This paper aims to collect all the necessary information and conclusions which deal with the anti-inflammatory drugs within the scope of teeth bleaching, and which are rooted in scientific research. It is a well-known fact that the teeth whiteners / bleachers are at the same time a very aggressive agents, which opened up the question of the safety of their application. The most frequently applied bleaching agents are the hydrogen-peroxide (H2O2) and carbim peroxide (CH6N2O3), therefore this paper will be based on the research which included these two agents. The first studies were directed towards investigating the outcome / impact on the enamel, i.e. if there is direct surface damage of the enamel layer after the use of such agents. However, bearing in mind that the clinical practice has shown that in a number of cases there arises the sensitivity of teeth in the form of painful sensation after the bleaching treatment, some researches were directed towards the estimation of the permeability of the enamel and dentin for the bleaching agent, and later the effect on the pulp tissue. Along with the existing proof about the irritability of these agents to the pulp tissue, the modern research have the idea of looking into the effects of the anti-inflamatory drugs as the accompanying and prevention therapy of any of the irreversible damage of the pulp. On one hand the application of these drugs can reduce the sensitivity and painfulness of the teeth, which makes the intervention pleasant for the patient, but on the other hand the intervention becomes completely justifiable from the aspect of safety and the basic principle primum non nocere. The anti-inflammatory drugs which will be the topic of this study are H hydrocortisone, acetaminophen, ipobruphen and etodolac. Taking into consideration the vasoconstrictive and anti-oxidative effect, the anti-inflammatory effect of the carvedilol will be looked into, which belongs to the group of beta blockers. Based on available informations it can be noticed that the most efficient anti-inflammatory effect in teeth whitening is achived by hydrocortisone.
Acute necrotizing pancreatitis (ANP) is a severe form of acute pancreatitis that is associated with high morbidity and mortality. Thus, an adequate initial treatment of patients who present with acute pancreatitis (AP) based on correct interpretation of early detected laboratory and clinical abnormalities may have a significant positive impact on the disease course. The aim of the study was to determine patient- and initial treatment-related risk factors for the development of acute necrotizing pancreatitis. For the purpose of this study a case-control design was chosen, including adult patients treated for AP in the surgical Intensive Care Unit (sICU) of Clinical Center of Kragujevac, from January 2006 to January 2011. The cases (n=63) were patients who developed ANP, while the controls (n=63) were patients with AP without the presence of pancreatic necrosis. The controls were randomly selected from a study sample after matching with the cases by age and sex. Significant association with the development of ANP was found for the presence of comorbidity (adjusted OR 6.614 95%CI 1.185-36.963), and the use of somatostatin (adjusted OR 7.460, 95%CI 1.162-47.833) and furosemide (adjusted OR 2710.57, 95%CI 1.996-56.035) started immediately upon admission to the sICU. This study suggests that comorbidities, particularly the presence of serious cardio-vascular disease, can increase the risk for development of acute necrotizing pancreatitis. The probability for the development of ANP could be reduced by the avoidance of the initial use of loop diuretics and somatostatin.
Acute pancreatitis represents an acute nonbacterial inflammation of the pancreas caused by a premature and ectopic activation of pancreatic digestive enzymes. Two of the most important genes in pancreatic autodigestion, PRSS1 and SPINK1, were implicated in the earliest discoveries of the genetic background of pancreatitis. However, the distribution of their variations displays interethnic variability, which could significantly affect the magnitude of their proposed effects on this disease worldwide. The aim of the present study was to investigate the distribution of the most important functional variations of PRSS1 (86A>T and 365G>A) and SPINK1 (101A>G), and their influence on the clinical course of acute pancreatitis in Serbian patients. The study enrolled 81 subjects, the severity of disease course was determined using the Atlanta Classification system, and the genotyping was conducted using a PCR-RFLP method. PRSS1 86A>T and 365G>A SNPs were not observed in the study population, while SPINK1 101A>G was present with the frequency of 0.62% (95% CI: 0.00, 3.83%). Due to extremely low frequencies or absences of examined variations, the proposed effect of these SNPs on the severity of acute pancreatitis could not be confirmed. The results do not support routine genotyping of either PRSS1 or SPINK1 in Serbs.
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