This document provides an overview of the diversity of microorganisms that make up the resident oral microbiota. It discusses the classification and identification of numerous bacteria, fungi, viruses, and other microbes found in the oral cavity. Key points covered include the variety of gram-positive and gram-negative bacteria isolated from the oral cavity, both aerobic and anaerobic species, and the diseases some opportunistic pathogens can cause. Molecular methods for identifying microbes are also summarized as being more accurate and able to detect non-culturable species compared to conventional techniques.
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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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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
4. -Simple
-Quantitative
-Sensitivity tests
-Rapid(serological tests)
-Some tests can be done
directly on clinical samples
(other than culture)
-Pure culture is needed
-Not all microorganisms can
be cultured(e.g: treponema)
Conventional Identification Methods
Advantages
Disadvantages
12. 2.
S. sobrinus
Inhibited by bacitracin
d,g serotypes are human specific
AntigenI/II is also present (SpaA)
Associated with dental caries
Produce extracellular and intracellular
polysaccharides
13. B. Anginosus Group
S.anginosus
• Isolated from
purulent
infections like
maxillofacial and
other body sites
• Don’t produce
extracellular
polysaccharides
S.intermedius
• Produce
intermedilysin
affect neutrophil
function in
abscess formation
• Don't produce
extracellular
polysaccharides
• isolated from
brain and liver
abscesses
S.constellatus
• Derived from
purulent
infections
• Don’t produce
extracellular
polysaccharides
15. • Isolated from vestibular mucosa of
mouth
• Produce urease and H2O2 which
inhibit competing bacteria
• Do not produce extracellular
polysaccharides
• Opportunistic endocarditis and
bacteremia
S.vestibularis
• Colonize mucosal surfaces mainly the
tongue ,rarely cause disease
• Produce extracellular fructan, glucan
and levanase
• Levan (extracllular fructan) make
mucoid colonies on sucrose containing
agar
S. salivarius
C. Salivarius group
16. D.Mitis group
S.sanguinis
Colonize
tooth
surface
Produce
extracellular
glucan
Cleave
arginine
and
generate
ammonia
Produce
IgA
prtoease
S.gordonii
Colonize
tooth
surface
Produce
extracellular
glucan
Cleave
arginine and
generate
ammonia
Cleave starch
using salivary
alpha
amylase(binding
to amylase
protect it from
host) defenses-
host mimicry
S.oralis
produce
neuraminidase
enhance
adherence by
cleaving sialic
acid from mucin
Produce IgA
protease
Competent for
natural genetic
transformation
S.mitis
Opportunistic
pathogen
misidentified as
S.pneumoniae
Cause infective
endocarditis
Competent for
natural genetic
transformation
17. Nutritionally variant streptococci
ØGranulicatella adiacens(S.adiacens):
ü Require cysteine ,pyridoxal(vitamin B6) for growth
ü Exhibit satellitism with other bacteria that provide
cofactors
ØAbiotrophia defectiva
18. Other Gram positive cocci
Ø Enterococcus faecalis : isolated from immunocompromised
patients, treatment failed periodontal pocket
Ø S.pyogenes: isolated from saliva of patients with sore throat
Ø Staphylococcus and Micrococci: Transient flora, isolated from
denture plaque
Ø Peptostreptococcus stomatis: anaerobic,isolated from dental
abscesses,infected pulp chambers,root canals and advanced
forms of periodontal disease
20. A. Actinomyces
A.naeslundii
Major portion of
dental plaque,
colonize mouth at
infant age
produce fructan,
urease,neuraminidase
have fimbriae for
coaggregation and
cell-surface
interaction
A.israelii
opportunistic
pathogen cause
actinomycosis
produce protective
granules that help
bacteria evade
immune system
and antibiotic
treatment and
disseminate into
body
A.odontolyticus
form red
pigment
colonize mouth
at infant age
21. B. Eubacterium
Gram variable,filamentous , obligate anaerobe, non
culturable
Asaccharolytic
Form dentoalveolar abscesses
22. C. Lactobacillus species
Some
species
are cocci
Acidogenic
and acid
tolerant
There salivary
levels are
useful to
monitor
patient's
dietary
behavior
(carbohydrate
intake) and
cariogenic
potential of a
mouth
Isolated
from
advanced
caries
lesions
24. Other Gram Positive Rods
qPropionibacterium spp.:obligate anaerobic, found in
dental plaque
qBifidobacterium dentium:isolated from dental plaque
qRothia mucilaginosa: produce extracellular
polysaccharides,isolated exclusively from the
tongue
qCorynebacterium matruchutii: short fat cell and long
filament growing out( whip-handle cell)
Corynebacterium matruchutii
27. Gram Negative Rods
q Haemophilus
Ø H.parainfluenzae: Require NAD
(nicotinamide adenine dinucleotide )
q Aggregatibacter
Ø A.actinomycetemcomitans
Ø Capnophilic (require 5-10% CO2)
Ø Opportunistic pathogen produce collagenase, IgG
protease
Ø Cause aggressive periodontitis in adults
28. Obligately Anaerobic Genera
qBlack pigmented anaerobes:
Ø Prevotella and Porphyromonas
Ø Produce brown-black pigment on Blood agar
Ø Require X-factor (hemin)
Ø Isolated from subgingival sites of dental plaques
qFusobacterium
Ø Pleomorphic,long filamentous
Ø Asaccharolytic Use amino acids as energy source
Ø Some species isolated from normal gingival crevice others are
associated with periodontal disease
31. Obligately Anaerobic Genera
qHelicobacter pylori
Ø Associated with gastritis, peptic ulcers and gastric
cancer
Ø Transiently found in the mouth following reflux from
the stomach
32. Obligately Anaerobic Genera
qSpirochaetes
Ø Isolated from subgingival plaque
Ø Their number is diagnostic for necrotizing ulcerative
periodontitis
Ø Characterized by endoplasmic flagella(axial filaments)
Ø Difficult to be cultured, need dark field microscope,
molecular methods
Ø Treponema denticola
ü Proteolytic: degrade collagen and gelatin
ü Can be cultured
34. Fungi
Present in
small
proportion
Imperfect
yeast
(divide
asexually)
like candida
are
common
flora
Perfect
(divide
sexually)
yeast are
transient in
healthy
individuals
Perfect
molds like
Aspergillus ,
Mucor,
Geotrichum
present in
AIDS
patients
35. 1. Candida albicans
is the main oral fungal
flora
2. C. glabrata, C. krusei,
C. tropicalis,
C.guilliermundii,
Rhodotorulla,
Saccharomyces
are present
3. Isolated mainly from
dorsum of the tongue and
increased with presence of
intra-oral devices like
dentures or orthodontic
appliances
4. Carriage rate increases
at middle and old age
Fungi
36. Mycoplasma
Disease associated
M.orale, M. salivarium associated with salivary gland
hypofunction
Isolation
mucosal surfaces
RT,UT
Saliva
M.salivarium
M.pneumonaie
Oral mucosa
M.buccale
M. orale
Growth media
Need enriched media with
protein
Elevated CO2
Shape and size
Lack cell wall
Gram negative pleomorphic
Smallest free growing
cells<1um
38. Viruses
1. Herpesviridae
Herpes simplex virus type1 (HSV1)
• Most virus isolated from saliva
and orofacial areas
• Persist within oral tissues
• Cause cold sores
• Remains latent in trigeminal
nerve ganglion
• Reactivated by stress or UV light
• Mainly recovered by molecular
methods
Cytomegalovirus(CMV)
• Isolated from saliva
• Latent
• persistent
• Portal entry to oral cavity
is unknown
40. Viruses
2. Coxakievirus A
Coxakievirus A serotypes
2,4,5,6,8,9,10,16 isolated from oral
epithelium and saliva
Disease
Herpangina( hand,foot,mouth
disease)
42. Viruses
3.Human papilloma virus(HPV)
more than 100 type
2,4,6,11,16 detected in
oral lesions of AIDS
Isolated from tissues
with hyperplastic warty
like lesions
(verruca vulgaris)
46. Other Viruses
qMumps and measles in oral lesions
qBacteriophage
ü Viruses for which bacteria are the natural hosts
ü Bacteriophage specific for S.mutans, Lactobacillus,
Actinomyces, Veillonella and Aggregatibacter sp.
ü Isolated from saliva and dental plaque samples
47.
48. Protozoa
microscopic
unicellular
eukaryotes
Their life cycle
consist of
trophozoite
the motile,
feeding form)
and cyst
(protective form)
Some are motile by
flagella , cilia or
pseudopodia while
others are non
motile
Reproduce
asexually by
binary
fission,
(apicomplexa
reproduce
sexually
49. Protozoa
Trichomonas tenax
Commensal in oral cavity
Heterotrophic (acquire
carbon through ingestion
of other microorganisms ,
organic matter and
leucocytes)
Motile by flagella and
undulating membrane
Increase in patients with
periodontal disease
Entamoeba gingivalis
First ameobae isolated
from human
Heterotrophic
Motile by pseudopodia
found in the gingival
pocket(abnormal depth of
the gingival sulcus