This document discusses systemic sclerosis, also known as scleroderma. It begins with an introduction defining scleroderma as a chronic autoimmune disease affecting connective tissues, characterized by thickened skin. The etiology is unknown.
It then describes the main clinical features of scleroderma, which can be remembered using the mnemonic "CREST" - calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia. Scleroderma can affect multiple organs and cause difficulties with eating, swallowing, and reduced mouth opening.
The document outlines the different types of scleroderma, epidemiology, pathology,
Skin Manifestations of Scleroderma, by Dr. Lorinda Chung MD maushard
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Keynote presentation by Dr. Lorinda Chung MD at March 9, 2013 Cheri Woo Scleroderma Education Seminar in Tualatin, OR hosted by Oregon Chapter of the Scleroderma Foundation.
Skin Manifestations of Scleroderma, by Dr. Lorinda Chung MD maushard
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Keynote presentation by Dr. Lorinda Chung MD at March 9, 2013 Cheri Woo Scleroderma Education Seminar in Tualatin, OR hosted by Oregon Chapter of the Scleroderma Foundation.
About failures of root canal treatment and retreatment. This presentation describes about various techniques for gutta percha removal, posts removal, pastes removal, and removal of separated instrument
The slowly progressive cutaneous form of systemic sclerosis (scleroderma) is termed CREST syndrome. The acronym CREST is derived from the clinical symptoms of Calcinosis of the skin, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly and Telangiectasia.1
'Oral Potentially Malignant Disorders' includes a variety of lesions with risk of progression to malignancy. It is widely prevalent in the Indian population, and early diagnosis and management is the need of the hour.
Here's a discussion of the same with methods of early diagnosis of such lesions.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
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Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
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RESULTS: Overall life span (LS) was 2252.1Âą1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years â 64.8%, 20 years â 42.5%. 513 LCP lived more than 5 years (LS=3124.6Âą1525.6 days), 148 LCP â more than 10 years (LS=5054.4Âą1504.1 days).199 LCP died because of LC (LS=562.7Âą374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0âN12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0âN12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMENâS CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. Thatâs why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminateâŚDr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMENâS CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. Thatâs why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminateâŚDr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganongâs Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Report Back from SGO 2024: Whatâs the Latest in Cervical Cancer?bkling
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Are you curious about whatâs new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Womenâs Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
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This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Tom Selleck Health: A Comprehensive Look at the Iconic Actorâs Wellness Journeygreendigital
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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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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
2. Introduction
⢠Itâs a chronic multisystem progressive disease
of Connective tissues. The thickened skin
distinguishes scleroderma from other
connective tissues.
⢠Etiology is unknown; insidious onset often
associated with Reynaud's phenomenon
(painful reversible digital ischemia on
exposure to cold).
3. Features
⢠Systemic sclerosis is sometimes referred to
as CREST. This is a mnemonic you can use to
remember some of the main symptoms of the
disorder:
⢠- C â Calcinosis â calcium deposits, usually
seen in the fingers
⢠- R â Raynaudâs phenomenon
⢠- E â Esophogeal Dysmotility
⢠- S â Scleodactyly â thickening of the skin
⢠- T â Telangiectasia â red spots on the skin
4.
5. Clinical features
⢠Skin pigmentation changes â commonly a loss of
pigment around the affected areas, but there
may also be patches of hyperpigmentation.
⢠Calcinosis of the fingertips â calcium deposits at
the fingertips. You may see these at little pits
near the finger tips (digital pitting), and they
are often visible as white dots around the distal
phalanges on radiograph.
6. ⢠Reynaudâs phenomenon â the result of vascular spasms that
reduce the blood supply to the fingers, usually when the hands
get cold. The phenomenon may also be triggered by emotional
stress. There is a classic pattern of colour change â the fingers
will go white, then blue, then as they warm up, or the episode
passes, they will become red. The red part of the cycle is the
result of hyperaemia that occurs after a period of reduced
blood flow. The episodes are often painful.
⢠o Sometimes also occurs in the tongue, toes, nose and ears.
⢠o Occurs in 4-30% of all women. Rarer in men
7. ⢠Patients are at high risk of early pulmonary
fibrosis and acute renal involvement.
⢠Eating difficulty due to immobility of
underlying tissues.
⢠Dysphagia when the esophagus is involved.
8. Cntd.
⢠waxy mask-like face (mona-lisa face).
⢠Thickening of skin
⢠Involvement of multiple organs GI liver
kidneys TMJ;hence reduced mouth opening
9. Types
⢠1- Limited cutaneous scleroderma â
aka scleroderma â in this variation, the signs are
mostly confined to the hands, arms and face â i.e.
mostly to the skin. In 80% there is also pulmonary
hypertension.
⢠o 5 year survival is >90%
⢠o 10 year survival is >75%
⢠o Generally only those with pulmonary
involvement with have life threatening illness
⢠o Usually skin changes on the upper limb
are distal to the elbow.
10. 2- Diffuse cutaneous scleroderma â aka systemic
sclerosis â tends to be more rapidly progressing
and severe. Affects larger areas of the skin, and
there is multi-systemic involvement. Can be life-
threatening, e.g. if the heart/lungs/liver/kidneys
become involved.
⢠o 5 year survival is 70%
⢠o 10 year survival is 55%
⢠o Skin changes can occur anywhere, and in
advanced cases, may cover the whole body!
⢠o Patches typically appear on the trunk
11. Epidemiology
⢠- 4x as common in women
⢠- Prevalence is about 1 per 1000
⢠- Peak incidence is between 30-50
⢠- Children sometimes affected in localised
patches
12. Pathology
⢠- The disease is the result of vascular
damage within the skin and organs.
⢠- Organ damage is usually the result
of fibrosis.
⢠- Renal and pulmonary complications are the
most life-threatening
⢠- In normal disease progression, there can
be some element of disease regression.This might
include periods, perhaps a few weeks long, where
the patient says their symptoms feel much less
severe â although they are usually still apparent.
13. Diagnosis
⢠Antibodies are present
⢠Circulating levels of E-selectin and
thrombomodulin are useful markers.
14. Treatment
⢠Combination of cyclophosamide and steroids
in early disease.
⢠In later stages ď pencillamine but it causes
unwanted effects.
15. CASE REPORT
⢠A 58 years old female edentulous patient
presented to the department of
Prosthodontics for a set of dentures. She was
a diagnosed case of systemic sclerosis and a
known case of hypertension for more than
four years on regular treatment. Her general
physical examination revealed hardening of
facial skin, vertical peri-oral furrows, thinning
of lips with reduced mobility
18. Procedure
⢠The smallest diameter stock tray was chosen
for preliminary impression, but still it was not
possible to insert the tray loaded with
impression material inside the patientâs oral
cavity. Hence, the modified impression
technique was adopted. The metal stock tray
was sectioned antero- posteriorly following
the line passing to the left side of the midline.
20. ⢠The impression of the right half was made and
the left section of the loaded impression tray
was inserted before removing the other half.
The two parts of the impression were
removed in the reverse order. Impression was
assembled outside the mouth to get the
primary cast. A similar technique was followed
for the secondary impression with lock and
key mechanism created in the handle of the
sectioned custom tray.
22. ⢠The assembled final impression was poured to
get the master cast. Conventional method for
preparation of occlusal rims was followed.
23. ⢠Reduced mouth opening limited the use of Fox plane
guide for the registration of occlusal plane. So, two
metal scales were used on each side to access the
occlusal plane. The visual methods are more significant
in such patients than conventional and the anatomical
landmarks were used as a guide. Try-in was done and
denture was processed using compression molding
technique. Patient was trained to use a rotational path
of insertion and removal. She was advised to
frequently sip water or non-sugary fluids for
xerostomia. The cosmetic and functional result of the
final denture was good.
25. References
⢠1. Albilia JB, Lam DK, Blanas N, Clokie CM, Sandor GK. Small
mouth...Big Problems? A review of scleroderma and its oral
health implications. J Can Dent Assoc 2007; 73: 831-6.
2. Amft N, Bowman SJ. Chemokines and cell trafficking in
Sjogren's syndrome. Scand J Immunol 2001; 54: 62-69.
3. Varga J. Systemic Sclerosis (Scleroderma) and related
disorders. In: Harrisonâs Principles of internal medicine. Fauci
AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL
et al Editors. 17th edition. New York USA, Mc Graw Hill; 2008.
p. 2096-2106.
4. Murmary Y, Glaiss R, Pisanty J. Scleroderma: Oral
manifestations. Oral Surg Oral Med Oral Pathol 1981; 52: 32-
7.
5. Naylor WP. Oral management of the scleroderma patient. J
Am Dent Assoc 1982; 105: 4-7.
26. ⢠6. Chaffee NR. CREST syndrome: clinical manifestations
and dental management. J Prosthodont 1998; 7: 155-60.
7. Scardina GA, Messina P. Systemic sclerosis: description
and diagnostic role of the oral phenomena. Gen Dent
2004; 52: 42-7.
8. Tolle SL. Scleroderma: considerations for dental
hygienists. Int J Dent Hygiene 2008; 6: 77-83.
9. Iannello S, Camuto M, Cantarella S, Cavaleri A, Ferriero
P, Leanza A, et al. Rheumatoid syndrome associated with
lung interstitial disorder in a dental technician exposed to
ceramic silica dust. A case report and critical literature
review. Clin Rheumatol 2002; 21: 76-81.
10. Jagger RG, Absi EG, Jeremiah HG and Sugar AW.
Bilateral mandibular condylisis in a patient with systemic
sclerosis. Dentomaxillofac Radiol 2006; 35: 461-463.
27. ⢠11. Auluck A, Pai KM, Shetty C and Shenoi SD. Mandibular
resorption in progressive systemic sclerosis: a report of
three cases. Dentomaxillofac Radiol 2005; 34: 384-386.
12. Luebke RJ. Sectional impression tray for patients with
constricted oral opening. J Prosthet Dent 1984; 52: 135-7.
13. Wahle JJ, Gardner LK, Fiebiger M. The mandibular
swing-lock complete denture for patients with
microstomia. J Prosthet Dent 1992; 68: 523-7.
14. Givan DA, AuClair WA, Seidenfaden JC, Paiva J.
Sectional impressions and simplified folding complete
denture for severe microstomia. J Prosthodont 2010; 19:
299â302.
15. Colvenkar SS. Sectional impression tray and sectional
denture for a microstomia patient. J Prosthodont 2010; 19:
161-5