Local.Anaesthesia.in.Dentistry.[taliem.ir]

Local Anaesthesia in Dentistry

According to the World Health Organization, pain is defined as an ‘unpleasant sensation that occurs from imminent tissue damage’. From a physiological perspective, pain is a warning system. During dental treatment, patients will experience pain as something unpleasant. Pain will also make it impossible for the dentist to work accurately.
Particulate.Technology.for.Delivery.[taliem.ir]

Particulate Technology for Delivery of Therapeutics

The scope of drug delivery has developed immensely in the past few decades by introducing a wide range of advanced drug delivery systems. Conventional forms of drug delivery system are generally based on pills, tablets, capsules, eye drops, ointments, and parenteral formulations. In recent times, different novel drug delivery methods have been studied. Some of the methods are chemical modification of drug, liposome that are administered into the bloodstream, and drug incorporated within pumps or polymeric materials those are administered orally, or through parenteral route or implanted in desired bodily compartments (for example, the eye or beneath the skin). This development causes increased therapeutic activity compared to the intensity of side effects, decreasing the required dose during treatment, or eliminating the need for frequent injections. Thus the newer types of delivery systems improve human health and patience compliance, and continuous research on this may transform the way many drugs are delivered.
Osteoporosis.Rehabilitation.A.Practical.[taliem.ir]

Osteoporosis Rehabilitation

Osteoporosis is a skeletal condition involving progressive bone loss and microarchitectural deterioration, leading to increased bone fragility and susceptibility to fractures. It is the most prevalent metabolic bone disease among adults worldwide. The magnitude of the disease is immense. A 2014 study of Americans aged 50 and older estimated that 10.2 million US adults have osteoporosis at the femoral neck and lumbar spine and another 43.4 million have low bone mass, meaning that over one-half of the total US adult population is affected . Approximately 8.2 million women and 2.0 million men had osteoporosis and another 27.3 million women and 16.1 million men had low bone mass. As the number of older Americans continues to increase, these numbers are likely to increase markedly. Osteoporosis has become one of the leading health problems of the elderly and those with medical conditions adversely affecting bone. In 2015, the frst study to examine the global burden of fracture probability projected that by 2040, approximately 319 million people will be at risk of fracture compared to 158 million in 2010. In the United States, over two million fragility fractures occur annually at an estimated cost of $19 million in direct medical care for prevention and treatment . Singer et al. have estimated that osteoporotic fractures among postmenopausal women resulted in more than a half- million hospitalizations, 800,000 emergency room visits, and 180,000 nursing home admissions . Moreover, they indicated that fracture incidence in these women is greater than that of heart attack, stroke, and breast cancer combined.
Paroxysmal.Nocturnal.Hemoglobinuria.[taliem.ir]

Paroxysmal Nocturnal Hemoglobinuria

Historically, a principal reason Western medicine has progressed to the degree it has is the epistemology used to defne disease. Diseases are distinguished by two main methods: (1) assembly of defning characteristics (symptoms, physical descriptions both direct and derived from imaging techniques, and laboratory fndings and clinical course) that recur so as to form a clinical template and (2) assessment of cause and effects of the clinically defned disease. The method was frst clearly established in the nineteenth century with the defnition of microbial diseases and received its second great impetus with the development of molecular genetics. Although the pattern has been altered in more recent times with the development of science leading to the defnition of disease, a study of the classical methodology has a clear place in the study of disease. The history of the development of understanding of paroxysmal nocturnal hemoglobinuria is an excellent example of this methodology at work. In the present paper, I will emphasize the investigation of the causes and effects and show how these investigations have played a crucial role in the defnition of the disease and the understanding of the clinical manifestations.
Oral.Anticoagulation.Therapy.Cases.[taliem.ir]

Oral Anticoagulation Therapy

Warfarin and other coumarin derivatives have long been the mainstays of oral anticoagulant therapy. While evidence has proven them effective for treating and decreasing the risk of thromboembolism, these agents also have many burdensome traits for use for both the clinician and patient. As narrow therapeutic index drugs, the therapeutic window between effcacy and toxicity is small with little correlation between dose and therapeutic effect. Genetic factors and other interpatient variability, such as diet and drug-drug interactions, also contribute to the wide dose range and need for frequent monitoring of the international normalized ratio (INR). The alternative therapies to oral anticoagulants used to only include injectable anticoagulants which were often utilized in place of or in addition to warfarin. These injectable agents limitations were mainly in cost and route of administration, and thus lack of patient acceptance. Fortunately, we have entered an era where several viable oral anticoagulant alternatives exist. These direct oral anticoagulants have much more predictable dose-response profles thus eliminating the need for frequent monitoring. In addition, they have few dietary precautions and much less drug-drug interactions. However, these agents are not benign, not interchangeable, and not entirely characterized in regards to drug-drug interactions, reversibility, or use in populations outside of those in the pivotal clinical trials. Dosing, although more predictable in response, does have limitations including various doses and renal doses based on indication. As such, management of all the anticoagulants, whether warfarin, injectable, or the direct oral anticoagulants, is complicated and very patient specifc. A need for extensive education of health care professionals is required.
Osteocardiology.Cardiac.Bone.Formation.[taliem.ir]

Osteocardiology

Osteocardiology, bone formation in the heart, has become a dominant feld of scientifc study due to the increasing sensitivity of imaging of the heart. Even though the incidence of coronary artery disease, is on the decline , it is still the number one cause of morbidity and mortality globally as reported by the World Health Organization . The American College of Cardiology, the European Society of Cardiology, American Heart Association and the World Health Organization are leading the fght against heart disease, by improving the effort to diagnose and recognize subclinical disease before it causes major adverse cardiovascular events, such as stroke, heart attack, heart failure, and death. Imaging modalities such as computed tomography of the chest and abdomen (CT), angiography, echocardiography, nuclear imaging and PET imaging have increased our knowledge in the diagnosis and detection of atherosclerosis, symptomatic and asymptomatic disease, and coronary artery calcifcation (CAC). Furthermore, these imaging modalities have increased our detection of calcifc aortic valve disease (CAVD), mitral annular calcifcation, and thoracic and abdominal aortic calcifcation. Recent studies over the past 20 years have elucidated the epidemiology, anatomic localization and molecular biology signaling pathways critical in the development of osteocardiology—bone formation in the heart. Atherosclerosis, is a systemic disease process in which fatty deposits, inflammatory cells and calcifcation build within the walls of arteries, valves and the endocardium of the heart specifcally, the mitral annulus, as shown in Fig. 1.1. Atherosclerosis is responsible for the majority of cardiovascular events. Atherosclerosis can develop in a variety of end-organs, including the heart, brain, kidneys, and extremities. This chapter will outline the epidemiologic risk factors for the development of cardiovascular calcifcation and bone disease, to provide a foundation for this textbook entitled Osteocardiology.
Oxidative.Stress.in.Human.Reproduction.[taliem.ir]

Oxidative Stress in Human Reproduction

Reactive oxygen species (ROS) are highly reactive molecules that are generated from oxygen metabolism. They can be free radicals or non-radicals. Free radicals are molecules that contain at least one unpaired valence electron at their outer shell, making them highly reactive and short lived . Among all the ROS, superoxide anion (•O2-), hydrogen peroxide (H2O2) and hydroxyl radicals (•OH) are the most known examples. Reactive nitrogen species (RNS), is the subclass of ROS that contain nitrogen compound . Both ROS and RNS, when present in physiological amount, have important roles in normal cellular functions such as fghting against infection, regulating different intercellular signaling pathways and facilitating normal maturation and fertilization in reproductive systems . However, when ROS present in high concentration, overwhelming the antioxidant defense system, oxidative stress results, and this may lead to cellular dysfunction via lipid peroxidation, protein and DNA damages . Due to such damaging effect on the cells, OS is related to many pathological conditions including infertility . This chapter introduces concepts of free radicals, redox reactions, and then focuses on ROS, RNS and their sources at cellular levels, particularly in both male and female reproductive systems as well as covering a brief overview of oxidative stress.
Opioid.Dependence.A.Clinical.and.Epidemiologic.Approach.[taliem.ir]

Opioid Dependence

Twenty years is a very long time in epidemiologic terms. It’s generally impossible to pinpoint an exact time and place of origin for most epidemics; sometime between 1996 and1999 is the commonly accepted inception of what the Centers for Disease Control (CDC) has labeled the opioid epidemic in America . That puts us at nearly 20 years at the time of this writing. Most epidemics run their course or are controlled within a handful of years. The influenza pandemic of the early twentieth century, often described as “the greatest medical holocaust in history,” lasted less than 2 years. Known at the time as the “Spanish flu,” this worldwide disaster infected an estimated 500 million people and killed as much as 5% of the world’s population. Yet it began and ended within a relatively short time period, within the closing years of the First World War (Fig. 1.1). Cholera ravaged the world for the greater part of the nineteenth and twentieth centuries, but the majority of the component epidemics lasted 10 years or less (Fig. 1.2). An epidemic is classically thought of as a widespread communicable disease affecting a signifcant percentage of a population; however in recent years noncommunicable diseases have been granted epidemic status, such as cardiovascular disease, chronic pulmonary disease, obesity, and the like.
Managing.Complications.in.Glaucoma.Surgery.[taliem.ir]

Managing Complications in Glaucoma Surgery

Argon laser trabeculoplasty (ALT) was frst introduced in 1979 by Wise and Witter (Coakes 1992). Despite its clinical effcacy in intraocular pressure (IOP) lowering, its use is limited by scarring of the trabecular meshwork, which may potentially restrict retreatment. ALT is usually performed with topical anesthesia under direct visualization using a gonioscopic lens. Initially, only 180° of the meshwork is treated. Around 40–50 laser spots are aimed at the anterior half of the trabecular meshwork to reduce the chance of peripheral anterior synechiae (PAS) formation. The laser spot size is 50 μm and the initial laser energy of 800 mW is titrated until minimal bubble formation in the pigmented trabecular meshwork is seen. After 4–6 weeks, IOP is reassessed and the remaining half of the trabecular meshwork may be treated if needed. Topical steroids are usually given for the frst week after ALT (Weinreb and Wilensky 1984).
Pediatric.Vaccines.and.Vaccinations.A.European.[taliem.ir]

Pediatric Vaccines and Vaccinations

Vaccination is widely considered to be one of the greatest medical achievements of civilization and one of the top major breakthroughs of humanity. From an almost empirical origin of vaccinology to the present vaccinomics, our knowledge has evolved substantially and we have learnedimportant lessons. Although the main target of a vaccine is direct protection against a particular microorganism or disease, the scope of vaccination has expanded with the discovery that vaccines can also protect unvaccinated people through herd protection, or even that certain vaccines can protect against additional diseases different from those that they were designed to prevent, through so-called heterologous effects.