Vitamins & minerals are essential for the development and functioning of the organism. Maintaining a healthy life will help in maintaining a healthy mouth since poor health is a link to diseases.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Saliva and its prosthodontic considerationsCPGIDSH
importance of saliva is often neglected by clinicians and practitioners but is one of the most important body fluids not only in dentistry perceptive but also in regard to medical diagnosis. in dentistry it plays a special role specially in complete denture patients
This presentation highlights the oral manifestations of each of the vitamins in general, citations of each of the references are provided within the slides.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Saliva and its prosthodontic considerationsCPGIDSH
importance of saliva is often neglected by clinicians and practitioners but is one of the most important body fluids not only in dentistry perceptive but also in regard to medical diagnosis. in dentistry it plays a special role specially in complete denture patients
This presentation highlights the oral manifestations of each of the vitamins in general, citations of each of the references are provided within the slides.
Calcium and phosphorous metabolism/ rotary endodontic courses by indian denta...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
An inlay may cap none, or may cap all but one cusp.
Sturdevant’s 4th ed. page579
Inlays may be used as single-tooth restorations for proximo-occlusal or gingival lesions with minimal to moderate extensions
Shillingburg page 1
An inlay may be defined as a restoration which has been constructed out of mouth from gold, porcelain, or other material & then cemented into the prepared cavity of a tooth.
William McGehee pg410
Calcium and phosphorous metabolism/ rotary endodontic courses by indian denta...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
An inlay may cap none, or may cap all but one cusp.
Sturdevant’s 4th ed. page579
Inlays may be used as single-tooth restorations for proximo-occlusal or gingival lesions with minimal to moderate extensions
Shillingburg page 1
An inlay may be defined as a restoration which has been constructed out of mouth from gold, porcelain, or other material & then cemented into the prepared cavity of a tooth.
William McGehee pg410
Introduction
Definitions
Nutrition & Normal occlusion
Calcium
Phosphorous
Vitamins D , A & C
Nutritional deficiencies
Nutrition & Dentofacial growth
Role of Nutritional counseling
Conclusion
Vitamins are organic compounds that are essential for normal growth and nutrition and are required in small quantities, their deficiency causes diseases.
Biochemist Casimir Funk discovered vitamin B1 in 1912 in rice bran.
It cannot be synthesized in sufficient quantities by an organism and must be obtained from the diet.
This presentation provide the basics of nutrition and nutritional supplements, the classification, sources, therapeutic uses, deficiency symptoms and toxicity.
Host modulation therapy is recommended as an adjunct to scaling and root planing in the periodontal therapy. The basic purpose of host modulation therapy is to restore the balance between pro-inflammatory and anti-inflammatory mediators.
Periodontal pocket is a pathologically deepened gingival sulcus. There are two types of pockets - gingival pocket and periodontal pocket. The periodontal pocket formation is the first step in the periodontal destruction. It is important to understand the etiopathogenesis of the periodontal pocket formation for appropriate diagnosis and treatment planning.
Majority of HIV infected individuals show oral manifestations of infection. Early diagnosis and treatment will improve the lifespan of HIV infected individuals.
Smoking is a major environmental risk factor associated with Periodontitis. Cessation of smoking is essential to prevent the progression of periodontal disease and for maintenance of health.
Dental caries is the major dental disease affecting a large population. Cariostatic efficacy of the fluorides have increased the use of fluoride agents. This presentation will enlighten us about the use of fluorides in preventive dentistry.
Halitosis is derived from a Latin word which means unpleasant breath. If not treated, it could affect your social life. Majority of the cases of halitosis have oral origin. Therefore, appropriate dental treatment eliminates the cause.
Phase I periodontal therapy is the first in the chronologic sequence of procedures that constitute periodontal treatment. It is also referred to as cause related therapy or non-surgical periodontal therapy.
Radiographs play an important role in the diagnosis and treatment of periodontal diseases. They provide important information regarding the anatomical structures and periodontal bone loss.
Acute periodontal diseases are clinical conditions of rapid onset that involve the periodontium. They are characterised by discomfort or pain and infection. They require urgent attention which involves prompt diagnosis and treatment to prevent the further destruction.
Periodontal abscess is a localised purulent infection in the tissues adjacent to the periodontal pocket that may lead to the destruction of the periodontal ligament and alveolar bone. Periodontal abscess is the third most prevalent emergency infection after acute alveolar abscess and pericoronitis. It could lead to complications due to bacteremia that may cause infection at distant locations. Proper management of the abscess is crucial to alleviate pain, establish drainage and control the spread of infection.
The cementum is a specialised calcified substance covering the root of the tooth. The cementum is a part of the periodontium that attaches the teeth to the alveolar bone by anchoring the periodontal ligament. This presentation covers the anatomy and pathologies associated with the cementum.
The gingiva may be involved in many of the local and systemic conditions. This presentation provides a review of the common pathological conditions affecting the gingiva and the diagnosis and the management associated with each of the conditions.
Every periodontal surgical procedure has its own indications. With proper knowledge of the etiology of the disease, correct diagnosis and treatment planning, the clinician is able to draw predictable success with periodontal flap surgery.
The future of dentistry and periodontics lies in regeneration. The goals of periodontal therapy lies in not only the arrest of periodontal disease progression but also regeneration of the lost periodontal structures. This presentation provides a review of the current understanding of the regeneration of the periodontium and the procedures involved to restore the periodontal tissues around the teeth.
The main objective of periodontal surgery is to achieve health and integrity of the periodontium by plaque removal and plaque control. Patient preparation is an important aspect of the intervention. The presentation mentions certain principles of periodontal surgery which are crucial for effective treatment of the patient.
DENTIN HYPERSENSITIVITY - ETIOLOGY, DIAGNOSIS AND TREATMENTDr.Shraddha Kode
Dentinal Hypersensitivity is a common clinical condition which is sharp in character and of short duration in response to stimuli. It is associated with exposed dentin surfaces. This presentation provides a brief overview - its etiology, diagnosis and treatment.
Biologic width - Importance in Periodontal and Restorative DentistryDr.Shraddha Kode
Biologic width plays a vital role for preservation of the periodontal health. This concept involves the dimensions of the epithelial and connective tissue attachment between the base of the sulcus and the alveolar crest which if involved can lead to gingival inflammation and gingival recession.
Bone Morphogenetic Proteins - Role in Periodontal RegenerationDr.Shraddha Kode
BMP's are the multifunctional growth factors extensively studied throughout the years. It has recently gained a lot of interest as therapeutic agents in periodontal regeneration.
Nicotine Replacement Therapy (NRT) can help with the withdrawal symptoms in patients who find it difficult to quit tobacco. It is available in the form of - gums, patches, sprays, inhalers or lozenges.
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
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
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.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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, Ganong’s 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
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 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 N0—N12, 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 N0—N12 (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.
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
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
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
3. INTRODUCTION
3
o Vitamins have been
defined as the organic
compounds which are
required in minute
amounts to maintain
normal health of the
organisms
5. VITAMIN A
5
o Source – yellow, red,
green vegetables and
fruits, meat, liver and
dairy products
o RDA – 600mcg per day
o Animal – pre-formed –
retinol; plants – pro-
formed - carotene
6. 6
o Physiological functions
Vision (rod and cone cells)
Epithelial cell integrity
Growth & reproduction
Resistance to infectious
diseases
10. Oral manifestations
10
o Defective formation of enamel –
hypoplasia
o Dentin lacks the normal
tubular structure
o Increased risk for caries
o Delayed eruption of teeth
o Hyperplastic and increased
keratinisation of gingival
epithelium
12. VITAMIN D
12
o “Sunshine Vitamin”
o 2 forms – cholecalciferol(D3)
& calciferol (D2)
o Source – Exposure to
sunlight synthesizes Vitmin
D; fatty fish, liver oils, egg
yolk
o RDA – 400IU of
cholecalciferol
13. Origin & Synthesis
13
o precursor – 7-dehydrocholesterol converted
to pre-vitamin D2 – then to vitamin D3
o Vitamin D2 & D3 – converted to calcitriol
in liver and kidney
18. VITAMIN E
18
o Naturally occurring
antioxidant
o Essential for reproduction
in animals – anti
sterility vitamin
o Sources – vegetable oils,
meat, butter and eggs
o RDA – men – 10mg;
women – 8mg
19. Functions
19
Membrane structure and
integrity – called
membrane antioxidant
Prevents peroxidation of
polyunsaturated fatty
acids in tissues and
membranes
Protects RBCs from
hemolysis
20. 20
Preserves and maintains
proper reproductive
function – prevents
sterility
Prevents oxidation of LDL
– protects from heart
diseases
23. 23
o Available in 2 forms: K1 – plant
origin
K2 – synthesised by intestinal
bacteria
o RDA – 70 to 140 mcg/day
o Source – milk, meat, fish,
spinach, cabbage, cauliflower,
soyabean, wheat germ, carrots,
potatoes, tomatoes
VITAMIN K
24. 24
o Hepatic synthesis of coagulation
factors – II, V, VII, IX, X
Functions
Deficiency
o Increased clotting time –
prolonged bleeding –
hemorrhagic conditions
25. VITAMIN C
25
o Ascorbic acid
o Powerful antioxidant
o Source – citrus fruits,
green vegetables,
gooseberry, guava,
tomatoes, potatoes
o RDA – 60-70mg/day
26. Functions
26
Collagen formation
Iron and hemoglobin
metabolism
Tryptophan, tyrosine and
folic acid metabolism
Immunological function
Sparing action on other
vitamins
27. Deficiency
27
o SCURVY – spongy and
sore gums, loose teeth,
anemia, swollen joints,
delayed wound healing,
hemorrhage
29. VITAMIN B COMPLEX
29
o Most of the B-complex vitamins in
the nature are in the bound form
within the cells of vegetables or
animal tissues
o Breakdown of cellular structures
in the gut –digestion for the
liberation of vitamins and
absorption
o Excretion - kidney
30. Thiamine (Vitamin B1)
30
oAnti Beri-Beri factor, Anti neurotic factor,
Aneurin
oSpecific coenzyme – thiamine pyrophosphate
(TTP) – associated with carbohydrate metabolism
oSource – cereals, pulses, oil seeds, nuts, yeasts,
meat, milk
oRDA – 1 to 1.3 mg/day
oFunction – TPP – transmission of nerve impulse.
Energy releasing in carbohydrate metabolism
31. 31
oDeficiency – Beri-beri (Dry, wet and infantile)
oOther diseases – Wernicke’s encephalopathy,
Peripheral neuritis, Korsakoff’s psychosis
oOral manifestations – hypersensitivity of oral
mucosa, pain in tongue, teeth, jaw and face
oTreatment – Thiamine 50mg IM for 3 days then
10mg TDS by oral route
32. 32
Riboflavin (Vitamin B2)
oTakes part in cellular oxidation reduction reactions
oCoenzymes – Flavin mononucleotide (FMN) and
Flavin adenine dinucleotide (FAD)
oSources – milk and milk products, meat, eggs,
liver, kidney, cereals, fruits, vegetables
oRDA – 1.2-1.7mg/day
oFunctions – Redox reactions responsible for energy
production
oDeficiency – cheilosis (chapping and fissuring of
lips), glossitis (inflamed, red beefy tongue)
33. 33
Niacin (Vitamin B3)
oNiacin or nicotinic acid – known as Pellagra
preventive factor of Goldberg
oCoenzymes – NAD and NADP – synthesised by
essential amino acid – tryptophan
oSources – wholegrain, cereals, pulses, liver, milk,
fish, eggs, vegetables
oRDA – 15-20mg/day
34. 34
oFunctions – oxidation reduction
reactions
oDeficiency – Pellagra – 3Ds –
Dermatitis, Diarrhoea, Dementia – if
not treated 4th D – death
oOral manifestations – oral mucosa –
fiery red, painful and profuse
salivation, desquamated epithelium of
tongue, red swollen and beefy tongue,
tongue loses all papillae and intense
reddening
37. Biotin (Vitamin B7)
37
oAnti-egg white injury factor, vitamin B7, vitamin H
oSulfur containing B-complex vitamin
oCoenzyme in carboxylation reactions
oSources- liver, kidney, egg yolk, milk, tomatoes, grains
oRDA – 100-300mcg/day
oFunctions – carrier for CO2 in carboxylation reactions,
metabolic reactions – gluconeogenesis, citric acid cycle,
fatty acid synthesis
38. 38
oDeficiency – anemia,
loss of apetite, nausea,
dermatitis, glossitis
oBiotin deficiency is
uncommon as it is well
distributed in food and
supplied by intestinal
bacteria
39. Pantothenic acid (Vitamin B5)
39
oChick anti-dermatitis factor
oMetabolic role as coenzyme A or CoA (A for
acetylation) is widespread
oRDA – 5-10mg
oSources – egg, liver, meat, yeast, milk (most widely
distributed vitamins found in plants and animals)
oFunctions – CoA – carrier for activated acetyl or acyl
groups
oDeficiency – burning feet syndrome – pain and
numbness in toes, sleeplessness, fatigue
40. Folic acid (Vitamin B9)
40
oLatin – folium – abundantly found in green leafy
vegetables
oSynthesis of amino acids, purines and pyrimadines –
thymine
oSources – green leafy vegetables, whole grains, cereals,
liver, kidney, yeast and eggs (milk is a poor source)
oRDA – 200mcg
oFunctions – tetra hydrofolate – coenzyme of folic acid –
involved in the one carbon metabolism
41. 41
oDeficiency – Macrocytic anemia
ofolic acid deficiency in pregnant women lead to
neural defects in foetus
42. Cyanocobalamin (Vitamin B12)
42
oMost of the therapeutic preparations contain
cyanocobalamin. It is sensitive to light and heat labile
oSources – liver, kidney, brain, meat, fish, eggs
oAbsent in plant foods – vegetarians are likely to develop vit
B12 deficiency
oRDA – 3mcg/day
oFunctions – synthesis of methionine from homocysteine
and isomerisation of methylmalonyl CoA
43. 43
oDeficiency – Pernicious anemia – low Hb levels,
decreased no of erythrocytes, neurological
manifestations
oOral manifestations – burning sensation in the
mouth, trouble swallowing, swollen tongue, pale tissues
in the inner cheeks
44. “Importance of understanding vitamin
deficiencies:
Act as exacerbating factors in infectious
diseases, chronic diseases thus impacting
the morbidity, mortality and quality of
life. Understand the pathophysiology and
implement successful methods of prevention
44
47. 47
Minerals
Macrominerals/
Principal elements
(60-80%; required in amounts
> 100mg/day)
Microminerals/
Trace elements
(Required in amounts <
100mg/day)
Ca, Mg, Na, K,
Cl, S
Essential trace elements
Possibly essential trace elements
Non essential trace elements
48. CALCIUM
48
o Most abundant
o Total content – 1-1.5kg
(about 99% present in
bones & teeth)
o RDA – 800mg/day
o Absorption of Ca takes
place in the duodenum
49. Functions
49
Development of bones & teeth – bone formation
Ca ions interact with troponin C to trigger
muscle contraction
Several reactions in the blood clotting process
depend on Ca ions
Ca ions are necessary for nerve transmission
50. 50
Membrane integrity &
permeability
Ca ions are required for direct
activation of enzymes –pancreatic
lipase and ATPase
Release of hormones from
endocrine glands is facilitated by
insulin, PTH and calcitonin
51. Factors promoting Ca absorption
51
o Vitamin D (through its active form
– calcitriol)
o PTH
o Low pH of intestinal lumen
o Lactose
o Lysine & arginine
52. Factors inhibiting Ca absorption
52
o Phytates & oxalates
o Dietary phosphate
o Free fatty acids
o High pH in intestinal lumen
o High content of dietary fibre
53. Hormonal regulation of plama Ca levels
53
o Calcitriol – absorption of Ca from
intestines – increased blood calcium
level - increased Ca uptake by
osteoblasts – promotes mineralisation
and remodelling of bone
o PTH – increased blood calcium level -
decalcification or demineralisation of
bone & increased Ca reabsorption by
renal tubules
54. 54
o Calcitonin – secreted by
parafollicular cells of thyroid
gland – opposite action of PTH –
decreased blood calcium level -
promotes calcification
55. Hypercalcemia
55
o Increased serum Ca levels
o Associated with hyperparathyroidism – caused
by increased activity of parathyroid glands
o Symptoms – lethargy, muscle weakness, loss of
appetite, constipation, nausea, increased
myocardial contractility
56. Hypocalcemia
56
o < 7mg/dl – fall of serum Ca level
– tetany
o Symptoms – neuromuscular
irritability, spasms, convulsions
o Mostly due to hypoparathyroidism
– surgical removal of parathyroid
gland or due to autoimmune
disease
57. Treatment
57
o Estrogen administration with calcium
supplementation in combination with
Vitamin D to postmenopausal women –
reduce the risk of fracture
o Higher dietary intake of Ca (1.5mg/day) –
recommended for elderly
58. SODIUM
58
o Chief cation of extracellular fluid
o RDA - 5-10gm/day
o Absorption – mainly in GI tract & excreted
through kidney
o Functions
acid-base balance regulated
Maintain osmotic pressure & fluid balance
Normal muscle irritability & cell
permeability
59. Hypernatremia
59
o Elevation in serum sodium level
o Symptoms – increased blood volume & blood
pressure
o Occurs due to hyperactivity of adrenal cortex –
Cushing’s syndrome, prolonged use of cortisone,
ACTH, sex hormones & loss of water from the body -
dehydration
60. Hyponatremia
60
o Serum sodium levels fall
below the normal level
o Occurs due to – diarrhoea,
prolonged vomitting,
chronic renal disease and
adrenocortical
insufficiency (Addison’s
disease)
61. IRON
61
o Contains about 3-5gm in an adult individual
o 70% present in erythrocytes of blood – Hb; 5%
present in myoglobin of muscles
o RDA – 19.3–20.5mg/day in men; 17-
18.9mg/day in women
o Heme is the most predominant iron containing
substance
o Constituents of several proteins& enzymes –
hemoglobin, myoglobin, cytochrome, xanthine
oxidase
62. 62
o Non - heme iron is present in transferrin,
ferritin & hemosiderin
o Dietary iron is mainly absorbed in
stomach & duodenum
o Storage of iron – ferritin & hemosiderin
o Function – Hb & myoglobin require iron
for transport of O2 & CO2, electron
transport chain & effective
immunocompetence
63. Diseased state
63
o Iron deficiency anemia – most common
nutritional deficiency in growing children,
adolescent girls, pregnant and lactating
mothers
o Microcytic hypochromic anemia with reduced
Hb levels (<12g/dl)
o Retarded growth
o Loss of appetite
o Sluggish metabolic activity
64. 64
o Hemosiderosis – excessive iron in the body
deposited as ferritin and hemosiderin
o High intake of iron or repeated blood
transfusions in patients of hemolytic
anemia and hemophilia
o Hemochromatosis – iron is deposited in
tissues like liver, spleen, pancreas and skin
o Bronze pigmentation of skin (Bronze
diabetes), cirrhosis and pancreatic fibrosis
65. Phosphorus
65
o Adult male person contains 1kg of phosphorus
o Mostly combined with Ca to deposit in teeth and
bones (80%) whereas 10% is found in muscles &
blood in association with protein, carbohydrate
and lipids and remaining 10% in various
chemical compounds
o RDA – 700mg/day
o Absorption from jejunum
o Excretion from kidney
66. 66
o Functions – development of bones & teeth,
formation & utilistion of ATPs, formation of
phospholipids, phosphoprotein and nucleic
acids and maintenance of pH of blood
67. Magnesium
67
o Body contains 20gm of Mg
o 70% in combination with Ca and P; 30% in
soft tissues and body fluids
o RDA – 350mg/day
o Functions – Formation of bones and teeth,
cofactor for several enzymes requiring ATP –
Hexokinase and glucokinase and for proper
neuromuscular function
68. Diseased state
68
o Deficiency leads to neuromuscular irritation,
weakness and convulsions
o Low level of Mg leads to uremia, rickets and
abnormal pregnancy
69. Potassium
69
o Principal intracellular cation
o Absorption in GI tract
o RDA – 3500-4500mg/day
o Functions – maintains intracellular osmotic
pressure, regulation of acid base balance and
water balance in the cell, transmission of
nerve impulse, influence cardiac muscle
activities
70. Diseased state
70
o Hyperkalemia – increased serum
potassium levels; seen in renal
failure, addison’s disease
(adrenocortical insufficiency),
diabetic coma, severe dehydration
o Hypokalemia – decreased serum
potassium levels; overactivity of
adrenal cortex (Cushing’s
syndrome), prolonged cortisone
therapy, prolonged diarrhoea and
vomitting
71. Copper
71
o Body contains 100mg of copper
o RDA – 2-3mg/day
o Functions – essential component of several
enzymes – cytochrome oxidase and catalase,
important component of ALA synthase –
needed for heme synthesis, synthesis of
melanin and phospholipids, development of
bone & nervous system
72. Diseased state
72
o Deficiency leads to demineralisation of bone,
demyelination of nervous sytem, anemia,
fragility of arteries, hypopigmentation of
skin, graying of hair
o Menke’s disease – defect in the intestinal
absorption of copper - decreased copper in
plasma and urine, anemia, depigmentation
of hair
73. 73
o Wilson’s disease – abnormal copper
metabolism – copper deposited in liver and
brain leads to hepatic cirrhosis and brain
necrosis, low level of copper and
ceruloplasmin in plasma, increased excretion
of copper in urine, copper deposition in
kidney causes renal damage
74. Iodine
74
o Body contains 20mg of iodine
o 80% present in the thyroid gland as
iodothyroglobulin – contains thyroxin and
triiodothyronine
o RDA – 150ug/day
o Absorption in the small intestine
o Excretion through kidney
o Function – required for synthesis of T3 and T4
o Disorders – simple & toxic goitre
75. Zinc
75
o Total content in the body – 2gm
o Majority of content in the prostate gland
o RDA – 8-11mg/day
o Zn is mainly an intracellular element
o Zn deficiency – growth retardation, poor
wound healing, loss of taste sensation, loss
of appetite, depression
o Zinc toxicity – nausea, gastric ulcers,
pancreatitis, anemia, excessive salivation
76. Fluorine
76
o Mainly found in bones & teeth
o RDA < 2ppm; drinking water is the main
source
o Functions – prevents development of caries,
necessary for proper development of bones,
o Diseased states – dental caries, dental
fluorosis
77. CONCLUSION
Maintain a healthy life by
making sure your body is
receiving all the proper
vitamins and minerals it
needs to function correctly
Maintain a healthy mouth
since poor health may be a
link to health issues
including heart disease,
obesity, stroke, cancer
77