Importance of Oral Care Before, During and After Chemotherapy

                                 https://www.austinpublishinggroup.com/pediatric-oncology/

Within the most current concepts of health, it is of fundamental importance to consider the patient in a holistic manner. A multidisciplinary team should form the oncology group, especially in the hospital setting. The role of a dentist on this team is to diagnose, prevent and minimize the immediate effects of chemotherapy and/or radiotherapy as well as identify the effects of treatment to improve the quality of life of patients.

The objective of the protocol is to establish a standard for the care of patients with cancer. Emphasize the importance of oral health, in support for outcomes associated with oral care health, the knowledge of oral health for effectiveness in continuing the therapeutic treatment of cancer and awareness of effects acute and late in the mouth from cancer therapy: prevention of local and systemic infections, control pain, maintain oral functions, reduce side effects and improve the quality of life of patients.

Hematopoietic Stem Cell Transplantation (HSCT) is a procedure that requires conditioning to high doses of chemotherapy and/or radiotherapy. Dental treatment prior of HSCT is important. The oral mucosa and teeth should be examined using panoramic radiography to document oral status prior to HSCT. Moreover, such patients need to develop a specific oral hygiene regimen, the instructions for which should be clear and concise. Motivation and understanding with regard to oral care can have a considerable impact during HSCT. Bacterial plaque should also be evaluated, as this is a key factor to the development of gingival and periodontal disease and can contribute to acute infection as well as systemic disorders.

Interdisciplinary Protocols for Timely Assessment and Management of Delirium Symptoms

                               https://www.austinpublishinggroup.com/palliative-care/

Deliriumis an epidemic among hospitalized adult patients, with an incidence of up to 64% in high risk populations such as patients in intensive care who are ventilated and patients receiving anesthetics and sedation. It is one of the most common neuro-psychiatric complications experienced by palliative care patients. Patients predisposed to delirium tend to be ill, frail and/or elderly. Delirium is generally the result of multiple contributory factors which are easily recognized and potentially modifiable. Yet, symptoms are under recognized and delirium is under-diagnosed, with up to 84% of physicians and 30% of nurses missing the diagnosis in hospitalized patients. Variable symptom presentation contributes to the challenge of detecting delirium and it is frequently misdiagnosed as “sedation”, “confusion” or “anxiety”.

Deliriumincreases per patient cost by approximately $24,000 and results in up to 8 additional hospital days. Total United States health care costs for delirium are estimated to be as high as $152 billion dollars which is equal to the combined annual cost of both nonfatal falls and diabetes. This fiscal cost does not consider the suffering endured by afflicted patients and families. Up to 80% of those who remember their delirious episode report it to be the worst nightmare of their lives. Some patients experience a post delirium cognitive decline that may be permanent or progressive, especially in the case of preexisting dementia. The distress that occurs in delirium is multidimensional for all involved. Severe distress has been reported by 76% of family members and 73% of nurses caring for patients with delirium. There may be worry on the part of patients’ families that their loved one is “going crazy” and that the change will be permanent. Delirium may also result in the loss of patient dignity and complicates discharge planning. Family members often feel a sense of helplessness, frustration and guilt. For the health professional, delirium symptoms are difficult to assess and manage.

MDT Spasticity Assessment

                           https://www.austinpublishinggroup.com/pediatrics-child-health-care/

We do inject our patients with Botulinum Toxin for their spa limbs following their neurological illness. To improve the multidisciplinary team and to improve the functional Ou management, now we developed a multidisciplinary approach includes them being seen in the ward round by the multidisc them for their spasticity together and make a management their goals in mind. We designed a Performa for each patient management to be filled via MDT approach and be reviewed.

We developed a multidisciplinary approach for these patient being seen in the ward round by the multidisciplinary team spasticity together and make a management plan according mind. We designed a Performa for each patient who needs filled via MDT approach and be reviewed accordingly. The timescale for this project was from October 2015 to Ja audit to make sure we achieved the goals and made the se implemented accordingly.

Epidemiology of Acinetobacter baumannii Infection in a University Hospital

                                https://www.austinpublishinggroup.com/pathology-microbiology/

AcinetobacterBaumannii is a gram-negative coccobacillus. it is an opportunistic pathogen in immunocompromised patients, that attracted considerable attention for the last 40 years as the most important emerging bacterial pathogen. this is explained by its ability to colonize the biotic and abiotic surfaces with high resistance to disinfectants but also to desiccation by formation of biofilms. baumannii currently occupies an important place in hospital pathology globally, with an important role in potentially epidemic nosocomial infection. indeed, infections due to a. baumannii are frequent and severe with high morbidity and mortality. a. baumannii is also characterized by its ability to over-regulate its innate resistance mechanisms, but above all to acquire new resistance mechanisms whose diversity is impressive with various genetic supports. therefore, the therapeutic options for this bacteria are very limited. knowledge of local epidemiology is essential to monitor trends in antibiotic resistance, in order to determine the magnitude of this phenomenon, to adapt the protocols of probabilistic antibiotic therapy and to evaluate actions to fight this bacterium. the aim of this study is to determine, through a 6 year descriptive study (from 2010 to 2015), the evolution of the epidemiological profile of a. baumannii isolated at the university hospital mohammed vi in marrakech (morocco) and evaluate levels of resistance to different antibiotics.

Mercury Emission Abatement Strategies of China’s Coal-Fired Power Plants

                               https://www.austinpublishinggroup.com/austin-public-health/

Mercuryand its compounds are highly toxic to humans, especially to the developing nervous system. They are also harmful to ecosystems and wildlife populations. Microbial metabolism of deposited mercury can create methylmercury, which has the capacity to collect in organisms (bioaccumulate) and to concentrate up food chains (biomagnify), especially in the aquatic food chain. Methylmercury is a well-documented neurotoxicant, which may in particular cause adverse effects on the developing brain. It readily passes both the placental barrier and the blood-brain barrier; therefore, exposures during pregnancy are of highest concern. It may also cause adverse effects on the cardiovascular system, thereby leading to increased mortality. Methylmercury compounds are considered possible carcinogenic to humans according to the International Agency for Research on Cancer. Furthermore, inhalation of elemental mercury vapour causes symptoms such as tremors, insomnia, memory loss, neuromuscular changes, and headaches. Kidney and thyroid may be affected.

Mercuryin the atmosphere is divided into three inorganic forms   i.e. the elemental mercury reactive gaseous mercury and particulate mercury. Hg0 is the main chemical speciation of atmospheric mercury, which constitutes the majority of the mercury in the atmosphere over 95%. As Hg0 has very low solubility in water and its chemical reaction rate is very slow with other components in the atmosphere such as the strong oxidant O3, H2O2, OH and NO3 radicals Hg0 has a long atmospheric lifetime  and can be transported through the atmosphere over thousands of kilometers.

Mucinous Adenocarcinoma of Bladder; a Primitive not to Disregard

                                       https://www.austinpublishinggroup.com/austin-pathology/

Bladdercancer is the second most common tumor in genitourinary tract. Adenocarcinoma represent less than 2% of all bladder cancers, mucinous variant is even more rare. They are characterized by a very aggressive behaviour and are not very sensitive to radio and chemotherapy. They exhibit histological features similar to those from other sites and adenocarcinoma of urachus, making diagnosis difficult, hence the primary role of immunohistochemistry in determining primitive site. Because of its rarity and these difficulties, diagnosis is always delayed. We report the case of an 80-year-old woman with no pathological history who consulted for total hematuria. The physical examination revealed a slight hypogastric sensibility.

Ultrasoundshowed a thickening of the bladder wall with a heterogeneous content from which the indication of a computerized tomography scan that showed presence of a bladder tumor process without repercussion on the upper urinary tract. A transurethral resection of the tumor is performed. Pathological study suggested the initial diagnosis of a mucinous adenocarcinoma infiltrating bladder muscle. An immunohistochemical study was performed, having objectified the positivity of tumor cells to cytokeratin 20 but cytokeratin 7 was negative. Cytoplasmic staining of the tumor cells with loss of nuclear expression of beta Cathenin confirmed the primitive character. Patient was readmitted after 6 months for radical treatment. She had a pelvic anterior flap with an lymph node iliac dissection and a urinary diversion with cutaneous ureterostomy.

Albright’s Hereditary Osteodystrophy: a Rare Cause of Hip Avascular Necrosis: a Case Report

                              https://www.austinpublishinggroup.com/pediatric-endocrinology/

Pseudohypoparathyroidism is a rare disease that was discovered initially by Fuller Albright and his colleagues in 1942 when they found group a of patients who presented with pictures of hypoparathyroidism (hypocalcemia, hyperphosphatemia) but their calcium and phosphate level failed to show responses after repeated injections of bovine parathyroid extract. It was concluded that the mechanism was end organ resistance that primarily impairs the renal actions of PTH, rather than deficiency in the hormones. PHP was divided into type 1 and type 2, and type 1 subdivided to 1a, 1b, 1c, with the most common form being type 1a. Presence of some distinctive features (short stature, rounded face, obesity, cutaneous ossification and metacarpophalangeal abnormalities) along with parathyroid hormone resistance indicate that which is known as Albright’s Hereditary Osteodystrophy.

PHP-1a is caused by heterozygous loss-of-function mutations in the Gs-alpha isoform of the GNAS gene on the maternal allele, which results in expression of the protein only from the paternal allele. Pseudopseudo hypoparathyroidism (PPHP) is a similar disorder characterized by features of AHO but with normal biochemistry and is caused by “mutations resulting in loss of function of the Gs-alpha isoform of the GNAS gene on the paternal allele and resultant expression of the protein only from the maternal allele”. Patients with type 1b have Renal PTH resistant hypocalcaemia and hyperphosphatemia, and imprinting/methylation defects at the GNAS locus, but they lack the features of AHO.