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Neonatal Teeth

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123. Oral Health Care During Pregnancy and Through the Lifespan

the maintenance of good oral health habits throughout their lives as well as the safety and importance of oral health care during pregnancy. Introduction The 2000 Surgeon General’s report Oral Health in America , stated that a “silent epidemic of oral diseases is affecting our most vulnerable citizens,” including the poor and many members of racial and ethnic minority groups ( ). Oral health, which includes health of the gums, teeth, and jawbone, is a “mirror for general health and well-being” (1). The World (...) Association recommends that prophylaxis for dental procedures is reasonable only for patients with heart conditions that place them at the highest risk of adverse outcomes from endocarditis ( ). For patients with these conditions, prophylaxis is reasonable for all dental procedures that involve manipulation of gingival tissue or the periapical region of teeth or perforation of the oral mucosa (12). It is important for patients to discuss screening for oral cancer with their dentists. Although the U.S

2013 American College of Obstetricians and Gynecologists

124. An evidence advent calendar!

about modest improvements in people’s diets, at least up to about a year. If you do indulge in some Christmas pudding, which we’ve been eating in some shape or form since the 15th century, better make sure you clean your teeth afterwards (though obviously that wasn’t a priority in the 1400’s, even for those who had teeth and weren’t just sucking on their meat-or-fish-with-fat-and-dried-fruit horror pudding). There’s some pretty decent this month that using a triclosan/copolymer fluoride toothpaste (...) that ibuprofen and paracetamol combined provide better pain relief than the same dose of either drug alone and with a smaller chance of needing more over about eight hours, or of experiencing side effects. These are the findings of a , which found three randomized trials exploring these painkillers in people after they had wisdom teeth surgically removed. This is often used to investigate the effectiveness of painkillers as the results are applicable to other forms of acute pain after trauma. Stay safe

2013 Evidently Cochrane

125. An evidence advent calendar!

about modest improvements in people’s diets, at least up to about a year. If you do indulge in some Christmas pudding, which we’ve been eating in some shape or form since the 15th century, better make sure you clean your teeth afterwards (though obviously that wasn’t a priority in the 1400’s, even for those who had teeth and weren’t just sucking on their meat-or-fish-with-fat-and-dried-fruit horror pudding). There’s some pretty decent this month that using a triclosan/copolymer fluoride toothpaste (...) that ibuprofen and paracetamol combined provide better pain relief than the same dose of either drug alone and with a smaller chance of needing more over about eight hours, or of experiencing side effects. These are the findings of a , which found three randomized trials exploring these painkillers in people after they had wisdom teeth surgically removed. This is often used to investigate the effectiveness of painkillers as the results are applicable to other forms of acute pain after trauma. Stay safe

2013 Evidently Cochrane

126. Guidelines on Equipment to Manage a Difficult Airway During Anaesthesia Background Paper

Societies of Anesthesiologists 10, 46 and the Difficult Airway Society (UK) 7 . The cLMA™ is considered a useful device in neonatal resuscitation and is included in the 2005 European Resuscitation Council guidelines for neonatal resuscitation. 47 Case studies suggest that the cLMA™ can provide suitable ventilation when BMV and endotracheal intubation fails, but a Cochrane review found no eligible studies comparing LMA with BMV in neonatal resuscitation. 24 The cLMA™ has the advantage of being readily (...) of the glottis or supraglottis. 69 Reported incidence of airway obstruction with the ProSeal™ varies with the size of the mask (0.4 per cent 70 in adults, 6.6 per cent with the size 2.5 71 and 10 per cent with the size 1.5 64 ). In a randomised series of 46 consecutive neonates and infants, the size 1.0 ProSeal™ (which lacks a dorsal cuff and bite block) formed a more effective seal than the cLMA™, suggesting that the size 1.0 ProSeal™ might have a benefit in newborn infants requiring high airway pressures

2012 Australian and New Zealand College of Anaesthetists

128. Molar incisor hypomineralisation- review suggests link with childhood illnesses

incisors. Similar lesions presenting in second primary molars have been termed, hypomineralised second primary molars (HSPM). The prevalence of MIH is reported to be between 2.4-40.2% and HSPM to be 4.9-6.9%. Affected teeth are associated with a high burden of disease and the nature of the defect predisposes them to treatment failure. The aim of this review was to assess the strength of evidence linking aetiological factors for MIH and HSPM. Methods Searches were conducted in the Medline and Embase (...) studies reporting a crude association. Studies also evaluated associations between antibiotics, anti-asthma medication and breastfeeding. Only 3 studies looked at HSPM one study suggested that maternal antibiotic use during pregnancy is unlikely to be associated with HSPM but maternal alcohol intake may be. Another study reported possible associations with a large number of factors, with perinatal factors and neonatal illness being most common, followed by prenatal factors. Conclusions The authors

2016 The Dental Elf

129. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Acromegaly

finding, and these changes can be disfiguring. The dental changes, including maxillary and mandibular widening with separa- tion of the teeth, mandibular overgrowth, jaw malocclu- sion, and overbite, may be disabling for patients (35 [EL 3]). Arthropathy develops early in the course of acromeg- aly and, with progression, resembles active osteoarthritis and often results in substantial disability (36 [EL 3], 37 [EL 4], 38 [EL 3]). Joint pains may be present in up to three-quarters of the patients (39

2011 American Association of Clinical Endocrinologists

130. CPG on sleep disorders in childhood and adolescence in primary care

. • The insomnia is due to a developmentally based normal sleep behavior or due to false expectations of the parents about sleep. • The insomnia is due to a short duration, self-limited condition (e.g., teething). • There may be potential drug interactions with the usual medication or with substance or alcohol abuse. • It is not possible to follow up on and/or monitor the treatment (parents are incapable of going to sched- uled appointments). Melatonin There is no evidence for recommending the use

2011 GuiaSalud

131. Family Practice Notebook Updates 2017

in early pregnancy Newborn (neonatal abstinence syndrome) if maternal use No evidence of safety (gi, esophagus) Immune mediated esophagitis ( of the esophagus) that does not respond to management May present with solid , food impaction, anterior , and refractory Strongly associated with allergic conditions If management ineffective, try activating steroid MDI (e.g. HFA) and swallowing, not inhaling IV. Updates: October 2017 (geri, prevent) Approach falls as a sentinel event, a predictor of future falls (...) mortality (er, environ, heat) Exertional is on a spectrum from to to Other es include , and Removal from heat and rapid external cooling are the mainstays of initial care Not all patients are volume depleted (avoid over-hydration) (dental, teeth sx) In a normal appearing tooth (without exposed root or abscess), implies exposed dentin or pulp (cavity) Antibiotics are not indicated in where infection is absent (id, ) In the returning traveler, keep in the differential diagnosis (esp. immunocompromised

2018 FP Notebook

132. SLC13A5 is the second gene associated with Kohlschütter-Tönz syndrome. (PubMed)

and absence of ROGDI mutations as well as one patient with unexplained epileptic encephalopathy were investigated by clinical and dental evaluation, parametric linkage analysis (one family), and exome and/or Sanger sequencing. Dental histological investigations were performed on teeth from individuals with SLC13A5-associated and ROGDI-associated KTZS.Biallelic mutations in SLC13A5 were identified in 10 affected individuals. Epileptic encephalopathy usually presents in the neonatal and (less frequently (...) associated with the clinical diagnosis of KTZS, characterised by neonatal epileptic encephalopathy and hypoplastic AI. Careful clinical and dental delineation provides clues whether ROGDI or SLC13A5 is the causative gene. Hypersensitivity of teeth as well as high caries risk requires individual dental prophylaxis and attentive dental management.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products

2016 Journal of Medical Genetics

133. Positive Pressure Ventilation

valve with finger during ventilation or Twist the pop-off valve into closed position Images Neonatal Ambu-Bag VII. Device: Noninvasive Positive Pressure Ventilation (NIPPV) (BiPAP) ( ) ( ) VIII. Precautions Do not use Bag Valve Mask to deliver free flow oxygen Oxygen only flows when squeezing bag Position patient for best ventilation ( , Levitan) Oxygen On Apply 15 lpm by under mask for Pull forward ( maneuver) Sit patient up (to 20 degrees) Anticipate difficult mask ventilation (Mnemonic: MOANS (...) ) Mask seal (e.g. beard) Obstruction Older Age No teeth (replace dentures for Bag Valve Mask Ventilation) Stiff lungs requiring increased y pressures ( , , , term pregnancy) References Difficult Airway Course IX. Technique Term Newborns Administer 5-8 ml/kg (15 to 25 ml per ventilation) Bag volume: 200 to 750 ml (usually >450 ml) Adults and older children Administer 10-15 ml/kg Hold mask over face with one hand Mask should fit snugly Covers mouth, nose and chin Should not cover eyes Thumb over nose

2018 FP Notebook

134. Hyperparathyroidism

) Familial Hyperparathyroidism (10-20%): Younger patients ( ) ( ) Hyperparathyroidism-Jaw Tumor Syndrome Neonatal severe Primary Hyperparathyroidism Other related causes Therapy External neck radiation exposure Neck surgery with injury or resection Tertiary Hyperparathyroidism Accelerated response to chronic (in advanced ) over-produces PTH causing V. Causes: Secondary Hyperparathyroidism Decreased calcium intake stage 4 or stage 5 and Decreased 1,25 dihydroxyvitamin D Normocalcemic Hyperparathyroidism (...) before Repeat serum testing in 2 weeks if normal Miscellaneous 1,25 Dihydroxyvitamin D3 Indicated if low and Phosphate ( ) Hyperphosphaturia tests IX. Imaging Classic XRay Findings "Salt and pepper" skull Distal Clavicle resorption Hand XRay Second and third middle phalange bone resorption Dental XRay Bone resorption of Lamina dura around teeth Sestamibi Technetium Tc 99mParathyroid Scan for localizing adenoma: 95% Causes of non-localizing scan Ectopic PTH production Diagnostic error Four-gland

2018 FP Notebook

135. Newborn Exam

Newborn Exam Newborn Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Newborn Exam Newborn Exam Aka: Newborn Exam , Neonatal Exam (...) ) Correction of asymmetry by depressing the nasal tip predicts spontaneous resolution (refer non-correcting cases to otolaryngology) Mouth and Midline clefts require evaluation for midline defects involving the brain and other central structures ( ) Small undersized for the associated associated with many congenital disorders (e.g. Pierre Robin Syndrome) Lower gum teeth that (usually require extraction, especially if loose due to risk of aspiration) Ankyloglossia (short frenulum) Short frenulum tethers

2018 FP Notebook

136. Infant Feeding

, Infant Nutrition , Neonatal Feeding , Neonatal Nutrition II. Monitoring Adequate newborn weight gain Anticipate up to 10% weight loss after delivery and regain to birth weight by 2 weeks Weight gain (1 gram = 0.0352 oz) Daily: 20-30 grams per day Weekly: 150-200 grams (5 to 7 ounces) per week Infant doubles birth weight in 6 months Adequate hydration Expect clear 6-8 times daily III. Protocol: Term Newborn Indications to delay start of enteral feeding Prolonged asphyxia with 5 minute less than 6 (...) weight for or Birth weight and still below reference growth chart weight at NICU discharge Neonatal dietician or Neonatologist Goals Infant feeds on demand every 2-4 hours Goal intake 120-150 ml/kg/day Ongoing growth approaches 50th percentile formula Inpatient (NICU): 24 calories/ounce used until weight >1800 grams Outpatient: Use 22 calories/ounce until one year of adjusted age or growth caught-up >25th percentile Use 20 calories/ounce after catch-up growth achieved up until one year

2018 FP Notebook

137. Family Practice Notebook Updates 2017

in early pregnancy Newborn (neonatal abstinence syndrome) if maternal use No evidence of safety (gi, esophagus) Immune mediated esophagitis ( of the esophagus) that does not respond to management May present with solid , food impaction, anterior , and refractory Strongly associated with allergic conditions If management ineffective, try activating steroid MDI (e.g. HFA) and swallowing, not inhaling IV. Updates: October 2017 (geri, prevent) Approach falls as a sentinel event, a predictor of future falls (...) mortality (er, environ, heat) Exertional is on a spectrum from to to Other es include , and Removal from heat and rapid external cooling are the mainstays of initial care Not all patients are volume depleted (avoid over-hydration) (dental, teeth sx) In a normal appearing tooth (without exposed root or abscess), implies exposed dentin or pulp (cavity) Antibiotics are not indicated in where infection is absent (id, ) In the returning traveler, keep in the differential diagnosis (esp. immunocompromised

2018 FP Notebook

138. Congenital Syphilis

: Congenital Syphilis , Parrot Pseudoparalysis , Neonatal Snuffles , Congenital Syphilitic Pemphigus , Olympian Brow , Syphilitic Saddle Nose , Mulberry Molars , Higoumenakis Sign , Clutton's Joints , Saber Shin II. Epidemiology Congenital Syphilis in U.S. is increasing 2008: 8.1 cases per 100,000 live births III. Pathophysiology Transmitted transplacentally or via contact with syphilitic lesions during delivery IV. Risk Factors Children born to mothers who have sex with multiple partners Unique pocket (...) in utero and manifested by any of several characteristic tooth (Hutchinson's teeth) or bone malformations and by active mucocutaneous syphilis at birth or shortly thereafter. Ocular and neurologic changes may also occur. Concepts Disease or Syndrome ( T047 ) MSH ICD9 090.9, 090 ICD10 , SnomedCT 186845009 , 154380005 , 187352005 , 35742006 English Congenital Syphilis , Syphilis, Congenital , Congenit syphilis, unspecfd , Congenital syphilis, unspecified , [X]Congenit syphilis, unspecfd , [X]Congenital

2018 FP Notebook

139. Calcium-vitamin D & Periodontal Therapy for Improving Metabolic and Inflammatory Profile Among Pregnant Women

Study Completion Date : March 1, 2019 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment Experimental: Early PT plus Fortified Milk early periodontal therapy (during pregnancy) plus fortified milk Other: Early PT Women will receive conventional non-surgical periodontal therapy (PT), consisting of prophylactic dental polishing to remove the sticky bacterial film that forms on the teeth over time, scaling and root planing (...) semi-skimmed milk powder (provided by the study) and one sachet with 500 IU of vitamin D3 and 1,2 g of a calcium supplement from milk extract (300 mg of calcium) twice a day. Experimental: Early PT plus Plain Milk early periodontal therapy (during pregnancy) plus plain milk Other: Early PT Women will receive conventional non-surgical periodontal therapy (PT), consisting of prophylactic dental polishing to remove the sticky bacterial film that forms on the teeth over time, scaling and root planing

2016 Clinical Trials

140. The Path towards Endangered Species: Prehistoric Fisheries in Southeastern Brazil (PubMed)

The Path towards Endangered Species: Prehistoric Fisheries in Southeastern Brazil Brazilian shellmounds are archaeological sites with a high concentration of marine faunal remains. There are more than 2000 sites along the coast of Brazil that range in age from 8,720 to 985 cal BP. Here, we studied the ichthyoarchaeological remains (i.e., cranial/postcranial bones, otoliths, and teeth, among others) at 13 shellmounds on the southern coast of the state of Rio de Janeiro, which are located (...) (i.e., 265 spp.) that have been documented along the coast of Rio de Janeiro state. This high fish diversity recovered from the shellmounds is clear evidence of well-developed prehistoric fishery activity that targeted sharks, rays and finfishes in a productive area influenced by coastal marine upwelling. The presence of adult and neonate shark, especially oceanic species, is here interpreted as evidence of prehistoric fisheries capacity for exploitation and possibly overexploitation in nursery

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2016 PloS one

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