tumor that are found among women in fertile age in Bosnia and Herzegovina. Final goal was to establish frequency of risk factors that are responsible for development of those types of cancer as well as establish possibility of prevention, according to the existence of each risk factor. Research was conducted through out surveys among women which were selected by accident. The amount of questioned women is 200, and out of that number 70 (35%) were out of rural environment, 130 (65%) were from urban environment which led to statistic- processed information. Variables that were defining our interviews were: age, marital status, education level, stay during the war in B&H, number of given birth, consistency of gynecological examinations, changes that were found during the medical (gynecological) examination, number of sexual partners, usage of contraception, existence of sexual infections, usage of tobacco, existence of genetic factor. The most important fact is that over 50% of interviewees do not visit gynecologist, and that the gynecological infections are frequent. Usage of tobacco is in high percent founded among interviewees from urban environment (85%).
OBJECTIVE examine detrusor contraction duration (DCD) in relation with obstruction grade and strength of detrusor contractility; analyze individual correlations of this parameter with urodynamic, physiological and symptoms variables in patients with benign prostatic enlargement (BPE). SAMPLE AND METHODOLOGY 102 patients with proved BPE, underwent complete urodynamic measurements (UDM), namely uroflowmetry, cystometry and pressure/flow studies. Postvoid residual urine (PVR) was measured and the International Prostate Symptom Score (I-PSS) was fulfilled by each patient. Methodology of measurement and definitions of UDM are based on definitions and terminology defined by the International Continence Society. RESULTS After grouping the patients (average age 64,7+/-8,5) related to obstruction grades according to the Schafer nomogram, ANOVA has shown a group extension of the detrusor contraction duration related to higher levels of obstruction (LinPURR 0-VI; p<0,01), which is also followed by stronger detrusor contractility (Pdetmax; p<0,001). Dichotomizing of the patients with DCD cut off point 90 sec. has shown that 67% patients with underactive detrusor have DCD>90 sec, while extension of DCD and increase of the obstruction level are directly related to preserved detrusor contractility only in 20,5% cases. There is neither statistically significant difference of DCD in the patients that are not in obstruction allocated in two groups depending on detrusor contraction strength, (t=1.2, p>0.05); nor in the patients who are in obstruction range, divided on the same way (t=0.568, p>0.05). There is also no difference of the same patients groups regarding PVR (t=1.38 and t=1.17, p>0.05). Individual correlation of DCD with I-PSS has not been shown (r=0.16, p>0.05), although there is a statistically significant correlation with its obstructive subset (r=0.20, p<0.05), as well as, with LinPUR and URA nomograms (r=0.33, r=0.29; respectively, p<0.005) and with Pdetmax (r=0.26, p<0.01), PdetQmax (r=0.24, p<0.05), Qmax and Qaver (r=0.31, p<0.005). DCD does not have individual correlations with patients' age, prostate volume and with cystometric capacity. CONCLUSION DCD is rather independent urodynamical variable, which does not correlate with I-PSS. Generally, DCD is prolonged during obstruction, while extension of DCD only partially depends on detrusor contraction strength. Practically, individual correlations of DCD with the urodynamic factors, which characterize obstructions, are modest.
The influence of the carrier-envelope phase (``absolute phase'') of a few-cycle pulse on the left-right asymmetry of the photoelectron spectrum of high-order above-threshold ionization is analyzed. Energy spectra are calculated for opposite detectors along the polarization axis of a linearly polarized four-cycle laser pulse. The results obtained allow us to determine the value of the absolute phase in a given experiment by comparison with the theoretical spectra. A classical analysis of the calculated spectra is presented, and the corresponding electron trajectories are analyzed. Emission of high-energy electrons is found to occur in one or two ultrashort subfemtosecond bursts.
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