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Safe use of gadolinium contrast agents during pregnancy and lactation
No full textRazvoj magnetske rezonancije (MRI) omogućio je slikovni prikaz raznih patoloških stanja i promjena, uključujući i ona u trudnoći i dojenju. Indikacije za MRI u navedenoj populaciji odnose se na brojne opstetričke i neopstetričke uzroke majki, kao i na one fetusa, koje su mnogo rjeđe. S obzirom na to da je riječ o osjetljivoj, ali ne i visoko specifičnoj metodi, tijekom snimanja se rabe gadolinijska kontrastna sredstva. Primjena istih široko je rasprostranjena, čineći gotovo polovicu svih MRI snimanja, među kojima su i ona na trudnicama i dojiljama. Dokazi o učincima gadolinijskih kontrastnih sredstava na nastanak nefrogene sistemske fibroze, kao i spoznaja o taloženju, dovode u pitanje njihovu sigurnost kada se apliciraju navedenoj populaciji, što zahtijeva promišljenu procjenu koristi i rizika. Različite studije obrađene u ovom radu razmatraju sigurnosne i teoretske nedoumice, koje se primarno odnose na potencijalno štetne učinke gadolinija na fetus, kao i moguću retenciju istog u majčinom mlijeku. Rezultatima je utvrđen prolazak gadolinija kroz placentalnu barijeru, pri čemu su dospjele koncentracije u fetusu bile minimalne, a iste su se unutar nekoliko dana u potpunosti izlučile. Navedeno vrijedi i za različite majčine organe te majčino mlijeko. Unatoč relativno malom broju studija provedenih na ovu temu, trenutne preporuke odobravaju primjenu najmanje štetnih, makrocikličkih gadolinijskih kontrastnih sredstava u situacijama kada je to neizbježno, kao i nastavak dojenja nakon primjene istog.The development of magnetic resonance imaging (MRI) has made it possible to visualize various pathological conditions and changes, including those in pregnancy and lactation. Indications for MRI in this population refer to a number of maternal obstetric and non-obstetric causes, as well as those of the fetus, which are much rarer. Since this is a sensitive but not highly specific method, gadolinium-based contrast agents (GBCAs) are used. The use of GBCA is widespread, accounting for almost half of all MRI examinations, including those on pregnant and lactating women. Evidence of the effects of GBCA on nephrogenic systemic fibrosis formation, as well as knowledge of deposition, calls into question their safety when administered to a specified population, which requires a thoughtful benefit-risk assessment. The various studies discussed in this paper consider safety and theoretical ambiguities that primarily relate to the potentially harmful effects of GBCA on the fetus, as well as the possible its retention in breast milk. The results showed the passage of gadolinium through the placental barrier, with the concentrations in the fetus being minimal, and they were completely excreted within a few days. This also applied to various mother organs and breast milk. Despite the relatively small number of studies conducted on this topic, current recommendations approve the use of the least harmful, macrocyclic GBCA in situations where it is unavoidable, as well as the continuation of breastfeeding after its application
RISK ASSESSMENT FOR FALL IN PARKINSON'S DISEASE
No full textParkinsonova bolest je neurodegenerativni poremećaj koji se uglavnom manifestira u kasnijoj dobi s generaliziranim usporavanjem pokreta (bradikinezija) i barem još jednim simptomom tremora u mirovanju ili ukočenosti. Ostale povezane značajke su gubitak mirisa, disfunkcija spavanja, poremećaji raspoloženja, prekomjerno lučenje sline, zatvor i periodični nekontrolirani pokreti udova u snu. Ova aktivnost daje pregled patofiziologije, prezentacije i dijagnoze Parkinsonove bolesti i naglašava ulogu interprofesionalnog tima u njenom upravljanju. Padovi kod osoba oboljelih od Parkinsonove bolesti česta su pojava te posljedice padova mogu dovesti do onesposobljenosti samog bolesnika. Učestalost padova općenito raste s progresijom bolesti, osobito tijekom rane i srednje faze. Čimbenici rizika za pad su: povijest prethodnih padova, zamrzavanje hoda, oštećena ravnoteža i ortostatska hipotenzija. Uloga medicinske sestre je procijeniti stabilnost bolesnika, hod, rizik za pad te svojim intervencijama osigurati bolesniku sigurnu okolinu, educirati bolesnika o čimbenicima rizika za mogući pad te naučiti bolesnika kako redovitom vježbom može utjecati na vlastiti stabilnost i vračanje tonusa mišića.Parkinson's disease is a neurodegenerative disorder that mainly manifests in later life with a generalized slowing of movement (bradykinesia) and at least one other symptom of resting tremor or rigidity. Other associated features are loss of smell, sleep dysfunction, mood disorders, excessive salivation, constipation, and periodic uncontrolled limb movements in sleep. This activity provides an overview of the pathophysiology, presentation and diagnosis of Parkinson's disease and emphasizes the role of the interprofessional team in its management. Falls in people suffering from Parkinson's disease are a frequent phenomenon, and the consequences of falls can lead to the disability of the patient himself. The frequency of falls generally increases with the progression of the disease, especially during the early and middle stages. Risk factors for falls are: history of previous falls, freezing of gait, impaired balance and orthostatic hypotension. The nurse's role is to assess the patient's stability, gait, risk of falling, and through her interventions to provide the patient with a safe environment, educate the patient about risk factors for a possible fall, and teach the patient how regular exercise can affect their own stability and restore muscle tone
Specifics of nurses work in planning health promotion activities
No full textPrema pokazateljima smrtnosti i pobola u Republici Hrvatskoj, kao i u ostatku svijeta dominiraju kronične nezarazne bolesti, na prvom mjestu kardiovaskularne, zatim maligne bolesti, dijabetes, kronične respiratorne bolesti, bolesti zuba te ozljede i njihove posljedice. U velikom postotku se mogu spriječiti rješavanjem uobičajenih čimbenika rizika: pušenja, nezdrave prehrane, pretjerane upotrebe alkohola i tjelesne neaktivnosti. Medicinske sestre djelujući kroz sve razine zdravstvene zaštite imaju vodeću ulogu u zdravstvenom odgoju i promociji zdravlja kod kroničnih nezaraznih bolesti. U Republici Hrvatskoj ulažu se veliki napori u svrhu prevencije i promocije zdravlja. Osnivaju se programi, potiče se rad preventivne medicine, organiziraju se javnozdravstvene akcije ili edukacije ciljane za određene skupine. Medicinske sestre provode aktivnosti promocije zdravlja i zdravstvenog odgoja djelujući kroz sve razine zdravstvene zaštite.According to the indicators of mortality and morbidity in the Republic of Croatia, as well as in the rest of the world, chronic non-communicable diseases dominate, firstly cardiovascular diseases, then malignant diseases, diabetes, chronic respiratory diseases, dental diseases and injuries and their consequences. A large percentage of them can be prevented by addressing common risk factors: smoking, unhealthy diet, excessive alcohol use and physical inactivity. Working through all levels of health care, nurses play a leading role in health education and health promotion in chronic non-communicable diseases. In the Republic of Croatia, great efforts are being made to prevent and promote health. Programs are established, the work of preventive medicine is encouraged, public health actions or education targeted for certain groups are organized. Nurses carry out health promotion and health education activities, acting through all levels of health care
The role of artificial intelligence in radiation dose optimization in computerized tomography (CT)
No full textPodručje umjetne inteligencije (UI) transformira gotovo svaki aspekt modernog društva, uključujući i medicinsku radiologiju. U kompjuteriziranoj tomografiji (CT), primjena umjetne inteligencije omogućuje daljnje smanjenje doze zračenja pacijenata kroz automatizaciju i optimizaciju procesa prikupljanja podataka, uključujući pozicioniranje pacijenta i postavke parametara akvizicije. Nakon prikupljanja podataka, optimizacija parametara rekonstrukcije slike, napredni algoritmi rekonstrukcije i metode uklanjanja šuma slike poboljšavaju nekoliko aspekata kvalitete slike, posebno u smanjenju šuma slike te omogućavanju korištenja nižih doza zračenja tijekom akvizicije. Ukratko, od uvođenja CT-a, veliki broj tehničkih poboljšanja omogućio je unapređenje dijagnostičke informacije i smanjenje rizika za pacijente, ne samo smanjenjem doze zračenja, već i smanjenjem vjerojatnosti pogrešaka u izvedbi i medicinskoj interpretaciji CT pretraga.
U ovom radu prikazana je važnost primjene novih algoritama umjetne inteligencije koji imaju važnu ulogu u poboljšanju kvalitete dijagnostičke informacije uz najnižu moguću dozu za pacijente.The field of artificial intelligence (AI) is transforming almost every aspect of modern society, including medical radiology. In computed tomography (CT), the application of artificial intelligence allows further reduction of patient radiation dose through automation and optimization of data collection processes, including patient positioning and acquisition parameter settings. After data collection, image reconstruction parameter optimization, advanced reconstruction algorithms, and image noise removal methods improve several aspects of image quality, especially in reducing image noise, and allow the use of lower radiation doses during acquisition. In short, since the introduction of CT, a number of technical improvements have made it possible to improve diagnostic information and reduce risks for patients, not only reducing radiation doses but also reducing the likelihood of errors in the performance and medical interpretation of CT scans.
This paper presents the importance of applying new artificial intelligence algorithms that play an important role in improving the quality of diagnostic information at the lowest possible dose for patients
Safe use of gadolinium contrast agents in pediatric population
No full textUnaprjeđenjem tehnologije te samim razvitkom magnetske rezonance dogodio se glavni preokret u domeni radiologije u dvadesetom stoljeću. Uvelike je olakšana vizualizacija svih dijelova ljudskog tijela uz održavanje odlične prostorne rezolucije. U pedijatrijskoj populaciji pregled magnetskom rezonancom korisna je metoda u evaluaciji mozga, toraksa, abdomena, zdjelice te ekstremiteta. Upravo je ovo jedna od prvih metoda izbora za mlađe pacijente zbog nekorištenja ionizirajućeg zračenja. S ciljem povećanja kontrastnosti slike koriste se kontrastna sredstva, najčešće kelati gadolinija, čije se prvo apliciranje odvilo 1983. godine. Ista se prema molekularnoj strukturi dijele na linearne i makrocikličke, a uz to postoji još i podjela na ionske i neionske. Makrociklički spojevi se općenito smatraju sigurnijima zbog niže brzine disocijacije slobodnog iona gadolinija, koji je u tom obliku toksičan. Za gadolinijska kontrastna sredstva dugo se vjerovalo da su u potpunosti sigurna, međutim 2000-tih uočena je njihova povezanost s nefrogenom sistemskom fibrozom, nakon čega se usmjerilo ka korištenju makrocikličkih spojeva u pedijatrijskih pacijenata zbog dokazano veće sigurnosti. Osim navedene nuspojave, moguć je razvoj i akutnih alergijskih reakcija, a u novije vrijeme otkrivene su i spoznaje o taloženju gadolinija u tkivima. Unatoč vrlo niskoj stopi navedenih nuspojava u pedijatrijskih pacijenata, njihova dugoročna sigurnost i primjena u neonatalnoj dobi još nije utvrđena. Upravo zbog toga, važno ih je oprezno koristiti uz naglasak na apliciranje najmanjih mogućih doza, korištenje makrocikličkih spojeva te dobru procjenu rizika.With the advancement of technology and development of magnetic resonance imaging, a major turning point in the field of radiology occurred in the twentieth century. Visualization of all parts of the human body is greatly facilitated while maintaining excellent spatial resolution. In the pediatric population, magnetic resonance imaging is a useful method in the evaluation of the brain, thorax, abdomen, pelvis, and extremities. This is one of the first methods of choice for younger patients due to the non-use of ionizing radiation. Magnetic resonance contrast agents are used in order to increase the contrast of the obtained image and better resolution. One group of them includes gadolinium chelates, whose first application took place in 1983. According to their molecular structure, they are divided into linear and macrocyclic, and in addition they can be divided into ionic and nonionic. Macrocyclic compounds are generally considered safer due to the lower rate of dissociation of the free gadolinium ion which is toxic in this form. Gadolinium contrast agents have long been believed to be completely safe, but their association with nephrogenic systemic fibrosis was observed in the 2000s, after which the focus was on the use of macrocyclic compounds in pediatric patients for proven safety. In addition to the mentioned side effect, the development of acute allergic reactions is also possible, and more recently, findings on the deposition of gadolinium in tissues have been discovered. Despite the very low rate of all these side effects in pediatric patients, their long-term safety and use in the neonatal age has not yet been established. Precisely because of this, they should be applicated with caution, with an emphasis on the application of the lowest possible doses, the use of macrocyclic chelates and a good risk assessment
Computed tomography of the heart
No full textRazvojem tehnologije i radiologije kao jedne od temeljnih grana medicine, dijagnostičke pretrage
postižu svoj vrhunac i daju sve bolje rezultate. Jedna od najčešćih pretraga u radiologiji jest
kompjutorizirana tomografija, koja se za neke pretrage smatra zlatnim standardom. Veliki spektar svojih
mogućnosti pokazuje i kod pretraga srca. CA scoring, perfuzije, različite metode procjena stenoze poput
fractional flow reserve-a ili transluminalnog atenuacijskog gradijenta, retrospektivno i prospektivno EKG
sinkroniziranje samo su neke od mogućnosti kojima ovom pretragom možemo dobiti izvrsne rezultate
potrebne za liječenje pacijenta. Kompjutorizirana tomografija srca kao prednost pred drugim radiološkim
pretragama ima neinvazivnost, ali i negativan aspekt velike doze ionizirajućeg zračenja. Svakako,
unaprijeđenjem tehnologije i redovitom edukacijom radioloških tehnologa i liječnika, doza ionizirajućeg
zračenja se sve više reducira. Također, tijekom pretrage je moguća pojava i različitih artefakata uzrokovanih
vanjskim utjecajima ili samim pacijentom, no omogućeni su mnogi programi i tehnike za suzbijanje istih.With the development of technology and radiology as one of the fundamental branches of
medicine, diagnostic tests reach their peak and give better and better results. One of the most common tests
in radiology is computed tomography, which is considered the gold standard for some tests. The wide
spectrum of its possibilities also shows itself in cardiac examinations. CA scoring, perfusions, various
methods of stenosis assessment such as fractional flow reserve or transluminal attenuation gradient,
retrospective and prospective ECG synchronization are just some of the possibilities with which we can
obtain excellent results necessary for patient treatment with this examination. Computed tomography of the
heart has the advantage over other radiological examinations of non-invasiveness, but also the negative
aspect of a large dose of ionizing radiation. Certainly, with the improvement of technology and regular
education of radiologic technologists and doctors, the dose of ionizing radiation is increasingly reduced.
Also, various artifacts caused by external influences or the patient himself may appear during the
examination, but many programs and techniques are available to combat them
ASSOCIATION OF MIGRAINE AND HLA DRB1* ALLELES
No full textSustav HLA najsloženiji je genetski sustav kod čovjeka. Između ostalog, osobitosti ovog
sustava su izraziti polimorfizam, kao i povezanost ovog sustava s bolestima, što je od
izrazite važnosti u dijagnostici autoimunih bolesti kao i neuroloških oboljenja. Migrena je
ponavljajuća, umjereno jaka do vrlo jaka glavobolja u trajanju između 4 i 72 sata u slučaju
kada se ne liječi. Postoji nekoliko čimbenika rizika povezanih s razvojem migrene. U
nepromjenjive čimbenike spadaju genetika, dob i spol.
Cilj je ovog rada odrediti zastupljenost alela sustava HLA u pacijenata kojima je
dijagnosticirana migrena i kod pacijenata koji pate od jakih glavobolja na području Splitskodalmatinske županije kao i prikazati zastupljenost pojedinih alela lokusa HLA - DRB1*.
Kod ispitanika s migrenom i jakim glavoboljama koji su imali HLA-DRB1*16,
zastupljenost spolova pokazuje da je znatno veći postotak oboljelih kod žena (68.96%) u
odnosu na muškarce (31.04%). Najveći broj ispitanika je bio u dobnoj skupini od 46 do 65
godina.
Antigeni i aleli sustava HLA za potrebe ove studije određeni su serološkim i
molekularnim metodama. Antigeni sustava HLA određuju se testom
mikrolimfocitotoksičnosti (MLCT), dok su za molekularno određivanje alela lokusa sustava
HLA korištene metode PCR-SSO i PCR-SSP.
Određivanjem alela lokusa HLA-DRB1 u skupini ispitanika s migrenom, uočeno je 14
različitih alela, od kojih najveću zastupljenost imaju HLA-DRB1*16 (19,59%) te HLADRB1*11,-13,-15 s učestalosti od 10,14%. U usporedbi sa kontrolnom skupinom, utvrđeno
je da je učestalost alela HLA-DRB1*16 (19,59% vs 9,60%, p=0,0063) i HLA-DRB1*10
(2,7% vs 0%, p=0,0327) statističko značajno povećana u skupini pacijenata koji boluju od
migrene ili jake glavobolje.
Budući da su našim ispitanicima u dijagnostičke svrhe određivani i aleli lokusa HLA
razreda I (HLA-A, HLA-B) prilikom analize uočena je statistički značajna povezanost alela
HLA-B*57 kod pacijenata s migrenom i jakim glavoboljama u odnosu na kontrolnu skupinu
zdravih ispitanika.
Da bismo sa sigurnošću govorili o povezanosti migrene i jakih glavobolja i alela HLADRB1*16 i ostalih alela lokusa sustava HLA (HLA-A, HLA-B) svakako je potrebno
proširiti studiju na veći broj ispitanika.The HLA system is the most complex genetic system in humans. Among other things, the
peculiarities of this system are its pronounced polymorphism, as well as the connection of this
system with diseases, which is of great importance in the diagnosis of autoimmune diseases as
well as neurological diseases. Migraine is a recurrent, moderately severe to very severe
headache lasting between 4 and 72 hours if left untreated. There are several risk factors
associated with developing migraines. Immutable factors include genetics, age and gender.
The objective of this work was to determine the representation of alleles of the HLA system in
patients suffering from migraines and severe headaches in the Split-Dalmatia County, as well
as to show the representation of individual alleles of the HLA locus - DRB1*.
In subjects with migraine and severe headaches who had HLA-DRB1*16, the representation of
genders shows that the percentage of patients is significantly higher in women (68.96%)
compared to men (31.04%). The largest number of respondents was in the age group of 46 to
65 years.
Antigens and alleles of the HLA system for the purposes of this study were determined by
serological and molecular methods. Antigens of the HLA system are determined by the
microlymphocytotoxicity test (MLCT), while the PCR-SSO and PCR-SSP were used for the
molecular determination of alleles of the HLA system locus. .
By determining the alleles of the HLA-DRB1 locus in the group of subjects with migraine, 14
different alleles were observed, of which the highest prevalence is HLA-DRB1*16 (19.59%)
and HLA-DRB1*11,-13,-15 with a frequency of 10 , 14%. Compared to the control group, the
frequency of alleles HLA-DRB1*16 (19.59% vs 9.60%, p=0.0063) and HLA-DRB1*10 (2.7%
vs 0%, p =0.0327) statistically significantly increased in the group of patients with migraine or
severe headache.
Since alleles of the HLA class I locus (HLA-A, HLA-B) were also determined for diagnostic
purposes in our subjects, the analysis revealed a statistically significant association of the HLAB*57 allele in patients with migraine and severe headaches compared to the healthy control
group examinee.
In order to talk with certainty about the connection between migraine and severe headaches and
the HLA-DRB1*16 allele and other alleles of the HLA system locus (HLA-A, HLA-B), it is
certainly necessary to expand the study to a larger number of subjects
Radiologic imaging of inflammatory bowel disease
No full textUpalne bolesti crijeva (UBC), u koje spadaju ulcerozni kolitis i Crohnova bolest, kronične su bolesti različitih dijelova gastrointestinalnoga trakta. Simptomi kao što mučnina, proljevasta stolica s primjesima krvi,sluzi, bol u trbuhu, visoka temperatua javljaju se u svim dobnim skupinama uz višu incidenciju između 15. i 30. godine. Za razliku od Crohnove bolesti, koja može zahvatiti bilo koji dio gastrointestinalnoga trakta, ulcerozni kolitis zahvaća samo debelo crijevo te rektum. Dijagnoza se utvrđuje kombinacijom kliničke procjene, laboratorijskih, endoskopskih ,patohistoloških i radioloških nalaza. Endoskopske pretrage iako su invazivnije od radioloških još uvijek se koriste jer nam daju mogučnost uzimanja tkiva za patohistološki nalaz. Neminovna je primjena radioloških metoda oslikavanja u vrijeme postavljanja dijagnoze, tijeka bolesti, za određivanje lokalizacije, aktivnosti i težine upalnih promjena. Nativna slika abdomena i konvencionalne radiološke metode kao što su pasaža tankoga crijeva te irigografija zastarjele su tehnike koje nisu dovoljne za potvrđivanje dijagnoze te trebaju biti potkrijepljene različitim dijagnostičkim metodama kao što su ultrazvuk, kompjutorozirana tomografija i magnetska rezonancija. Slojevne metode oslikavanja, odnosno kompjutorozirana tomografija i magnetska rezonancija imaju temeljnu ulogu pri dijagnostici i otkrivanju intramuralnih i ekstramuralnih manifestacija. Kompjuterizirana tomografija široko je dostupna tehnika te zbog svoje visoke specifičnosti, osjetljivosti i brzine izvođenja smatra se metodom izbora u akutnim stanjima za bolesnike UBC. Glavni nedostatak ove metode je preveliko izlaganje zračenju pacijenata koji radi egzacerbacije bolesti su primorani ponavljati radiološke pretrage. Uloga MRI u procjeni upalne bolesti crijeva sve više se primjenjuje u dijagnostici zbog odsutnosti ionizirajućega zračenja i superiornog kontrasta mekoga tkiva. Međutim, nedostatci ove metode su visoka cijena i nedostupnost pretrage, manja prostorna i vremenska rezolucija te nemogućnost snimanja pacijenata s metalnim implatatima i klaustrofobijom. Odgovornost je kliničara da odvagne rizike i koristi u svakom jedinstvenom kliničkom scenariju, uzimajući u obzir stabilnost pacijenta, dostupnost i informacije koje su potrebne.Inflammatory bowel diseases (IBD), which include ulcerative colitis and Crohn's disease, are chronic diseases of different parts of the gastrointestinal tract. Symptoms such as nausea, diarrheal stools with admixtures of blood, mucus, abdominal pain, high temperature occur in all age groups with a higher incidence between the ages of 15 and 30. Unlike Crohn's disease, which can affect any part of the gastrointestinal tract, ulcerative colitis affects only the colon and rectum. The correct diagnosis is determined by a combination of clinical assessment, laboratory, endoscopic, pathohistological and radiological findings. Although endoscopic tests are more invasive than radiological ones, they are still used because they allow us to take tissue for pathohistological findings. It is inevitable to use radiological imaging methods at the time of diagnosis, the course of the disease, to determine the localization, activity and severity of inflammatory changes. Native imaging of the abdomen and conventional radiological methods such as small bowel passage and irrigography are outdated techniques that are not sufficient to confirm the diagnosis and should be supported by different diagnostic methods such as ultrasound. Layered imaging methods, i.e. computed tomography and magnetic resonance, play a fundamental role in the diagnosis and detection of intramural and extramural manifestations. Computed tomography is a widely available technique, and due to its high pecificity, sensitivity and speed of execution, it is considered the method of choice in acute conditions for IBD patients. The main disadvantage of this method is the excessive radiation exposure of the patient, who, due to exacerbation of the disease, is forced to repeat radiological examinations. The role of MRI in the assessment of inflammatory bowel disease is increasingly used in diagnostics due to the absence of ionizing radiation and superior soft tissue contrast. However, the disadvantages of this method are the high price and unavailability of the examination, lower spatial and temporal resolution, and the impossibility of imaging patients with metal implants and claustrophobia. It is the clinician's responsibility to weigh the risks and benefits in each unique clinical scenario, taking into account the patient's stability, availability, and the information needed
THE ROLE OF CBCT IN THE PLACEMENT OF DENTAL IMPLANTS
No full textUvod: Sve šira primjena radiologije u dentalnoj medicini stvorila je zahtjeve za razvoj radioloških uređaja
specijaliziranih za rad u tom području. Razvojem kompjutorizirane tomografije konusnim zrakama omogućen je
trodimenzionalni prikaz orofacijalnog područja. CBCT snimanje je motoda izbora prilikom planiranja postavljanja
dentalnih implantata.
Cilj rada: Cilj ovog rada je opisati primjenu CBCT uređaja u procesu planiranja i postavljanja dentalnih
implantata. U radu su opisane prednosti i nedostatci radiološke metode te artefakti i doze zračenja koje su od velikog
značaja za kvalitetu slike.
Rasprava: Potpuna ili djelomična bezubost negativno utječe na kvalitetu života i održavanje optimalnog
zdravlja. Dvodimenzionalne radiološke metode nisu se pokazale optimalnima prilikom prikaza trodimenzionalnih
struktura. CBCT uređaj omogućuje generiranje multiplanarnih rezova područja od interesa i njihovu 3D
rekonstrukciju. Prije postavljanja dentalnih implantata, ključna je procjena anatomskih struktura te kvalitete i
volumena kosti. Potrebno je odrediti kvalitetu i kvantitetu kosti, 3D topografiju alveolarnog grebena, identificirati i
lokalizirati vitalne anatomske strukture, izraditi kirurški vodič i moguće implantološke opcije kako bi zahvat na kraju
bio uspješan. Prednosti CBCT uređaja su trodimenzionalni pregled struktura glave i vrata, generiranje
dvodimenzionalnih struktura, smanjenje pogreške povećanja, doza zračenja, artefakti i cijena. Uz brojne prednosti,
CBCT uređaj ima i određene nedostatke. Nedostatci CBCT uređaja su nizak raspon kontrasta, ograničeni FOV i
volumen snimanja, artefakti pomicanja, mjerenje gustoće kosti i nijansi sive skale i doza zračenja. Osim za
predkiruršku procjenu i planiranje, CBCT uređaj se koristi i postoperativno za procjenu cijeljenja implantata,
komplikacija koje su najčešće povezane s neurovaskularnim oštećenjima. CBCT snimanje se treba provoditi uz
održavanje ravnoteže između cijene i doze zračenja s jedne strane i svih neophodnih kliničkih informacija s druge
strane.
Zaključak: Primjena CBCT uređaja u planiranju i postavljanju dentalnih implantata postaje sve više osnovna
dijagnostika bez koje se ne može zamisliti ozbiljna implantologija, a isto tako koristi se sve više kao svakodnevna
pretraga u oralnoj kirurgiji, endodonciji, ortodonciji i parodontologiji.Introduction: All wider application of radiology in dental medicine has created a demand for the development
of radiological devices specialized for that field. The development of Cone Beam Computed Tomography has enabled
a three-dimensional view of the orofacial area. CBCT screening is the method of choice during the planning of
placement of dental implants.
Aim: The aim of this paper is to describe the application of CBCT devices in the process of planning and
placing dental implants. The paper illustrates the advantages and disadvantages of this radiological method, artifacts,
and radiation dosage which are significant factors for the quality of the image.
Discussion: Complete or partial toothlessness has a negative impact on the quality of life and maintenance of
optimal health. Two-dimensional radiological methods have not been proven optimal for the view of three-dimensional
structures. The CBCT device enables the generation of multiplanar slices of the areas of interest and their 3D
reconstruction. The assessment of anatomical structures and the quality and volume of bone is key to the placement of
dental implants. It is necessary to determine the quality and quantity of bone, 3D topography of the alveolar ridge, to
identify and localize vital anatomical structures, make a surgical guide as well as possible implantological options so
that the intervention is successful. The advantages of the CBCT device are three-dimensional overview of the head
and neck, the generation of two-dimensional structures, the reduction of the increase error, the dose of radiation,
artifactxs, and price. Alongside many advantages, the CBCT device has certain flaws as well. Its disadvantages are the
low span of contrast, limited FOV and volume of screening, artifacts of movement, measuring the density of bone and
the shades of gray scale and the dose of radiation. The CBCT device is used not only for presurgical assessment and
planning, but also for postoperative assessment of healing of the implants, complications which are usually connected
to neurovascular damage. CBCT screening should be conducted while taking into account the balance between price
and dose of radiation on one side, and all necessary clinical information on the other.
Conclusion: The application of CBCT devices in planning and placement of dental implants is increasingly
becoming fundamental diagnostics without which serious implantology cannot be pictured. It is also being used
increasingly more as a daily examination in oral surgery, endodontics, orthodontics and parodontology
Attitudes on postpartum depression - public opinion survey
No full textCilj ovog rada je kod stanovnika Republike Hrvatske ispitati znanja i stavove o postporođajnoj depresiji (PPD) te utvrditi čimbenike koji na njih utječu. Istraživanje je provedeno na 1063 pripadnikaopće populacije. Korišten je on-line anketni upitnik koji je uključivao opće i demografske podatke, skale o znanju i stavovima prema PPD, pitanja o osobnom iskustvu s PPD te informativnim kampanjama vezanim uz istu. Povezanost rezultata i utjecaj ispitivanih čimbenika na stavove i znanje ispitan je višestrukom linearnom regresijom. Prosječna razina ukupnog znanja sa srednjom vrijednosti 10 upućuje na prosječnu razinu znanja o PPD. Razina stavova sa srednjom vrijednosti 2,44 upućuje na njihovu orijentaciju prema pozitivnijim stavovima. Na ukupnu razinu znanja statistički značajno utječe spol, imaju li djecu, obrazovanje, jesu li zdravstveni djelatnik, poteškoće s mentalnim zdravljem i liječenje od istih, osobno iskustvo i poznavanje osobe s PPD te izloženost informativnim kampanjama (P < 0 ,005). Na stavove o PPD značajno utječu: spol, bračni status, imaju li djecu, obrazovanje, jesu li zdravstveni djelatnik, poteškoće s mentalnim zdravljem i liječenje od istih, osobno iskustvo i poznavanje osobe s PPD te educiranost putem informativnih kampanja (P < 0 ,005). Istraživanje može poslužiti kao pomoć pri planiranju i realizaciji preventivnih mjera kako bi se utjecalo na pronalazak strategija za unaprjeđenje znanja populacije o PPD što bi u konačnici dovelo do destigmatizacije poremećaja i osoba koje boluju od njega.This paper aims to examine the knowledge and attitudes on postpartum depression (PPD) in the population of the Republic of Croatia and to determine the factors that are related to them. The survey was conducted on 1,063 members of the general population. An online survey questionnaire was used, which included general and demographic data, scales on knowledge and attitudes towards PPD, questions on personal experience with PPD, and information campaigns related to it. The correlation of results and the influence of the examined factors on attitudes and knowledge were examined by multiple linear regression. An average level of total knowledge with a mean of 10 indicates an average level of knowledge on PPD. The level of attitudes with a mean value of 2.44 indicates their orientation towards more positive attitudes. The overall level of knowledge is statistically significantly influenced by gender, whether they have children, education level, whether they are a health worker, mental health problems and treatment, personal experience, and acquaintance of a person with PPD, and exposure to information campaigns (P <0, 005). Attitudes towards PPD are significantly influenced by gender, marital status, whether they have children, education level, whether they are a health worker, mental health problems and treatment, personal experience, and acquaintance of a person with PPD, and education through information campaigns (P <0, 005). The research can serve as an aid in the planning and implementation of preventive measures to influence strategies to improve the knowledge of the population about PPD, which would ultimately lead to the de-stigmatization of the disorder and people suffering from it