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Rheumatological diseases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],4/11/2011 Mohamed Abdelhakim, NYUCD 2013
Rheumatoid Arthritis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],4/11/2011 Mohamed Abdelhakim, NYUCD 2013
Clinical presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],4/11/2011 Mohamed Abdelhakim, NYUCD 2013
Cell-derived mediators: arachidonic acid metabolite inhibition Phosphatidylcholine Arachidonic acid Phosphatidyl inositol–P 2 Cycloxygenase pathway Lipoxygenase pathway ,[object Object],[object Object],[object Object],[object Object],[object Object],HPETES Leukotriene A 4 HETES LTB 4 LTC 4 ↓ LTD 4 ↓ LTE 4 SRS-A P-lipase A 2 P-lipase C Aspirin, COX-2 inhibitors, NSAIDS corticosteroids Zileutin  4/11/2011 Mohamed Abdelhakim, NYUCD 2013
Treatment ,[object Object],[object Object],[object Object],4/11/2011 Mohamed Abdelhakim, NYUCD 2013
Treatment cont. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],4/11/2011 Mohamed Abdelhakim, NYUCD 2013
Dental implications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],4/11/2011 Mohamed Abdelhakim, NYUCD 2013
Dental management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],4/11/2011 Mohamed Abdelhakim, NYUCD 2013
Osteoarthritis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],4/11/2011 Mohamed Abdelhakim, NYUCD 2013
Management 4/11/2011 Mohamed Abdelhakim, NYUCD 2013
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],4/11/2011 Mohamed Abdelhakim, NYUCD 2013
Sjogren syndrome ,[object Object],[object Object],[object Object],4/11/2011 Mohamed Abdelhakim, NYUCD 2013

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rheumatological diseases

Notes de l'éditeur

  1. Celebrex failed to establish superiority to traditional NSAIDs in reducing GIT side effects Cardiovascular effects include heart attach, thromboemboli and strokes Systemic vs Injectable glucocorticoids Systemic causes adrenal suppression, impaired wound healing, and infections and it causes steroid diabetes (hyperglycemia)
  2. The disease affects the hand joints which in turn impairs the manual dexterity, and reduces the patients ability for oral hygiene, which may lead to caries and perio disease There is a systemic link between periodontal disease and arthritis since both of them are inflammatory diseases and associated with increase of inflammatory markers such as CRP The disease affects the hand joints which in turn impairs the manual dexterity, and reduces the patients ability for oral hygiene, which may lead to caries and perio disease There is a systemic link between periodontal disease and arthritis since both of them are inflammatory diseases and associated with increase of inflammatory markers such as CRP Varying degrees of pain and discomfort: sitting or semisupine position with frequent position changes. Short appointments. C1-C2 instability may lead to spinal nerve compression. Physical support such as pillow or rolled towel.
  3. Aspirin and Ibuprofen block cox irreversibly for 10 days. Other NSAIDS for 2-3 days. If bleeding time is less than 20 minutes, you can do minor surgeries. More than 20 minutes, consult the physician. Bone marrow suppression: CBC with differential WBCs and bleeding time. Abnormal results must be discussed with the physician.
  4. Also known as degenerative arthritis 17 millions have painful degenerative arthritis. It’s the lading cause of disabiltiy in the US. Heberden’s nodes are bone outgrowths in the distal interphalanges. Actually most of autoimmune diseases are more common in females except for type I DM which is equal. Etiology: normal wear and tear. Genetics, trauma and obesity. The cartilage becomes thicker as a repair method. May last for year. Ultimately the joint thins out.bone becomes polished and sclerotic and resemble ivory. The most two common complications are pain and disability. Heberden’s nodes may occasionally be painful. There is narrowing of the joint space TMJ changes with age anyway, but it could be affected with OA causing unilateral pain. Crepitus can also happen.
  5. Treatment is mainly analgesic. Acetaminophen is the drug of choice since there is no remarkable inflammation but this may change depending of the patients liver condition. Also they might not be effective sometimes so we can switch to NSAIDs or Acetaminophen. Opioids for acute flares and used for a short period.
  6. 1ry generalized OA is a type that can involve a group of joints.
  7. This is basically an autoimmunity against lacrimal and salivary glands which causes a chronic inflammation. Our body is not very smart in terms of how it responds to chronic inflammation. The salivary glands end up healing with fibrosis. And on biopsy we see CD4 lymphocytes. The same thing happens with HIV as well, but we see CD8 lymphocytes instead. Xerostomia causes cervical and incisal caries as well.