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Polomanary disease dental management
- 1. Pulmonary problems Fateme Ameri,Dentistry student,SEMums Fateme Ameri,Dentistry student,SEMums
- 2. Asthma Asthma vs respiratory problem such as allergic rhinitis True asthma: episodic narrowing of inflamed small airways wheezing and dyspnea chemical, infectious,immunologic, or emotional stimulation Check: Precipitating factors frequency and severity of attacks: emergency room visits and hospital admissions Medications &response to medications Fateme Ameri,Dentistry student,SEMums
- 3. Aspirin allergy: high frequency of generalized (NSAID) allergy severe asthma xanthine-derived bronchodilators such as theophylline corticosteroids. Cromolyn protect against acute attacks but ineffective once bronchospasm occurs sympathomimetic amines such as epinephrine or metaproterenol in an aerosol if wheezing occurs. Fateme Ameri,Dentistry student,SEMums
- 4. Samter’s triade (2019) NSAID allergy asthma, chronic rhinitis, or sinusitis presence of nasal polyps Fateme Ameri,Dentistry student,SEMums
- 5. Oral manefisation Candididasis in patient who use bronchodilators Fateme Ameri,Dentistry student,SEMums
- 7. Oral surgical management role of anxiety in bronchospasm initiation potential adrenal suppression in patients receiving corticosteroid Elective oral surgery should be deferred respiratory tract infection wheezing is present Fateme Ameri,Dentistry student,SEMums
- 9. COPD COPD Obstructive restrictive pulmonary diseases spectrum of pathologic pulmonary problems long-term exposure to pulmonary irritants such as tobacco metaplasia of pulmonary airway airways inflammation and disruption loss their elastic properties Fateme Ameri,Dentistry student,SEMums
- 11. symptoms Dyspnea mild to moderate exertion chronic cough large amounts of thick secretions frequent respiratory tract infections barrel shaped chests purse their lips to breathe audible wheezing during breathing Fateme Ameri,Dentistry student,SEMums
- 12. Bronchodilators such as theophylline significant COPD in more severe cases corticosteroids Only in the most severe chronic cases supplemental portable oxygen Fateme Ameri,Dentistry student,SEMums
- 15. What is Hyperventilation? Hyperventilation is defined as ventilation in excess of that required to maintain normal blood PaO2 (arterial oxygen [O2] tension) and PaCO2 (arterial carbon dioxide [CO2] tension. Fateme Ameri,Dentistry student,SEMums
- 18. Tberculosis An Old Disease – New Twists A Continuing Public Health Challenge Fateme Ameri,Dentistry student,SEMums
- 19. Robert Koch 1882 – Robert Koch – “one seventh of all human beings die of tuberculosis and… if one considers only the productive middle- age groups, tuberculosis carries away one- third and often more of these…” Fateme Ameri,Dentistry student,SEMums
- 20. M tuberculosis as causative agent for tuberculosis 1886 Robert Koch Fateme Ameri,Dentistry student,SEMums
- 21. MBT is carried in airborne particles called droplet nuclei that are generated when persons with infectious TB disease coughs, sneezes, shouts, sings, or talks.Fateme Ameri,Dentistry student,SEMums
- 22. TB – A Multi-system Infection Fateme Ameri,Dentistry student,SEMums
- 23. Natural History of TB Infection Exposure to TB No infection (70-90%) Infection (10-30%) Latent TB (90%) Active TB (10%) Untreated Die within 2 years Survive Die Cured Never develop Active disease Treated Fateme Ameri,Dentistry student,SEMums
- 24. Latent TB vs. Active TB Latent TB (LTBI) (Goal = prevent future active disease) = TB Infection = No Disease = NOT SICK = NOT INFECTIOUS = INFECTIOUS if PULMONARY (usually) = NOT INFECTIOUS if not PULMONARY (usually) Active TB (Goal = treat to cure, prevent transmission) = TB Infection which has progressed to TB Disease = SICK (usually) Fateme Ameri,Dentistry student,SEMums
- 25. Symptoms of TB in the lungs may include A bad cough that lasts 3 weeks or longer Weight loss Loss of appetite Coughing up blood or mucus Weakness or fatigue Fever Night sweats Fateme Ameri,Dentistry student,SEMums
- 26. Oral Manifestation Fateme Ameri,Dentistry student,SEMums
- 27. lesion of the dorsum of the tongue in a patient with both TB disease and HIV infection. Oral tuberculous Fateme Ameri,Dentistry student,SEMums
- 28. While high-speed and ultrasonic dental instrumentation clearly generate droplet nuclei, there is a paucity of data linking dental instrumentation to the generation of droplet nuclei containing MBT. Fateme Ameri,Dentistry student,SEMums
- 29. Dentist should be perform 1 time a year Fateme Ameri,Dentistry student,SEMums
- 31. Fateme Ameri,Dentistry student,SEMums Thanks for your attention
Hinweis der Redaktion
- Tuberculosis Jane L. Moore, RN, MHSA, Virginia Department of Health Review the slide show presentation on Tuberculosis: Part 1, Slides,. Then look at the example of goal setting to reduce TB incidence and be prepared to discuss the epidemiological basis for such goal setting. Even though this slide is more than 30 years old there are still lessons to be learned today. Although increasing, there are still few only a few instances of community analysis and results oriented programming and evaluation on the web. Also, review at the CDC web pages devoted to TB, HIV & STDs and click on Dr Fenton's blog. Finally look at a discussion of a recent TB outbreak in New York compared to one in London, UK (Second item under Perspective). Where was the information published? Why do you think I selected this topic? Consider why TB persists today with all our antibiotics. Take a look at the Global Issues defined by the WHO (look at some of the publications on the right side of the screen). Scan at the WHO global plan to STOP TB and the reprint from the NEJM of global TB. You may wish to visit the PBS Deadly Diseases - TB site All of you should watch the 4 minute video (part III). Also students from outside the US who have seen the effectiveness of BCG in TB prevention, look at this article from the Lancet (April 2006) and try to determine why BCG is not used in the US. A recent article on the planned use of BCG in London is worth reviewing,as is this report in the Guardian. Also look at this editorial on BCG use in Developing Countries (the second editorial). The latest informationon a new test for TB The [WHO] has endorsed a new rapid test for tuberculosis use worldwide. Review the articles on the [WHO] website. How will this new test be a game changer for TB diagnosis and morbidity? Blood testing for TB infection - http://www.medscape.com/viewarticle/738519 Pros and cons of available blood tests over tuberculin skin test Do you agree with the current CDC recommendations – if you were making policy what would you change? Program evaluation for TB Control – are we evaluating the right indicators? Review the 15 national TB Program indicators. How will improvement on these indicators improve TB Control in the United States? http://www.cdc.gov/tb/publications/factsheets/statistics/NTIP.htm. Look at this short editorial from the Lancet. Finally a recent report on TB Trends in the USA from the MMWR. References: The BCG Quandary (pdf) BCG Effectiveness (pdf) Stopping BCG in the UK TB & AIDS, Recent JAMA Article TB among Foreign Born in US, JAMA, July 08 What is Thwarting Tb Prevention - Editorial NEJM, July 2011