Pacientes portadores de doenças crônicas em programa de transplante de órgãos sólidos apresentam condições sistêmicas que comprometem seu sistema imune, o que os predispõe a risco potencial de infecções, que devem ser prevenidas para o momento pós-transplante, principalmente diante do uso de imunossupressores. Os focos infecciosos em cavidade oral após o transplante são uma preocupação com essa condição e merecem atenção especial. Objetivo: Avaliar dados referentes à condição da saúde bucal de pacientes em programa de transplante de órgãos sólidos, buscando evidenciar a importância da assistência odontológica prévia. Métodos: Este estudo teve caráter quantitativo, descritivo, exploratório e retrospectivo, onde foram analisados 225 prontuários de pacientes em programa de transplante de fígado, rim e coração, os dados referentes à condição bucal e os possíveis riscos infecciosos (cáries, doença periodontal e lesões infecciosas de mucosas) obtidos nos relatórios de avaliação odontológica. Foram aplicados métodos estatísticos para análise de relevância através do teste de qui-quadrado e teste exato de Fisher com significância (p<0,05). Resultados: Foi registrada a presença de alterações bucais sinalizadoras de focos de infecção em (134/166) 80,72% pacientes em programa de transplante hepático, (35/43) 81,39% em programa de transplante renal e (13/16) 81,25% de transplante cardíaco. Conclusão: Os dados obtidos permitiram concluir que nos pacientes em programa de transplantes de órgãos, a incidência de focos infecciosos bucais é significativa e sugerem que a adequação bucal prévia aos transplantes é relevante diante da condição de imunossupressão a que aqueles pacientes são submetidos.  

Guidelines and Expert Consensus Documents summarize and evaluate all available evidence with the aim of assisting physicians in selecting the best management strategy for an individual patient suffering from a given condition, taking into account the impact on outcome and the risk benefit ratio of diagnostic or therapeutic means. Guidelines are no substitutes for textbooks and their legal implications have been discussed previously. Guidelines and recommendations should help physicians to make decisions in their daily practice. However, the ultimate judgement regarding the care of an individual patient must be made by his/her responsible physician(s). The recommendations for formulating and issuing ESC Guidelines and Expert Consensus Documents can be found on the ESC website (http://www.escardio.org/knowledge/ guidelines/rules). Members of this Task Force were selected by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) to represent all physicians involved with the medical and surgical care of patients with coronary artery disease (CAD). A critical evaluation of diagnostic and therapeutic procedures is performed including assessment of the risk benefit ratio. Estimates of expected health outcomes for society are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to predefined scales, as outlined in Tables 1 and 2. The members of the Task Force have provided disclosure statements of all relationships that might be perceived as real or potential sources of conflicts of interest. These disclosure forms are kept on file at European Heart House, headquarters of the ESC. Any changes in conflict of interest that arose during the writing period were notified to the ESC. The Task Force report received its entire financial support from the ESC and EACTS, without any involvement of the pharmaceutical, device, or surgical industry. ESC and EACTS Committees for Practice Guidelines are responsible for the endorsement process of these joint Guidelines. The finalized document has been approved by all the experts involved in the Task Force, and was submitted to outside specialists selected by both societies for review. The document is revised, and finally approved by ESC and EACTS and subsequently published simultaneously in the European Heart Journal and the European Journal of Cardio-Thoracic Surgery. After publication, dissemination of the Guidelines is of paramount importance. Pocket-sized versions and personal digital assistant-downloadable versions are useful at the point of care. Some surveys have shown that the intended users are sometimes unaware of the existence of guidelines, or simply do not translate them into practice. Thus, implementation programmes are needed because it has been shown that the outcome of disease may be favourably influenced by the thorough application of clinical recommendations.

SAŽETAK: U radu su prikazana istraživanja unutarpopulacijske i međupopulacijske varijabilnosti morfoloskih svojstava lista hrasta lužnjaka na podrucju zemalja zapadnog Balkana (Hrvatska, Bosna i Hercegovina, Srbija, Crna Gora). Analizirano je ukupno 65 populacija i 650 stabala, a morfometrijska analiza ukljucivala je ukupno 14 morfoloskih svojstava. Za statisticku obradu koristene su deskriptivna analiza, analiza varijance, diskriminacijska analiza i multipli testovi. Utvrđene su signifikantne razlike na međupopulacijskom, kao i na individualnom unutarpopulacijskom i bile su statisticki znacajnije od međupopulacijske varijabilnosti. Najvecu varijabilnost imala su svojstva duljine peteljke lista, usjecenost lista od sredisnje žile i usjecenost baze plojke. Analiza varijance, diskriminacijska analiza i multipla testiranja za istraživana svojstva, a grupirana prema zemljama porijekla, ukazuju na postojanje statisticki znacajnih razlika između istraživanih populacija, tako da istraživani materijal iz svake zemlje cini zasebnu skupinu, te bi pri uporabi sumskog reprodukcijskog materijala trebalo iskljucivo koristiti autohtoni materijal. Kod istraživanog lisnog materijala nije registrirana dlakavost listova, sto ukazuje da nije prisutna pojava hibridizacije sa hrastom meduncem (Quercus pubescens). Istraživanja mogu poslužiti kao polazna osnova za odabir sjemenskih sastojina, oplemenjivanje i ocuvanje geneticke raznolikosti hrasta lužnjaka, kao i za razlikovanje pojedinih vrsta, hibridnih rojeva i nižih svojti hrasta lužnjaka. Kljuc ne rijec i: hrast lužnjak (Quercus robur L.), morfometrijska analiza lista, unutarpopulacijska i međupopulacijska varijabilnost

Aims To ascertain the frequency and geographical distribution of patients diagnosed with known genetic causes of Alzheimer's disease (AD) and inherited prion disease (IPD) in the UK 2001–2005. By comparison with frequencies predicted from published population studies, to estimate the proportion of patients with these conditions who are being accurately diagnosed. Methods All the positive diagnostic test results (from both genetic testing centres) were identified for mutations in presenilin-1 (PSEN1), presenilin-2 (PSEN2), amyloid precursor protein (APP) and prion protein genes (PRNP) for patients resident in the UK in a 5 year period. The variation in the incidence of mutation detection between UK regions was assessed with census population data. Published studies of the genetic epidemiology of familial early onset AD (EOAD) were reviewed to produce estimates of the number of patients in the UK that should be detected. Results The rate of detection of EOAD and IPD varied very significantly and consistently between regions of the UK with low rates of detection in Northern and Western Britain (72% less detection in these regions compared with Central and Southeast Britain). The estimates from population studies further suggest a greater number of patients with EOAD than are diagnosed by genetic testing throughout the UK. Conclusions It is likely that patients with EOAD and IPD are not being recognised and referred for testing. With the prospect of meaningful disease modifying therapeutics for these diseases, this study highlights an issue of relevance to neurologists and those planning for provision of National Health Services.