Ultrastructural analysis of the surface changes on the nickel-titanium endodontic instruments after multiple use

One of the primary goals in endodontics is efficient cleaning and shaping of the root canal while maintaining its original configuration. Numerous studies highlight the advantage of using nickel-titanium instruments and the most important is their high flexibility and the ability to penetrate the curved canals. The aim of this study was to analyze the ultrastructure of the surface of nickel-titanium endodontic files before and after use. Eighty-four instruments were included in this study. The instruments were used one, three and six times for root canal preparation on extracted upper premolars. The analysis was performed based on the number of uses and the size of the instruments. Changes on flat surfaces in the grooves of the instruments, defects of the cutting edges and fractures were evaluated. The surface ultrastructure was analyzed on a scanning electron microscope (SEM). SEM analysis showed irregularities on the surfaces of the new instruments. Surface defects and damage of the cutting edges were present after the first use. After three uses, the damage was more evident in instruments of all sizes. After six uses, all instruments showed damage of the cutting edges, and a significant number of fractures were observed. Irregularities on the working parts are already noticed on the new endodontic instruments and originate from the production process. The first signs of damage appear after the first use. In order to prevent errors in clinical work during root canal preparation, it is recommended that the number of instruments uses should be limited.

Possible health benefits of polyphenols in neurological disorders associated with COVID-19

Novel Coronavirus disease 2019 (COVID-19) represents an emergent global health burden that has challenged the health systems worldwide. Since its sudden upsurge in 2019, many COVID-19 patients have exhibited neurological symptoms and complications. Till now, there is no known effective established drug against the highly contagious COVID-19 infection despite the frightening associated mortality rate. This article aims to present the mechanism of action of coronavirus-2 (SARS-CoV-2), the clinical neurological manifestations displayed by COVID-19 patients, and present polyphenols with neuroprotective ability that can offer beneficial effects against COVID-19-mediated neuropathology. Reports from COVID-19 clinical studies, case reports, and other related literature were evaluated for this review. Neurological complications of COVID-19 include anosmia, acute cerebrovascular disease, acute disseminated post-infectious encephalomyelitis, encephalitis, etc. Also, SARS-CoV-2 sould be a neurotropic vіruѕ due to its iѕolatіon from serebroѕrіnal fluіd. Multіrle neurologіsal damages displayed by COVID-19 patients might be due to hyperinflammation associated with SARS-CoV-2 infections. Resveratrol, kolaviron, quercetin and apigenin are polyphenols with proven anti-inflammatory and therapeutic properties that can extenuate the adverse effects of COVID-19. These polyphenols have been documented to suppress c-Jun N-terminal kinase (JNK), phosphoinositide-3-kinase (PI3-K), extrasellularѕіgnal-regulated kinase (ERK), nuclear factor kappa-light-chain-enhancer of activated B-cells (NF-kB) and mіtogen-astіvated protein kіnaѕe (MAPK) pathways which are essential in the pathogenesis of COVID-19. They also showed significant inhibitory activities against SARS-CoV-2 proteins. Taken together, these polyphenols may offer neuroprotective benefits against COVID-19 mediated neuropathology via modulation of the pathogenic pathways.

Effectiveness of Tocilizumab after switching from intravenous to subcutaneous formulation in patients with rheumatoid arthritis: A single-centre experience

Nowadays, the appropriate control of rheumatoid arthritis (RA) involves the absence of clinical disease activity, delaying joint destruction as long as possible and adequate quality of life of the affected. With currently available therapeutic modalities, this therapeutic goal can be achieved in a large number of patients. The aim of this research was to determine the effectiveness of an IL-6 blocker (Tocilizumab) in patients with RA in everyday clinical practice. We also analyzed whether a change in the mode of drug administration (switching from intravenous to subcutaneous drug formulation) had an impact on drug effectiveness (using the DAS 28 SE and CDAI indexes) and quality of life of patients with RA (HAQ, Beck Depression Inventory, FACIT F score and SF 36 questionnaire). The study included 53 subjects diagnosed with RA, treated with Tocilizumab. After a six-month use of subcutaneous Tocilizumab, we concluded that the method of drug administration did not have an impact on its effectiveness and on all the examined parameters of quality of life assessment.

Protein-protein interaction networks and protein-ligand docking: Contemporary insights and future perspectives

Traditional research means, such as in vitro and in vivo models, have consistently been used by scientists to test hypotheses in biochemistry. Computational (in silico) methods have been increasingly devised and applied to testing and hypothesis development in biochemistry over the last decade. The aim of in silico methods is to analyze the quantitative aspects of scientific (big) data, whether these are stored in databases for large data or generated with the use of sophisticated modeling and simulation tools; to gain a fundamental understanding of numerous biochemical processes related, in particular, to large biological macromolecules by applying computational means to big biological data sets, and by computing biological system behavior. Computational methods used in biochemistry studies include proteomics-based bioinformatics, genome-wide mapping of protein-DNA interaction, as well as high-throughput mapping of the protein-protein interaction networks. Some of the vastly used molecular modeling and simulation techniques are Monte Carlo and Langevin (stochastic, Brownian) dynamics, statistical thermodynamics, molecular dynamics, continuum electrostatics, protein-ligand docking, protein-ligand affinity calculations, protein modeling techniques, and the protein folding process and enzyme action computer simulation. This paper presents a short review of two important methods used in the studies of biochemistry - protein-ligand docking and the prediction of protein-protein interaction networks.

Compilation and testing the reliability of questionnaires about the fear of blood extraction (venipuncture) among students of Medical Faculty of Kragujevac

It is of particular importance to use validated questionnaires to remove fear of needles and blood collection, as this public health problem has been observed in a large number of patients and may inadequately affect medical healthcare. The aim of the study was to conduct a research on the reliability of the questionnaire on the fear of blood sampling among students of the Faculty of Medical Sciences in Kragujevac. The method used in this research was a cross-sectional study. The sample involved the students of medicine, pharmacy, dentistry and professional studies of health care at the Faculty of Medical Sciences in Kragujevac (Republic of Serbia), a total of 300 students, which was 20% of the student population at the aforementioned faculty. The research instrument was the questionnaire The Blood-Injection Symptom Scale (BISS) which contained 22 questions. The research lasted one month during 2016. Statistical data processing was performed using IBM SPSS Statistics 21. Cronbach's Alpha value - 0.894 and other parameters used to determine reliability showed a high reliability of this questionnaire. After explorative factor analysis, three factors that most affect adverse outcomes for venepuncture were obtained - vasovagal symptoms that occur as a result of fear, fear of needles and consequences of puncture, and the fear of hospitals and personnel who take blood samples. The BISS questionnaire showed good reliability in the population of students of the Faculty of Medicine in Kragujevac and can be used in the general population for examining the fear of needles, the consequences of needle stings, fear of hospitals and people who take blood samples, and therefore to prevent these symptoms.

Prevalence of asthma and other allergic diseases in pregnant women

Asthma and allergic disorders can affect the outcome of pregnancy. Asthma and allergies are common comorbidities during pregnancy and exacerbations are the major clinical problem. Results are not consistent between studies .Therefore, the aim of this study was to determine the frequency of asthma and allergic disease during pregnancy. This prospective cohort study was carried out at the antenatal clinic of Mobini Hospital in Iran. Overall, 1,603 women were enrolled prior to the 24th week of pregnancy. All participants were interviewed for allergy disease, allergic trigger factors and severity of asthma. Also, asthma control was categorized as per GINA guidelines. The diagnosis of asthma was based on symptoms, pulmonologist diagnosis, and spirometry assessment. The results were analyzed using SPSS version 20 and T-tests and Chi-square test. The prevalence of asthma during pregnancy was 2.1% among the participants. The most common allergens in asthmatic group were pollen, stress, and climate. There was a significant relationship between age, education and place of living in asthmatic and non-asthmatic group, p = 0.003, p=0.05, p=0.008, respectively. There was a significant relationship between asthma symptoms among the two groups (p=0.001). In addition, a significant relationship was found between asthma and other allergic diseases including eczema, allergy, rhinitis, and wheeze in asthmatic women, with a significant relationship between wheeze and coughing and allergy. Exposure of the pregnant women to high levels of allergens, like pollen, and allergic diseases resulted in an increased risk of pregnancy outcomes. Careful management of these diseases should prevent most of the serious complications

Facial symmetry in subjects with full dental arches

The universal notion of beauty does not exists, however, the facial symmetry contributes to a better aesthetic effect. This harmony is primarily determined by the relationship between parts of the face and dental parameters. Tooth loss leads to a decrease in the height of the bite and consecutive oncoming of the tip of the nose and chin and a violation of the vertical and horizontal relationship between the maxilla and mandible. The aim of the study was to determine the interrelationship of facial parts in subjects with a full dentition. The study included 60 dental students of both sexes in whom the presence of a complete dentition was determined by clinical examination. Facial parameters of the subjects' profiles were measured, as well as the ratio of bipupillary distance and intercommissural distance. The obtained results partially confirmed the theory of matching the heights of the profile thirds and halves of the face. The values of the distance between the two pupils and the lip commissure did not differ statistically significantly. The obtained results could be used in the reconstruction of intermaxillary relationships after the loss of some or all teeth.

COVID-19 outbreak: How the public health network could function better in disseminating information and instruction for action: Lessons learned

The priority for the period of COVID-19 outbreak was to provide fast, well-timed dissemination of information to the general population (especially vulnerable groups) as well to health professionals and professionals from other areas of public life (police, army, local governments, education, and the business sector) on behavior change and prevention measures, in terms of guidance for the current epidemiological situation. At the Public Health Institute Niš, Serbia, we directed activities relying primarily on formal intervention approaches, WHO guidance and on information and knowledge gained at the April 2019 WHO "Emergency Risk Communication training and plan-writing workshop" in Belgrade/Serbia. To define the advantages and disadvantages of the applied method for dissemination of information, we followed the reporting guidance contained in Duncan E and colleagues', Guidance for reporting intervention development studies in health research (GUIDED). Guidelines for treatment and recommendations were disseminated through standard communication channels. A local public health network with a large number of partners from the governmental and non-governmental sector, established in recent years, was a kind of channel for dissemination of materials. We realized that formal intervention approaches should be rapidly improved by better mapping of all population groups, by modern ways of communication, by urgent introduction of digital communication channels such as telemedicine, smart phone engagement and internet applications, in order to educate and exchange information more efficiently and quickly, especially in crisis situations such as COVID-19 epidemics/pandemics.

Acute myocardial infarction trends in the population of the Nišava District

Acute myocardial infarction is the leading cause of premature morbidity and premature death worldwide. The aim of the paper was to determine the trends of acute myocardial infarction in the period between 2006 and 2019 in the population of the Nišava District. A descriptive study was performed. Data about acute myocardial infarction incidence and mortality were obtained from the population registry for Acute Coronary Syndrome of Serbia. Crude, specific and age-standardized incidence and mortality rates per 100,000 persons were calculated as well as the trend lines. A total number of 12,142 new cases of acute myocardial infarction (7,595 in males and 4,547 in females) were registered. Men suffered 1.7 times more often than females. An insignificantly decreasing acute myocardial infarction incidence trend y = 0.4868x + 112.24, R² = 0.0029 was recorded. A total of 3,925 persons died (2,260 males and 1,665 females). Men died 1.4 times more often than women and a significant decreasing mortality trend was recorded both males (y = -1.6112x + 52.563, R² = 0.7779) and in females (y = -0.4956x + 22.81, R² = 0.3306). A significant increasing mortality trend of acute myocardial infarction by age was determined y = 11.152x - 34.519, R² = 0.7022. The trend of incidence tended to decrease however, without statistical significance, but insignificantly. The incidence and mortality rates were higher in men than in women for the whole observed period. Mortality trend significantly decreased both in men and in women and significantly increased with age.

Predictors of sexual dysfunction in HIV-infected women

Sexual dysfunction is more common among the people with human immunodeficiency virus (HIV) infection than in those without it. The sexual dysfunction in HIV-infected people is associated with adverse outcomes such as reduced quality of life, unprotected sexual activities, and reduced adherence to highly active antiretroviral therapy. Therefore, the present study was designed to investigate a potential predictor role of some variables such as socioeconomic status, hormonal and HIV disease profile, type of treatment, depression, anxiety, stress, domestic violence, and status of partner infection for sexual function in people with HIV infection. This descriptive cross-sectional study was conducted on 40 HIV-infected women with medical records in behavioral disease counseling centers of Shiraz University of Medical Sciences. The required data were collected using the Female Sexual Function Index (FSFI), Depression‚ Anxiety‚ Stress Scale (DASS-21), and Domestic Violence Questionnaire. To examine the CD4 cell levels and hormonal profiles, 5cc blood was taken from the patients simultaneously on days 3 - 5 of their menstrual cycles. The data were analyzed using the SPSS18 software. The mean age of the participants was 38.2 ± 5.2 years, and the frequency of sexual dysfunction was 100%. There was a statistically significant difference in the levels of the elevated variables such as estradiol, stress, anxiety, and depression. The multivariate analysis showed that only the increased estradiol level (P = 0.005, B = 0.06) was a predictor factor of sexual dysfunction. All the HIV-infected women had sexual dysfunction. The results of this study showed that in those women the increased levels of estradiol could be a predictor of sexual dysfunction.