This document summarizes various oral manifestations of systemic diseases. It discusses oral signs of gastrointestinal diseases like ulcers and glossitis in celiac disease. It also covers oral signs of liver diseases like bleeding tendency in alcoholic cirrhosis. Further, it outlines oral manifestations of hematological conditions like gingival hypertrophy in leukemia. The document also discusses oral signs of endocrine, pulmonary, renal and nutritional deficiencies. Finally, it examines various oral lesions like aphthous ulcers, changes in tongue coating, and disorders of the salivary glands.
This document discusses various oral manifestations of systemic diseases. It begins by classifying systemic diseases into 14 categories that can present with oral lesions. Several infectious diseases are then discussed in detail, including viral infections like herpes simplex, herpes zoster, herpangina and hand foot mouth disease. Bacterial infections such as tuberculosis, syphilis and leprosy are also mentioned. Clinical features, diagnosis and treatment are provided for many of the infectious diseases.
This document discusses the oral manifestations of various systemic diseases. It covers gastrointestinal diseases like Crohn's disease and ulcerative colitis which can present with apthous ulcers, cobblestoning of the mucosa, and angular cheilitis. Hematologic diseases like anemia and leukemia may cause glossitis, oral pain, petechiae, and gingival hypertrophy. Connective tissue diseases like Sjogren's syndrome, scleroderma, and lupus erythematosus can result in xerostomia, ulcerations, and lichen planus lesions. Pulmonary diseases cystic fibrosis and sarcoidosis may present with dryness, nodular lesions, and x
Ulcerative lesions of the oral cavity can be caused by local trauma, infections, recurrent aphthous stomatitis, or systemic conditions. Traumatic ulcers are usually solitary and caused by factors like sharp teeth or dental appliances. They heal within 6-10 days after removing the cause. Recurrent aphthous stomatitis causes painful ulcers and comes in minor, major, and herpetiform types. Infections like herpes virus or tuberculosis can also lead to oral ulcerations. A thorough history and examination is needed to diagnose the underlying cause of ulcers.
This document discusses several systemic diseases and their potential oral manifestations. It describes Wegener's granulomatosis as a necrotizing vasculitis that can cause oral ulcerations and characteristic "strawberry gingivitis." Sarcoidosis is characterized by noncaseating granulomas and can involve the oral mucosa. Psoriasis may rarely cause oral lesions resembling those on the skin. Acanthosis nigricans can involve the lips, tongue, and gingiva with hyperplasia. Amyloidosis commonly causes macroglossia. Sjögren's syndrome and Kawasaki disease are also discussed.
Oral lichen planus is a common chronic mucocutaneous disease of unknown etiology that may undergo malignant transformation. It typically presents as white reticulated lines on the oral mucosa but can also appear as erosive, atrophic, bullous or other lesions. A confirmed diagnosis requires characteristic histopathology. While there is no cure, treatment focuses on managing symptoms like pain with topical or systemic corticosteroids and maintaining oral hygiene to reduce cancer risks.
Viral infections of oral cavity - Dr. Abhishek SolankiAbhishek Solanki
This document discusses various viral infections including herpes simplex virus, varicella, herpes zoster, infectious mononucleosis, cytomegalovirus, enteroviruses, rubeola, rubella, mumps, and human immunodeficiency virus. It provides details on the causative viruses, clinical manifestations, histopathological features, diagnosis and treatment of each infection. Complications are also mentioned for some viruses. Classification systems for HIV infected patients based on CD4 count and clinical categories are summarized.
This document discusses various vesiculobullous and ulcerative lesions that can occur in the oral cavity. It begins by defining vesicles, bullae, erosions, and ulcers. It then examines the causes of acute multiple oral lesions which can include viral infections like herpes simplex virus or coxsackievirus. It also discusses recurrent lesions like recurrent aphthous stomatitis. Chronic multiple lesions may be caused by conditions like pemphigus. Single ulcer lesions can result from fungal infections. The document then examines specific conditions in more detail like herpes infections, lichen planus, and pemphigus. It provides information on diagnosis and treatment of these oral conditions.
This document discusses various oral manifestations of systemic diseases. It begins by classifying systemic diseases into 14 categories that can present with oral lesions. Several infectious diseases are then discussed in detail, including viral infections like herpes simplex, herpes zoster, herpangina and hand foot mouth disease. Bacterial infections such as tuberculosis, syphilis and leprosy are also mentioned. Clinical features, diagnosis and treatment are provided for many of the infectious diseases.
This document discusses the oral manifestations of various systemic diseases. It covers gastrointestinal diseases like Crohn's disease and ulcerative colitis which can present with apthous ulcers, cobblestoning of the mucosa, and angular cheilitis. Hematologic diseases like anemia and leukemia may cause glossitis, oral pain, petechiae, and gingival hypertrophy. Connective tissue diseases like Sjogren's syndrome, scleroderma, and lupus erythematosus can result in xerostomia, ulcerations, and lichen planus lesions. Pulmonary diseases cystic fibrosis and sarcoidosis may present with dryness, nodular lesions, and x
Ulcerative lesions of the oral cavity can be caused by local trauma, infections, recurrent aphthous stomatitis, or systemic conditions. Traumatic ulcers are usually solitary and caused by factors like sharp teeth or dental appliances. They heal within 6-10 days after removing the cause. Recurrent aphthous stomatitis causes painful ulcers and comes in minor, major, and herpetiform types. Infections like herpes virus or tuberculosis can also lead to oral ulcerations. A thorough history and examination is needed to diagnose the underlying cause of ulcers.
This document discusses several systemic diseases and their potential oral manifestations. It describes Wegener's granulomatosis as a necrotizing vasculitis that can cause oral ulcerations and characteristic "strawberry gingivitis." Sarcoidosis is characterized by noncaseating granulomas and can involve the oral mucosa. Psoriasis may rarely cause oral lesions resembling those on the skin. Acanthosis nigricans can involve the lips, tongue, and gingiva with hyperplasia. Amyloidosis commonly causes macroglossia. Sjögren's syndrome and Kawasaki disease are also discussed.
Oral lichen planus is a common chronic mucocutaneous disease of unknown etiology that may undergo malignant transformation. It typically presents as white reticulated lines on the oral mucosa but can also appear as erosive, atrophic, bullous or other lesions. A confirmed diagnosis requires characteristic histopathology. While there is no cure, treatment focuses on managing symptoms like pain with topical or systemic corticosteroids and maintaining oral hygiene to reduce cancer risks.
Viral infections of oral cavity - Dr. Abhishek SolankiAbhishek Solanki
This document discusses various viral infections including herpes simplex virus, varicella, herpes zoster, infectious mononucleosis, cytomegalovirus, enteroviruses, rubeola, rubella, mumps, and human immunodeficiency virus. It provides details on the causative viruses, clinical manifestations, histopathological features, diagnosis and treatment of each infection. Complications are also mentioned for some viruses. Classification systems for HIV infected patients based on CD4 count and clinical categories are summarized.
This document discusses various vesiculobullous and ulcerative lesions that can occur in the oral cavity. It begins by defining vesicles, bullae, erosions, and ulcers. It then examines the causes of acute multiple oral lesions which can include viral infections like herpes simplex virus or coxsackievirus. It also discusses recurrent lesions like recurrent aphthous stomatitis. Chronic multiple lesions may be caused by conditions like pemphigus. Single ulcer lesions can result from fungal infections. The document then examines specific conditions in more detail like herpes infections, lichen planus, and pemphigus. It provides information on diagnosis and treatment of these oral conditions.
This document outlines the process for differential diagnosis of oro-facial swellings. It discusses collecting the chief complaint, medical history, clinical examination including extra-oral and intra-oral findings. Differential diagnosis is formed considering location, color, consistency, investigations and specialty testing. Final diagnosis is built by integrating information from history, examination, investigations and anatomical classification of swelling type such as gingiva, lip, palate, tongue or salivary glands. Common etiologies are provided for each anatomical location including infections, cysts, tumors and other disorders.
This document discusses the clinical features of gingivitis. It begins by defining gingivitis as inflammation of the gingiva and describes how plaque bacteria can damage gingival tissues. It then covers the different types of gingivitis based on duration and distribution. Key signs of gingivitis that are discussed include gingival bleeding, color changes, changes in consistency, size, surface texture, position and contour. Specific conditions like gingival recession are also explained in terms of definition, classification, etiology and clinical significance.
This document discusses different types of periapical abscesses, including acute periapical abscesses, phoenix abscesses, and chronic alveolar abscesses. It describes the etiology, symptoms, diagnosis, and treatment of each. Bacteria entering the pulp through breaks in dentin are the most common cause of these periradicular tissue lesions. Acute periapical abscesses present with rapid onset pain and swelling, while chronic alveolar abscesses are generally asymptomatic but can be detected by sinus tracts or radiographs. Treatment involves drainage, antibiotics if needed, and resolving the pulpal infection through root canal treatment or extraction.
describes the etiopathogenesis , clinical features, investigations, differential diagnosis and management and prophylaxis of all important viral lesions affecting the oral cavity
The document discusses oral manifestations of HIV infection at different stages. It begins by outlining methods of HIV transmission. In primary HIV infection, nonspecific flu-like symptoms occur within 6-12 weeks and resolve within a few weeks. Then follows a clinical latency period where HIV replicates slowly lowering CD4 counts. Oral opportunistic infections like candidiasis and hairy leukoplakia may occur as immunity declines. Advanced HIV is diagnosed when CD4 counts drop below 200, putting one at risk for serious infections. Kaposi's sarcoma lesions in the mouth may appear as well. Topical treatments are discussed for various oral conditions.
Classification of periodontal diseasesEnas Elgendy
This document classifies periodontal diseases into two main categories: gingivitis and periodontitis. Gingivitis is further divided into plaque-induced gingivitis and non-plaque induced gingivitis. Periodontitis is classified as chronic periodontitis, aggressive periodontitis, periodontitis as a manifestation of systemic diseases, and several other types. The document provides detailed descriptions and examples for each category and type of periodontal disease.
This document provides an overview of gingival enlargement (gingival overgrowth). It begins with definitions and classifications including by etiology, location/distribution, and degree. The main types discussed are inflammatory (chronic, acute), drug-induced, idiopathic, and those associated with systemic diseases. Neoplastic and false enlargements are also covered. Clinical features and treatments are described for various types. Treatment involves scaling, root planing, gingivoplasty and gingivectomy which can be performed conventionally, with electrosurgery, lasers, or chemosurgery.
Oral manifestations of systemic disease marwan nassar
This document discusses oral manifestations of systemic diseases. It covers 9 categories of diseases: gastrointestinal, hematological, endocrine, metabolic, connective tissue/rheumatologic, mucocutaneous, genetic, pulmonary, and infectious diseases. For each category and disease, common oral signs and lesions are described. Diseases discussed in detail include celiac disease, Crohn's disease, ulcerative colitis, thalassemias, sickle cell anemia, diabetes mellitus, Sjogren's syndrome, lichen planus, psoriasis, Down syndrome, and HIV/AIDS. The document provides an overview of how systemic conditions can impact the oral cavity.
Acute necrotising ulcerative gingivitis is a rare condition characterized by necrosis of the gingiva and interdental papillae. It frequently occurs during times of stress and poor oral hygiene. The condition is caused by fusiform bacillus and Borrelia vincentii bacteria. Clinically, the gingiva becomes painful and develops punched-out ulcers. It can spread to other oral tissues and rarely the skin, causing further complications.
This document discusses osteomyelitis, including its pathogenesis and management. It defines osteomyelitis as an infection of the bone marrow and describes how local and systemic predisposing factors can lead to decreased bone vitality and impaired host defense. The main types of osteomyelitis covered are suppurative, focal sclerosing, diffuse sclerosing, and proliferative perositis. For each type, the document discusses pathogenesis, clinical features, histology, radiology, and management. Key points include how acute suppurative osteomyelitis can progress to chronic form if inadequately treated, and how eliminating infection sources is important but bone changes may persist radiographically for some types.
This document discusses oral ulcers caused by various infectious and non-infectious conditions. It describes the clinical features and management of several specific conditions that can cause oral ulcers, including herpes simplex virus infections (primary and recurrent), varicella-zoster virus infections (chickenpox, herpes zoster), hand-foot-and-mouth disease, herpangina, tuberculosis, and syphilis. For each condition, it covers the presentation of oral ulcers, pathogenesis, diagnosis, and treatment approaches.
This document describes vesiculo-bullous lesions, which present clinically as vesicles or bullae that often rupture early, appearing as ulcerated or erosive areas. Some key points:
- Vesicles are fluid-filled lesions less than 1 cm, while bullae contain fluid and are over 1 cm.
- Causes include trauma, infection, autoimmunity, and genetic factors.
- Examples described include herpes simplex infection, varicella zoster infection, and hand foot and mouth disease. Clinical features, pathogenesis, management are provided for each. Classification is discussed based on acute vs chronic presentation, clinical presentation, and histopathological location.
Dentine dysplasia is a rare genetic disorder characterized by abnormal dentin formation and pulp morphology. There are two main types - Shield Type I, which affects the roots and causes extremely small, translucent teeth with excessive mobility. Shield Type II affects both the roots and crowns, resulting in differences in tooth color and normal root size. Radiographs reveal short, conical roots with obliterated pulp chambers and canals for Shield Type I, and a "thistle tube" appearance with multiple pulp stones for Shield Type II. Proper oral hygiene and endodontic treatments are recommended for management.
This document discusses radicular cysts, which are the most common inflammatory cysts in the oral cavity. Radicular cysts arise from epithelial residues in the periodontal ligament as a result of periapical periodontitis following pulp necrosis. They are usually asymptomatic but can cause swelling and bone resorption as they expand. The cyst forms from the proliferation of epithelial cell rests in the granulation tissue surrounding the apex of an infected tooth. Histologically, they are lined by stratified squamous epithelium and surrounded by fibrous connective tissue that may contain cholesterol crystals. Treatment involves root canal therapy or extraction with curettage of the cyst lining.
This document summarizes several common viral infections that can affect the oral cavity. It discusses the causative agents, symptoms, and treatments for conditions like herpes simplex, varicella, infectious mononucleosis, herpangina, hand-foot-and-mouth disease, mumps, measles, and HIV/AIDS. For each condition, it provides details on factors like typical age of occurrence, incubation period, clinical manifestations, potential complications, diagnosis, and recommended treatment approaches. The document serves as a comprehensive overview of the major viral infections that can impact oral health.
This document provides an overview of aphthous ulcers, also known as canker sores. It discusses their other names, predisposing factors, pathogenesis, presentations as minor, major or herpetiform ulcers, diagnosis, differentials, associated systemic disorders, and treatment. The three main types are minor aphthae (Mikulicz ulcers), major aphthae (Sutton’s ulcers) and herpetiform aphthae (Cooke’s ulcers). Diagnosis involves meeting major and minor criteria. Aphthous ulcers can be associated with conditions like celiac disease and recurrent aphthous stomatitis. Treatment options are also covered.
This document discusses various types of oral candidiasis, including acute pseudomembranous (thrush), acute atrophic, chronic atrophic forms such as denture stomatitis and angular cheilitis, and chronic hyperplastic candidiasis. It describes the clinical features, predisposing factors, histological findings, and treatments for each type. Immunocompromised individuals such as those with HIV/AIDS are more susceptible to oral candidiasis. Topical and systemic antifungal medications are used to treat infections, though relapses may occur due to underlying immune deficiencies.
This document summarizes the effects of radiation therapy on oral tissues. Radiation is commonly used to treat oral cancers. It is delivered in small daily doses over 6-7 weeks for a total of 60-70 Gy. This causes damage to oral mucosa, taste buds, salivary glands, teeth, bone, and muscles. Oral mucositis is a common side effect, along with loss of taste, xerostomia, and rampant dental caries due to changes in saliva. Teeth may have arrested development. Long term risks include osteoradionecrosis and trismus. Management involves oral hygiene, pain control, fluoride application, and sometimes surgery.
Lichen planus is a chronic inflammatory skin and mucous membrane disease characterized by violaceous papules that may form plaques. Oral lichen planus commonly presents as striae - sharply defined white lacy patterns - but can also be erosive, atrophic, or bullous. CD8 T cells trigger apoptosis of oral epithelial cells. Treatment aims to reduce symptoms, resolve lesions, and prevent oral squamous cell carcinoma through topical corticosteroids, systemic medications, surgery or laser, with complications including infection and malignant transformation requiring careful long-term follow-up.
This document provides information on oral manifestations of systemic diseases. It begins by stating that many systemic diseases are reflected in the oral cavity and can cause mucosal changes, infections, bone diseases, and dental issues. It then discusses specific conditions like lupus, Sjogren's syndrome, systemic sclerosis, and pemphigus. For each condition, it provides details on criteria for diagnosis, clinical features, oral manifestations, and other relevant information. The document uses headings and bullet points to organize the material into clear sections for each disease.
Manipulating the Microbiome: diet, environment, and geneticsJack Gilbert
This document discusses using metagenomic approaches and next generation sequencing technology to understand surgical site infections. It summarizes some key findings:
1) Microbial differences in the gut microbiome are associated with disease states, age, sex, and diet.
2) Certain gut bacteria like Enterobacter cloacae B29 have been linked to weight gain and obesity in mice studies.
3) Infant gut microbiomes depend mainly on delivery method, with C-section babies clustering with adult skin microbes rather than vaginal microbes.
4) Future applications discussed include profiling a patient's microbiome to be included in their medical records and using microbial tracing to identify physical connections between individuals and surfaces.
This document outlines the process for differential diagnosis of oro-facial swellings. It discusses collecting the chief complaint, medical history, clinical examination including extra-oral and intra-oral findings. Differential diagnosis is formed considering location, color, consistency, investigations and specialty testing. Final diagnosis is built by integrating information from history, examination, investigations and anatomical classification of swelling type such as gingiva, lip, palate, tongue or salivary glands. Common etiologies are provided for each anatomical location including infections, cysts, tumors and other disorders.
This document discusses the clinical features of gingivitis. It begins by defining gingivitis as inflammation of the gingiva and describes how plaque bacteria can damage gingival tissues. It then covers the different types of gingivitis based on duration and distribution. Key signs of gingivitis that are discussed include gingival bleeding, color changes, changes in consistency, size, surface texture, position and contour. Specific conditions like gingival recession are also explained in terms of definition, classification, etiology and clinical significance.
This document discusses different types of periapical abscesses, including acute periapical abscesses, phoenix abscesses, and chronic alveolar abscesses. It describes the etiology, symptoms, diagnosis, and treatment of each. Bacteria entering the pulp through breaks in dentin are the most common cause of these periradicular tissue lesions. Acute periapical abscesses present with rapid onset pain and swelling, while chronic alveolar abscesses are generally asymptomatic but can be detected by sinus tracts or radiographs. Treatment involves drainage, antibiotics if needed, and resolving the pulpal infection through root canal treatment or extraction.
describes the etiopathogenesis , clinical features, investigations, differential diagnosis and management and prophylaxis of all important viral lesions affecting the oral cavity
The document discusses oral manifestations of HIV infection at different stages. It begins by outlining methods of HIV transmission. In primary HIV infection, nonspecific flu-like symptoms occur within 6-12 weeks and resolve within a few weeks. Then follows a clinical latency period where HIV replicates slowly lowering CD4 counts. Oral opportunistic infections like candidiasis and hairy leukoplakia may occur as immunity declines. Advanced HIV is diagnosed when CD4 counts drop below 200, putting one at risk for serious infections. Kaposi's sarcoma lesions in the mouth may appear as well. Topical treatments are discussed for various oral conditions.
Classification of periodontal diseasesEnas Elgendy
This document classifies periodontal diseases into two main categories: gingivitis and periodontitis. Gingivitis is further divided into plaque-induced gingivitis and non-plaque induced gingivitis. Periodontitis is classified as chronic periodontitis, aggressive periodontitis, periodontitis as a manifestation of systemic diseases, and several other types. The document provides detailed descriptions and examples for each category and type of periodontal disease.
This document provides an overview of gingival enlargement (gingival overgrowth). It begins with definitions and classifications including by etiology, location/distribution, and degree. The main types discussed are inflammatory (chronic, acute), drug-induced, idiopathic, and those associated with systemic diseases. Neoplastic and false enlargements are also covered. Clinical features and treatments are described for various types. Treatment involves scaling, root planing, gingivoplasty and gingivectomy which can be performed conventionally, with electrosurgery, lasers, or chemosurgery.
Oral manifestations of systemic disease marwan nassar
This document discusses oral manifestations of systemic diseases. It covers 9 categories of diseases: gastrointestinal, hematological, endocrine, metabolic, connective tissue/rheumatologic, mucocutaneous, genetic, pulmonary, and infectious diseases. For each category and disease, common oral signs and lesions are described. Diseases discussed in detail include celiac disease, Crohn's disease, ulcerative colitis, thalassemias, sickle cell anemia, diabetes mellitus, Sjogren's syndrome, lichen planus, psoriasis, Down syndrome, and HIV/AIDS. The document provides an overview of how systemic conditions can impact the oral cavity.
Acute necrotising ulcerative gingivitis is a rare condition characterized by necrosis of the gingiva and interdental papillae. It frequently occurs during times of stress and poor oral hygiene. The condition is caused by fusiform bacillus and Borrelia vincentii bacteria. Clinically, the gingiva becomes painful and develops punched-out ulcers. It can spread to other oral tissues and rarely the skin, causing further complications.
This document discusses osteomyelitis, including its pathogenesis and management. It defines osteomyelitis as an infection of the bone marrow and describes how local and systemic predisposing factors can lead to decreased bone vitality and impaired host defense. The main types of osteomyelitis covered are suppurative, focal sclerosing, diffuse sclerosing, and proliferative perositis. For each type, the document discusses pathogenesis, clinical features, histology, radiology, and management. Key points include how acute suppurative osteomyelitis can progress to chronic form if inadequately treated, and how eliminating infection sources is important but bone changes may persist radiographically for some types.
This document discusses oral ulcers caused by various infectious and non-infectious conditions. It describes the clinical features and management of several specific conditions that can cause oral ulcers, including herpes simplex virus infections (primary and recurrent), varicella-zoster virus infections (chickenpox, herpes zoster), hand-foot-and-mouth disease, herpangina, tuberculosis, and syphilis. For each condition, it covers the presentation of oral ulcers, pathogenesis, diagnosis, and treatment approaches.
This document describes vesiculo-bullous lesions, which present clinically as vesicles or bullae that often rupture early, appearing as ulcerated or erosive areas. Some key points:
- Vesicles are fluid-filled lesions less than 1 cm, while bullae contain fluid and are over 1 cm.
- Causes include trauma, infection, autoimmunity, and genetic factors.
- Examples described include herpes simplex infection, varicella zoster infection, and hand foot and mouth disease. Clinical features, pathogenesis, management are provided for each. Classification is discussed based on acute vs chronic presentation, clinical presentation, and histopathological location.
Dentine dysplasia is a rare genetic disorder characterized by abnormal dentin formation and pulp morphology. There are two main types - Shield Type I, which affects the roots and causes extremely small, translucent teeth with excessive mobility. Shield Type II affects both the roots and crowns, resulting in differences in tooth color and normal root size. Radiographs reveal short, conical roots with obliterated pulp chambers and canals for Shield Type I, and a "thistle tube" appearance with multiple pulp stones for Shield Type II. Proper oral hygiene and endodontic treatments are recommended for management.
This document discusses radicular cysts, which are the most common inflammatory cysts in the oral cavity. Radicular cysts arise from epithelial residues in the periodontal ligament as a result of periapical periodontitis following pulp necrosis. They are usually asymptomatic but can cause swelling and bone resorption as they expand. The cyst forms from the proliferation of epithelial cell rests in the granulation tissue surrounding the apex of an infected tooth. Histologically, they are lined by stratified squamous epithelium and surrounded by fibrous connective tissue that may contain cholesterol crystals. Treatment involves root canal therapy or extraction with curettage of the cyst lining.
This document summarizes several common viral infections that can affect the oral cavity. It discusses the causative agents, symptoms, and treatments for conditions like herpes simplex, varicella, infectious mononucleosis, herpangina, hand-foot-and-mouth disease, mumps, measles, and HIV/AIDS. For each condition, it provides details on factors like typical age of occurrence, incubation period, clinical manifestations, potential complications, diagnosis, and recommended treatment approaches. The document serves as a comprehensive overview of the major viral infections that can impact oral health.
This document provides an overview of aphthous ulcers, also known as canker sores. It discusses their other names, predisposing factors, pathogenesis, presentations as minor, major or herpetiform ulcers, diagnosis, differentials, associated systemic disorders, and treatment. The three main types are minor aphthae (Mikulicz ulcers), major aphthae (Sutton’s ulcers) and herpetiform aphthae (Cooke’s ulcers). Diagnosis involves meeting major and minor criteria. Aphthous ulcers can be associated with conditions like celiac disease and recurrent aphthous stomatitis. Treatment options are also covered.
This document discusses various types of oral candidiasis, including acute pseudomembranous (thrush), acute atrophic, chronic atrophic forms such as denture stomatitis and angular cheilitis, and chronic hyperplastic candidiasis. It describes the clinical features, predisposing factors, histological findings, and treatments for each type. Immunocompromised individuals such as those with HIV/AIDS are more susceptible to oral candidiasis. Topical and systemic antifungal medications are used to treat infections, though relapses may occur due to underlying immune deficiencies.
This document summarizes the effects of radiation therapy on oral tissues. Radiation is commonly used to treat oral cancers. It is delivered in small daily doses over 6-7 weeks for a total of 60-70 Gy. This causes damage to oral mucosa, taste buds, salivary glands, teeth, bone, and muscles. Oral mucositis is a common side effect, along with loss of taste, xerostomia, and rampant dental caries due to changes in saliva. Teeth may have arrested development. Long term risks include osteoradionecrosis and trismus. Management involves oral hygiene, pain control, fluoride application, and sometimes surgery.
Lichen planus is a chronic inflammatory skin and mucous membrane disease characterized by violaceous papules that may form plaques. Oral lichen planus commonly presents as striae - sharply defined white lacy patterns - but can also be erosive, atrophic, or bullous. CD8 T cells trigger apoptosis of oral epithelial cells. Treatment aims to reduce symptoms, resolve lesions, and prevent oral squamous cell carcinoma through topical corticosteroids, systemic medications, surgery or laser, with complications including infection and malignant transformation requiring careful long-term follow-up.
This document provides information on oral manifestations of systemic diseases. It begins by stating that many systemic diseases are reflected in the oral cavity and can cause mucosal changes, infections, bone diseases, and dental issues. It then discusses specific conditions like lupus, Sjogren's syndrome, systemic sclerosis, and pemphigus. For each condition, it provides details on criteria for diagnosis, clinical features, oral manifestations, and other relevant information. The document uses headings and bullet points to organize the material into clear sections for each disease.
Manipulating the Microbiome: diet, environment, and geneticsJack Gilbert
This document discusses using metagenomic approaches and next generation sequencing technology to understand surgical site infections. It summarizes some key findings:
1) Microbial differences in the gut microbiome are associated with disease states, age, sex, and diet.
2) Certain gut bacteria like Enterobacter cloacae B29 have been linked to weight gain and obesity in mice studies.
3) Infant gut microbiomes depend mainly on delivery method, with C-section babies clustering with adult skin microbes rather than vaginal microbes.
4) Future applications discussed include profiling a patient's microbiome to be included in their medical records and using microbial tracing to identify physical connections between individuals and surfaces.
This document discusses infectious bursal disease virus (IBDV) which affects poultry. It begins by describing the virus's characteristics, including that it is a small, non-enveloped double stranded RNA virus with a bi-segmented genome. It then covers the virus's protein structure and the roles of the different proteins. The document discusses how the virus spreads horizontally through infected feces or contaminated equipment. It outlines the virus's epidemiology, describing the natural hosts, ages of highest susceptibility, and pathogenesis. The document concludes by covering treatment and control methods like biosecurity and vaccination programs. It also discusses how extreme vaccination pressure, improper cleaning, and other factors have led to the evolution of more virulent virus strains
This review paper presentation summarizes inflammatory bowel disease (IBD) and the potential anti-inflammatory effects of curcumin. IBD causes severe inflammation of the gastrointestinal tract and is linked to genetic, environmental, and immunological factors. Curcumin is a compound obtained from turmeric that has antioxidant and anti-inflammatory properties. Studies show curcumin may decrease inflammation in the intestines for IBD by regulating molecules involved in the immune response and stress pathways. However, more research is still needed to fully understand curcumin's effects on IBD as not all studies have found impacts on the same molecules.
dental consideration for inflammatory bowel diseaseJigyasha Timsina
This document discusses dental considerations for patients with inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. Key points include:
- These conditions can cause oral manifestations like ulcers, glossitis, and pyostomatitis vegetans.
- Medications used to treat the bowel conditions can also cause oral side effects.
- Dental treatment requires modifying procedures to minimize stress and supplementing steroids to prevent adrenal issues. Frequent preventive care is important due to risk of infection and delayed healing.
Biological therapy for Ulcerative colitisDr Amit Dangi
The document discusses biological therapy options for ulcerative colitis (UC), including anti-TNF agents. It summarizes key trials on infliximab, adalimumab, and golimumab. The ACT1 and ACT2 trials found infliximab effective for inducing and maintaining remission in moderate-to-severe UC. The ULTRA1 and ULTRA2 trials showed adalimumab induced remission and was effective for maintenance therapy. The PURSUIT trials found golimumab induced clinical response and remission in UC patients. Anti-TNF agents are effective treatment options for moderate-to-severe UC when conventional therapies are inadequate.
Richard Frye, MD, PhD, FAAP, FAAN, CPI, will discuss:
*The enteric (gut) microbiome has an important influence on health and disease states in humans.
* The enteric microbiome influences the human host using chemical mediators, some of which can directly affect mitochondrial function
* Short chain fatty acids produced by gut bacteria not only modulate mitochondrial function and cellular regulatory pathways, but can also be used as mitochondrial fuels.
This case presentation describes a 36-year-old woman with severe, steroid-refractory ulcerative colitis who developed immune thrombocytopenic purpura (ITP). She was initially treated with medications but did not improve. She underwent a laparoscopic colectomy with ileostomy due to continued bloody diarrhea and abdominal pain. Her platelet count decreased during the hospitalization but increased with treatment including intravenous immunoglobulin and steroids. Following discharge, her platelet count continued to improve on prednisone taper. She will return for an ileal pouch anal anastomosis surgery.
The document summarizes research on the gut microbiome and its relationship to obesity and non-alcoholic fatty liver disease (NAFLD). It reviews how the microbiome is influenced by factors from birth and can impact disease risk. Studies show differences in microbiome composition between obese, normal weight, and NAFLD patients, with NAFLD patients having higher levels of Escherichia bacteria that can produce alcohol. A pilot study found that treating pediatric NAFLD patients with the probiotic Lactobacillus GG for 8 weeks improved liver enzymes regardless of weight changes. Further research is still needed to fully understand the mechanisms and potential microbiome-based therapies.
Science Cabaret by Dr. Rodney Dietert "How to train your super organism..via ...Kitty Gifford
This document summarizes a presentation by Rodney Dietert on training the human-microbial superorganism. It discusses how Dietert found his superorganism through research linking the microbiome to health and disease. He learned that humans are majority microbial and the microbiome helps produce our identity through volatile compounds. Microbial dysbiosis can lead to inflammation and disease. Dietert trained his own superorganism after years of antibiotics by adjusting his microbiome and diet. He provides three takeaway points on the importance of microbiome seeding at birth, co-maturation of the immune and microbial systems, and basing safety assessments on the human superorganism.
This document provides an overview of new oral medications for treating hepatitis C virus (HCV) infection, including NS3/4A protease inhibitors telaprevir and boceprevir. It discusses HCV genotypes and lifecycle, focusing on improved understanding of viral targets leading to drug discovery. NS3/4A protease inhibitors and NS5B polymerase inhibitors currently in clinical development are described, targeting polyprotein processing and HCV replication respectively. Nucleoside and non-nucleoside NS5B inhibitors as well as NS5A inhibitors and their mechanisms of action and clinical trial status are summarized.
This document discusses nonalcoholic fatty liver disease (NAFLD). It begins by explaining that NAFLD ranges from simple steatosis to nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis. Insulin resistance plays a key role in the metabolic abnormalities seen in NAFLD. The pathogenesis of NASH is not fully understood. Currently, there are no approved therapies, so treatment focuses on lifestyle modifications like weight loss and exercise to improve comorbidities. The prevalence of NAFLD is increasing due to the rising obesity epidemic.
This document discusses vaccination against infectious bursal disease virus (IBDV) in chickens. It covers hyperimmunizing breeder chickens to provide maternal antibodies to offspring, different types of IBD vaccines including live attenuated and inactivated vaccines. The document recommends choosing more invasive live vaccines when field viruses are very virulent and outlines factors to consider for optimal vaccination timing against IBDV. Characteristics of good live vaccines include early protection and minimal immunosuppression.
IBD Therapy discusses treatments for Crohn's disease and ulcerative colitis. 5-aminosalicylates are first-line treatments for mild to moderate disease. Corticosteroids are effective for inducing remission but not maintaining it. Immunosuppressants like azathioprine and methotrexate are used when steroids cannot be tapered. Anti-TNF antibodies like infliximab are effective for severe disease refractory to other therapies. Nutritional supplementation is important for patients with Crohn's disease due to potential deficiencies from the condition.
This document provides an overview of the history and current state of inflammatory bowel disease (IBD) research. It highlights that research has progressed from a time when treatment options were limited to now having many approved therapies. Breakthroughs include unraveling the genetics of IBD and understanding the importance of the IL23/17 pathway. Current areas of focus include further exploring causation factors like genetics, immunology, microbiology and environment. Diagnosis and treatment options have also greatly advanced. The future of research relies on continued clinical trials to develop new treatments and gain a deeper understanding of IBD to ultimately find a cure.
This document discusses recent trends in the histopathological assessment and diagnosis of colitis. It outlines changes including improved endoscopic evaluation, recognition of disease variations over time and with treatment, and differentiation from mimics of inflammatory bowel disease. Proper tissue sampling and analysis of features like distribution, extent, activity and the presence of dysplasia are important for confirming diagnoses of conditions like ulcerative colitis and Crohn's disease and excluding other conditions. Terminology and reporting schemes are also discussed to help pathologists clearly communicate diagnostic findings to clinicians.
Human nutrition, gut microbiome and immune system S'eclairer
Dr Zahida Chaudnary talks with the students about nutrition, gut microbiomes, and nutrition as we look at diseases and how your body reacts to what you eat.
Check out the slideshow by itself here.
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This document discusses various systemic conditions that can manifest orally and affect oral health. It covers conditions associated with oral ulcers, lesions, pigmentation changes, periodontal disease and tooth alterations. Specific conditions discussed in detail include lichen planus, lupus erythematosus, pemphigoid, pemphigus vulgaris, Crohn's disease, Behcet's syndrome and Sjogren's syndrome. It also covers syndromes associated with cleft lip/palate and factors that can cause delayed tooth eruption.
This document discusses various bacterial infections that can affect the mouth, including staphylococcal mucositis, streptococci, gonorrhea, syphilis, and tuberculosis. It provides details on the microbiology, pathogenesis, clinical presentation, diagnosis, and treatment of each infection. Key information includes that streptococci are a common cause of pharyngitis and tonsillitis, gonorrhea can result in pharyngitis, syphilis presents initially as a chancre and can later cause gummas or congenital defects if untreated, and tuberculosis may form non-healing oral ulcers. Diagnosis involves microscopy, culture, and serology, while treatment consists of appropriate antibiotics.
Many systemic diseases are reflected in the oral mucosa, maxilla, and mandible.
Mucosal changes may include ulceration or mucosal bleeding.
Immunodeficiency can lead to opportunistic diseases such as infection and neoplasia.
Bone disease can affect the maxilla and mandible.
Systemic disease can cause dental and periodontal changes.
Drugs prescribed for a systemic disease can affect oral tissue.
This document provides descriptions and distinguishing characteristics of various white and red lesions that may appear in the oral cavity. It describes conditions such as leukoplakia, lichen planus, oral thrush, hairy leukoplakia, chemical burns, and more. For each condition, it outlines where in the mouth they typically appear, their appearance (color, texture, etc.), potential causes, how to diagnose, and important histopathological findings. The goal is to differentiate between these various oral lesions based on clinical and microscopic examination.
Oral inflammatory lesions include aphthous ulcers, herpes simplex virus infections, and oral candidiasis. Aphthous ulcers are painful but self-limiting, while herpes simplex virus causes vesicles that rupture and heal without scarring. Oral candidiasis occurs when the oral microbiota is altered. Proliferative lesions like fibromas and pyogenic granulomas are reactive lesions of the oral mucosa. Leukoplakia and erythroplakia are pre-neoplastic lesions, with erythroplakia carrying a greater risk of malignant transformation. Oral squamous cell carcinoma is the most common oral cancer, often associated with tobacco and alcohol
Diseases of the Lips, Swellings of the Face and NeckHadi Munib
This document discusses diseases of the lips and tongue, disturbances of taste and halitosis, and swellings of the head and neck. It describes common conditions that can cause swelling of the lips such as angioedema, mucocele, and abscess. Diseases of the tongue covered include geographic tongue, hairy tongue, and median rhomboid glossitis. Causes of altered taste and halitosis are also outlined. The document concludes by discussing the differential diagnosis of facial and neck swellings, including infectious, neoplastic, traumatic, endocrine/metabolic etiologies and more.
This document summarizes oral cavity ulcers. It defines ulcers as defects in the oral mucosa exposing the connective tissue below. Ulcers are classified as traumatic, recurrent aphthous stomatitis, associated with systemic diseases, or associated with dermatological conditions. Causes of oral ulcers include infections, trauma, idiopathic conditions like recurrent aphthous stomatitis, associations with systemic diseases, associations with dermatological conditions, and neoplasms. The document describes characteristics and treatments for different types of ulcers.
This document summarizes various oral pathologies including infections, precancerous lesions, cancers, cysts, tumors and other diseases that can affect the mouth. It describes common conditions like herpes, candidiasis, leukoplakia and squamous cell carcinoma. It also discusses pathologies of the salivary glands such as pleomorphic adenoma, Warthin's tumor, and adenoid cystic carcinoma. Additionally, it provides details on odontogenic cysts and tumors as well as rare conditions like Behcet's disease.
The document describes various normal anatomical structures and abnormalities that can present on the tongue, including different types of papillae, taste buds, and developmental variations. It then discusses many potential clinical findings involving the tongue related to deficiencies, infections, tumors, and other oral diseases. Specific conditions covered in detail include hairy tongue, leukoplakia, geographic tongue, candidiasis, macroglossia, ulcers, deviations and ties. Multiple images are also provided to illustrate key pathologies.
Commonest diseases and tumours of oral cavitySarab Ji
This document summarizes diseases of the oral cavity, including developmental anomalies, tumors and cysts, teeth and periodontal diseases, and epithelial cysts of the jaw. It provides details on conditions like cleft lip/palate, leukoplakia, dental caries, periodontitis, and radicular cyst. Developmental anomalies can result from genetic or environmental factors and include conditions affecting the tongue, like macroglossia and ankyloglossia. Dental caries is caused by plaque acids demineralizing enamel and dentin. Untreated caries can lead to pulpitis and periapical abscesses. Leukoplakia is a precancerous white patch caused by hyperker
This document provides an overview of diseases of the oral cavity, including developmental anomalies, tumors and cysts, teeth and periodontal diseases, and epithelial cysts of the jaw. It discusses conditions like cleft lip/palate, Fordyce's granules, leukoplakia, dental caries, periodontitis, and radicular and dentigerous cysts among others. Key information includes the etiology, pathogenesis, clinical features, and microscopic findings of various oral diseases.
The tongue is made up of papillae and muscles that contain different types of taste buds. Diseases and deficiencies can affect the tongue's appearance, including changes in color, surface texture, size, and presence of ulcers. Common tongue conditions include hairy tongue, fissured tongue, geographic tongue, median rhomboid glossitis, candidiasis, macroglossia, atrophic glossitis, and leukoplakia. Examination of the tongue can provide clues to underlying systemic diseases or nutritional deficiencies.
The document discusses oral submucous fibrosis (OSF), a chronic condition characterized by dense white patches in the oral cavity and pharynx caused by juxtaepithelial deposition of fibrous tissue. It commonly affects people in South Asia and is premalignant, with a 40% risk of developing oral cancer. Main risk factors include chewing betel nut, tobacco, and eating spicy foods. Symptoms range from mild inflammation and burning sensation to severe trismus. Treatment involves medications to reduce inflammation and fibrosis as well as surgical procedures in advanced cases.
This document discusses several hematologic diseases and autoimmune conditions and their oral manifestations. For iron-deficiency anemia, glossitis and a smooth erythematous tongue can occur. Pernicious anemia causes burning of the mouth and a magenta-colored tongue. Leukemia may present with oral bleeding and gingival swelling. Langerhans cell histiocytosis typically causes oral ulcerations and bone loss. Multiple myeloma sometimes involves amyloid deposits in the tongue. Sjögren's syndrome can result in a dry mouth and bald or cobblestone tongue. Kawasaki disease is characterized by strawberry tongue. Scleroderma may cause a purse-string mouth and smooth tongue. Systemic l
THE TONGUE IN HEALTH AND SICKNESS.pptxAisha lamido
The document provides an overview of the tongue's anatomy, functions, and clinical significance. It discusses the appearance of a healthy tongue and various abnormalities that may indicate underlying oral or systemic diseases. Color changes, surface features, moisture, size, ulcers, tumors, movement abnormalities, and developmental anomalies are described. The role of family physicians in examining the tongue and recognizing abnormalities that may assist in diagnosis is emphasized. The tongue is a useful clinical indicator and abnormalities can present diagnostic challenges requiring thorough history and examination.
Children have oral mucosal conditions and other head and neck medical problems which have both similarities and differences to those found in adults .
A wide variety of oral lesions and soft tissue anomalies are detected in children, but the low frequency at which many of these entities occur makes them challenging to clinically diagnose.
Allergic and Immunologic Diseases of the Oral Cavity.pptxDr.Shubham Patel
The document outlines several allergic and immunologic diseases that can affect the oral cavity. It discusses recurrent aphthous stomatitis, its classification and clinical features. It also covers Behcet's disease, Reiter's syndrome, sarcoidosis, Wegener's granulomatosis and other conditions like contact stomatitis, perioral dermatitis, latex allergy and lichenoid reactions that can impact the oral mucosa. For each condition, it provides details on etiology, clinical presentation and histopathological findings.
The document discusses various oral pigmentations that can occur both exogenously and endogenously. Exogenous pigmentations include those caused by heavy metal poisoning from substances like lead, mercury, silver and bismuth. Endogenous pigmentations include conditions like smoker's melanosis caused by tobacco use, as well as pigmentations associated with medical disorders and neoplasms involving melanin deposition or hematological changes. A thorough history, examination and appropriate diagnostic tests are needed to identify the cause of oral pigmentation in each case.
This document discusses several oral disorders including oral hairy leukoplakia, hairy tongue, ankyloglossia, squamous cell carcinoma of the tongue, salivary gland diseases, diseases of the lips, periodontitis, dental caries, and periapical abscess. It covers the pathogenesis, clinical presentation, diagnosis and management of these conditions.
Similar to Oral manifestations of systemic diseases (20)
HEV is a single-stranded RNA virus that causes hepatitis E and can also affect other organs beyond the liver. It is transmitted via the fecal-oral route from contaminated water or undercooked meat. While HEV primarily affects the liver, it has also been associated with neurological, renal, hematological, musculoskeletal and cardiac effects. The most common extrahepatic manifestation is neurological disorders such as Guillain-Barré syndrome. Treatment of extrahepatic manifestations involves antiviral medication like ribavirin as well as steroids. Preventive measures include avoiding raw meat and untreated water from areas where HEV is prevalent.
HEV is a single-stranded RNA virus that causes hepatitis E and can also affect other organs beyond the liver. It is transmitted via the fecal-oral route from contaminated water or undercooked meat. While HEV primarily affects the liver, it has also been associated with neurological, renal, hematological, musculoskeletal and cardiac effects. The most common extrahepatic manifestation is neurological disorders such as Guillain-Barré syndrome. Treatment of extrahepatic manifestations involves antiviral medication like ribavirin as well as steroids. Preventive measures include avoiding raw meat and untreated water from areas where HEV is prevalent.
The document discusses probiotics, prebiotics, and synbiotics. It defines them as follows:
- Probiotics are live microorganisms that confer health benefits when consumed. They include bacteria like Lactobacillus and Bifidobacterium.
- Prebiotics are non-digestible food ingredients that promote the growth of beneficial bacteria. They include fibers like inulin and oligosaccharides.
- Synbiotics refer to products containing both probiotics and prebiotics to help probiotics survive and colonize the gut.
This document provides information on Gastroesophageal Reflux Disease (GERD). It defines GERD as abnormal reflux of gastric contents into the esophagus causing troublesome symptoms or complications, with more than 2 heartburn episodes per week. Approximately 20% of adults experience frequent GERD symptoms. The document discusses the pathogenesis, risk factors, diagnosis and diagnostic tests, and treatment options for GERD including pharmacologic therapies, surgery, and endoscopic treatments. It provides details on classifications of esophagitis, guidelines for endoscopy and pH monitoring in GERD diagnosis and management.
The document discusses malabsorption syndromes and provides details about celiac disease. It defines celiac disease as an immune-mediated disorder caused by ingestion of gluten, which damages the small intestine mucosa. Key points include that celiac disease is diagnosed by small bowel biopsy showing villous atrophy and response to gluten-free diet, and that complications can include lymphoma, ulcerative jejunoileitis and dermatitis herpetiformis.
The document discusses several changes that occur in the aging liver. Morphological changes include a reduction in liver size of around 25% between ages 20 and 70 due to a decrease in hepatocytes. The liver also develops brown atrophy from lipofuscin accumulation. Vascular changes lead to a reduction in liver blood flow and perfusion of up to 35% and 10%, respectively. Metabolic function declines as well, shown by reduced drug clearance and hepatic enzyme activity. While the liver remains tolerant of insults, its regenerative capacity is impaired with age. Several liver diseases are also more prevalent or have worse prognosis in elderly patients.
1) Acute-on-chronic liver failure (ACLF) describes acute deterioration of liver function in patients with previously stable chronic liver disease, due to a precipitating event.
2) The Asian Pacific Association for the Study of the Liver defined ACLF as acute hepatic insult (jaundice and coagulopathy) within 4 weeks of ascites and/or encephalopathy in patients with chronic liver disease.
3) Pathogenesis involves systemic inflammatory response, neutrophil dysfunction, circulatory changes, oxidative stress, and circulating toxins that further damage the liver and impair regeneration.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
3. Background
- The mouth (buccal cavity)
is the reservoir for the
chewing and mixing of
food with saliva.
- It is the primary site of
digestion and respiration
as well as the primary
communication structure.
12. • Sjögren syndrome
– autoimmune disease
– men : women - 1 : 9, 50 years and older
Main signs
– sicca syndrome
– keratoconjuctivitis sicca
– xerostomia
Oral signs
– decrease in saliva
• xerostomia
– dry, red, wrinkled mucosa
• difficulty in swalloving and eating
• disturbance in taste and speech
• increased dental caries
• infections
• atrophy of the papilae
• candidiasis
Connective-tissue diseases
13. • Kawasaki disease
– vasculitis of medium and large arteries
Oral signs
– swelling of papilae on the surface of the
tongue (strawbery tongue)
– intense erythema of the mucosal
surfaces
– cracked, cherry red, swolen and
hemorrhagic lips
Connective-tissue diseases
14. • Scleroderma
– diffuse sclerosis of the skin, GIT,
heart muscle, lungs, kidney
Oral signs
– pursed lips – dificult to open the
mouth
– esophageal sclerosis
gastroesophageal reflux – damage
of enamel
– pale, rigid mucosa
– teleangiectasias
– decreased mobility of tongue
– salivary hypofunction
Connective-tissue diseases
Limited mouth opening and decreased
tongue mobility
Gingival retraction
21. • Cushing´s syndrome
– osteoporosis pathological
fractures of the mandible,
maxilla or alveolar bone
– delayed healing of fractures
and soft tissue injuries
• Addison´s disease
– oral mucosal melanosis –
buccal mucosa, tongue
Endocrine diseases
moon face
hyperpigmentation
22. • Uremic stomatitis
– in undiagnosed and untreated chronic renal
failure
– irritation and chemical injury of mucosa by
ammonia or ammonium compounds
Signs
– painful plagues and crusts – bucal mucosa,
the floor or dosrum of the tongue, floor of the
mouth
– Type I
• generalized or localized erythema
• exudate
• pain, burning, xerostomia, halitosis,
gingival bleeding, candidiosis
– Type II
• ulceration
• secondary infection
• anemia
Renal diseases
24. Nutritional Deficiencies
• Thiamine (Vitamin B1) and Niacin/nicotinic acid
(Vitamin B3) are also reported to cause some glossitis
and cheilitis.
• Folate deficiency leads to a megaloblastic anemia that
demonstrates many of the same oral characteristics of
pernicious anemia.
• Scurvy caused by vitamin C deficiency may cause
petechiae to ecchymoses in the submucosa.
• Mucous membrane changes may lead to gingival
hypertrophy and erosive, bleeding gums.
25. Disorders of Teeth
DISORDER FINDINGS
Bulimia Erosion of enamel and loss of dentin
Congenital
cytomegalovirus
Yellow dentin and hypoplastic pitted
enamel
Congenital
porphyria
Erythrodontia of canine teeth and molars
and brown discoloration of incisors
Congenital
syphilis
Hutchinson teeth, mulberry molars
Gardner
syndrome
Supernumerary teeth
Dr. TAREK SHETA, M.D
26. Disorders of Teeth
Lepromatous leprosy Reddening of upper teeth (pink spots)
Primary biliary
cirrhosis
Green pigment deposits
Sjogren syndrome Caries, increased plaque accumulation, poor
oral hygiene
GERD Erosion of enamel due to repeated exposure to
gastric acid
Tetracycline staining Permanent gray discoloration
Tuberous sclerosis Pitted enamel of the permanent teeth
Dr. TAREK SHETA, M.D
27. Periodontitis
Definition -chronic infection of connective tissue, periodontal
ligament and alveolar bone
Aetiology: diabetes, heart disease, stroke and preterm birth
birth control pills , steroids, Down syndrome, Langerhans cell
histiocytosis, HIV
29. Aphthous ulceration
• Acute, recurrent,
painful ulcers on
nonkeratinized
mucosa
• Most common
cause of oral
ulcerations
• Effect up to 30 %
of the population
Dr. TAREK SHETA, M.D
30. Aphthous ulceration
Minor aphthae
(90 -95 %)
Major aphthae
(5-10%)
Herpetiform
ulcers
(1-5%)
Age of onset Childhood or
adolescence
Childhood or
adolescence
Young adult
Ulcer size 2–4 mm 10 mm or larger Initially tiny, but
ulcers coalesce
Number of ulcers Up to about 6 Up to about 6 10–100
Sites Mainly vestibule,
labial, buccal
mucosa &
floor of mouth
Any site Any site but often
on ventrum of
tongue
Duration of each
ulcer
Up to 10 days Up to 1 month Up to 1 month
39. Normal tongue coating is formed of:
1- Tongue papillae.
2- Food debris.
3- Bacteria.
4- Desquamated epithelium.
Dr. TAREK SHETA, M.D
40. The tongue coating
varies in different individuals.
Varies in the same individual during the day
It is continuously formed
it is marked in the morning and is removed by:
1-Mechanical factors: speaking and chewing food.
2-Salivary flow
Dr. TAREK SHETA, M.D
41. Tongue coating is in a continuous
process of removal and formation.
- If removal exceeds formation
atrophy
- If formation exceeds removal
increased tongue coating.
Dr. TAREK SHETA, M.D
43. 1- Deficient or impaired utilization of
nutrients
1-Iron deficiency anemia.
3-Vitamin B deficiency especially (vitamin B2,
B6, B12, folic acid and nicotinic acid).
Pernicious anemia.
4-Anemia associated with parasitic infection as
ascaris and bilhariziasis.
5-Malnutrition, malabsorption.
6-Chronic alcoholism.
Etiology
Dr. TAREK SHETA, M.D
45. 3- Drugs
-Drugs that:
• Interfere with the growth and maturation
of the epithelium e.g cyclosporine.
• Induce candidosis e.g. antibiotic, steroid.
• Induce xerostomia e.g anticholinergic
drugs, radiotherapy.
Dr. TAREK SHETA, M.D
46. 4- Miscellaneous
1- Frictional irritation: atrophy at tip &
lateral borders of tongue.
2- Atrophic lichen planus.
3- Epidermolysis bullosa: ulceration
healed by scar.
4- Long standing xerostomia.
5- Diabetes and chronic candidiasis may
produce a lesion called central papillary
atrophy.
Dr. TAREK SHETA, M.D
48. White hairy tongue
• hypertrophy of filiform papillae resembling hair-
like projections
• Aetiology:- heavy tobacco use, mouth breathing,
antibiotic therapy, poor oral hygiene, general
debilitation, radiation therapy, chronic use of
bismuth containing antacids, lack of dietary
roughage, Febrile illness.
• White, yellow green, brown, or black color is due
to chromogenic bacteria or staining from
exogenous sources
52. Geographic tongue
• benign inflammatory condition,
due to Loss of filiform papillae
• Erythematous plaques with well
demarcated white border
• Etiology- diabetes mellitus,
anemia, hormonal disturbances,
psoriasis, Reiter syndrome,
atopic dermatitis,, Down
syndrome, lithium therapy
53. Fissured tongue (furrowed tongue,
scrotal tongue, grooved tongue)
• normal variant in 5-
11% individuals
• Also seen in :
psoriasis, Down
syndrome,
acromegaly, Sjogren
syndrome
57. Macroglossia
• CP: Difficult mastication
and speech and accidental
tongue biting
• CAUSES:
– Down syndrome,
– hypothyroidism,
– neurofibromatosis,
– infection by mycobacteria,
– amyloidosis
58. The stratified squamous epith. if chronically irritated by:
Chemical: spices.
Thermal: smoking.
Infection: syphilis.
Mechanical: dental irritation.
Formed by thickening and hyperkeratinization with the
formation of white patches.
Precancerous: biopsy
Leukoplakia of the tongue
Dr. TAREK SHETA, M.D
59. Oral hairy leukoplakia
• caused by Epstein-Barr
virus, presents as
asymptomatic,
corrugated, white plaques
with accentuation of
vertical folds along the
lateral borders of tongue
• Mainly seen in HIV
infection, organ transplant
recipients and patients on
chemotherapy
Dr. TAREK SHETA, M.D