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 Systemic diseases | Document

استعرض الموضوع السابق استعرض الموضوع التالي اذهب الى الأسفل 
كاتب الموضوعرسالة
Dr.Insaf
المدير العام


انثى عدد الرسائل : 997
العمر : 33
الموقع : https://www.facebook.com/pages/Brush/187262171338671
المزاج : الحمد لله تمام
احترام المنتدى :
السنة الدراسية : Internal ship
تاريخ التسجيل : 07/02/2009

مُساهمةموضوع: Systemic diseases | Document   الإثنين فبراير 14, 2011 6:35 pm


[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]


Systemic diseases | Document


a very important guide for the 3rd and 4th year


.



Hi everyone!

..

Here in this page I will post a document for the systemic diseases

that helps you all to know any thing about any disease and how we should

manage it in the dental office!


...
.

.


[
Asthma ]


[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]
....................


Asthma is a chronic, ongoing lung disease marked by acute flare-ups or attacks of difficulty with breathing.




t is a common disease that can happen at any age but most often occurs during childhood and can continue into adulthood.




Characteristics of asthma include inflammation of the airways in the lungs. These include the bronchioles, small hollow passageways that branch off the main airway from the mouth and nose. Air and oxygen pass through the bronchioles into the alveoli, tiny hollow structures in the lungs where oxygen is absorbed in to the bloodstream. In asthma, bronchioles and alveoli become inflamed, irritated and swollen, blocking the flow of air into the lungs.






[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

The surrounding muscles react by tightening and further blocking the
flow of oxygen into the lungs and bloodstream. The airway also begins to
make more mucus than normal, which further blocks the airways and
compounds the problem with the intake of air.



*Symptomes*

Asthma symptoms can range from mild to life threatening. The hallmark symptoms include shortness of breath and wheezing. Wheezing
is a whistling sound that is created as air is forced through the
narrowed airways in the lungs of a person with asthma. Wheezing is often
heard when a person with asthma exhales, but may also be heard when a
person inhales. Some wheezing can be heard by the naked ear, but it is
not unusual to need to use a stethoscope
to hear it. In severe cases, it may be difficult to hear wheezing
because the airways have become so narrowed that there is not enough air
moving through them to create the sound.



Other typical symptoms of asthma chest tightness, cough, anxiety, pallor of the skin, and a "retracting" of the muscles.



* Causes *

The following conditions have been cited in various
sources as potentially causal risk factors
related to Asthma:

  • Low socioeconomic status
  • Poverty
  • Substandard housing
  • Indoor allergens
  • Lack of education
  • Inadequate access to health care

* Types *

Most people with asthma also have allergies. For these people, exposure to an allergen, a substance that triggers an allergic reaction such as animal dander, will also trigger asthma symptoms. This condition is frequently referred to as allergic asthma
or allergy-induced asthma. In some people, asthma symptoms can also be
induced by exercise. Today there are effective preventive treatments for
]exercise-induced asthma.
It is generally accepted that, under regular medical supervision, most
people with asthma can and should exercise. Nocturnal asthma occurs when
symptoms occur at night. Asthma symptoms are generally more likely to
occur at night.Occupational asthma
is due to exposure to irritating chemicals, often at work.
Cough-variant asthma is a form of asthma in which a dry, irritating
cough is the most prominent symptom.



* Diagnostic tests *

A diagnosis of asthma
is made only after a complete evaluation, history, and physical is done
by a health care professional. This will help to determine the type and
severity of asthma you have and the most appropriate and effective
treatment plan for you. Diagnostic testing can include lung function
tests, such as a spirometry, which measures how much air you are able
to move in and out of your lungs. This easy, painless, and noninvasive
breathing test is often done regularly to monitor how well treatments
are working. A chest X-ray
may be done, which can evaluate a number of factors, including the
presence of other conditions that may occur with or without asthma
symptoms, such as pneumonia, and bronchitis. A bronchoprovocation test
may also be performed to measure lung function after a variety of
factors that potentially provoke asthma symptoms are introduced to the
patient. Allergy testing
is also commonly performed to determine a person's individual
sensitivities to allergens, substances that trigger an allergic reaction
that can result in asthma symptoms.



* Complications *

The list of complications that have been mentioned in various sources
for Asthma includes:

  • School absenteeism (see Absenteeism)
  • Home confinement
  • Breathing difficulty
  • Hospitalization
  • Asphyxia
  • Death
  • Status asthmaticus - repeated bouts of asthma attacks without respite.



* Sequelae *


  • Cardiac arrest
  • Pneumothorax
  • Pectus carinatum
  • Short stature
  • Eosinophilia
  • Respiratory failure
  • Pulsus paradoxus
  • Bronchospasm
  • Chest hyperinflation
  • Chest expansion poor
  • Cough



* Prognosis *

Almost all asthma patients can become free of symptoms with proper
treatment. Patients and their families should expect nothing
less.


.....

TO BE CONTINUED,

[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]



[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]
الرجوع الى أعلى الصفحة اذهب الى الأسفل
http://bdsds.ahlamuntada.org
Dr.Insaf
المدير العام


انثى عدد الرسائل : 997
العمر : 33
الموقع : https://www.facebook.com/pages/Brush/187262171338671
المزاج : الحمد لله تمام
احترام المنتدى :
السنة الدراسية : Internal ship
تاريخ التسجيل : 07/02/2009

مُساهمةموضوع: رد: Systemic diseases | Document   الإثنين فبراير 14, 2011 6:42 pm

[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Dental management of asthmatic patient

..

Updating patients health
history at every visit
about these following factors will help
you identify the risk of an acute exacerbation:

[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]Frequency of asthmatic attacks
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]Precipitating agents
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]Types of pharmacotherapy used
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]Length of time since
an emergency visit owing to acute asthma

As a general rule, elective dentistry should be performed only on
asthmatic patients who are asymptomatic or whose symptoms are
well-controlled
.


The symptomatic person should not be
treated
, and the
presence of asthmatic symptoms such as coughing and wheezing necessitate
reappointment.

Be aware of the
potential for dental materials and products that exacerbate asthma. These
items include:


[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

dentifrices
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

fissure sealants
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

tooth enamel dust
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

methyl methacrylate
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

fluoride trays and cotton rolls also have
been implicated in
promoting asthmatic events
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]corticosteroid-dependent asthmatic people may have
a higher tendency for having an adverse reaction to sulfites
.

When an
asthmatic dental patient seeks care, the dental professional must:

[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Assess the patient's risk level by taking an oral history of the
illness.
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Ascertaining
the frequency and severity of acute episodes.
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Reviewing the patient’s
medications thoroughly (as they provide an indication of disease
severity).
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Determining the patient’s specific triggering agents.
It should be recognized that dental
treatment can invoke a significant decrease in pulmonary function
among
asthmatic patients. It has been demonstrated that there is a reduction of lung function in 15 percent of asthmatic
patients studied while receiving dental care.

During
Dental Treatment

The most likely times for an
acute exacerbation
are:




  1. During and immediately after local anesthetic
    administration.



  2. With stimulating procedures such as extraction,
    surgery,
    pulp extirpation.


At each visit
make sure:


[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Confirm that they have taken their most recent scheduled dose of
medication.
Inhaled corticosteroids are used for maintenance
therapy and do not improve an acute attack.
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

The patient’s own metered-dose inhaler bronchodilator
should be on hand at each visit to minimize the risk of an attack.
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Patient’s appointment should be in the
late morning or the
late afternoon.
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

If the asthmatic patient
does not use a bronchodilator, make sure the
emergency kit
has both a bronchodilator and oxygen .
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Prophylactic dose of b2
agonist bronchodilator could prevent diminished lung function during
dental treatment. The H1-blocking
antihistamines, too, have been shown to be useful in blunting the
bronchoconstrictor response with a pretreatment dose. Promethazine and
diphenhydramine have the benefit of being antiemetic and sedative as
well as antihistaminic.
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Anxiety is a known asthma trigger thus
the dental
environment is a common site for an acute asthmatic attack.
Therefore, it should be ascertained that the patient has taken his or
her most recent scheduled dose of antiasthma medication
before
treatmen
t.
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Additionally, substantive stress-management techniques should
be used.
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

The use of N2O
in patients with mild-to-moderate asthma can prevent acute stress
related symptoms.
However, because of its potential for causing airway irritation, N2O
is contraindicated for use in patients with severe asthma.

It is advisable to obtain a medical consultation before administering N2O
to such patients
.
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Consequently, patients with severe persistent asthma

and those who are prone to severe abrupt episodes of airway obstruction
are best given dental treatment in the hospital.
During treatment check
for:




  1. Improper positioning of suction tips


  2. If fluoride trays
    or cotton rolls could trigger a hyperreactive airway response in your
    patient.



  3. Rubber dams should be used cautiously to avoid
    possible respiratory compromise or aggravation.



  4. Avoid prolonged supine positioning.


  5. Bacteria-laden aerosols from plaque or carious lesions
    and
    ultrasonically nebulized water also can be asthma triggers in the
    dental
    setting.



  6. Additionally, aeroallergens such
    as tooth-enamel dust and methyl methacrylate have been reported to
    trigger asthmatic attacks.


Emergency
Protocol for Managing Asthmatic Exacerbation:




Assessment of Severity

Acute exacerbations are manifested by episodes
of bronchospasm and resulting hypoxia and hypercarbia.


Management
strategy is directed at determining the level of hypoxia and
correcting it
.


The following indicate that the
exacerbation is severe:

[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

peak expiratory flow rate, or PEFR, is at
or below 50 percent of reference value;

[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

oxygen saturation is below 91 percent;
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

bronchodilator does not improve PEFR by at
least 10 percent after two treatments;

[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

patient has difficulty speaking;
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

patient is struggling for
air
.

Managing an Acute Asthmatic
Attack



  1. Discontinue the dental procedure and allow the patient to
    assume a comfortable position.


  2. Establish and maintain a patent airway and administer b2
    agonists via inhaler or nebulizer.


  3. Administer oxygen 6-10 liters via face mask, nasal hood or cannula. If
    no improvement is observed and symptoms are worsening,
    administer epinephrine subcutaneously (1:1,000 solution, 0.01
    milligram/ kilogram of body weight to a maximum dose of 0.3
    mg).


  4. Document in time form the beginning of
    the event.


  5. Alert emergency medical services-911.

  6. Maintain a good oxygen level until the patient stops
    wheezing and/or medical assistance arrives
    .


  7. Begin diligent basic life support A,
    B,C,Ds activity as needed.


  8. Escort patient to hospital as needed.




General Oral Health Care
Instructions


[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Prescribe fluoride supplements
for all asthmatic patients
, but especially for those taking b2
agonists
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Instruct patients to rinse their
mouths after using an inhaler
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Reinforce oral hygiene
instructions
to help minimize gingivitis
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Be aware of possible need to
prescribe antifungal agents for patients who chronically use
nebulized corticosteroids
Summary
of Recommendations:


Before Treatment



  1. Schedule appointments for late
    morning or afternoon.


<li>

Assess severity of asthmatic
condition.


</li><li>

Consider antibiotic prophylaxis
for immunosuppressed patients

</li><li>

Consider corticosteroid
replacement for adrenally suppressed patients

</li><li>

Avoid using dental materials
that may elicit an asthmatic attack

</li><li>

Have supplemental oxygen and
bronchodilators
available in case of acute asthmatic exacerbation
</li>

During Treatment

[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Use vasoconstrictors judiciously
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Avoid using local anesthetics
containing sodium metabisulfite
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Use rubber dams cautiously
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Avoid eliciting a coughing
reflex
[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]

Use techniques to reduce the
patient’s stress:



<table width="100%" border="0" cellpadding="0" cellspacing="0"><tr><td valign="baseline" width="42">[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]</td><td valign="top" width="100%">

Avoid using barbiturates
</td></tr><tr><td valign="baseline" width="42">[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]</td><td valign="top" width="100%">

Avoid using nitrous oxide in
people with severe asthma
</td></tr></table>


After Treatment



  1. Be aware that some patients may
    have an adverse reaction to nonsteroidal anti-inflammatory drugs.



  2. Use tetracycline cautiously.


  3. Avoid use of erythromycin in
    patients taking theophylline.



  4. Avoid use of phenobarbitals in
    patients taking theophylline.



  5. Analgesic of choice for these patients is acetaminophen.

Oral
health care providers play a role that is important in terms of
both the patient's overall health and the systemic condition's
effect on oral health.



........

From [ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذا الرابط] and

[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذا الرابط]


.

[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]


[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]
الرجوع الى أعلى الصفحة اذهب الى الأسفل
http://bdsds.ahlamuntada.org
safdar
مشرف قسم القرآن الكريم
مشرف قسم القرآن الكريم


ذكر عدد الرسائل : 73
العمر : 96
المزاج : 100 %
السنة الدراسية : 2nd Grade Dentistry
تاريخ التسجيل : 04/12/2010

مُساهمةموضوع: رد: Systemic diseases | Document   الإثنين فبراير 14, 2011 8:43 pm


مجهود رائع , شكرا Dr.Insaf


بسم الله الرحمن الرحيم

( الحمد لله الذي له ما في السماوات وما في الأرض وله الحمد في الآخرة وهو الحكيم الخبير ( 1 ) يعلم ما يلج في الأرض وما يخرج منها وما ينزل من السماء وما يعرج فيها وهو الرحيم الغفور ( 2 ) )


[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]
الرجوع الى أعلى الصفحة اذهب الى الأسفل
Dr.Insaf
المدير العام


انثى عدد الرسائل : 997
العمر : 33
الموقع : https://www.facebook.com/pages/Brush/187262171338671
المزاج : الحمد لله تمام
احترام المنتدى :
السنة الدراسية : Internal ship
تاريخ التسجيل : 07/02/2009

مُساهمةموضوع: رد: Systemic diseases | Document   الثلاثاء مارس 01, 2011 4:49 pm

safdar كتب:

مجهود رائع , شكرا Dr.Insaf

أهلا .. Safdar

العفو

الرجوع الى أعلى الصفحة اذهب الى الأسفل
http://bdsds.ahlamuntada.org
Dr.Insaf
المدير العام


انثى عدد الرسائل : 997
العمر : 33
الموقع : https://www.facebook.com/pages/Brush/187262171338671
المزاج : الحمد لله تمام
احترام المنتدى :
السنة الدراسية : Internal ship
تاريخ التسجيل : 07/02/2009

مُساهمةموضوع: رد: Systemic diseases | Document   الثلاثاء مارس 01, 2011 5:08 pm


[ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]


[Diabetes]

..

.


*Introduction*

Diabetes,
also known as diabetes mellitus, is a general term for a
variety of different metabolic disorders that affect the ability of
the body to process and use sugar properly. Medically, this is referred to as
an inability of the body to metabolize
glucose effectively. This results in an abnormally high level of glucose in the
blood, called hyperglycemia.


*Causes*

Diabetes is
caused by a defect in production or use of insulin, a hormone secreted from the
pancreas.
Type 1
diabetes
is caused by autoimmune-mediated destruction of the
insulin-producing cells of the pancreas. Type 2
diabetes
is related to excess weight, inactivity, and a family
history of (type 2) diabetes.


*Symptoms*

Symptoms of
diabetes can be vague or very dramatic, depending on the individual and the
type of diabetes. Both type 1 diabetes and type
2 diabetes
can present with excessive thirst,
excessive urination,
fatigue, weakness, weight loss, and blurred vision.


*Types*

The full
scientific name of the condition is "diabetes mellitus"
and there are various subtypes. Type
1 diabetes
or juvenile diabetes is the classic insulin-requiring
severe diabetes of young people, but is less common than Type
2 diabetes
or adult diabetes, which typically afflicts overweight
over-40's. About 90-95% of diabetics have Type 2 diabetes and when many people
say "diabetes" they are often referring to Type 2 diabetes. One of
the most important early aspects of diabetes diagnosis (and misdiagnosis) is to
correctly distinguish between Type 1 and Type 2 diabetes. Another type that is
common in pregnant women is gestational diabetes. Other types of diabetes
that are rare but may be misdiagnosed initially include MODY and other genetic types of diabetes.
Secondary diabetes is caused by an underlying condition such as hemochromatosis, PCOS,
or other conditions or medications.

...

Diabetes Types 1

Type 1
diabetes is a metabolic disorder that is also known by the name
juvenile diabetes or insulin-dependent diabetes. In type 1 diabetes the
pancreas, an endocrine gland
in the abdomen, does not produce enough of the hormone insulin or stops making
it altogether. Insulin is vital to the process of moving glucose from the
bloodstream into the body's cells, where it is used for energy. It also is
needed to help the liver to store excess glucose.
Without
sufficient insulin, the body is unable to process and use sugar properly to
produce the energy that the body needs. Medically, this is known as an
inability to metabolize
glucose, which results in an abnormally high level of glucose in the blood,
called hyperglycemia.


Diabetes type 2


Type 2
diabetes is a metabolic disorder in which the body does not
respond to the effects of the hormone insulin. This is known as insulin resistance. In addition, some people with
type 2 diabetes also may not produce sufficient amounts of insulin in the
pancreas.

The role of
insulin is to facilitate movement of sugar (glucose) from the bloodstream into
the body's cells, where it is used for energy. Insulin also helps the liver to
store excess glucose. When the body cannot process and use glucose properly,
the body's cells do not get the energy they need. Medically, this is known as
an inability to metabolize
glucose, which results in an abnormally high level of glucose in the blood,
called hyperglycemia.


Gestational diabetes

Gestational diabetes is a specific form of diabetes that
develops during pregnancy. Gestational diabetes is marked by high blood sugar
levels and is a risk factor for the development of type 2 diabetes
later in life. Complications of untreated gestational diabetes
can be serious and include the development of preeclampsia
in the mother and developmental problems, respiratory
distress syndrome, and excessive growth of the baby.


Gestational
diabetes can occur as a result of the normal hormonal changes a pregnant
woman's body experiences. During pregnancy, the placenta produces hormones that
interfere with the actions of the hormone insulin. In a normal pregnancy, the
woman's pancreas,
the gland that produces insulin, can compensate for this by making additional
insulin during pregnancy. However, if the pancreas cannot keep up with the
body's demand for more insulin, gestational diabetes may develop.

MODY diabetes


Maturity Onset Diabetes of the Young
(MODY) is a form of diabetes that is genetically inhereted. Whereas most types of diabetes only have genetic inheritance
as a "risk factor",
MODY is more strongly inherited. MODY is similar to Type II
diabetes
in its severity, leading to a form of insulin
deficiency. Whereas typical Type 2 diabetics
are over-forty and over-weight,
a MODY patient is typically in teens or twenties and is thin.



*Diagnostic tests*

The list of
diagnostic tests mentioned in various sources as used in the diagnosis of Diabetes includes:


  • Physical Examination
  • Urine sugar test
  • Urine ketones test
  • Oral Glucose Tolerance Test
    (OGTT) - also called "glucose challenge" test.
  • Blood glucose tests

    • Fasting plasma glucose (FPG)
    • Random plasma glucose
    </li>
  • C-peptide blood test
  • Insulin level blood test
  • Self-managed blood glucose
    testing

    • Fingerprick blood drop blood
      glucose tests
    • Urine glucose home testing
    • Urine ketone home testing
    </li>
  • See also the various tests for complications of diabetes such as:

    • Diabetes eye tests - see also tests for diabetic retinopathy
    • Kidney tests - see also tests for diabetic
      nephrophathy
    • Nerve tests - see also tests
      for diabetic neurophathy
    • Foot tests - see also tests for diabetic
      peripheral neurophathy
    • Reflex tests - also for diabetic
      neurophathy
    • Foot reflex test
    • Knee reflex test
    </li>
  • Other tests for associated conditions or other problems:

    • Cholesterol blood tests
    • Blood lipid tests
    • Liver function tests
    • Thyroid tests - see also tests for thyroid conditions
    </li>
  • Type 1 diabetes antibody tests

    • Glutamic Acid Decarboxylase
      (GAD) antibody tests - tests for Type 1 diabetes antibodies.
    • Islet cell antibody (ICA)
      tests
    • Insulin antibody tests
    </li>
  • Tests for conditions related to
    Type 1 diabetes

    • TSH blood test - tests thyroid function;
      see tests for thyroid conditions
    • Vitamin B12 blood test - test for
      pernicious anemia and other digestive problems
    </li>
  • Tests for ongoing monitoring of
    diabetes control:

    • HbA1c blood test - an average blood sugar
      measure over about 3 months.
    • Fructosamine blood test - an average blood
      sugar measure over about 2 weeks
    </li>
  • Tests to detect initially and
    then regularly screen for diabetes complications:

    • Lipids and cholesterol - used
      to test risks of heart disease from diabetes.
    • Blood pressure tests
    • Eye tests
    • Foot tests
    • Urine protein test - tests for kidney
      problems.
    • Microalbumin urine test - also called
      "microalbuminurea" test; detects early kidney problems.
    </li>

.....

To be continued,



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Dr.Insaf
المدير العام


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مُساهمةموضوع: رد: Systemic diseases | Document   الثلاثاء مارس 01, 2011 5:20 pm


*Treatment*



At this
time, there is no cure for diabetes, but with careful, medically monitored
management, diabetes can be successfully managed, minimizing complications and
allowing people with diabetes to live a normal active life. Treatment of all
types of diabetes includes regular monitoring of blood sugar
levels
, following a well-balanced healthy diet and regular aerobic exercise
program recommended by your health care
provider
. It is also important not to smoke and to follow your
health care provider's advice on preventing, monitoring, and treating any
coexisting medical conditions, such as hypertension and high cholesterol.


Type
1 diabetes
is always managed with injected insulin. A new treatment
that may be an option for some people with type
1 diabetes
is pancreatic
islet transplantation.
This experimental surgery transplants insulin-producing beta cells from a donor
into the pancreas of a person with type
1 diabetes
.


Type
2 diabetes
is often managed with oral antidiabetic drugs,
such as glipizide,
glyburide,
and metformin.
Pregnant women with gestational diabetes may be treated with
glyburide, and some people with type
2 diabetes
or gestational diabetes may need insulin injections.




*Complications*



The list of
complications that have been mentioned in various sources for Diabetes
includes:


  • Short-term complications

    • Hypoglycemia - does not occur from diabetes
      itself but from the treatments for diabetes (pills or insulin).
    • Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)
      - a dangerous syndrome from high blood sugars; typically in Type 2
      diabetics at diagnosis or non-compliant to treatment.
    • Diabetic Ketoacidosis (DKA) - a dangerous
      condition due to high blood sugars; typically in Type 1 diabetics at
      diagnosis or non-compliant to treatment.
    • Diabetic lens - vision distortions from
      high blood sugars; usually reverses when sugars controlled.
    • Hyperinsulemia - insulin in the blood rises
      due to insulin resistance.

  • Kidney complications

    • Diabetic nephropathy

  • Eye complications

    • Diabetic retinopathy
    • Diabetic lens

  • Foot complications

    • Diabetic peripheral neuropathy
    • Foot ulcers (type of Ulcer)
    • Foot gangrene
    • Foot amputation

  • Neuropathy - various nerve complications
    affecting different parts of the body:

    • Diabetic neuropathy
    • Peripheral neuropathy
    • Distal symmetrical
      polyneuropathy (type of Neuropathy)
    • Hand neuropathy
    • Autonomic neuropathy
    • Sexual neuropathy
    • Impotence
    • Vaginal dryness
    • Eye neuropathy
    • Bladder neuropathy (type of
      Neuropathy)
    • Vascular neuropathy - blood vessel
      neuropathy
    • Sweat gland neuropathy (type
      of
      Neuropathy)
    • Balance problems (Dizziness)
    • Breathing problems
    • Cranial Mononeuropathy (type
      of
      Neuropathy)
    • Radiculopathy - affecting roots of the
      spinal nerves.
    • Proximal Motor Neuropathy
      (Diabetic Amyotrophy) (type of Neuropathy)
    • See also types of neuropathy

  • Digestive complications

    • Diabetic gastroparesis
    • Diabetic diarrhea

  • Heart complications

    • Diabetic heart disease
    • Heart disease
    • Cardiac neuropathy

  • Cerebrovascular disease
  • Stroke

    • Pregnancy-related mother
      complications of diabetes
    • Toxemia of pregnancy (type
      of
      Toxemia) - a higher risk of toxemia than
      non-diabetic pregnancies.

  • Pregnancy-related baby
    complications of diabetes

    • Birth defects - the risk is about 4 times
      higher than normal.
    • Macrosomia (large baby)
    • Neonatal hypoglycemia

  • Dental complications
  • Acanthosis nigricans
  • See also complications of insulin resistence
  • Abscess





....

To be continued,

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http://bdsds.ahlamuntada.org
Dr.Insaf
المدير العام


انثى عدد الرسائل : 997
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تاريخ التسجيل : 07/02/2009

مُساهمةموضوع: رد: Systemic diseases | Document   الثلاثاء مارس 01, 2011 5:32 pm


Dental management

Medical history.

It is important for clinicians to take a good medical historyand assess glycemic control at the initial appointment. Theyshould ask patients about recent blood glucose levels and frequencyof hypoglycemic episodes. Antidiabetic medications, dosagesand times of administration should be determined. A varietyof other concomitantly prescribed medications may alter glucosecontrol through interference with insulin or carbohydrate metabolism.The hypoglycemic action of sulfonylureas may be potentiatedby drugs that are highly protein-bound, such as salicylates,dicumerol, ß-adrenergic blockers, monoamine oxidaseinhibitors, sulfonamides and angiotensin-converting enzyme inhibitors.Epinephrine, corticosteroids, thiazides, oral contraceptives,phenytoin, thyroid products and calcium channel–blockingdrugs have hyperglycemic effects.

<blockquote>In general, morning appointments are advisable since endogenouscortisol levels are generally higher at this time.
</blockquote>
Patients undergoing major surgical procedures may require adjustmentof insulin dosages or oral antidiabetic drug regimens. Any complicationsof DM, such as cardiovascular or renal disease, will have theirown effects on dental treatment planning. If necessary, thedentist should consult with the patient’s physician.
Scheduling of visits.

In general, morning appointments are advisable since endogenouscortisol levels are generally higher at this time (cortisolincreases blood sugar levels). For patients receiving insulintherapy, appointments should be scheduled so that they do notcoincide with peaks of insulin activity, since that is the periodof maximal risk of developing hypoglycemia.

Diet.

It is important for clinicians to ensure that the patient haseaten normally and taken medications as usual. If the patientskips breakfast owing to the dental appointment but still takesthe normal dose of insulin, the risk of a hypoglycemic episodeis increased. For certain procedures (for example, conscioussedation), the dentist may request that the patient alter hisor her normal diet before the procedure. In such cases, themedication dose may need to be modified in consultation withthe patient’s physician.

Blood glucose monitoring.

Depending on the patient’s medical history, medicationregimen and procedure to be performed, dentists may need tomeasure the blood glucose level before beginning a procedure.This can be done using commercially available electronic bloodglucose monitors, which are relatively inexpensive and havea high degree of accuracy. Patients with low plasma glucoselevels (< 70 mg/dL for most people) should be given an oralcarbohydrate before treatment to minimize the risk of a hypoglycemicevent. Clinicians should refer patients with significantly elevatedblood glucose levels for medical consultation before performingelective dental procedures.

During treatment.

The most common complication of DM therapy that can occur inthe dental office is a hypoglycemic episode. If insulin or oralantidiabetic drug levels exceed physiological needs, the patientmay experience a severe decline in his or her blood sugar level.The maximal risk of developing hypoglycemia generally occursduring peak insulin activity. Initial signs and symptoms includemood changes, decreased spontaneity, hunger and weakness. Thesemay be followed by sweating, incoherence and tachycardia. Ifuntreated, possible consequences include unconsciousness, hypotension,hypothermia, seizures, coma and death.

If the clinician suspects that the patient is experiencing ahypoglycemic episode, he or she should terminate dental treatmentand immediately administer 15 grams of a fast-acting oral carbohydratesuch as glucose tablets or gel, sugar, candy, soft drinks orjuice. It is important to note that the [ندعوك للتسجيل في المنتدى أو التعريف بنفسك لمعاينة هذه الصورة]-glucosidase inhibitorsprevent the hydrolysis of sucrose into fructose and glucose.Therefore, a hypoglycemic episode in a patient taking thesedrugs should be treated with a direct source of glucose. Afterimmediate treatment, dentists should measure blood glucose levelsto confirm the diagnosis and determine if repeated carbohydratedosing is needed. If the patient is unable to swallow or losesconsciousness, the dentist should seek medical assistance; 25to 30 mL of a 50 percent dextrose solution or 1 mg of glucagonshould be administered intravenously. Glucagon also can be injectedsubcutaneously or intramuscularly.7

<blockquote>It is important for dentists to educate patients about the oralimplications of diabetes mellitus.
</blockquote>
Severe hyperglycemia associated with type 1 ketoacidosis ortype 2 hyperosmolar nonketotic state usually has a prolongedonset. Therefore, the risk of a hyperglycemic crisis is muchlower than that of a hypoglycemic crisis in a dental practicesetting. Ketoacidosis may develop, with nausea, vomiting, abdominalpain and an acetone odor. Definitive management of hyperglycemiarequires medical intervention and insulin administration. However,it may be difficult to differentiate between hypoglycemia andhyperglycemia based on symptoms alone. Therefore, the dentistshould administer a carbohydrate source to a patient in whoma presumptive diagnosis of hypoglycemia is made. Even if thepatient is undergoing a hyperglycemic episode, the small amountof additional sugar is unlikely to cause significant harm.7The clinician should measure blood glucose levels after immediatetreatment.
After treatment.

Clinicians should keep in mind these postoperative considerations.Patients with poorly controlled DM are at greater risk of developinginfections and may demonstrate delayed wound healing. Acuteinfection can adversely affect insulin resistance and glycemiccontrol, which, in turn, may further affect the body’scapacity for healing. Therefore, antibiotic coverage may benecessary for patients with overt oral infections or for thoseundergoing extensive surgical procedures.


If the dentist anticipates that normal dietary intake will beaffected after treatment, insulin or oral antidiabetic medicationdosages may need to be appropriately adjusted in consultationwith the patient’s physician. Salicylates increase insulinsecretion and sensitivity and can potentiate the effects ofsulfonylureas, resulting in hypoglycemia. Therefore, aspirinand aspirin-containing compounds generally should be avoidedfor patients with DM.

.

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مُساهمةموضوع: رد: Systemic diseases | Document   الثلاثاء مارس 01, 2011 7:27 pm

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مُساهمةموضوع: رد: Systemic diseases | Document   الثلاثاء مارس 01, 2011 9:19 pm

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