Stress is defined as a state in which homeostasis, as a dynamic balance of internal conditions necessary for the proper functioning of cells or the living organism as a whole, is affected by the action of various stressors. Stress reaction occurs as a result of stress system activities, which is located in the central and peripheral nervous system. Stress evaluation involves a qualitative and quantitative analyses and valuation of certain biologically active substances (biomarkers of stress) in body fluids that are so often associated with stress. Saliva as a diagnostic medium is being increasingly used for purposes of clinical and basic research because of its composition and content as well as the advantages of the process of sampling, as compared to traditional methods of collecting blood samples and urine samples. Cortisol, as a biomarker of stress, is the most often studied salivary biomarker, which is associated with the activation of the hypothalamic-pituitaryadrenal (HPA) axis. Since stress leads to the suppression of the immune system, values of salivary secretory IgA and salivary lysozyme, as biomarkers of stress, can be analyzed. In saliva, it is difficult to monitor acute stress parameters, catecholamines, due to their low concentrations, rapid degradation and instability in the samples. Chromogranin A (CgA) and α-amylase enzyme can be used as alternative indices of adrenergic activity during stress reactions, due to their stability in saliva and reliability of the obtained values.Stress reaction and the diseases in whose pathogenesis it participates are yet another proof of the constant interaction of physical, psychological and social factors in health / disease.
Kratak sadržajTemporomandibularne disfunkcije (TMD) su grupa kliničkih stanja koja su praćena bolom i poremećajem funkcija orofacijalnog sistema. Nastaju kao posljedica narušavanja normalnog funkcionisanja i/ili oštećenja strukture, najčešće, temporomandibularnih zglobova i/ili mastikatornih mišića, glavnih komponenata orofacijalnog sistema. Smatra se da su žene izložene većem riziku od pojave TMD u poređenju sa muškarcima, a razlog za žensku predominaciju još uvijek nije u potpunosti razjašnjen. Uticaj pola i starosne dobi na distribuciju TMD upućuju na moguću vezu između patogeneze TMD i hormonske osovine kod žena sa posebnim osvrtom na uticaj estrogena.U ovom preglednom radu sagledana je uloga estrogena u patofiziologiji TMD. Prvo je na osnovu epidemioloških istraživanja ukazano na povezanost između nivoa estrogena i učestalosti TMD. Zatim je prikazan uticaj estrogena na morfologiju i funkciju temporomandibularnog zgloba, kao i uticaj estrogena na mehanizme kontrole bola.Ključne riječi: temporomandibularne disfukcije, temporomandibularni zglob, estrogen, bol UvodTerminom "temporomandibularne disfunkcije" (TMD) je obuhvaćena grupa različitih kliničkih stanja koja su praćena bolom i poremećajem funkcija orofacijalnog sistema. TMD nastaju kao posljedica narušavanja normalnog funkcionisanja i/ili oštećenja strukture, najčešće, temporomandibularnih zglobova (TMZ) i/ ili mastikatornih mišića, glavnih komponenata orofacijalnog sistema. Kardinalni znaci i simptomi TMD su: bol u mastikatornim mišićima, preaurikularnoj regiji i/ili u predjelu TMZ koji se pogoršava funkcijama orofacijalnog sistema, zatim palpatorna osjetljivost ovih regiona, ograničena i/ili asimetrična kretnja donje vilice, kao i prisusutvo karakterističnih zvučnih efekata u TMZ u vidu pucketanja ili krepitacija [1][2][3]. Kako je muskuloskeletni bol kod TMD hroničnog toka, ova bolna stanja su često praćena psihičkim Adresa autora: Doc. dr Nedeljka Ivković
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