This document discusses various pathologies that can affect the oral cavity, categorizing them as metabolic, inflammatory, neoplastic, or developmental. It outlines an algorithm ("MIND") for evaluating these pathologies. It also describes 12 questions that can be asked of patients to help determine the etiology and diagnosis of oral lesions or issues. Key factors include duration of the problem, location, appearance, symptoms, exacerbating/relieving factors, medical history, and medication use. Herbal products and supplements are also discussed.
Pharmaceuticals, Personal Care Products & Chemicals of Concern v2zq
Pharmaceuticals, Personal Care Products & Chemicals of Concern - Resources for Healthy Children www.scribd.com/doc/254613619 - For more information, Please see Organic Edible Schoolyards & Gardening with Children www.scribd.com/doc/254613963 - Gardening with Volcanic Rock Dust www.scribd.com/doc/254613846 - Double Food Production from your School Garden with Organic Tech www.scribd.com/doc/254613765 - Free School Gardening Art Posters www.scribd.com/doc/254613694 - Increase Food Production with Companion Planting in your School Garden www.scribd.com/doc/254609890 - Healthy Foods Dramatically Improves Student Academic Success www.scribd.com/doc/254613619 - City Chickens for your Organic School Garden www.scribd.com/doc/254613553 - Huerto Ecológico, Tecnologías Sostenibles, Agricultura Organica www.scribd.com/doc/254613494 - Simple Square Foot Gardening for Schools - Teacher Guide www.scribd.com/doc/254613410 - Free Organic Gardening Publications www.scribd.com/doc/254609890 ~dep.state.fl.us
The rapid cure using Transfer Factor Science.
Team 4Life is a group of world-renowned athletes who excel in their disciplines and endorse 4Life Transfer Factor® products.
Global Team 4Life athletes include World Series starting pitcher Orlando Hernández (“El Duque”), Denver Broncos Offensive Guard Manuel "Manny" Ramirez, Super Bowl Champion Sam Madison, 2010 Baseball World Series Most Valuable Player (MVP) Edgar Rentería, World Golf Hall of Famer Johnny Miller, Ian Baker-Finch, winner on all-four major tours, world-class powerlifter Brady Stewart, Kona Ironman Triathlete Glenn Dobson, Karate World Champion Yohana Sánchez, Freestyle Aerialist Alexa Devereaux, and professional golfers Paosingh Nissaisook and Thitipong Na Songkhla in the Eastern Hemisphere and triathletes Ty Hopkins and Modesto Duran Riquelme in the Western Hemisphere.
Dr. Rick Sibbel - Pharmaceutical Industry Perspective of the Impacts of the R...John Blue
Pharmaceutical Industry Perspective of the Impacts of the Regulatory Environment - Dr. Rick Sibbel, Merck Animal Health, from the 2012 NIAA One Health Approach to Antimicrobial Resistance and Use Symposium, October 26-27, 2012, Columbus, OH, USA.
More presentations at:
http://www.trufflemedia.com/agmedia/conference/2012-one-health-to-approach-antimicrobial-resistance-and-use
Presented to the University-Industry Consortium on March 3, 2015. Kevin M. Folta speaks about his experience at the public interface of GMO education and why there is resistance to good technology.
In his third of five lectures, Dr. Cady reviews the concepts of food allergy testing with IgG and IgE antibodies, traces the development of this body of knowledge from the 1960's, and reviews two illustrative cases.
Pharmaceuticals, Personal Care Products & Chemicals of Concern v2zq
Pharmaceuticals, Personal Care Products & Chemicals of Concern - Resources for Healthy Children www.scribd.com/doc/254613619 - For more information, Please see Organic Edible Schoolyards & Gardening with Children www.scribd.com/doc/254613963 - Gardening with Volcanic Rock Dust www.scribd.com/doc/254613846 - Double Food Production from your School Garden with Organic Tech www.scribd.com/doc/254613765 - Free School Gardening Art Posters www.scribd.com/doc/254613694 - Increase Food Production with Companion Planting in your School Garden www.scribd.com/doc/254609890 - Healthy Foods Dramatically Improves Student Academic Success www.scribd.com/doc/254613619 - City Chickens for your Organic School Garden www.scribd.com/doc/254613553 - Huerto Ecológico, Tecnologías Sostenibles, Agricultura Organica www.scribd.com/doc/254613494 - Simple Square Foot Gardening for Schools - Teacher Guide www.scribd.com/doc/254613410 - Free Organic Gardening Publications www.scribd.com/doc/254609890 ~dep.state.fl.us
The rapid cure using Transfer Factor Science.
Team 4Life is a group of world-renowned athletes who excel in their disciplines and endorse 4Life Transfer Factor® products.
Global Team 4Life athletes include World Series starting pitcher Orlando Hernández (“El Duque”), Denver Broncos Offensive Guard Manuel "Manny" Ramirez, Super Bowl Champion Sam Madison, 2010 Baseball World Series Most Valuable Player (MVP) Edgar Rentería, World Golf Hall of Famer Johnny Miller, Ian Baker-Finch, winner on all-four major tours, world-class powerlifter Brady Stewart, Kona Ironman Triathlete Glenn Dobson, Karate World Champion Yohana Sánchez, Freestyle Aerialist Alexa Devereaux, and professional golfers Paosingh Nissaisook and Thitipong Na Songkhla in the Eastern Hemisphere and triathletes Ty Hopkins and Modesto Duran Riquelme in the Western Hemisphere.
Dr. Rick Sibbel - Pharmaceutical Industry Perspective of the Impacts of the R...John Blue
Pharmaceutical Industry Perspective of the Impacts of the Regulatory Environment - Dr. Rick Sibbel, Merck Animal Health, from the 2012 NIAA One Health Approach to Antimicrobial Resistance and Use Symposium, October 26-27, 2012, Columbus, OH, USA.
More presentations at:
http://www.trufflemedia.com/agmedia/conference/2012-one-health-to-approach-antimicrobial-resistance-and-use
Presented to the University-Industry Consortium on March 3, 2015. Kevin M. Folta speaks about his experience at the public interface of GMO education and why there is resistance to good technology.
In his third of five lectures, Dr. Cady reviews the concepts of food allergy testing with IgG and IgE antibodies, traces the development of this body of knowledge from the 1960's, and reviews two illustrative cases.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- 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
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of 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 leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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BIO4360_Sept. 19th, 2011
1. BIO4360 Oral Medicine Etiology of Pathologies II Monday, Sept. 19 th , 2011
2. Metabolic Inflammatory Neoplasms Developmental Metabolic a) Hormonal b) Nutritional c) Compromised Organ Systems Inflammatory a) Trauma b) Infection – viral, fungal, bacterial c)Immunologic - autoimmune ‘ MIND’ Algorithm
3. Inflammatory – c) immunologic i) immune response to body’s own antigens (autoimmune) -pemphigus, pemphigoid ii) allergic reaction to external antigen - cinnamon, toothpaste, medications, etc. ‘ MIND’ Algorithm
4. Inflammatory – c) immunologic i) immune response to body’s own antigens (autoimmune) -pemphigus, pemphigoid ii) allergic reaction to external antigen - cinnamon, toothpaste, medications, etc. Inflammatory – d) reactive -body’s response to chronic, physical irritation -papillary hyperplasia, pyogenic granuloma, epulis fissuratum ‘ MIND’ Algorithm
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7. 12 Questions to Ask “ Listen to your patient and the patient will give you the diagnosis” Sir William Osler
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12. 12 Questions to Ask 6) What can you do/have you done that makes it better or worse? -if stopped using product and it resolved…immunologic -hypersensitivity/allergic rxn -improves with salt water, worsens with orange juice -ulceration/erosion
13. 12 Questions to Ask 6) What can you do/have you done that makes it better or worse? -if stopped using product and it resolved…immunologic -hypersensitivity/allergic rxn -improves with salt water, worsens with orange juice -ulceration/erosion 7) Does it come and go/change during the day? -if rapid change…….trauma related -if stress related…..less in morning, worse later in day -around mealtime?
14. 12 Questions to Ask 8) Do you remember injuring the area of the lesion? -identify trauma or recurrent trauma
15. 12 Questions to Ask 8) Do you remember injuring the area of the lesion? -identify trauma or recurrent trauma 9) Do you have any lesions on other parts of your body? -increased potential for immunologic cause -auto-immune diseases with dermatologic symptoms -some developmental lesions also have skin changes (café au lait spots)
16. 12 Questions to Ask 8) Do you remember injuring the area of the lesion? -identify trauma or recurrent trauma 9) Do you have any lesions on other parts of your body? -increased potential for immunologic cause -auto-immune diseases with dermatologic symptoms -some developmental lesions also have skin changes
17. 12 Questions to Ask 10) Do other people in your family have anything similar? -family Hx points to developmental problem (usually)
18. 12 Questions to Ask 10) Do other people in your family have anything similar? -family Hx points to developmental problem (usually) 11) How is your general health? Other than the oral problem, do you feel medically well? -if ‘yes’ less likely due to metabolic or systemic disease
19. 12 Questions to Ask 10) Do other people in your family have anything similar? -family Hx points to developmental problem (usually) 11) How is your general health? Other than the oral problem, do you feel medically well? -if ‘yes’ less likely due to metabolic or systemic disease 12) Are you taking any medication for any reason currently or were you taking medication recently? -verifies info about general health -oral effects of meds
20. 12 Questions to Ask REMEMBER: -intra-oral exam is NOT all that’s required to arrive at diagnosis -need to combine with info gained from questioning -either confirm Dx or lead to next step in tmt plan -biopsy, drug therapy, or ‘watchful waiting’ depends on suspected etiology
27. The products and the claims made about specific products on or through this site have not been evaluated by Herbal Remedies or the United States Food and Drug Administration and are not approved to diagnose, treat, cure or prevent disease. The information provided on this site is for informational purposes only and is not intended as a substitute for advice from your physician or other health care professional or any information contained on or in any product label or packaging. You should not use the information on this site for diagnosis or treatment of any health problem or for prescription of any medication or other treatment. You should consult with a health care professional before starting any diet, exercise or supplementation program, before taking any medication, or if you have or suspect you might have a health problem . Disclaimer
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32. Beliefs -Canadian studies have shown herbal medicines being used by 30-35% of people “ Patients often believe that herbs are natural alternatives to prescription medications, and do not recognize that herbs are composed of bio-active chemicals which may be toxic and can interact with other medications” Arch Fam Med 1998;7(6):523-36 " Better Living Through Chemistry "
33. Beliefs -Canadian studies have shown herbal medicines being used by 30-35% of people “ Patients often believe that herbs are natural alternatives to prescription medications, and do not recognize that herbs are composed of bio-active chemicals which may be toxic and can interact with other medications” Arch Fam Med 1998;7(6):523-36 "The miracles of science"
37. Ethnobotany Poisonous plants are medicinal plants & Medicinal plants are poisonous plants Herbal medications are important
38. Ethnobotany Poisonous plants are medicinal plants & Medicinal plants are poisonous plants Herbal medications are important
39. Herbal based Medicines -1900’s – herbal supplements hallmarks of pharmaceutical industry -67% of all medicine listed in US Pharmacopeia were botanicals……now only 2% - >1/2 of “modern” prescription & OTC drugs have botanical origins (aspirin, caffeine, cyclosporine, digoxin, quinine)
40. Herbal based Medicines -1900’s – herbal supplements hallmarks of pharmaceutical industry -67% of all medicine listed in US Pharmacopeia were botanicals……now only 2% - >1/2 of “modern” prescription & OTC drugs have botanical origins (aspirin, caffeine, cyclosporine, digoxin, quinine) -ethnobotany very important - < 0.5% of the world’s vanishing tropical plant species have been investigated for their medicinal qualities
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43. Definitions Herbal supplements : -are one type of dietary supplement -An herb is a plant or plant part (leaves, flowers, seeds, roots) that is used for its flavor, scent, and/or therapeutic properties -"Botanical" is often used as a synonym for "herb." -may contain a single herb or mixtures of herbs.
44. Regulations (USA) -US Dietary Supplement Health and Education Act (1994) -compromise -exempts vitamins, minerals, & botanical products from meaningful FDA regulation
45. Regulations (USA) -US Dietary Supplement Health and Education Act (1994) -compromise -exempts vitamins, minerals, & botanical products from meaningful FDA regulation -burden of proof? -2006 – Changes to Federal food, Drug and Cosmetic Act -require industry to report all serious dietary supplement related adverse drug effects to the FDA -2007-10 – manufacturers must test for purity, -ensure no contaminants -verify contents match labeling information
46. -Labeling according to the DSHEA: -prevents use of therapeutic claim ex: “for treatment of hypertension” -must be labeled as dietary supplement -CAN contain claims of effect on structure or function of body (ex: increases immunity) Regulations (USA)
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48. -Labeling according to the DSHEA: -prevents use of therapeutic claim ex: “for treatment of hypertension” -must be labeled as dietary supplement -CAN contain claims of effect on structure or function of body (ex: increases immunity) -info does not have to be scientific, but cannot be false or misleading (responsibility in hands of FDA) Multiple violations / near violations Regulations (USA)
49. … your webpage …. bears the following claim: "[F]our recent studies in people at risk for coronary disease have shown a significant cholesterol lowering effect from tea or tea flavonoids ... One of these studies, on post-menopausal women, found that total cholesterol was lowered by 8% after drinking 8 cups of green tea daily for 12 weeks ....“ The therapeutic claims on your website establish that the product is a drug because it is intended for use in the cure, mitigation, treatment, or prevention of disease. Regulations (USA)
50. Your Sparkling Green Tea Ginger Ale bears the claim, "ENHANCED WITH 200 mg OF ANTIOXIDANTS FROM GREEN TEA & VITAMIN C**" with the double asterisk referring to the statement, "* *Each 8 oz serving contains 200 mg of antioxidants from Green Tea Flavonoids and Vitamin C" on the principal display panel of the product label. In the context of this label the term "enhanced" is an unauthorized synonym for a "more" nutrient content claim. FDA has defined the nutrient content claim "more" and its authorized synonyms in 21 CFR 101.54(e). Regulations (USA)
51. -Labeling according to the DSHEA: -prevents use of therapeutic claim ex: “for treatment of hypertension” -must be labeled as dietary supplement -CAN contain claims of effect on structure or function of body (ex: increases immunity) -info does not have to be scientific, but cannot be false or misleading (responsibility in hands of FDA) -information can be physically separate from the product (ie: product on one shelf, info in another isle) HUH????? Regulations (USA)
52. Canada: Natural Health Product Regulations (2004) -allowed for sale of products otherwise not allowed under the Food and Drug Regulations -pre-2004 natural health products either drugs, or foods ( Food and Drug Act ) Regulations (Canada)
53. Canada: Natural Health Product Regulations (2004) -allowed for sale of products otherwise not allowed under the Food and Drug Regulations -pre-2004 natural health products either drugs, or foods ( Food and Drug Act ) -different sets of reg’s for cosmetics, foods, drugs, etc. -burden of proof varies Regulations (Canada)
54. Canada: Natural Health Product Regulations (2004) -allowed for sale of products otherwise not allowed under the Food and Drug Regulations -pre-2004 natural health products either drugs, or foods ( Food and Drug Act ) -different sets of reg’s for cosmetics, foods, drugs, etc. -burden of proof varies Regulations (Canada)
55. Canada: Natural Health Product Regulations (2004) Natural health products (NHPs) are defined as: -vitamins and minerals, -herbal remedies (ex: St. John’s Wort), -homeopathic medicines ** -traditional medicines (Traditional Chinese Medicines), -probiotics, Regulations (Canada)
56. Canada: Natural Health Product Regulations (2004) Natural health products (NHPs) are defined as: -vitamins and minerals, -herbal remedies (ex: St. John’s Wort), -homeopathic medicines ** -traditional medicines (Traditional Chinese Medicines), -probiotics, Regulations (Canada)
57. Canada: Natural Health Product Regulations (2004) Natural health products (NHPs) are defined as: -vitamins and minerals, -herbal remedies (ex: St. John’s Wort), -homeopathic medicines ** -traditional medicines (Traditional Chinese Medicines), -probiotics, -other products like amino acids and essential fatty acids. Regulations (Canada)
60. Energy Drinks -call for Health Canada to get involved with regulating -if considered ‘foods’ only have to list ingredients -talks about natural product not having to label caffeine containing herbal ingredients -if ‘natural health products’ also have to have appropriate warnings packs 505 mg of caffeine and 5000 mg of taurine Beverage…..or drug delivery systems??
61. Energy Drinks -call for Health Canada to get involved with regulating -if considered ‘foods’ only have to list ingredients -talks about natural product not having to label caffeine containing herbal ingredients -if ‘natural health products’ also have to have appropriate warnings packs 505 mg of caffeine and 5000 mg of taurine Beverage…..or drug delivery systems??
-MIND organizes the 200+ oral pathologies into categories based on etiology Metabolic – diabetes, Vit B 12 , HIV/AIDS Inflammatory – cheek biting,
-Plasma cell gingivitis due to flavouring agents (cinnamon) in tooth pastes, gums etc….. Diffusely edematous and fiery red gingiva
-papillary hyperplasia below a denture…papillary hyperplasia due to suction effect of CUD, - pyogenic granuloma assoc. with a rough tooth, -epulis fissuaraum adjacent to a denture flange…..often in situations where denture reline would be beneficial
-if long standing, pt. may not be aware -usually from one location so ask pt. if only one or multiple locations -multiple location decreases likelihood of neoplasm -95% of oral cancers associated with these 2 risk factors -pic of squamous cell carcinoma
-Basal cell Nevus (mole) and macule (focal melanosis) are both genetic conditions
-William Osler…..famous Canadian Physician in 1800s -first physician-in-chief of John Hopkins Hospital -one of the first people to do ‘rounds’ with med students…… &quot;He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.&quot; -that applies equally well to this program!!
-doesn’t necessarily change what is on your diff. diagnosis but could change the ranking of those possibilities. -can also help arrive at definitive Dx. How Long? -often people will not even be aware that there is a lesion there (ex: tori) -could still be metabolic if went off meds recently (ex: diabetes) -apthous ulcers…..etiology not full known….speculation that it is caused by hypersensitivity rxn, autoimmune response, etc. >6wks could also be chronic inflammation
4)-pain increases likelihood of inflammation and decreases but does not eliminate other possibilities -offering pt. descriptive options prejudices the patient’s comments and accurate information can be lost -if patient can’t describe then may have to give options, but be aware that info may not be accurate anymore -sharp, throbbing, burning -could still be neoplastic based on description
5) Assumes pt. is even aware of it -compiling of responses can help order your diff. diagnosis
6) -if lesion resolved after stopping use of a specific product likely due to hypersentivity -if improves with salt water and worsens with acidic juices really doesn’t help with etiology other than to say it’s likely an ulcer or erosion -erosion can be difficult to distinguish
7)-changes over short period of time often more related to traumatic origins -fluctulant lesion that is larger around dinner time and smaller between meals could be saliva cyst
8) sometimes trauma in an area draws your attention to that spot where coincidentally there is some other pathology going on, so trauma may not actually be associated (ex: tori, maybe chronic abscess, etc)
9) if lesions elsewhere on body more likely to be of immunologic origin (sub-category of inflammation) -pemphigoid, pemphigus, erythema multiformi may have intraoral and dermatologic manifestations -developmental conditions like café au lait spots assoc. with neurofibromatosis
-lichen planus is an oral AND cutaneous disorder…most often noted intraorally but 5-45% have both oral and cutaneous lesions at some point -Scleroderma…immune disfunction disease affecting connective tissue. -combines rheumatoid arthritis, Sjogrens, Raynaud’s phenomena, skin lesions -may not be a mouth problem, but a problem that expresses itself in the mouth
10) familial relationship may also be coincidental….ex: lichen planus…frequent enough occurrence that other family members may have also but is still and immunologic problem
11) will already have an idea based on health history -if is still possible that pt. has an undetected metabolic disease but usually sub-clinical disorders don’t cause oral mucosal symptoms without causing other systemic symptoms ex: malaise, fever, etc. -studies show that 75% of people with serious life threatening conditions when asked how you rate your overall health will say “pretty good”
12) some people will say they’re health is good and neglect to mention that they are using corticosteriod inhaler for asthma (causing local immuniosuppresion and candiasis) -maybe recently took amox. For sinusitis and indirectly caused the fungal infection…..anti-hypertensives causing swollen and tender ging. -some meds may cause allergic reactions and manifest as oral ulcerations. …..ex: NSAIDs
-oral exam only provides SOME of the info needed to arrive at a diagnosis -ex: many lesions present as an ulceration…..observing it clinically helps little with developing a Dx -your not just a recording secretary, you’re a health care professional -sometimes Dx based on success of tmt. Ex: sore tooth could be root exposure, occlusion related, cracked tooth, necrotic pulp -may start with duraflur first and see if that helps
-pain secondary to bruxism may be a result of nervousness and anxiety issues -phobias may cause pt. to worry about ‘lesions’ that are really normal anatomy (lingual tonsils, sublingual varicosities, fordyce’s granules, etc.) -excessive cleaning for ex: -Dx of psychological cause is made after all other possible etiologies have been eliminated. -pic of fingernail damage
How many of you take some sort of supplements or natural or herbal products? -have you ever purchased them either in the US or online? -this can often be a divisive topic with strong feelings on both sides -information hopefully benefit from both a professional and a personal perspective
-supplements and herbal are available everywhere…..esp. thanks to the internet -along with all kinds of other medications
-vitamins, mineral supplements, amino acids, antioxidants, vegetable subsititutes, etc
-this disclaimer is buried pretty deep in the site -Try to find out where this site is based……can’t. -the assumption based on shipping info is that they’re out of the States, but who really knows -that is very IMPORTANT because different countries have different regulations governing the sale of these products
-what are ‘natural health products’…..pretty nebulous term that means different things to different people - ‘biologics’ typically refers to ‘probiotics’….ie: good bacteria
-study released last week in the British Medical Journal indicating that Chondroitin and glucosamine have little or know effect
-#2 on list is the internet......now THAT is scary -#4 on the list with only 14% is the family Doc. -when surveyed about who they see if they have an adverse reaction to a supplement who is #1?? -THE FAMILY DOC!!!
-this is interesting because it gives some insight into people's perceptions of the difference between 'natural' and 'man made' -# 5 is ‘chemical free/toxin free’…….chemicals are not just man made substances……how do you know it’s toxin free if you don’t know all that’s in it……..think pet food and melamine!!! -# 10 on the list is ‘recommended by medical doctor’…and only 1/3 the number that were ‘recommended by family member or friend’ -what are things that ads typically say? ‘Better for you than chemical products/drugs’, ‘concerned about your health’, ‘maintain and promote health’, ‘chemical free’, ‘build immune system’, ‘no side-effects’, …… who says marketing doesn’t work??
-from the Archives of Family Medicine in 1998 -if something can affect your health then it has to be acting biologically within the body….same as pharmaceuticals -chemistry is often considered to be something that is ‘man made’ and was once accepted to be the saviour……then it turned into the enemy Dupont chemicals used as their slogan &quot; Better Living Through Chemistry &quot; from 1935-82 Then when the environmental movement started to take off thru the ’70s in 1982 they dropped the chemical reference
-since 1998 the slogan has been &quot;The miracles of science&quot;…..so ‘science’ is good, but ‘chemicals’ are still bad
Mark Plotkin – ethnobotanist - Amazon Conservation Team works in partnership with indigenous people to save the forest This was a talk he gave to Google employees in Apr/07
Paracelsus was a Swiss chemist and physician Father of modern toxicology
-if something can affect your health then it has to be acting biologically within the body….same as pharmaceuticals -’Natural’ does NOT equal ‘safe’ -herbal drugs are important because many ‘modern’ drugs are synthesized versions of ones found originally in nature
-if something can affect your health then it has to be acting biologically within the body….same as pharmaceuticals -’Natural’ does NOT equal ‘safe’ -herbal drugs are important because many ‘modern’ drugs are synthesized versions of ones found originally in nature
-US Pharmacopeia was the equivalent of the current CPS -Quinine used to treat malaria -reasons for manufactured pharmaceuticals 1) active ingredient in herbal product can be isolated (ex: active portion without hallucinogenic effects 2) Can develop different strengths of product 3) can make ‘standardized’ product (potency of herbs can vary based on climate and soil conditions they were grown in) 4) plant may not be available in sufficient quantities……or at all anymore due to other environmental issues
-ethnobotanists are on the front lines of trying to put a stop to deforestation of the Amazon and other undeveloped areas of the world -they’re concerned about the disappearance of undiscovered and unique plants as well as the disappearance of indigenous cultures -It’s like burning all the libraries before you’ve had a chance to read the books -I’ve posted link to entire video (~1hr long
-in developed countries, most people use herbals for preventative medicine then health maintanence -enormous challenges and costs to drug companies to conduct R&D in areas of preventative medicine
Dietary Supplement Health and Education Act -tobacco is the #1 herbal product that is used today -dietary ingredients (including vitamins, minerals, herbs, amino acids, and certain other substances) -taken by mouth (tablet, capsule, powder, softgel, gelcap, or liquid) -no wonder people have different definitions of what a dietary supplement is
Dietary Supplement Health and Education Act Botanicals A plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots -may be listed to build immunity and have herb added, but for flavoring only
-US regulations still important to know given the availability of products on the internet and the exposure to US media…..it’s important to understand how the reg’ns differ from ours -in ’94, US wanted to bring in stricter reg’ns (at that time the supplement industry was not very big) -aggressive lobbying from industry and public ended up with current compromise regulations -**Must remember that all government regulations are usually the result of compromise and often heavily affected by industry lobbying**
-pre-94 manufacturers had to prove that herbal product was safe and effective -post-94, the FDA must prove that it’s unsafe -2006 – had to start reporting adverse drug effects -2007-10 – phasing in of requirements to test for purity, ensure no contaminants, verify contents match labelling info -IF YOU ARE BUYING ONLINE – you may be purchasing product that does not meet the current requirements…dumping old stock? Or product that failed testing? -what is the country of origin for the website….what regulations are they under? -counterfeit products…..dollar store products, etc.
-Dietary Supplement Health and Education Act
Driving in to the College listening to the sports station and heard an ad for one of the many supplement stores and they were pushing this…
-whether info is false or misleading is up to FDA to prove
Lipton Green Tea 100% Natural Naturally Decaffeinated -warning letting from FDA in Aug/10 concerning claims made by Lipton -8 CUPS PER DAY???? Maybe cholesterol went down because they were spending so much time peeing that they didn’t have time to eat!!
Canada Dry Sparkling Green Tea Ginger Ale -warning letting from FDA in Aug/10 concerning claims made by Lipton -also listed other issues with information on website referring to antioxidants -these are the sorts of statements that we see all the time on products, but in reality they are not allowed.
-separation of information…..hard to see an advantage of this part of the act other than maybe to get the bill passed in the first place due to industry lobby efforts?? -Remember……all gov’t legislation is a compromise!!!! Especially regulatory type legislation is a balance between industry interests and public interests. - ‘stakeholders’ are always asked to make presentations on how the proposed legislation may or may not affect them.
-in Canada regulations evolved after extensive public consultations -pre-2004 fell under either the ‘drugs’ or the ‘foods’ requirements in the -if as ‘drugs’ had to follow the more rigorous drug review process re: safety, efficacy, clinical trials, etc. -if as ‘food’ could only make limited health claims and only had to carry limited safety info on labels
-claims/evidence of effectiveness require different levels based on classifications -ex: toothpastes are considered cosmetic agents….not drug (now do have an NPN on them) -so…..manufacturers are held to different levels of proof for claims made….ex: whitening, tarter reduction, etc. -don’t assume that because a product is covered by a ‘regulation’ that it is held to the same level as drugs -the changes introduced in the 2004 legislation were also to be phased in with the last of them being completed by the end of 2010
-in Canada regulations evolved after extensive public consultations -pre-2004 fell under either the ‘drugs’ or the ‘foods’ requirements in the -if as ‘drugs’ had to follow the more rigorous drug review process re: safety, efficacy, clinical trials, etc. -if as ‘food’ could only make limited health claims and only had to carry limited safety info on labels -claims/evidence of effectiveness require different levels based on classifications -ex: toothpastes are considered cosmetic agents….not drug (now do have an NPN on them) -so…..manufacturers are held to different levels of proof for claims made….ex: whitening, tarter reduction, etc. -don’t assume that because a product is covered by a ‘regulation’ that it is held to the same level as drugs -the changes introduced in the 2004 legislation were also to be phased in with the last of them being completed by the end of 2010
-Homeopathic medicines are treated differently under the NHP Regulations in that they can contain or be manufactured from substances ( Schedule F or Schedule D substances) that are not otherwise regulated under the Natural Health Products Regulations .
-probiotics - A microorganism introduced into the body for its beneficial qualities -typically beneficial bacteria used to re-establish healthy intestinal flora in the human body
-Canadian regs much better defined than US -also more rigorous hence the availability of some products in the US that are not available in Canada
-prescription drugs have a DIN (drug infromation number) -natural health products have an NPN -my tube of Crest toothpaste has an NPN # on it -homeopathic products have a DIN-HM number
-taurine is an amino acid required for normal function of skeletal muscle and is touted to allow quicker recovery when exercising -zero evidence that it has any effect on repair, energy, etc -many ‘energy’ drinks also combine herbal ingredients
-taurine is an amino acid required for normal function of skeletal muscle and is touted to allow quicker recovery when exercising -zero evidence that it has any effect on repair, energy, etc -many ‘energy’ drinks also combine herbal ingredients
-studies show that people drinking AmED drinks will drink more, but not feel as intoxicated as they really are. -“have a cup of coffee to sober you up”…….doesn’t work - ‘sobering up’ is based on the rate of metabolism of the alcohol -will changes be made??? I won’t hold my breath given the strength of lobby groups for the beverage industry Jägermeister’s ingredients include 56 herbs, fruits, roots and spices including citrus peel, liquorice , anise , poppy seeds , saffron , ginger , juniper berries and ginseng