Medicinski časopis

Peculiarities of titanium implants in patients with long-term absence of teeth and significant atrophy of hard and soft tissues of the jaws

2025-03-28T14:54:23+01:00

Background/aim: The placement of artificial teeth in case of significant atrophy of hard and soft tissues of the jaws remains one of the most difficult problems in dentistry. The task was set to eliminate the unsolved problems by modernizing the existing methods of transplantation and implantation and analyzing the results of their application in clinical conditions.

Materials and methods: In the period from 2002 to 2022, standard surgical dentistry operations of transplantation and implantation were performed in several dental clinics in Russia for 5,280 men and women aged 22 to 85 years. Of these, autogenic bone materials were used in 788 patients, and in 4492 patients, surgical operations were performed with transplantation of xenogenic OsteoBiol biomaterials. All patients were implanted with titanium implants Replace Select (Nobel Biocare, Switzerland).

Results: It was shown that transplantation of autogenous bone and xenogenic biomaterials lasted on average about 2.5 and 1.5 hours and resulted in successful engraftment in 83% and 94% of cases (respectively). To exclude accidental perforation of Schneider's membrane during biomaterial transplantation in conditions of significant maxillary crest atrophy, a method of elevating the floor of the maxillary sinus under illumination with blue light from the nasal cavity was proposed. To improve the aesthetic result when placing the crown on the implant in the conditions of soft tissue deficiency around it the method of transplantation of autogenous material in the form of a round disk with a hole in the center for "dressing" on the implant is proposed.

Conclusion: Modern dental technology makes it possible to restore significant defects of soft and bone tissues of the jaws and replace teeth in patients of all age groups.

From Symptoms to Survival: Tracking COVID-19 Patient Outcomes in an Outpatient Clinic

2025-03-28T14:54:24+01:00

Background and Aim: The Coronavirus Disease 2019 (COVID-19) pandemic has significantly impacted public health, requiring a deeper understanding of its transmission, pathogenesis, and effective treatment strategies. This study aims to investigate the clinical outcomes of COVID-19 patients treated at an outpatient respiratory clinic, focusing on the impact of comorbidities on mortality rates.

Methods: We conducted a retrospective cohort study at Al-Zahra Hospital's outpatient respiratory clinic, involving 524 patients diagnosed with COVID-19 through PCR tests or CT scans. The study focused on evaluating changes in clinical status, laboratory parameters, vital signs, and 28-day mortality rates after treatment.

Results: An analysis of 524 COVID-19-confirmed participants demonstrated statistically significant correlations between mortality, history of cardiovascular disease, and diabetes (p < 0.05). However, the associations between mortality and diverse factors, such as gender, psychiatric disorders, neurological diseases, renal diseases, hypertension, and the number of vaccinations, were not statistically significant (p > 0.05).

Conclusion: The study revealed increased COVID-19-related mortality rates in individuals particularly with cardiovascular disease and diabetes. No substantial correlation was observed between mortality and age, gender, other illnesses, and laboratory data.

RESILIENCE AND HEALTHY LIFESTYLES IN THE POPULATION OF NURSES, NURSING STUDENTS AND ADMINISTRATIVE WORKERS

2025-03-28T14:54:24+01:00

Aim: The aim of this study is to determine whether resilience is associated with healthy lifestyles, defines as physical activity, dietary habits and proper sleep, in a population of nurses, students and administrative workers. Materials and methods: The study included a total of 290 respondents: 149 nurses, 71 clerks and 70 nursing students, from six different cities in the territory of Serbia, during the year 2022. To assess resilience, we used Brief Resilience Scale (BRS). In order to examine the influence of healthy lifestyles, we asked respondents to fill out a questionnaire which included general questionnaire about socio-demographic and lifestyle characteristics, International Physical Activity Questionnaire (IPAQ) and Mediterranean Diet Adherence Screener (MEDAS). Results: People who predominantly use olive oil in their diet as a main culinary fat are more resilient that those who do not use it (r = 0.024). There is no statistically significant difference between resilience and parameters of physical activity. Resilience is associated with sleep problems, optimism and place of living. Conclusion: The results of our study represent an important starting point for establishing strategies for building resilience, especially in the population of healthcare workers, considering that the majority of our sample consists of nurses. Such results take on a new dimension in times of major social global changes (recent coronavirus pandemic, wars), which result in the overloading of national health systems.

PREHOSPITAL CARE AND TREATMENT OF INJURED IN TRAFFIC ACCIDENTS

2025-03-28T14:54:24+01:00

Efikasna nega svih vrsta trauma kao posledica povređivanja u saobraćaju je prioritet u svim zdravstvenim sistemima. Svake godine mnogi od 1,35 miliona izgubljenih života na globalnom nivou mogu biti spaseni i veliki deo invaliditeta povređenih mogao bi da se spreči ako bi brze i kompetentne prebolničke usluge bile dostupne na mestu gde se nesreća dogodila. Godine 2016. svetska zdravstvena organizacija (SZO) izvestila je da su saobraćajne nesreće među 10 vodećih uzroka smrtnosti, posebno kod mlađe kategorije učesnika u saobraćaju gde dominiraju osobe muškog pola. Trijaža i protokol traume imaju za cilj da postojeće resurse sitema zdravstvene zaštite i civilnog sektora, upotrebe u korist što većeg broja povređenih. Smatra se da je vremenski interval između pojave saobraćajne nezgode i početka prve medicinske pomoći i zdravstvene nege, u određenom centru za traumu važan prediktor preživljavanja žrtve. Cilj ovog rada je bio, da se naglasi važnost korišćenja protokola prilikom zbrinjavanja povređenih i istaknuti značaj prehospitalnog zbrinjavanja i nege, za smanjenje motaliteta nakon povređivanja u saobraćaju. U ovom radu biće predstavljene informacije iz relevantnih izvora podataka: PubMed, MEDLAJN, SCOPUS i Srpskog citatnog ideksa i drugih relevantnih baza. Uvođenje i primena efikasnih trijažnih protokola, kao i formiranje lako dostupne mreže trauma centara, ključni su za poboljšanje prehospitalne nege i smanjenje smrtnosti. Ove mere omogućavaju brži odgovor na nesreće, optimalnu raspodelu resursa i poboljšanje ishoda za povređene, što je od suštinskog značaja za unapređenje sistema javnog zdravlja jedne države.

SUCCESSFUL CARDIOPULMONARY RESUSCITATION USING A DEFIBRILLATOR PLACED IN A PUBLIC PLACE - CASE REPORT

2025-03-28T14:54:25+01:00

SAŽETAK:

Cilj: Rana defibrilacija ritmova koji se mogu defibrilirati povezana je sa poboljšanim preživljavanjem, ali je osiguravanje pravovremenog pristupa defibrilatorima predstavljalo značajan izazov. Do danas, razvoj javnih programa defibrilacije, koji uključuje postavljanje automatizovanih eksternih defibrilatora u javni prostor, bio je glavna strategija za rešavanje ovog izazova.

Metode: Prikazan je slučaj 47-godišnjeg muškarca sa akutnim infarktom miokarda i VF. Analizirani su podaci ambulantnog protokola, anamneza i otpusne liste iz hitne pomoći, jedinice intenzivne nege.

Rezultati: Pacijent je osjetio mučninu, vrtoglavicu, znojenje. Kćerka ga pronalazi na podu bez svijesti, ne diše. Otpočeo reanimaciji, i pozvana je hitna pomoć. Policija dolazi prva i upotrebljava AED defibrilator. Na monitoru defibrilatora registrje se VF i donijeta je odluka o primeni DC šoka. AED defibrilator isporučuje 5 šokova.

Nakon DC šoka, pacijent počinje da diše. Hitna dolazi nakon 6 minuta i nastavlja se sa reanimacijom. Pacijent je prevezen u Urgentni centar. EKG tokom transporta pokazao je sinusni ritam od 100/min sa elevacijom ST segmenta u V1-V5 i depresijom ST segmenta V6. Vitalni parametri tokom transporta (CCS 11, SpO2 90% , krvni pritisak je nemerljiv) Pacijent je intubiran. Terapija Amoidaron amp 150mg/3m: 300mg IV Fentamed amp 0,5/10ml: 0,3 mgIV, Biropehen amp.0,5mg/5ml :0,4mg IV, Rocuroniumbromid kabl.50mg/5ml: 80mg/5ml: 80mg/1mg 0,3 mg IV

U Hitnoj pomoći imao je tri epizode ventrikularne tahikardije. Nakon uspješne kardioverzije, pacijent je imao stabilan ritam.

Pacijent je pripremljen za PCI, stent na LAD. Nakon katakterizacije, implantacije STENT i stabilizacije, primijenjena je terapijska hipotermija sa Hladnim Ringer laktatom 500 ml na 4°C intravenski. Temperatura je smanjena na 33°C i održavana je 24 sata.

Zaključak: Što se prije započne CPR, to je bolji ishod. U prve 3 minute šansa za povratak spontane cirkulacije je 75%. Nakon 4 minute je 40%. Nakon 5 minuta šansa za povratak spontane cirkulacije je minimalna.

Ključne riječi: zastoj srca, kardiopulmonalna reanimacija, AED, defibrilacija