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Rola opieki stomatologicznej nad pacjentami onkologicznymi poddanymi radioterapii głowy i szyi

Oborska-Kumaszyńska Dominika

Inżynier i Fizyk Medyczny

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2022

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Vol. 11, nr 5

447--451

PL

Nowotwory głowy i szyi obejmują heterogenną grupę nowotworów wywodzących się z górnych dróg oddechowych i przewodu pokarmowego, zatok przynosowych oraz ślinianek i tarczycy. Optymalne postępowanie w leczeniu tych nowotworów wymaga multidyscyplinarnego podejścia. Radioterapia jest jedną z technik oferowanych w kompleksowym leczeniu tego regionu anatomicznego. Głównym celem radioterapii jest uzyskanie miejscowej kontroli guza przy jednoczesnym zminimalizowaniu uszkodzeń narządów krytycznych i tkanek zdrowych. Przy tak złożonym anatomicznie regionie i bliskości poszczególnych struktur anatomicznych radioterapia wymaga zastosowania niezwykle złożonych technik i zapewnienia bardzo wysokiego poziomu zgodności dostarczania dawki promieniowania w oparciu o proces optymalizacji leczenia (pokrycie targetów przepisaną dawką vs o chrona zdrowej t kanki). J ednym z głównych p roblemów jest wpływ promieniowania na normalne komórki. Głównymi tkankami/narządami dotkniętymi promieniowaniem podczas radioterapii dla obszaru głowy-szyi są gruczoły ślinowe, błona śluzowa jamy ustnej, kubki smakowe oraz kości i zęby. Zniszczenie tkanek/narządów powoduje w jamie ustnej powstanie wielu niepożądanych skutków ubocznych. Ważne jest, aby w procesie terapeutycznym zapobiegać i leczyć powikłania ustno-twarzowe. Wymagają one multidyscyplinarnego podejścia, które obejmuje dedykowany zespół radioterapii, chirurga głowy i szyi, lekarza dentysty, pielęgniarki, dietetyka, fizjoterapeuty, pracownika socjalnego, a w niektórych przypadkach chirurga plastycznego, protetyka i psychologa.

EN

Head and neck tumors include a heterogeneous group of cancers originating in the upper respiratory and gastrointestinal tract, paranasal sinuses, and the salivary glands and the thyroid gland. Optimal management of these cancers requires a multidisciplinary approach. Radiation is one possible treatment method for cancers in this area of the body. This treatment method is utilized to treat the tumor while minimizing damage to critical organs and healthy tissue. The head and neck area is anatomically complex and is proximal to numerous vital structures. Therefore, radiotherapy treatment of tumors in this region requires extreme precision involving complex techniques. These techniques must ensure a high level of compliance for radiation dose delivery with respect to optimization of treatment processes (target coverage with prescribed dos vs protection of healthy tissue). One of the main problems is the effect of radiation on normal cells. The main tissues / organs affected by radiation in the head-neck area are the salivary glands, oral mucosa, taste buds, and bones and teeth. The destruction of tissues/organs causes many undesirable side effects in the oral cavity. It is important to prevent and treat orofacial complications. Such complications require multidisciplinary treatment which would involve a dedicated radiation therapy team, head and neck surgeon, dentist, nurse, dietitian, physical therapist, social worker, and, in some cases, plastic surgeon, prosthetist, and a psychologist.

2

W kwestii potrzeby zmian ustawy o zawodach lekarza i lekarza dentysty w obliczu sytuacji kryzysowej wywołanej pandemią COVID-19

Sobczak Jacek

Cybersecurity and Law

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2020

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Vol. 3 (1)

39--52

PL

Ustawa o zawodach lekarza i lekarza dentysty bez wątpienia wymaga zmian, które powinny być wprowadzone niezwłocznie. Na potrzebę tę wskazują liczne środowiska, nie tylko medyczne. Leczenie osób, które zachorowały na COVID-19, wymaga specjalistów, a tych już od jakiegoś czasu zaczyna brakować. Ustawa o szczególnych rozwiązaniach związanych z zapobieganiem, przeciwdziałaniem i zwalczaniem COVID-19, innych chorób zakaźnych oraz wywołanych nimi sytuacji kryzysowych, traktowana jako odpowiedź na zaistniałe zagrożenia wynikające z pandemii, nie spełnia pokładanych w niej nadziei. Odniesienie się do wykazu podmiotów udzielających świadczeń opieki zdrowotnej wykonywanych w związku z przeciwdziałaniem COVID-19 oraz teleporad udzielanych przez lekarzy jest niewystarczające.

EN

The Act on the professions of physician and dentist undoubtedly requires urgent amendments. This need has been raised by many communities, not only medical. Treating COVID-19 patients requires specialists, and there has been a shortage of them recently. Drafted in response to the pandemic-related threats, the Act on special measures to prevent and counteract COVID-19 and other infectious diseases, including associated crisis situations, failed to deliver on the hopes that it raised. It is not sufficient to provide a directory of entities providing healthcare services to counteract COVID-19 and to introduce telehealth services rendered by physicians.

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Technical aspects of the dentist’s work safety

Markowska-Dyner A.

Production Engineering Archives

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2018

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Vol. 21

40--43

EN

In the work of a dentist there are many factors that affect the occupational risk. They cover the area of the human factor, work organization and technical area. The latter often determines the safety and ergonomics of the workplace. The purpose of this article is to identify occupational hazards in the work of a dentist, with particular emphasis on the technical area. The method used in the article is a survey supported by observation with elements of a direct interview. The research tool used in the article is a questionnaire in the form of a checklist.

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Evaluation of static load in dentists’ work by means of OWAS method

Niciejewska M., Klimecka-Tatar D.

Czasopismo Techniczne. Mechanika

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2016

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Y. 113, iss. 3-M

125--130

EN

In this study, the work of the dentist and the identification of musculoskeletal disorders have been characterized. The analysis and compatibility with literature on the identification of musculoskeletal disorders resulting from professional work of dentists have been presented. The authors assessed the occupational risks associated with static load on the position of the dentist by means of the OWAS method.

PL

W niniejszym artykule scharakteryzowano pracę lekarza stomatologa oraz dokonano analizy literaturowej dotyczącej identyfikacji dolegliwości mięśniowo-szkieletowych będących skutkiem pracy zawodowej lekarzy stomatologów. Autorzy pracy dokonali oceny ryzyka zawodowego związanego z obciążeniem statycznym na stanowisku lekarza stomatologa z zastosowaniem metody OWAS.

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Development of Personal Protection Equipment for Medical Staff: Case of Dental Surgeon

Tran T. A. D., Arnold M., Schacher L., Adolphe D. C., Reys G.

Autex Research Journal

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2015

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Vol. 15, no. 4

280--287

EN

During daily oral health care, dental surgeons are in contact with numerous potentially infectious germs from patients’ saliva and blood. Appropriate personal protection equipment should be chosen to mitigate these risks, but the garment must also be comfortable and not hamper activities. This paper presents our research work on optimised working clothing for dentists and discusses some important points in the functional design. Following a consumer study on how users wear the garment and what are their expectations, three main functions were investigated: protection, ergonomics and thermal comfort. Aesthetic appearance was also taken into consideration as it is necessary that the wearer should feel appropriately and attractively dressed in the context of health care. Concerning protection, spray tests in real conditions helped us to localise the potential contamination areas on the garment and led us to select a three-layered material that is protective and breathable enough. However, this part of the garments made from these fabrics exhibited low thermal comfort and the wearer felt some discomfort. In terms of ergonomics, instrumented garments were worn and pressure measurements were taken. The results highlight that a special shape and raglan sleeves should be selected for a better dynamic comfort. Concerning thermal comfort, an infrared camera was used to detect warm zones of the garment where heat and moisture transfers should be enhanced. Breathable, stretchable and shape-retaining knitted fabric that is usually used for sportswear was selected. These fabrics were strategically placed as low and high vents to promote a chimney effect, which minimises retention of heat and humidity inside the garment. The usual PES/cotton fabric was selected for the rest of the gown. Based on these results, a new gown has been proposed. Through fitting tests conducted in a hospital on 25 dentists, it was revealed that the new design was highly appreciated, particularly on the ergonomic structure of the sleeves and thermal comfort of breathable zones. However, some points can be further improved, such as durability of the PES/cotton fabric, the neck length or the shape of ‘breathable zones’. The final product will be produced based on necessary improvements.

6

Dental Ergonomics to Combat Musculoskeletal Disorders: A Review

Gupta A., Ankola A. V., Hebbal M.

International Journal of Occupational Safety and Ergonomics

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2013

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Vol. 19, No. 4

561--571

EN

Musculoskeletal disorders (MSDs) are significant workplace problems affecting occupational health, productivity and the careers of dental professionals. The prevalence of MSDs is on the rise for all types of dental workers. In spite of different patterns of work culture, there are parallel levels of symptoms in dentists across nations. Risk factors for MSDs are multifactorial. Symptoms appear very early in careers, with higher prevalence of MSDs even during educational training. Ergonomics improvements, health promotion and organizational interventions are necessary to reduce the risk. An interdisciplinary approach with progressive efforts should be taken to address MSDs in dental professionals.

7

Differences in Dentists’ Working Postures When Adopting Proprioceptive Derivation vs. Conventional Concept

Chaikumarn M.

International Journal of Occupational Safety and Ergonomics

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2005

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Vol. 11, No. 4

441--449

EN

New technologies and changes in dental care, including the proprioceptive derivation (Pd) concept, aimed at providing dentists with greater comfort and better health, were introduced in Thailand. The aim of this study was to investigate the differences in dentists’ working postures when adopting different work concepts: Pd and the conventional concept. The results showed differences in dentists’ sitting posture, clock-related working positions, and Rapid Upper Limb Assessment (RULA) scores. This implied that Pd helped dentists to discover new ways of positioning themselves, and working comfortably and effectively, which made it possible for them to adopt better working posture and have lower RULA scores. In conclusion, the Pd concept had a positive effect on dentists’ working posture.

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Working Conditions and Dentists’ Attitude Towards Proprioceptive Derivation

Chaikumarn M.

International Journal of Occupational Safety and Ergonomics

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2004

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Vol. 10, No. 2

137--146

EN

Proprioceptive derivation (Pd), a new method of organising a dentist workstation as well as a working procedure, was introduced to Thailand. The aim of this study was to assess the working conditions and the attitude to Pd among experienced users. Questionnaires were distributed among 12 dentists. The results showed that all dentists chose to work in a sitting posture and mostly worked without breaks between patients. They spent less time on dental examination and crown and bridge therapy tasks. Solving problems in patients with physical limitations resulted in a low stress level. Seven dentists (58.3%) always used Pd and liked it. Five dentists (41.7%) sometimes used Pd, with 3 of them liking it. Only 2 dentists, who sometimes used Pd, did not like it because it could not cover all dental tasks and treatment, and it was difficult and complex.