Exercises for nursing, dentistry and medical students with an environmental approach (página 2)
GIARDIASIS1.1 READ THE TEXT CAREFULLY. ANSWER THE FOLLOWING QUESTIONS BELOW.TASK.I WHAT IS GIARDIASIS?
Giardiasis (GEE-are-DYE-uh-sis) is a diarrheal illness caused by a one-celled, microscopic parasite, GIARDIA INTESTINALIS (also known as GIARDIA LAMBLIA). Once an animal or person has been infected with GIARDIA INTESTINALIS, the parasite lives in the intestine and is passed in the stool. Because the parasite is protected by an outer shell, it can survive outside the body and in the environment for long periods of time. During the past 2 decades, GIARDIA infection has become recognized as one of the most common causes of waterborne disease (found in both drinking and recreational water) in humans in the United States. GIARDIA is found worldwide and within every region of the United States. The GIARDIA parasite lives in the intestine of infected humans or animals. Millions of germs can be released in a bowel movement from an infected human or animal. GIARDIA is found in soil, food, water, or surfaces that have been contaminated with the feces from infected humans or animals. You can become infected after accidentally swallowing the parasite; you cannot become infected through contact with blood. GIARDIA can be spread by:
WHAT ARE THE SYMPTOMS OF GIARDIASIS? GIARDIA infection can cause a variety of intestinal symptoms, which include
These symptoms may lead to weight loss and dehydration. Some people with giardiasis have no symptoms at all. WHO IS MOST LIKELY TO GET GIARDIASIS? Anyone can get giardiasis. Persons more likely to become infected include
Contaminated water includes water that has not been boiled, filtered, or disinfected with chemicals. HOW IS A GIARDIA INFECTION DIAGNOSED? Your health care provider will likely ask you to submit stool samples to check for the parasite. Because GIARDIA can be difficult to diagnose, your provider may ask you to submit several stool specimens over several days. WHAT IS THE TREATMENT FOR GIARDIASIS? Several prescription drugs are available to treat GIARDIA. Although GIARDIA can infect all people, young children and pregnant women may be more susceptible to dehydration resulting from diarrhea and should, therefore, drink plenty of fluids while ill. If your child does not have diarrhea, but is having nausea, fatigue (very tired), weight loss, or a poor appetite, you and your health care provider may wish to consider treatment. If your child attends a day care center where an outbreak is continuing to occur despite efforts to control it, screening and treating children who have no obvious symptoms may be a good idea. The same is true if several family members are ill, or if a family member is pregnant and therefore not able to take the most effective anti- GIARDIA medications. IF I HAVE BEEN DIAGNOSED WITH GIARDIASIS, SHOULD I WORRY ABOUT SPREADING THE INFECTION TO OTHERS? Yes, a GIARDIA infection can be very contagious. Follow these guidelines to avoid spreading giardiasis to others:
HOW CAN I PREVENT A GIARDIA INFECTION? Practice good hygiene.
Avoid water that might be contaminated.
If you are unable to avoid using or drinking water that might be contaminated, then you can make the water safe to drink by doing one of the following:
Avoid food that might be contaminated.
Avoid fecal exposure during sexual activity. IF MY WATER COMES FROM A WELL, SHOULD I HAVE MY WELL WATER TESTED? It depends. You should consider having your well water tested if you can answer "yes" to any of the following questions:
Tests used to specifically identify GIARDIA are often expensive, difficult, and usually require hundreds of gallons of water to be pumped through a filter. If you answered "yes" to the above questions, consider generally testing your well for fecal contamination by testing it for the presence of coliforms or E. COLI instead of GIARDIA. Although tests for fecal coliforms or E. COLI do not specifically tell you whether GIARDIA is present, these tests will show whether your well water has been contaminated by fecal matter. These tests are only useful if your well is not routinely disinfected with chlorine, since chlorine kills fecal coliforms and E. COLI. If the tests are positive, it is possible that the water may also be contaminated with GIARDIA or other harmful bacteria and viruses. Contact your county health department, your county cooperative extension service, or a local laboratory to find out who offers water testing in your area. If the fecal coliform test comes back positive, indicating that your well is fecally contaminated, stop drinking the well water and contact your local water authority for instructions on how to disinfect your well. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
What Are the Signs and Symptoms?In some parts of the world, especially in developing countries, giardiasis is a disease that's generally found in people who live in that particular area or region. In these cases, more than two thirds of people who are infected may have no signs or symptoms of illness, even though the parasite is living in their intestines. When the parasite DOES cause symptoms, the illness usually begins with severe watery diarrhea, without blood or mucus. Giardiasis affects the body's ability to absorb fats from the diet, so the diarrhea contains unabsorbed fats. That means that the diarrhea floats, is shiny, and smells very bad. Other symptoms include:
These symptoms may last for 5 to 7 days or longer. If they last longer, a child may lose weight and begin to show signs of poor nutrition. Sometimes, after acute (or short-term) symptoms of giardiasis pass, the disease begins a chronic (or more prolonged) phase. Symptoms of chronic giardiasis include:
Can It Be Prevented? Here are some ways you can keep your family from getting giardiasis:
Also, it's questionable whether infants and toddlers still in diapers should be sharing public pools. But certainly they should not if they're having diarrhea or loose stools (poop). Is It Contagious?People and animals (mainly dogs and beavers) that have giardiasis can pass the parasite in their stool. The stool can then contaminate public water supplies, community swimming pools, and "natural" water sources like mountain streams. Uncooked foods that have been rinsed in contaminated water may also spread the infection. In child-care centers or any facility caring for a group of people, giardiasis can easily pass from person to person. At home, an infected family dog with diarrhea may pass the parasite to human family members who take care of the sick animal. How Is It Diagnosed?Doctors confirm the diagnosis of giardiasis by finding GIARDIA parasites in an infected person's stool (poop). Stool samples are sent to the laboratory for examination. Several samples may be needed before the parasites are found. Less often, doctors make the diagnosis by looking at the lining of the small intestine with an instrument called an endoscope and taking samples from inside the intestine to be sent to a laboratory. This is done in more extreme cases, when a definite cause for the diarrhea hasn't been found. How Is It Treated?Giardiasis is treated with prescription medicines that kill the parasites. Treatment typically takes 5 to 7 days, and the medicine is usually given as a liquid that your child can drink. If your child has giardiasis and your doctor has prescribed medication, be sure to give all doses on schedule for as long as your doctor directs. This will help your child recover faster and will kill parasites that might infect others in your family. Again, encourage all family members to wash their hands frequently, especially after using the bathroom and before eating. A child who has diarrhea from giardiasis may lose too much fluid in the stool and become dehydrated. Make sure the child drinks plenty of fluids – but no caffeinated beverages, because they make the body lose water faster. Ask the doctor before you give your child any nonprescription drugs for cramps or diarrhea because these medicines may mask your child's symptoms and interfere with treatment. How Long Does It Last?The incubation period for giardiasis is 1 to 3 weeks after exposure to the parasite. In most cases, treatment with 5 to 7 days of antiparasitic medication will help children recover within a week's time. Medication also shortens the time that children are contagious. If giardiasis isn't treated, symptoms can last up to 6 weeks or longer. When Should You Call Your Child's Doctor?Call the doctor whenever your child has:
I CAN PREVENT A GIARDIA INFECTION.
e) If you are unable to avoid using or drinking water that might be contaminated, then you can make the water safe to drink by doing one of the following:
It depends. You should consider having your well water tested if you can answer "yes" to any of the following questions:
Task II
D. Good morning, sit down, please. P. Good morning doctor, doctor. D. What´s your name? P. ________________________. D. What´s your age? P. _____________________________. D. What´s your marital status? P. _____________________________. D. What´s your profession? P.___________________________. D. What brings you to the doctor´s today? P. _____________________________________________________. D. When did you first notice it? P. _______________________________________________________. D. Have you taken any medication for the vomiting? P. ____________________________________________________. D. Have you noticed anything that brings it on? P.________________________________________________________. D. Have you noticed anything that makes it better? P.__________________________________________________________. D. Do you get any other symptoms with it? P. ______________________________________________________________. D. Have you had any other problem before? P. _______________________________________________________________. D. Do you smoke or drink alcohol? P. _________________________________________________________. D. Has anyone in your family suffered from this problem or stomach disease? P. ______________________________________________________________. D. Well, I´m going to examine you now. Please, take off your blouse to palpate your abdomen. P. Is it serious doctor? D. I´m going to order you an endoscopy immediately to determine the real cause of your problem, but I suspect you have Giardiasis. P. ________________________________________________________. D. You should _____________________________________________________________________________. However, you should take metronidazol 250mg every eight hours for seven days or albendazole 400mg once a day. P. Thank you doctor. D. __________________. P. Good bye. D. __________________.
Task III
Name: Sandra Sarmiento Age:24 Sex: F C/O: vomiting/frequent diarrhia/ nausea/gas AS: Stomach cramp/greasy stools that tend to float. Onset: 2/52 Precipitating factors: greasy and spicy foods Relieving factors: a glass of milk. PMH: Gastritis 6 years ago. SH: +++ coffee and alcohol drinker/ FH: Mother/PUD/10 years ago Sister /parasite/ 2 months ago O/E:NAD on reviewed systems Ix: Endoscopy_________________ giardiasis CBC______________ anaemia US______________ normal DDx:? Dx: ? Rx:? Complications? Prognosis? Task IV 1.1- As a general practitioner you have been assigned to Pedro Pompa neighbourhood belonging to Jimmy Hirzy policlinic in Bayamo municipality which is suffering from giardiasis outbreak. Fill in the chart. Pathology | Environmental factors influencing in it. | Preventive measures | Doctor´s advice for the affected population | Adequate solution with environmental approach. | |||||
1.2- Identify the most important ideas concerning this disease, taking into account the information chart, you may also support on the reading for your selection. Yellow feverRead the text below carefully. Yellow fever is a viral disease that has caused large epidemics in Africa and the Americas. It can be recognized from historic texts stretching back 400 years. Infection causes a wide spectrum of disease, from mild symptoms to severe illness and death. The "yellow" in the name is explained by the jaundice that affects some patients. Although an effective vaccine has been available for 60 years, the number of people infected over the last two decades has increased and yellow fever is now a serious public health issue again. The disease is caused by the yellow fever virus, which belongs to the flavivirus group. In Africa there are two distinct genetic types (called topotypes) associated with East and West Africa. South America has two different types, but since 1974 only one has been identified as the cause of disease outbreaks. The virus remains silent in the body during an incubation period of three to six days. There are then two disease phases. While some infections have no symptoms whatsoever, the first, "acute", phase is normally characterized by fever, muscle pain (with prominent backache), headache, shivers, loss of appetite, nausea and/or vomiting. Often, the high fever is paradoxically associated with a slow pulse. After three to four days most patients improve and their symptoms disappear. However, 15% enter a "toxic phase" within 24 hours. Fever reappears and several body systems are affected. The patient rapidly develops jaundice and complains of abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes and/or stomach. Once this happens, blood appears in the vomit and feces. Kidney function deteriorates; this can range from abnormal protein levels in the urine (albuminuria) to complete kidney failure with no urine production (anuria). Half of the patients in the "toxic phase" die within 10-14 days. The remainder recovers without significant organ damage. Yellow fever is difficult to recognize, especially during the early stages. It can easily be confused with malaria, typhoid, rickettsial diseases, hemorrhagic viral fevers (e.g. Lassa), arboviral infections (e.g. dengue), leptospirosis, viral hepatitis and poisoning (e.g. carbon tetrachloride). A laboratory analysis is required to confirm a suspect case. Blood tests (serology assays) can detect yellow fever antibodies that are produced in response to the infection. Several other techniques are used to identify the virus itself in blood specimens or liver tissue collected after death. These tests require highly trained laboratory staff using specialized equipment and materials. Humans and monkeys are the principal animals to be infected. The virus is carried from one animal to another (horizontal transmission) by a biting mosquito (the vector). The mosquito can also pass the virus via infected eggs to its offspring (vertical transmission). The eggs produced are resistant to drying and lie dormant through dry conditions, hatching when the rainy season begins. Therefore, the mosquito is the true reservoir of the virus, ensuring transmission from one year to the next. Several different species of the Aedes and Haemogogus (S. America only) mosquitoes transmit the yellow fever virus. These mosquitoes are domestic (i.e. they breed around houses), wild (they breed in the jungle) or semi-domestic types (they display a mixture of habits). Any region populated with these mosquitoes can potentially harbor the disease. Control programmes successfully eradicated mosquito habitats in the past, especially in South America. However, these programmes have lapsed over the last 30 years and mosquito populations have increased. This favours epidemics of yellow fever. There is no specific treatment for yellow fever. Dehydration and fever can be corrected with oral rehydration salts and paracetamol. Any superimposed bacterial infection should be treated with an appropriate antibiotic. Intensive supportive care may improve the outcome for seriously ill patients, but is rarely available in poorer, developing countries. Vaccination is the single most important measure for preventing yellow fever. In populations where vaccination coverage is low, vigilant surveillance is critical for prompt recognition and rapid control of outbreaks. Mosquito control measures can be used to prevent virus transmission until vaccination has taken effect. Yellow fever vaccine is safe and highly effective. The protective effect (immunity) occurs within one week in 95% of people vaccinated. A single dose of vaccine provides protection for 10 years and probably for life. Over 300 million doses have been given and serious side effects are extremely rare. However, recently a few serious adverse outcomes, including deaths, have been reported in Brazil, Australia and the United States. Scientists are investigating the cause of these adverse events, and monitoring to ensure detection of any similar incidents. The risk to life from yellow fever is far greater than the risk from the vaccine, so those who may be exposed to yellow fever should be protected by immunization. If there is no risk of exposure, for example, if a person will not be visiting an endemic area, there is no necessity to receive the vaccine. Since most of the other known side effects have occurred in children less than six months old, vaccine is not administered to this age group. The vaccine should only be given to pregnant women during vaccination campaigns in the midst of an epidemic. Vaccination can be part of a routine preventive immunization programme or can be done in mass "catch-up" campaigns to increase vaccination coverage in areas where it is low. The World Health Organization (WHO) strongly recommends routine childhood vaccination. The vaccine can be administered at age nine months, at the same time as the measles vaccine. Eighteen African nations have agreed to incorporate yellow fever vaccine into their routine national vaccination programmes. This is more cost effective and prevents more cases (and deaths) than when emergency vaccination campaigns are performed to control an epidemic. Past experience shows the success of this strategy. Between 1939 and 1952 yellow fever cases almost vanished from French West Africa after intensive vaccination campaigns. Similarly, Gambia instituted mass routine vaccination after its 1979/1980 epidemic and later incorporated yellow fever vaccine into its childhood immunization programme. Gambia reported 85% vaccine coverage in 2000. No cases have been reported since 1980, yet the virus remains present in the environment. To prevent an epidemic in a country, at least 80% of the population must have immunity to yellow fever. This can only be achieved through the effective incorporation of yellow fever into childhood immunization programmes and the implementation of mass catch-up campaigns. The latter is the only way to ensure that coverage of all susceptible age groups is achieved and will prevent outbreaks from spreading. Very few countries in Africa have achieved this level to date. Because vaccination coverage in many areas is not optimal, prompt detection of yellow fever cases and rapid response (emergency vaccination campaigns) are essential for controlling disease outbreaks. Improvement in yellow fever surveillance is needed as evidenced by the gross underreporting of cases (estimates as to the true number of cases vary widely and have put the underreporting factor between three- and 250-fold). A surveillance system must be sensitive enough to detect and appropriately investigate suspect cases. This is facilitated by a standardized definition of possible yellow fever cases that is "acute fever followed by jaundice within two weeks of onset of symptoms, or with bleeding symptoms or with death within three weeks of onset". Suspect cases are reported to health authorities on a standardized case investigation form. Ready access to laboratory testing is essential for confirming cases of yellow fever, as many other diseases have similar symptoms. WHO has recently recommended that every at-risk country have at least one national laboratory where basic yellow fever blood tests can be performed. Training programmes are being conducted and test materials are provided by WHO. Given the likelihood that other cases have occurred (but have not been detected), one confirmed case of yellow fever is considered to be an outbreak. An investigation team should subsequently explore and define the outbreak. This produces data for analysis, which guides the epidemic control committee in preparing the appropriate outbreak response (e.g. emergency vaccination programmes, mosquito control activities). This committee should also plan for the long term by implementing or strengthening routine childhood yellow fever vaccination. In March 1998, WHO held a technical consensus meeting in Geneva to identify obstacles to yellow fever prevention and control. Priorities identified included: prevention through routine immunization and preventive mass immunization campaigns; detection, reporting and investigation of suspect cases; laboratory support; outbreak response; vaccine supply; and furthering research. Guidelines for investigation and control of yellow fever outbreaks, and a background document reviewing topics of importance discussed at this meeting have been published. Task I
Task II
Disease | Cause | Symptoms | Transmission | Treatment | Prevention | Environmental factors | |||
1.1 Working in team prepare different ways for controlling yellow fever to stop a risk of epidemics.
1.2 MY CHILD DOES NOT HAVE HEADACHE, SHIVERS, LOSS OF APPETITE, BUT WAS RECENTLY DIAGNOSED AS HAVING YELLOW FEVER. MY HEALTH CARE PROVIDER SAYS TREATMENT IS NOT NECESSARY. IS THIS TRUE? Name: Carmen Galan Age: 46 Sex: F C/O: fever, muscle pain, headache, shivers, and nausea AS: prominent backache, loss of appetite, slows pulse, and vomiting. Onset: 2/52 PMH: Dengue 6 years ago. SH: +++ coffee and alcohol drinker/ FH: Mother/PUD/10 years ago Sister /chincungunya/ 2 months ago O/E:on reviewed systems:vomiting blood, loss of weight, ictericia, yellow skin, and red tongue. Ix: Blood tests (serology assays) CBC______________ viral infections. Erictrosedimentation ___________ high Urinalisis ______________ normal DDx:? Dx:? Rx:? Complications? Prognosis? 1.4 You have already done the differential diagnosis, but a group of researchers who are studying an outbreak of this disease want to know details about it. Prepare a clinical picture considering what you know about this disease from your specialty. A concerned patient
Dr. Frutos: Good morning, Mr. Fabre, sit down please, what"s the problem? Mr. Fabre: _____________________, I came here because of these small bubbles around my mouth, they itch me a lot and also they hurt. Dr. Frutos: Well, lie down, ______________________ you, you"ll see, together we´ll solve your problem. Mr. Fabre: _______________________. Dr. Frutos: Ok, oh! These lesions are compatible with the lesions caused by the Herpes Simplex Virus. Mr. Fabre______________________? Is it serious? Dr. Frutos: Don"t worry, the herpes simplex virus affects mainly the derived tissues of the Ectoderm inside those that are the mucous and cause a sharp viral infection, probably the most frequent in the viral ones that affects the man (except the breathing infections). Mr. Fabre: A friend of mine got herpes down there,______________________? Dr. Frutos: No, it isn"t._________________________________________, the type I that affects skin and mucous of the superior part of the body and the type II: that produces manifestations in the genital and the inferior part of the body. You got the type I. Mr. Fabre: You see, I got fever, headache and pain while I eat. Can the virus cause that? Dr. Frutos: Yes, it can. In this case you are in the primary stage of the infection and you mustn"t worry because the bubbles will disappear in a lapse of 7 to 14 days and the lesions don't leave scar. Mr. Fabre: Is that all, ________________________________? Dr. Frutos: ______________________, the virus is still in your system and after a period of immunosuppression like periods of maintained stress, the lesions will appear again and it will be the stage of secondary infection. Mr. Fabre __________________________________________? Dr. Frutos: In fact you can, before appearing the lesions you will feel as itch or ardor in the area. Mr. Fabre: ________________________________________? Dr. Frutos: For the moment the treatment is going to be symptomatic or palliative like cold foods, not seasoned, protective of mucous, ionized oil and topical anesthetics like Analden. You must avoid some toxic habits like smoking or alcohol because the lesions will take a long time in healing. Do you smoke? Mr. Fabre: Yes a pack of cigarettes daily. Mr. Fabre: and when the lesions appear again? Dr. Frutos: _________________________________________like Acyclovir, Yodoxuridin eyewash and ionized oil. Mr. Fabre: thank you Dr. I will follow your recommendations perfectly. Task I.
Task II The smoking and chewing of tobacco products has a number of well documented side effects on the oral cavity.
Possible answers.
Most cancers occur within the oral cavity itself: the most common place for them to exist are the tongue, with other areas including the gums, floor of the mouth, lip and salivary gland. a-Prepare a poster, for promoting health of the oral cavity. 1.3- The preventive actions against the toxic habits have a general objective. Comment on this topic to your classmate. 1.4- How would you implement a campaign to reduce mortality due to toxic habits involving the family and the community? a- Prepare it with an environmental focus. 1.5- Write a composition to extend one of the following ideas in no less 120 words. 1. Harmful effect of drinking alcohol. 2. Smoking a bad habit. 3. Preventive actions against environmental diseases. Task III 1.1. Explain the term: a) Herpes simplex. 1.2- Read the passage once more carefully and write a piece of information for each blank. Disease | Cause | Symptoms | Transmission | Treatment | Prevention | Environmental factors | |||
Denture-related stomatitis
I- Read the following text carefully.
Denture – related stomatitis(also termed denture sore mouth, denture stomatitis, chronic atrophic candidacy, Candida- associated denture induced stomatitis, and denture-associated erythematous stomatitis) is a common condition where mild inflammation and redness of the oral mucous membrane occurs beneath a denture. In about 90% of cases, Candida species are involved. This is a harmless component of the oral macro biota in many people. Denture-related stomatitis is the most common form of the oral candidacies (a yeast infection of the mouth). It is most common in elderly people, and in those who wear a complete upper denture ( a denture which replaces al the upper teeth, worn by someone with no natural teeth in the upper jaw). Denture-related stomatitis is more likely to develop when the denture is left constantly in the mouth, rather than removing it during sleep, and when the denture is not cleaned regularly.
The Newton classification divides denture-related stomatitis into three types based on severity. Type one may represent an early stage of the condition, while type two is the most common and type three is uncommon.
Type 1 Localized inflammation or pinpoint hyperemia.
Type 2 More diffuse erythema (redness) involving part or all of the mucosa which is covered by the denture.
Type three inflammatory nodular –papillary hyperplasia usually on the central hard palate and the alveolar ridge.
Signs and symptoms.
Despite the alternative name for this condition, denture sore mouth, it is usually painless and asymptomatic. The appearance of the involved mucosa is erythematous (red) and edematous (swollen), sometimes with petechial hemorrhage. This usually occurs beneath an upper denture. Sometimes angular chelitis can coexist, which is inflammation of the corners of the mouth, also often associated with Candida albicans, Stomatitis rarely develops under a lower denture. The affected mucosa is often sharply defined, in the shape of the covering denture.
Causes.
The major risk factor for the development of this condition is wearing an upper complete denture, particularly when is not removed during sleep and cleaned regularly. Older dentures are more likely to be involved. Other factors include xerostomia (dry mouth), diabetes or high carbohydrate diet. Human immunodeficiency virus (HIV) can rarely be an underlying factor.
Wearing dental appliances such dentures alters the oral macro biota. A macrobial plaque composed of bacteria and/or yeasts forms on the fitting surface of the denture (the surface which rests against the pale) and on the mucosa which is covered. Over the time, this plaque may be colonized by Candida species. The local environment under a denture is more acid and less exposed to the cleansing action of saliva, which favors high Candida enzymatic activity and may cause inflammation in the mucosa. C. Albicans is the most commonly isolated organism, but occasionally bacteria are implicated.
The most important aspect treatment is improving denture hygiene, i.e. removing the denture at night, cleaning and disinfecting it, and sorting it overnight in an antiseptic solution. This is important as the denture is usually infected with C. A will cause re-infection if it is not removed.
Substances which are used include solutions of alkaline peroxides, alkaline hypochlorite"s (e.g. hypochlorite, which may over time corrode metal components of dental appliances), acids (e.g. benzoic acid), yeast lytic enzymes and proteolytic enzymes (e.g. alkalize protease). The other aspect of treatment involves resolution of the mucosal infection, for which topical antifungal medications are used (e.g. nystatin, amphotericin, miconazole, fluconazole or itraconazole). Often an antimicrobial mouthwash such as chlorhexidine is concurrently prescribed. Possible underlying disease (diabetes, HIV) should be treated where possible.
Task I
1. – What´s the main idea of the text?
2. – Give a clear definition of denture- related stomatitis.
3.-Classify it.
4. – What are most common signs and symptoms?
5. – Provide an effective treatment for a patient who is suffering from denture – related stomatitis.
6. – Which are the environmental conditions that favor this pathology?
7. – Taking into consideration environmental conditions. How would you promote people´s health against this illness?
Task II
1. – Identify two secondary ideas in paragraphs 2, 3, 4. Rewrite them enriching these ideas with your own words.
2. – Incorporate new information about this pathology: Talk to your group about it.
3. – As a specialist on the matter, Can you provide a prognosis for a case with this disease?
4.-Make a conversation and strike it out including your presumptive diagnosis.
5. – You are in a doctor –doctor discussion now. Associate some other possible causes of this disease.
6. – Establish whenever possible a differential diagnosis.
7. – Prepare a doctor –doctor discussion. Be ready to make an exposition of it in front of the rest of the specialists.
8. – Reach to your own conclusions about a case you are assisting in the clinic during a whole year with this pathology.
Task III
Disease | Cause | Symptoms | Definition | Treatment | Prevention | Environmental factors | ||
1.-Read the passage once more carefully and write a piece of information for each blank.
1.1 Working in team prepare different ways for avoiding Denture – related stomatitis.
e) Which methods would you use to achieve people change their habits?
f) From the environmental view point. What would you suggest to prevent this pathology?
g) What are environmental conditions that favor the proliferation of this disease?
Gingivitis
Listen to the following dialogue below carefully.
A. Good morning please, sit down. What is s your name?
B. Sally.
A. What seems to be the problem?
B. My gums.
A. Could you describe what happens with your gums?
Well, they are quite red and bleed.
B. How often does it happen?
A. Nearly every day. It´s much worse in the morning after brushing my teeth.
B. We´d better have a look at you. Open your mouth, please. It seems that it´s gingivitis.
A. What´s that?
B. It´s a dysfunction in which the gums are red, swollen and bleed. There are some factors that contribute to this illness such as toxic habits and stress.
B. I guess there are some of those in me.
A. Do you smoke?
B. Yes, about fifteen a day. Too much I guess.
A. What about drinking alcohol?
B. Not much, just on holidays or at parties.
A. What about work? Does your job involve long hours?
B. Yes it does. I never get home before 8 o´clock.
A. Well, there is a little problem with your gums.
B. Is it serious doctor?
A. Nothing to be worry about.
B. What a relief!
A. Is there any particular reason why you were anxious?
B. There is, actually.
A. Would you like to tell me? Is it anything to do with your family?
B. Yes. It´s my father and my older brothers. They lost all their teeth at an early age. And I´m just rather worried because I don´t want lose mine.
A. I´m sorry to hear that about your relatives. But thanks for telling me. I´m sure you´ve got no need to be anxious. I´m going to order you a few more tests.
B. And, should be the treatment?
A. The first goal consists of reducing the inflammation. Then we proceed to a complete cleaning. With posteriority it is necessary to keep an oral hygiene.
B. Thank you, doctor.
A. Don´t mention it.
Task I
I. Listen to the conversation once more and choose the correct answer.
1- The patient comes to the dentist´s due to.
a- A toothache.
b- Bleeding gums.
c- Tender gums.
2- His oral hygiene is…
a- Good.
b- Acceptable.
c- Bad
3- The patient has…
a. Chronic gingivitis.
b. Marginal gingivitis.
c. Initial gingivitis.
4- The patient is …
a. Relaxed
b. Stressed
c. Busy.
5- In this appointment the doctor …
a. Reassure the patient.
b. Doesn´t reassure the patient.
c. Never reassure the patient.
6- The patient is a heavy…
a. Alcohol drinker.
b. Coffee drinker.
c. Smoker.
II. Taking into consideration this case.
1- Give this patient an educational talk.
2- Suggest a better lifestyle.
3- Concerning stress. How does it affect the patients?
4- Is it an environmental factor which contributes to the increase of the bucal pathologies? Support your answer.
5- Provide recommendations for the patient´s dental attention.
Task II
I. According to your specialty knowledge. Answer these questions.
1. What is the distinction between necrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis?
2. Coincident factors may include heavy smoking and poor nutrition, especially for those presenting with necrotizing ulcerative periodontitis. Support this statement.
3. Which is the risk factor associated with necrotizing ulcerative periodontitis?
4. Give advice to your classmate for preventing gingivitis.
Task III
a) Clinical features of gingivitis disease may include:
1. _________________________________________________________________________ .
2. _________________________________________________________________________ .
3. _________________________________________________________________________ .
4. _________________________________________________________________________ .
5. _________________________________________________________________________ .
6. _________________________________________________________________________ .
I. Talk about the treatment considering the different environmental factors.
II. Mention the most common signs and symptoms.
III. What is the main cause of this disease?
IV. What are the possible complications?
Task IV
1.1 Due to the patient"s condition, the DGP referred the patient to the specialist. When signs of poor oral hygiene are present, the dentists send the patients to the preventive care department.
a) Recreate the consultation.
Name: Sandra Surname: Kova Age: 40. Job. Retired teacher Sex: F
Reason: Burning pain
Onset: About a week ago.
Progress: Getting worse.
Precipitating factors: Hot food.
Relieving factors: Cold water
Aggravating factors: Mastication of hard food
Other symptoms: bleeding gums.
Personal history: Asthma Allergy: Penicillin.
Habits: +++smoker and coffee drinker.
O/E: red, swollen and tender gums, tartar and dental bacterial plaque (DBP) on the front lower maxilla. Below the gingival margin / inflammation and bruises
Ix: The radiographic exams how revealed bone destruction.
c) According to the information you already have from your specialty. Fill in the blanks.
CLINICAL HEALTH HISTORY
CASE HISTORY FORM.
First name: _________ Surname: _______________
Age: _______ Sex: _______ Marital Status: ________
Occupation: _____________________________
Present Complaint: __________________________________________________________
Site ____________________ Radiation_________________________________
Character ___________________________ Onset ________________________
Progress____________________ severity ____________________________
(11) Precipitating factors ________________________________________________
(12) Relieving factors________________________________________________
(13) Aggravating factors _____________________________________________
(14)Other symptoms ____________________________________________________
General condition: _________________________________________________________
Immediate Past History: ____________________________________________________
SH: _________________________________________________________________________
Investigations: _______________________________________________________________
_______________________________________________
Diagnosis: __________________________________________________________________
Management:
Points of notes:
1.2. – Write a doctor-doctor discussion about a patient who suffered from gingivitis recently. Take into consideration the details you have already analysed in your specialty.
A 40 year-old male patient who came to the clinic complaining of bleeding gums. It only happens when eating hard foods. He also had bad breath. The patient is allergic to Penicillin. The patient"s medical history is contributory. He brushed once a day, smokes 30 cigarettes a day and drinks coffee and alcohol every day. The oral exam revealed red, swollen and tender gums, tartar and dental bacterial plaque (DBP) on the front lower maxilla. There are signs of mobility. The radiographic exam showed bone destruction. The diagnosis was chronic gingivitis. The treatment consisted of reducing the inflammation and a complete cleaning. The prognosis was favorable if the patient follows the treatment plan.
a. 1.3) Prepare a clinical picture for a patient who is suffering from chronic gingivitis.
Oral higiene
I- Listen to the conversation carefully.
A. Good morning doctor.
B. Good morning, please, come in, sit down.
What brings you to my office today?
A. I came here to get information about oral hygiene and how can I have a good health.
B. What is your name?
A. My name is Tom.
B. What´s your address?
·28 Milan"s Ave. El Cristo neighborhood.
B. What´s your occupation?
A. I´m a painter.
B. Where do you work?
A. I work in San Alejandro Gallery.
B. How do you feel?
A. O.K
B. What do you want to know?
A. What´s good oral hygiene?
B. Good oral hygiene results in a mouth that looks and smells healthy.
A. What do you mean doctor?
B. For example, your teeth must be clean and free of debris, your gums must be pink and do not hurt or bleed when you brush or floss. If you are experiencing persistent halitosis, you must see your dentist. Any of these conditions may indicate a problem.
A. How can I get a good oral hygiene?
B. Well… you must brush your teeth four times a day; you must have a balance diet and limit snacks between meals. You could use dental products that contain fluoride, including tooth paste and mouth wash.
A. What about diet?
B. Deficiencies in minerals and vitamins can also affect your oral health as well as your general health. You should eat more vegetables and fruits, and fewer sweets. Remember you shouldn´t smoke.
A. Oh doctor! But I like smoking.
B. Tobacco is not healthy; smoking increases your risk of oral cancer, gingivitis, periodontitis and caries.
A. O.K doctor I will follow your recommendations, thank you very much.
B. You are quite welcome.
Task I
I. – Answer the following questions about the conversation above.
1. What´s a good oral hygiene?
2. From your view point. What are the possible environmental conditions that can affect a good oral hygiene?
3. What steps would you advise to your patients to keep a good oral hygiene?
4. Concerning toxic habits. Can you mention them?
5. What would you recommend to avoid them?
6. What are the main causes of a poor oral hygiene?
Task II
I. Express the same ideas of the following sentences but in an impersonal way.
1. Due to the patient"s condition, the DGP referred the patient to the specialist.
2. When signs of poor oral hygiene are present, the dentists send the patients to the preventive care department.
3. There the hygienists show the patients how to brush their teeth effectively.
4. On the physical exam the doctor observed a deep caries on occ surface of tooth 32.
5. The periodontist prescribed warm chamomile mouth rinses to release the inflammation.
6. The x-ray revealed a radiolucent area around the apex of tooth 26.
II. – Complete the ideas taking into account the dialogue information and information you already have from your specialty.
Good oral hygiene results in __________________________________.
When you must see a dentist _____________________________.
You could use dental products that______________________________________.
Deficiencies in ____________________________________________ can also affect your__________________________ as well as ______________________________________.
Tobacco is not healthy; ___________________________________________________.
As a dentist I recommend patients to ___________________________________________________________________________________________________________________________________.
Task III
1. Promote a good oral hygiene. Prepare a poster for your promotion with the necessary information for the patients.
2. Involve your classmate in the activity.
3. Take into account the different environmental conditions that can affect people.
4. Provide adequate solutions for patients´ problems.
Task IV
1. You are in the outpatient department on call and a concerned patient come to your office suffering from a terrible toothache. On a physical examination carried out you found a Bad breath (halitosis) he/she is suffering from.
2. After assisting the patient, give him/her an educative talk on this matter.
3. Explain the different causes including smoking, alcohol, poor care of dentures, gum disease, breathing through the mouth, not brushing or flossing on a regular basis.
4. Candida is a very common infection of the mouth in individuals due to poor oral hygiene. Write a paragraph commenting on the fact.
5. Deal with an environmental approach the problem.
ENVIRONMENTAL FACTORS
1. – Alcohol consumption.
2. – Cigarette smoking.
3.-Consumption of untreated water from shallow wells, lakes, rivers, springs, ponds, and streams.
4. – Improper food hygiene.
5. – Dirty hands after defecation and contact with food or drinking water.
6. – Consumption of food that is not very well cooked or unrefrigerated after they are opened
1.1. – How would you make the water safe to drink?
1.2. – Below you have the following hygienic measures. If you consider them necessary to prevent oral cavity diseases. Support your answer.
. Do not swallow recreational water
Do not drink untreated water from shallow wells, lakes, rivers, springs, ponds, and streams.
Do not drink untreated water during community-wide outbreaks of disease caused by contaminated drinking water.
Do not use untreated ice or drinking water when travelling in countries where the water supply might be unsafe.
1.2 If you are unable to avoid using or drinking water that might be contaminated, then you can make the water safe to drink by doing one of the following:
Heat the water to a rolling boil for at least 1 minute. OR
Use a filter that has an absolute pore size of at least 1 micron or one that has been NSF rated for "cyst removal."
If you cannot heat the water to a rolling boil or use a recommended filter, then try chemically treating the water by chlorination or iodination.
Which of the methods above is the most effective? Why?
Conclusions
It was achieved the incorporation of knowledge related with the environmental culture, with the purpose of preventing and promoting health through an exercise proposal of the English subject matter.
It was newly achieved students´ motivation at the time of establishing interdisciplinary relationship of the English subject matter with the environmental topics.
Bibliography
1. English through Medicine 1 Student´s book. Colectivo de autores 2012. Tercera edición.
2. Dictionary Spanish-English and English-Spanish New Bantam.
3. Dentally Speaking. Colectivo de autores. La Habana, noviembre, 1988.
4. Jump to: navigation, search For other uses, see Dengue fever (disambiguation)
5. URLof this pagehttp://www.nlm.nih.gov/medlineplus/ency/article/001374.htm
6. Giardiasis(GEE-are-DYE-uh-sis)Fact Sheet
7. World Health Organization Fact sheet N°100 Revised December 2001
8. Fact sheet N°100 Revised December 2001 Yellow fever
9. ORAL AND MAXILLOFACIAL PATHOLOGY – 1st Ed. (2003)FRONT MATTER. Title Page. Oral and Maxillofacial PATHOLOGYA Rationale for Diagnosis and Treatment. Robert E. Marx, DDS. Professor of Surgery and Chief. Division of Oral and Maxillofacial Surgery. University of Miami. School of Medicine. Miami, Florida. Diane Stern, DDS. Clinical Professor of Surgery. Division of Oral and Maxillofacial Surgery. University of Miami. School of Medicine. Miami, Florida. Quintessence Publishing Co, Inc. Chicago, Berlin, Tokyo, Copenhagen, London, Paris, Milan, Barcelona, Istanbul, Sao Paulo, New Delhi, Moscow, Prague, and Warsaw Copyright. Library of Congress Cataloguing-in-Publication Data Marx, Robert E. Oral and maxillofacial pathology: a rationale for diagnosis and treatment / Robert E. Marx, Diane Stern. Includes bibliographical references and index. ISBN 0-86715-390-3 (hardcover) Mouth–Pathophysiology. 2. Face–Pathophysiology.[DNLM: 1. Face–pathology. 2. Jaw–pathology. 3. Mouth–pathology. Jaw Diseases–pathology.
10. Inside dentistry. A comprehensive Course of English for Specific Purposes. Student´s Book. Editorial Ciencias Médicas 2007. Autor Luisa F. Acosta Ortega.
11. Glosario Bilingüe de Términos Odontolólogicos. Inglés–Español Español-Inglés. Editorial Ciencias Médicas. Lic. Texidor Pellón. Lic. Daniel Reyes Miranda. La Habana 2008.
12. Vision Student´s book III. Colectivo de autores. Editorial Ciencias Médicas. La Habana 2009.
Authors
-Lic. Inglés. Luis Carlos Verdecia Castro
– Master in Sciences. Adalis Labrada Espinoza
_ Lic.Inglés. Fernando Nolbert Tenrero
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