PubMed Health⌕ Search

Biomedical subjects

L Petrović

Publications and source records attributed to L Petrović.

At least 19 recordsLinked to original sources

[The importance of monitoring with the Swan-Ganz catheter in cardiac surgery--personal experience].

In our paper we will present the advantages of the modern hemodynamic monitoring system in open heart surgery, especially in high risk patients. The Swan-Ganz monitoring system, with great possibilities for measuring and calculating a large number of parameters, is necessary for the postoperative treatment, for regular diagnosis and therapy of heart insufficiency, as well as the low cardiac output syndrome. There is no correlation between pulmonary capillary wedge pressure and central venous pressure, and central venous pressure isn't significant for heart insufficiency estimation, more exactly left heart insufficiency estimation. Pulmonary capillary wedge pressure is significant in the prevention and therapy of the low cardiac output syndrome.

Cardiac Surgical Procedures↗

Possibilities of predicting results after surgical correction of ischemic mitral regurgitation on the basis of the degree of left ventricular dysfunction.

Results of surgical treatment for ischemic mitral regurgitation were retrospectively analyzed in 209 patients. All patients underwent myocardial revascularisation as well as mitral valve surgery. Preoperative myocardial infarction was registered in 75% of cases. These patients had different degrees of left ventricular dysfunction. Postoperative 30-day mortality was 4.3% for the whole group but higher in patients with lower ejection fraction. Looking at preoperative values of ejection fraction (EF), long term follow-up of 75 months, there is a statistically significant differences in survival rate (p < 0.05), freedom from cardiac decompensation (p < 0.05), and other complications (p < 0.001), but only comparing two subgroups of patients, those with preoperatively ejection fraction lower and higher than 20%. Early postoperative, and especially long term results, are better in patients with higher ejection fraction. According to our experience, it is possible to predict the results after surgery for ischemic mitral regurgitation, depending on the degree of preoperative left ventricular dysfunction.

Adult↗

[Specifics of mastication with complete dentures].

INTRODUCTION: Mastication is a process characterized by alternating phases of physiological inactivity, food intake, initial food crumbling, mouthful formation and deglutition. Although there is a so called human type of mastication, this process is individual for variety of reasons. Mastication is not an innate characteristic and it must be learned, but once it is learned, it gets a reflexive function, demanding maximal involvement of the highest nervous system centers. DISCUSSION: Specificities of mastication in complete denture wearers are caused by specificities connected to changes of the oral cavity due to teeth loss, technical features of complete dentures and quality of their manufacture. Loss of teeth causes loss of periodontal receptors consequently damaging the source of information which, as long as teeth are present, travels from the oral cavity towards the central nervous system and regulates the masticatory muscles activity. As one of the consequences of periodontal receptors' loss, interocclusal perception decreases, because the number of receptors within the masticatory mucosa is negligible. Another problem is that loss of teeth causes loss of the occlusal surface. Occlusal surface is considered to be the only reference coordinate of the zero intermaxillary separation with precise spatial representation within the someostatic field cortex. Permanent loss of antagonistic contact causes disappearance of the memory pattern of the occlusal surface. Therefore completely edentulous mouths are characterized by disintegration of the free interocclusal space. Masticatory forces' value directly depends on the: size of muscles creating the forces, their position in the mandibula, shape of the edentulous alveolar ridge, type of chewing, the relationship between the height of the branch, length of the mandibular body, gonial angle, mandibular angle in relation to the anterior cranial base and posterior facial height and the degree of intermaxillary separation. Bite forces in complete denture wearers are significantly decreased in relation to persons with natural teeth. There is a fundamental difference in the distribution of the functional energy in complete denture wearers and subjects with intact teeth. Persons with natural teeth tend to generate energy through bolus, whereas in complete denture wearers most of the chewing energy is distributed outside bolus, directly through the denture base on the supporting tissues. RESULTS: As the result of this specific dynamics stress of supporting tissues often occurs with consequential mucosal inflammation and rapid alveolar bone resorption. Reduction of masticatory efficacy in denture wearers may be caused by irregular activity of masticatory musculature or is the consequence of irregular flow of energy during mastication. In comparison with young examinees with healthy teeth, authors have registered that complete denture wearers need about seven times more masticatory movements to achieve equal number of sample parts. CONCLUSION: It has been documented by experience and also scientifically proved, that the satisfaction of complete denture wearers is not often proportional with objective functional denture values. Comparison of subjective parameters with objective test results reveals that the percentage of complete denture wearers who consider their dentures to be good, although they objectively are not such, is significantly higher than the percentage of those who complain about their dentures, although they are functionally proper. Our study comprised patients (average age of 69) who wore complete dentures longer than five years.

Denture, Complete↗

[Periapical surgery of the molars].

INTRODUCTION: If loss of a great number of teeth occurs, one molar in the lateral segment is of great importance. Contemporary techniques and materials provide extremely successful conservative treatment of pulpal diseases and apical periodontitis. In some cases, however, surgery is indicated. INDICATIONS: Indications for periapical surgery used to be a matter of double standards. If periapical surgery is indicated in incisors, it is performed without delay, but if it is indicated in molars, it is often exchanged for extraction. Surgical access in the region of upper and lower molars is specific in regard to much more frequently operated incisors due to anatomic structures at the surgical site. Canal filling techniques, implants, endodontic surgical procedures are of importance and can provide better healing. High quality canal filling is condition sine qua non in treatment of apical periodontitis. It is performed prior surgery, by conventional orthograde endodontic techniques, during surgery by orthograde technique and/or retrogradely. Implants provide better bone healing and are recommended in surgery of molar apex. Surgical packing has numerous advantages (better psychological and mechanical care). CONCLUSION: Good knowledge of anatomy and surgical techniques is a pre-requisite for molar apicoectomy. Careful establishment of indications and good relations with the patient provide good prognosis of this therapeutic method.

Apicoectomy↗