Periodontics
Periodontics involves the prevention, diagnosis, and treatment of periodontal disease. Periodontal disease, also known as gum disease, is an inflammation and infection of the gum tissues. It includes the stages commonly known as gingivitis and periodontitis. Periodontal disease is the leading cause of tooth loss in adults. When plaque and tartar are left untreated on teeth and gums, gum disease may develop. You can reduce your risk of gum disease by brushing twice and flossing once every day. You should also have a dental exam and professional cleaning at least twice each year. Gingivitis includes a variety mild to moderate symptoms, such as: Red, swollen gums. Sensitive teeth. Gums bleeding from normal brushing or eating. Chronic halitosis (bad breath). Difficulty or pain chewing. Periodontitis is a more advanced form of gum disease. In this case, gums begin to pull away from teeth, creating small “pockets” along the gum line. Tooth loss, bone loss, and damage to gums and soft tissues can occur with periodontitis. Common risk factors for gum disease include poor oral hygiene habits, diabetes, smoking, and hormonal changes. Some medications can also increase your likelihood of developing gum disease. Many recent studies have found that untreated gum disease negatively impacts other aspects of your overall health. This is especially common for patients with cardiovascular disease or diabetes. Treatment The most common treatment for gum disease is known as deep cleaning or scaling and root planing. Our hygienist can perform this gentle and effective removal of tartar, calculus, and infected tissue. In many cases, we may use or recommend the use of a product called Perioscience. We have selected this product for use in our office because our patients have received exce Continue reading >>
Type 2 Diabetes, Immunity And Cardiovascular Risk: A Complex Relationship
1. Introduction Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels (Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 1997, 2003) 2. Epidemiology Diabetes is one of the most common chronic diseases in the world. It is thought that more than 360 million persons will be affected by this disease in 2030 (Wild et al., 2004). Prevalence of diabetes is higher in western countries because of the increasing of population age, physical inactivity and obesity, however it is rapidly spreading also in developing countries due to the socio-economic growth with progressive urbanization and changes in lifestyle. Cardiovascular disease (CVD) in diabetic patients is characterized by microvascular damage, associated with the development of diabetic retinopathy, nephropathy, and neuropathy, and macrovascular complications linked to the accelerated course of atherosclerosis shown in these patients. Coronary heart disease (CHD) remains the principal cause of morbidity and mortality, in association with an increased risk of developing cerebrovascular disease, peripheral vascular disease and heart failure. 3. Classification and pathogenesis (Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 1997) DM is classified on the basis of pathogenetic mechanisms leading to hyperglycemia: Type 1, due to a virtually complete lack of endogenous pancreatic insulin production caused by an immune-mediated destruction of pancreatic beta cells (Immunomediated Type I diabetes), o Continue reading >>
Jeanne Lavelle Scott Brinton Dean
Jeanne Lavelle Scott Brinton Dean 1926 ~ 2014 Jeanne Lavelle Scott Brinton Dean, age 87, passed away January 25, 2014 Highland, Utah. Born May 14, 1926 in Pasadena, California to Rulon Stephen and Harriett Lavelle Pay Scott. She married Caleb Jefferis Brinton III in 1944 in Pasadena, CA. They later divorced. She married John Owen Dean on September 17, 1966 in the Los Angles Temple. Jeanne was a member of the Daughters of Utah Pioneers and an active member of the LDS church serving in many callings. Jeanne and John served together as a couple in the Independence, Missouri Visitor Center. She was an antique collector. She loved her family and cherished time spent with them. She is survived by her children: Caleb Jefferis (Linda) Brinton IV, Marguerite (Bryant) Johnson, James Scott (Maria)Dean, Linda Gay (Michael) Harris, Margaret Lee (Lorin) Thompson, 22 grandchildren, 52 great grandchildren, 1 great great grandchild. She was preceded in death by her husband, John, her parents, a bother, a sister, and a grandson. Funeral services will be held Saturday, February 1, 2014 at 11:00 a.m. in the Cedar Hills 6th Ward, 9737 Chesterfield Drive. Friends may call Saturday from 9:30-10:45 a.m. at the church prior to the service. Burial in American Fork Cemetery. Please share a message at andersonmortuary.com. Continue reading >>
Diabetic Firefighters: Spot It And Fix It
You are a paramedic on a crew doing a standby at a room-and-contents fire. After about 30 minutes, the fire is under control and you are setting up a small rehab area. Suddenly you notice some commotion as one of the younger firefighters is being escorted over to you. He seems to be fighting the other firefighters a bit as they do so. Paul is a 19-year-old college student who has been with the department for three years, joining as a junior firefighter while in high school. He comes from a firefighting family — his father, two brothers and grandfather are all active members. His crew puts him on the stretcher and informs you that he started acting weird, stumbling around, not able to do any of the typical tasks that he has gotten to be quite good at. They say he was acting drunk but everyone knows he is not a drinker. You start to assess him and find his vitals within expected limits — his heart rate is a bit elevated at 120 but nothing out of the ordinary for someone who just finished fire duties. He is certainly altered and a bit combative, definitely out of the ordinary for Paul, an easy-going guy with a long firefighting career in front of him. A few of his crew are hanging nearby but his best friend comes closer to you while you are running through some differential diagnoses. "Um, I think you should check his sugar." "OK, but why?" you ask. His friend seems reluctant to say more. "Look, if you know something that will help me treat Paul, you need to tell me," you advise him. Finally his friend states, "Paul was diagnosed with diabetes six months ago. He swore everyone to secrecy because he thought it would prevent him from being a firefighter. He takes insulin at every meal and at night." You check his blood glucose and it is 37 mg/dL, quite low. An IV and som Continue reading >>
My Story
If it had not been the Lord who was on our side, now may Israel say; Our help is in the name of the Lord, who made heaven and earth. When I speak of change, I don’t speak from the seat of an armchair advice giver. In terms of my health, at the absolute worse state of my life I was over 400 pounds and struggling with high blood pressure. On top of that I had been diagnosed as having gout and type two diabetes. The diabetes was so bad that I was giving myself two types of insulin shots per day (3 shots daily) with the largest daily dosage being 300 units (just one of the prescribed insulin I was taking DAILY). Can you imagine having to give yourself a 300 unit shot each day? It took two syringes just to do that each morning. Add to that, the most devastating diagnosis I could have received to date – a trip to the ER for a lingering dry cough turned into a battery of heart tests. The doctor came in and told me later that my heart was in the condition of an eighty year old man that never took care of himself…who spent all his years abusing nicotine, drugs, and alcohol. He went on to say my heart was pumping out at twenty percent, and that I had what was called “Congestive Heart Failure”. At that moment I fully realized that my Goliath had silently stepped onto the field of my life. And if there was really anything to this thing called faith; I was about to find out. With such a strong energy that rose up in me, I declared “Goliath, I accept your challenge in the strong name of Jesus Christ by faith!”. This proved to be the greatest challenge of my young life, and through faith in God AND faith in myself I would years later lose over 140 pounds! Most importantly I would receive TOTAL healing of diabetes, gout, AND Congestive Heart Failure – all verified and v Continue reading >>
Effectiveness Of The Diabetes Education And Self Management For Ongoing And Newly Diagnosed (desmond) Programme For People With Newly Diagnosed Type 2 Diabetes: Cluster Randomised Controlled Trial
Go to: Abstract Objective To evaluate the effectiveness of a structured group education programme on biomedical, psychosocial, and lifestyle measures in people with newly diagnosed type 2 diabetes. Design Multicentre cluster randomised controlled trial in primary care with randomisation at practice level. Setting 207 general practices in 13 primary care sites in the United Kingdom. Participants 824 adults (55% men, mean age 59.5 years). Intervention A structured group education programme for six hours delivered in the community by two trained healthcare professional educators compared with usual care. Main outcome measures Haemoglobin A1c levels, blood pressure, weight, blood lipid levels, smoking status, physical activity, quality of life, beliefs about illness, depression, and emotional impact of diabetes at baseline and up to 12 months. Main results Haemoglobin A1c levels at 12 months had decreased by 1.49% in the intervention group compared with 1.21% in the control group. After adjusting for baseline and cluster, the difference was not significant: 0.05% (95% confidence interval −0.10% to 0.20%). The intervention group showed a greater weight loss: −2.98 kg (95% confidence interval −3.54 to −2.41) compared with 1.86 kg (−2.44 to −1.28), P=0.027 at 12 months. The odds of not smoking were 3.56 (95% confidence interval 1.11 to 11.45), P=0.033 higher in the intervention group at 12 months. The intervention group showed significantly greater changes in illness belief scores (P=0.001); directions of change were positive indicating greater understanding of diabetes. The intervention group had a lower depression score at 12 months: mean difference was −0.50 (95% confidence interval −0.96 to −0.04); P=0.032. A positive association was found between change Continue reading >>
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- The interpretation and effect of a low-carbohydrate diet in the management of type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials
- Diabetes Care Management Teams Did Not Reduce Utilization When Compared With Traditional Care: A Randomized Cluster Trial
Four Things You Need To Know About Borderline Type 2 Diabetes
The majority of Americans are blind to their risk of type 2 diabetes, also known as prediabetes. The onset of the disease is a growing epidemic with nearly 1 in 10 adult Americans now being labeled as diabetic. According to the American Diabetes Association, 1.7 million new cases of diabetes are diagnosed every year, affecting both adults and children; and diabetes will kill more Americans every year than AIDS and breast cancer combined. What do you need to do now if you think you are borderline diabetic? Get a Blood Test James B. LaValle, clinical pharmacist and board certified clinical nutritionist, details in his book, “Your Blood Never Lies,” (SquareOne Publishers/2014) why a blood test is the only way to confirm the presence of high blood sugar in the body and how to read the blood test to make sure you know your level of risk. “What’s alarming is that when you go to your doctor for this test, you could be told your blood sugar is in the normal range when in reality you may have a 50 percent chance of becoming diabetic,” said LaValle, executive chair of Metabolic Code Enterprises, a cloud-based personalized lifestyle medical solution for healthcare practitioners and their patients. “Borderline-high blood sugar should not be ignored, especially when insulin resistance and type 2 diabetes are likely consequences.” Be Aware of Potential Diabetes Symptoms Symptoms that should elevate concern that you may be a candidate for type 2 diabetes include weight gain around the waistline, erratic energy drops throughout the day, feeling agitated or anxious between meals and feeling less mentally sharp. LaValle says that prevention is the watchword in the public health campaign to rein in diabetes and that there is well-documented scientific evidence that if you ma Continue reading >>
Endogenous Oils Derived From Human Adipocytes Are Potent Adjuvants That Promote Il-1α–dependent Inflammation
Limitation of Use: The safety and efficacy of Humulin R U-500 used in combination with other insulins has not been determined. The safety and efficacy of Humulin R U-500 delivered by continuous subcutaneous infusion has not been determined. Humulin R U-500 is contraindicated during episodes of hypoglycemia and in patients hypersensitive to Humulin R U-500 or any of its excipients. For the Humulin R U-500 vial, particular attention should be paid to the 20-mL vial size, prominent “U-500” and warning statements on the vial label, and distinctive coloring on the vial and carton. Dosing errors have occurred when Humulin R U-500 was administered with syringes other than a U-500 insulin syringe. Patients should be prescribed U-500 syringes for use with Humulin R U-500 vials. The dose of Humulin R U-500 should always be expressed in units of insulin. If using the Humulin R U-500 KwikPen, patients should be counseled to dial and dose the prescribed number of units of insulin (NO dose conversion is required). Hyperglycemia or Hypoglycemia with Changes in Insulin Regimen: Changes in insulin, manufacturer, type, or method of administration should be made cautiously and only under medical supervision and the frequency of blood glucose monitoring should be increased. Hypoglycemia: Hypoglycemia is the most common adverse reaction associated with insulin, including Humulin R U-500. Severe hypoglycemia can cause seizures, may be life-threatening, or cause death. Severe hypoglycemia may develop as long as 18 to 24 hours after an injection of Humulin R U-500. Hypoglycemia can impair concentration ability and reaction time; this may place an individual and others at risk in situations where these abilities are important, such as driving or operating other machinery. Early warning symp Continue reading >>
Fat Is Spreading
News Obesity epidemic sweeps into developing world. Obesity is spreading to all corners of the globe, researchers warned the meeting of the American Association for the Advancement of Science in Boston. Sedentary lifestyles and fast food are causing previously unaffected populations to fall foul of fat. "Obesity is no longer confined to Western, industrialized societies," said anthropologist Marquisa LaVelle of the University of Rhode Island, Providence. Guatemalans in the United States, South Pacific islanders and desert-dwelling Australians are all expanding. "It puts a burden on the developing world they can ill-afford," LaVelle warned. Obesity increases the risk of heart disease, diabetes and some cancers. "A decline in world health is inevitable," she said. The scale of the epidemic is challenging the view that laziness or genetics are to blame for obesity. Campaigns to promote exercise and a healthy diet have done little to stem obesity's spread. LaVelle wants cities and buildings designed to help people lead healthier lives. Urban areas should incorporate playgrounds and footpaths, she suggests. The US Centers for Disease Control and Prevention in Atlanta have begun a project to explore these possibilities. Obesogenics The South Pacific may have the world's highest rates of obesity. In Rarotonga, the capital of the Cook Islands, 52% of men were clinically obese in 1996, compared with only 14% in 1966, Stanley Ulijaszek of the University of Oxford, UK, told the meeting. The figures are worse among skilled professionals. In rural Papua New Guinea, obesity is on the rise thanks to higher incomes and connections to urban centres. "Modernizing influences are penetrating the remotest places on Earth," said Ulijaszek. The global spread of sedentary jobs and energy-rich Continue reading >>
Children's Hospital Of Philadelphia
BOHB Recommendations 0 - 0.9 Assure hydration SubQ insulin as clinically indicated 1-1.9 Give 1st dose rapid acting SubQ insulin, 0.15 unit/kg > 2 Send VBG, BMP (See evaluate for DKA in order set) NS 10 mL/kg IV If clinical suspicion for DKA is low, give 1st SubQ insulin, 0.15 unit/kg DKA Pathway Insulin Pump Verify and document recent infusion site change or have family/patient change site Continue insulin basal rate Bolus doses should be ordered by FLOC and given via Aspart injection Do not use pump for boluses IV Hydration Encourage PO hydration Consider ondansetron if nausea, vomiting present For patients with BOHB > 2 mmol/L (if BOHB unavailable, give IV fluids if large urine ketones): Give NS bolus 10 mL/kg, repeat as clinically indicated Add glucose to IVF if blood glucose < 300 RN Monitoring Hourly VS, I/O Continue reading >>
Lavell Crawford On Weight Loss Surgery: “i’ve Got A Beautiful Wife & Son I Want To Be Around For”
(Photo from @lavellthacomic instagram) Funnyman Lavell Crawford has always been a big guy. But this big guy has been making us crack up and fall out laughing for 20+ years. From comedy clubs to shows and movies like Breaking Bad and Netflix’s Ridiculous 6, Lavell is the go to man for funny jokes including jokes about his weight. But now, taking a look at his family life and goals, Levell is no longer laughing, but decided to do something about it. On a recent interview with Sway In the Morning, Lavell explained why and how he went about losing over 65 pounds. “For all big folks out there, I’m gonna keep it real. I’m having the gastric sleeve,” admits Crawford. “I’m 47 and I’ve got a beautiful 5-year-old son that I want to be around for. I’ve got a beautiful wife that I want to be here for. I don’t want to leave her hanging.” MUST READ: Kat Williams Describes Why He Got Into A Fight With A 7-Grader Gastric sleeve surgery, also known as the sleeve gastrectomy, has become a popular choice for patients seeking excellent weight loss in a straightforward procedure that doesn’t require the maintenance and long-term complication rates of a Lap Band. Some benefits of gastric sleeve surgery are: Reduction of hunger Shorter operating time compared to gastric bypass. Does not re-route intestines. Reduces the risk of nutrient deficiencies. Less daily vitamins are needed after surgery compared to gastric bypass. The pylorus remains intact and sugars have time to digest since the intestines remain untouched. No adjustments are needed. The Lap Band requires regular adjustments (doctor visits). No foreign objects are left in the body. The Lap Band leaves a silicone band around the upper portion of your stomach. Weight loss occurs over 18 months. Gastric bypass we Continue reading >>
Diabetes Self-management Education In The Home.
Abstract PURPOSE: Diabetes self-management education and home visits have been found to improve clinical outcomes in individuals living with diabetes. The purpose of this pilot project was to evaluate the feasibility and effectiveness of conducting self-management education in patients' homes. METHODS: Baseline biometric data was collected from a cohort of adult patients with diabetes. Home visits to 19 patients were conducted by doctoral students from Rutgers University School of Nursing. The visits included knowledge assessment, review of foods in the home, diabetes self-management education, and teaching the proper use of monitoring tools such as the glucometer and blood pressure monitor. Biomarkers were obtained post-intervention and were compared to baseline biomarkers. Descriptive lifestyle data was collected and opportunities for customized patient education were provided. RESULTS: The biomarkers improved overall during the four months after the education intervention. The mean A1C reduced 12% (p=0.0107), the mean glucose reduced 12% (p=0.0994), the mean BMI reduced 2% (p=0.1490), the systolic pressure reduced 1% (p=0.4196), and the diastolic pressure remained stable. Specific goal setting further increased the improvement in the area the individual planned to address. CONCLUSIONS: This project supports prior studies that found that in-home educational programs can improve the self-management of diabetes and lead to improvement in health indicators. The benefits of the study included personal attention in ensuring the correct use of home health monitoring devices, building self-management confidence, and identifying treatment barriers that may not be easily discerned in a clinic setting. Continue reading >>
Diabetes Self-management Education In The Home
Go to: Introduction Diabetes is a chronic condition that can result in costly health-related complications, reduced quality of life, and loss of life. In the most recent national assessment of diabetes in the United States, the prevalence of diabetes was 9.3% with costs of diagnosed diabetes reaching $245 billion annually [1]. The need for individual self-management and patient participation in care is paramount. What makes diabetes unique is the need for sufficient self-management skills, which can result in improved quality of life and care [2]. Wakefield, et al. state that, “Transmission of education and advice to the patient on an ongoing basis with close surveillance by nurses can improve clinical outcomes in patients with comorbid chronic illness.” [3]. Diabetes Self-Management Education (DSME) has been found to improve biometrics in diabetic patients. In multiple studies, including research by Yuan, et al., Tshiananga, et al., Brunisholz, et al., Atak, et al., and Wattana, et al., DSME was found to effectively improve clinical markers such as A1C, glucose level, blood pressure, weight, lipids, and self-efficacy scores [4-8]. In studies by Ribeiro, et al., Cooper, et al., and others [9-10], in-home visits to patients for disease self-management, not necessarily diabetes self-management, have been found to improve clinical markers such as blood pressure, fasting glucose, body mass index (BMI), and self-efficacy score in patients with a chronic disease. This project combines and interweaves two concepts: 1) the concept of DSME, which is not typically provided in a patient’s home, and 2) the concept of providing education in the home. In 2015, McElfish, et al. found that DSME in the home was effective when DSME was provided in a family setting in the home [1 Continue reading >>
Nurses Get To The Foot Of Diabetes.
Nurses Kathy Taylor and May Lavelle are letting their tootsies do the talking to raise awareness of diabetes. The pair, from the Royal Alexandra Hospital in Paisley, use cartoons to help GPs and other health care staff spot foot problems which can be a tell-tale sign of the illness. The two Diabetes Nurse Specialists - with more than 36 years' nursing experience between them - use talking feet called Ruby and Rose to liven up diabetes lectures. Now a pharmaceutical firm has been so impressed that it has persuaded the two former ward sisters to make a video of Ruby and Rose and the cartoon approach pioneered at the RAH will soon be used in nursing lectures throughout Britain. Demand for the cartoon, Look Who's Talking Now, is so great that Kathy and May are sought after to talk to health care workers. The next appearances for the nurses and their cartoon chums is in Dundee at a diabetes conference during National Diabetes Week, which kicked off yesterday. Look Who's Talking Now tells you how to spot the warning signs of diabetes and, crucially, how to get help. Ruby and Rose came from the medical term "ruberose"- the red colour of feet caused by poor circulation. Frequent trips to the loo, excessive thirst and blurred vision are the best known symptoms of diabetes. But foot disorders are also a sign. May said: "Blisters, no feeling in the feet, and poor circulation, can be signs of diabetes. "We use Ruby and Rose to inform others who work in the NHS that knowing what to look for could help provide an early diagnosis of the illness." Continue reading >>
Endogenous Oils Derived From Human Adipocytes Are Potent Adjuvants That Promote Il-1α-dependent Inflammation.
Abstract Obesity is characterized by chronic inflammation associated with neutrophil and M1 macrophage infiltration into white adipose tissue. However, the mechanisms underlying this process remain largely unknown. Based on the ability of oil-based adjuvants to induce immune responses, we hypothesized that endogenous oils derived from necrotic adipocytes may function as an immunological "danger signal." Here we show that endogenous oils of human origin are potent adjuvants, enhancing antibody responses to a level comparable to Freund's incomplete adjuvant. The endogenous oils were capable of promoting interleukin (IL)-1α-dependent recruitment of neutrophils and M1-like macrophages, while simultaneously diminishing M2-like macrophages. We found that endogenous oils from subcutaneous and omental adipocytes, and from healthy and unhealthy obese individuals, promoted comparable inflammatory responses. Furthermore, we also confirmed that white adipocytes in visceral fat of metabolically unhealthy obese (MUO) individuals are significantly larger than those in metabolically healthy obese individuals. Since adipocyte size is positively correlated with adipocyte death, we propose that endogenous oils have a higher propensity to be released from hypertrophied visceral fat in MUO individuals and that this is the key factor in driving inflammation. In summary, this study shows that adipocytes contain a potent oil adjuvant which drives IL-1α-dependent proinflammatory responses in vivo. Continue reading >>
