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Archive for July, 2012

Welcome Ravi Mehta!

Posted by worldorphanrelief on July 31, 2012

Ravi Mehta

 

We wish to welcome Ravi Mehta who will be our point person for all issues regarding refugees.  Ravi will be coordinating with agencies such as the UNHCR, UNICEF, IOM, JRS, etc, and streamlining our aid activities to make them as effective as possible.  Mr. Mehta bears a MHS from Johns Hopkins Bloomberg School of Public Health.  Welcome aboard, Ravi, and thank you for joining us!

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Scar Management After Trauma/Surgery of the Hand and Upper Extremity by Richard Wilson

Posted by worldorphanrelief on July 30, 2012

Richard Wilson

SCAR MANAGEMENT AFTER TRAUMA/SURGERY (OR BONEY

INVOLVEMENT) OF THE HAND AND UPPER EXTREMITY: PRINCIPALS FOR

IMPROVING FUNCTIONAL OUTCOMES

Presented by Richard C. Wilson, OTR

I.  Phases of Soft Tissue Healing-Intervention

 

A.  Inflammatory Phase:  Immobilizing splint or sling may be used to protect tissue (2 days to 1 week).

B.  Fibroblastic Phase:  Splint or device may be used to allow protected mobility.  This allows the healing tissue to strengthen while minimizing the negative effects of scar adhesion with the surrounding tissue. Passive Range of Motion is provided in the direction of the injury (Active concentric movement is minimized so as not to disrupt the repair).   Light resistance or dynamic pulleys may be used in the direction away from the injury.  This will allow eccentric recruitment of the injured tissue and helps improve the tensile strength of the repair.  Active assisted and place and hold exercise are graduated to active and resisted exercise by the end of the phase (up to 8 weeks post surgery). Pressure applications may help to control scar development.

C.  Maturation Phase:  Healing tissue is strong; however, there may be hypertrophic scar due to tissue density (increased molecular bonds) and disorganized collagen fibers.  Splint or device may be used to provide low load stretch (static progressive splint or serial casting).  This would coincide with manual soft tissue and joint mobilization along with progressive strengthening and activity.

Note:  During the Fibroblastic phase, it is important to initiate controlled movement as soon as possible. Protocols are established for various injuries and surgical repairs.  Frequency of therapy will depend on the patient’s pain levels and/or ability to comply with a home exercise program to provide early gliding of the tissues. Frequency may also be governed by the size of the involved joints.

During the late Fibroblastic and Maturation Phase, therapy should be more frequent (depending on patient compliance) and it should be progressive.  The emphasis is on specific adaptation to imposed demand (SAID).  Respect should be given to pain so as not to disrupt the healing tissue or develop a secondary inflammatory response (which will perpetuate the scarring effect).  NSAIDS and physical agents may be necessary to control inflammation.  Manual therapy is a very important intervention during this phase to reestablish joint balance and muscle length-tension. Again, care should be taken not to be too aggressive. The requirement for aggressive manual therapy should be minimized by the proper implementation of movement during the 2nd phase of healing. The patient’s compliance with a home exercise program for flexibility and gradual strengthening is very important.

All research indicates a direct correlation with total end-range time (TERT) and the effect of lengthening tissue and scar modeling.

*Heat Modalities versus Cold Modalities

Heat can be applied through moist packs, paraffin or continuous frequency Ultrasound.  Heat preparation before tissue stretch helps to move the patient through the second of the three phases of stretch (elastic, visco-elastic and plastic deformation or scar modeling) by lowering the viscosity of the tissue.  Heat can also have an anesthetizing effect on the tissue and can promote relaxation.  Care should be exercised with heat when there is an active inflammatory process.

Cold (or non-thermal modalities such as electrical stimulation or pulsed frequency ultrasound) can be used specifically to cool tissue after manual intervention or exercise.  Collagen fibers tend to contract as they cool so application of Cold Pack to the lengthened tissue may help to facilitate scar modeling in the lengthened state.

 

II. Phases of Bone Fracture Healing

 

A.    “Movers” versus “Resters”

Fractures that are closed and relatively non-displaced and stable can be managed by protection without reduction or immobilization. Fractures that are non-displaced but are unstable require immobilization such as a cast or fracture brace.  Open reduction is required when bone fragments cannot be approximated through closed reduction alone and internal fixation devices are then used.

With immobilization by cast there is slight movement of the fracture sight and immature woven bone or external callous forms first as the bone consolidates and remodels.  When external callous forms first, more healing time is required.

With internal fixation, direct healing occurs and may be faster depending on the nature of the fracture and the number of fragments.

  Fracture Healing estimated time tables according to Apley and Solomon (1994)

 

Phase

 

 

Upper Limb

 

Lower Limb

Callus Visible

 

2 – 3 weeks 2 – 3 weeks
Union

4 – 6 weeks 8 – 12 weeks
Consolidation

 

6 – 8 weeks 12 – 16 weeks

 

B.    Immobilization or Early Mobilization

Early mobilization treatment programs have specific focused protocols which govern timing, type and quantity of desired movement. Advancement is determined by the stability of the fracture and radiographic indication of fracture healing.  Any immobilizing device should be monitored for signs of adverse response such as constriction of circulation or skin breakdown. Hinged splinting may be used to allow some restricted movement of a joint.  Care must be taken to preserve joint function above and below the fracture site. Muscle co-contraction of the muscles isometrically across the fracture site is encouraged to facilitate circulation and bone healing.

C.    Early Consolidation

Therapy begins to focus on active use of the effected limb.  Active therapy may include specific resistance training as well as activities and tasks designed to remediate the muscles of the injured region.  There is continued focus on edema control and soft tissue management in the adjacent regions.  If there are changes in body posture or compensatory movement patterns these must be addressed.  Adherent or hypertrophic scar should be treated as previously described. Increased Muscular activity will help with edema control and the scar modeling.

D.    The Final phase

Once we have good primary healing, Physical or Occupational Therapy in orthopedic rehabilitation should include activities to reintegrate the injured extremity to the body scheme and to condition the individual for specific Activities of Daily Living, Instrumental Activities of Daily Living and Vocational Tasks. This allows intrinsic recovery of function and neurological relearning. Whole body exercise and activity should be incorporated to reverse any deconditioning that occurred during the convalescent period.  Sufficient data may be gleaned from the measurement of function and performance during this time in the program.

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Oral Hygiene Overview Data Sheet by Joanna LiVecchi

Posted by worldorphanrelief on July 30, 2012

Joanna LiVecchi

ORAL HYGIENE INFORMATION

 

GINGIVITIS/PERIODDONTAL DISEASE/ORAL HEALTH OVERVIEW

 

WHAT IS GINGIVITIS?

Gingivitis is an inflammation of the gums caused by bacteria in dental plaque.  Some       medications and medical conditions can increase the risk of developing gingivitis.  Healthy gum tissue should be a light pink color, firm, flat, and completely fill the spaces between the teeth.  If the gums are red or purple, puffy and swollen, and bleed when the teeth are brushed or flossed, it is an indication that there is inflammation present.

 

Gingivitis is a reversible condition.  Thorough plaque removal by proper brushing and flossing will allow the gums to heal.  It takes a few weeks for the tissues to heal and stop bleeding.  It is very important to reduce gum inflammation, as gingivitis can affect overall health and can progress, if untreated, to more serious gum infections known as Periodontal Disease.

 

WHAT IS PERIODONTAL DISEASE?

 

Periodontal Disease is an infection of the oral tissues surrounding the teeth.  These tissues include the gums, connective tissue, fibrous ligaments, and bone supporting the teeth. Periodontal Disease is the progression of untreated gingivitis and results in the irreversible destruction of the tissues and bone support.  Most people do not lose their teeth from cavities; teeth are usually lost when they become loose due to periodontal infections.  There usually is no pain or discomfort associated with the early stages of periodontal infections.  The key to preventing periodontal disease is to practice good oral hygiene and monitor the health of the gums regularly.

 

THE EFFECT OF ORAL HEALTH ON OVERALL HEALTH

 

Good oral hygiene is necessary not only to maintain healthy gums and teeth, but it also contributes to overall health.  Gingivitis and periodontal disease are infections and left untreated, they can weaken the body’s immune system and exacerbate other medical conditions.  Recent medical studies have shown a direct link between diabetes, heart disease, and even premature, low weight babies (when the mother had Periodontal Disease during pregnancy) to Gingivitis and Periodontal Disease.  A healthy mouth is an important component of total body health.

 

HOW CAN I PREVENT GINGIVITIS AND PERIODONTAL DISEASE?

 

The best way to prevent or reverse gum infections and inflammation is to practice good oral hygiene.  Good homecare consists of daily flossing, brushing, and rinsing with antibacterial mouthwashes.  It is also important to have regular dental check-ups and cleanings.  Dental cleanings remove hard bacteria deposits from the teeth that cause gum disease.  Once bacteria has calcified, it can no longer be removed by floss and brushing; that is why it is very important to floss and brush regularly to remove bacteria while it is still soft.

 

ORAL HYGIENE RECOMMENDATIONS

 

1.       TOOTH BRUSHING:

 

  • It’s important to brush at least two times daily (once in the morning and once at night before bed).

 

  • Brush for two minutes each time.  It is a good idea to time yourself with a watch to make sure you actually brush the correct amount of time.  Most people usually brush for only 30 seconds, so two minutes may seem very long at first.

 

  • It is important to access all surfaces of the teeth with your toothbrush bristles. This includes the front, back, and biting surface.  The molars often have deep grooves and can collect plaque and food easily.  Try to get your brush bristles in the grooves of the molars and thoroughly scrub.  It is okay to use a lot of pressure when brushing the grooves since there is no gum tissue to irritate.

 

  • Always make sure to gently brush around the gum line.  It is important to be thorough and remove plaque, but you don’t want to irritate or traumatize the gums.

 

  • Try to avoid scrubbing and brushing around in circles; scrubbing can traumatize the gums and just spreads the plaque around instead of removing it.

 

  • The correct tooth brushing method is to angle the brush bristles at a 45 degree angle to the gum line.  Start at the gum line and move the bristles away from the gums (on the top teeth you will brush down and on the bottom teeth move the brush up).  The best way to control the bristles is to lightly flick your wrist (a sweeping motion) to gently pull the bristles away from the gum line.  This sweeping motion helps dislodge the plaque away from the tooth as well.

 

  • It is best to use a small amount of toothpaste when you brush.  Just a little squirt about the size of a pea is all you need.  When helping a young child brush, make sure they fully spit out the toothpaste and rinse.  Toothpaste contains fluoride and should not be ingested.

 

  • When is it time to replace your toothbrush?  It all depends on how hard you brush.  It is time for a new toothbrush when the bristles are splayed and frayed.  Usually this occurs after 3-6 months.  Some people are more aggressive and may wear bristles much faster.  Generally, you should use a new toothbrush after 3-4 months.

 

2.      FLOSSING METHOD:

 

  • It is important to floss daily to remove harmful bacteria that collects between the teeth (even the best tooth brushing technique cannot access these areas).

 

  • Gum disease often begins between the molars (hardest area to access and clean).

 

  • The best way to floss is to use a technique called the “C”-Shape method.  This method gets the floss gently under the gum line and pulls out bacteria.

 

C-Shape Method:

 

  1. Cut a large strand of floss; about 12 inches.
  2. Begin by winding each end tightly around both of your middle fingers (see diagram).  Wind floss until it is very taught and you have only 1-2 inches of floss left between your middle fingers.
  3. Next, using your thumb and index fingers, pinch down on either end of the floss. Now you have a small area of floss that you can easily control and work between the teeth.
  4. Start by gently wiggling the floss between two teeth.  It is easiest to start at one end of your mouth and work your way around in a circuit.  Once the floss is between the two teeth and still above the gum line, gently curve the floss around one of the teeth.  It should be a tight loop or C-shape.
  5. Think of the gums in between your teeth as triangles.  The goal is to get the floss between the tooth and one side of the triangle.  Once you have gently slid the floss under the gum (between the side of the tooth and gum) gently move the floss up and down- a quick shoe-shine motion.  Remove the floss and repeat on the other side of the triangle.  Continue like that around the mouth until you have flossed between all the teeth.

*Young children will have difficulty learning how to floss.  An easier way for them to floss is to use Floss Sticks.  Children can hold onto the handle and gently work            the floss in between the teeth.  Although this method may not get slightly under the gum line as the C-shape method with string floss, its much easier for young children and will still remove plaque from between the teeth and minimize their chance of developing tooth decay.

 

 SUGGESTIONS FOR MAINTAINING GOOD ORAL HYGIENE WHEN

YOU HAVE LIMITED SUPPLIES.

 

  1. The goal of oral homecare is to mechanically remove plaque (oral bacteria) found between the teeth and around the gum line.
  2. Is it possible to remove plaque and keep the teeth clean if you don’t have access to toothpaste or even a toothbrush?  The answer is yes.  Although a soft toothbrush is the most effective and safe way to clean the teeth, it is possible to improvise in a pinch and remove plaque from the teeth.
  3. Suggestions for improvising:

 

  • No Toothpaste?  If you have access to baking soda, you can add a drop or two of water to the baking soda and create a thick paste.  Baking soda is very effective in removing surface stains and deodorizing the mouth (baking soda is very abrasive and can wear the enamel down over time if it is brushed with every day).  You can also just dip the toothbrush bristles in water and gently brush around the gum line.  The most important aspect of tooth brushing is the physical removal of plaque.  Even a moistened brush will still be effective.

 

  • No Mouthwash?  Rinsing with an antibacterial mouthwash is very effective in preventing gingivitis.  If you do not have access to a bottle of mouthwash, you can create your own rinse by combining Hydrogen Peroxide (3% is the best; a stronger concentration of Hydrogen Peroxide is not recommended for rinsing) with equal parts water.  Hydrogen Peroxide is antibacterial and very effervescent (bubbly) and the foaming action helps the liquid reach all the areas of gum tissue.  Rinsing with Hydrogen Peroxide daily should significantly reduce inflammation and bleeding of the gums.  If you don’t have any Hydrogen Peroxide, you can add salt to warm water.  Although salt water in itself is not antibacterial, it does help draw out inflammation from the gum tissues.

 

  • No Toothbrush?  Although it is difficult to remove plaque without a toothbrush, there are a couple basic supplies you can use instead.  For infants and young children, a good way to clean their gums, and first few teeth, is to use a washcloth.  Wet a small washcloth in warm water and wrap part of the cloth tightly around your index finger.  Use your covered finger and massage the gums and rub along any teeth present.  This will gently remove any bacteria that may be present.  For older children with most or all of their teeth, you can use a Q-Tip or cotton tipped applicator.  Wet the tip in water or dip in mouthwash, and gently rub the tip back forth along the gum line of each individual tooth.  It will take some time but you can remove and loosen most of the plaque deposits this way.  If you don’t have any Q-Tips, you can use a bobby pin or other similar object and wrap gauze or thin cloth around one end and use as you would the Q-Tip.

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Preventing Tooth Decay Data Sheet by Joanna LiVecchi

Posted by worldorphanrelief on July 30, 2012

Joanna LiVecchi

PREVENTING TOOTH DECAY

 

  1. It’s very important to brush regularly to keep the teeth as clean as possible. Bacteria in dental plaque feed off of sugar alcohols that are formed from the breakdown of carbohydrates and sugary foods.  The bacteria and sugar alcohols combine to create acids that begin to demineralize the enamel.  Tooth decay begins when the pH level of saliva falls to the critical level of ph 5.5 (very acidic).   Normal saliva (saliva present in the mouth when no food is being consumed) is neutral.
  2. Try to avoid regularly consuming sticky sweet foods such as raisins, honey, sweetened peanut butter, toffee and chewy candies.  These foods tend to stick to the teeth and are not easily washed off by saliva.  They will sit in the grooves of teeth and can increase the chance of the tooth becoming demineralized.  It’s a good idea to rinse out your mouth with water after consuming a sweet sticky snack.
  3. It’s actually not the best idea to brush your teeth right after eating something sweet and sticky.  The enamel is temporarily softer the first 30 minutes after being exposed to the acids created by sugar reacting with oral bacteria.  The mechanical force, of the tooth brush bristles, generated while brushing can erode the softened enamel and actually aid the decay process.  It’s best to wait for about a half hour or so and then thoroughly brush to remove any remaining food particles.
  4. Soda, iced teas, sweetened drinks, and even natural fruit juices all can contribute to decay when consumed regularly.  Soda has the greatest potential for decay because it has a high sugar content and is carbonated.  The carbonation is acidic and combined with the high sugar content can quickly erode the enamel and lead to rampant tooth decay.  Milk and water are the best beverages to consume regularly.  Milk contains Calcium and helps to neutralize other acidic or sugary foods when consumed along with them.  Natural fruit juices are part of a healthy diet and are fine as long as they are drunk along with meals.
  5. A serious condition of rampant tooth decay commonly referred to as “baby bottle decay” can occur if infants and children are put to bed with a bottle that contains any liquid other than water.  Even a bottle of milk can contribute to decay because milk contains sugar enzymes that can break down into sugar alcohols.  During sleep the teeth are more vulnerable to decay because the saliva flow in the mouth is greatly decreased while resting.  The saliva not only helps to wash away food and bacteria particles from the tooth, but it also contains many minerals that help to mineralize the enamel. It is also not a good idea to dip a soother in honey or a sweet liquid as this can also contribute to decay of the front teeth.
  6. Eat desserts or other sugary snacks along with your meals or shortly thereafter, not in between.  The proteins, fats, and minerals present in a balanced meal help to neutralize the acidity created by sugary snacks. Another idea would be to eat a piece of cheese or a couple spoonfuls of non-sweetened yogurt after consuming a sweet snack.

 

SUGGESTIONS FOR HELPING MALNOURISHED CHILDREN PREVENT DECAY

 

  1. Children who have suffered from malnutrition and vitamin deficiencies in their early years, often have poorly formed enamel (Enamel Hypoplasia).  The malformed enamel is softer than regular enamel and can decay much more easily.  Children with Enamel Hypoplasia should have regular fluoride treatments.  These treatments can be in several forms.  There are fluoridated mouth rinses that they can rinse with daily.  After rinsing for one minute with the fluoride rinse, the child should spit it out completely (ingesting the rinse can be harmful and upset their stomach), and avoid eating or rinsing with water for a half hour after.  This allows the fluoride mineral to stick to the tooth longer and better strengthen the enamel.  There are also chewable fluoride tablets or gels that can be brushed on the teeth.
  2. Children with Enamel Hypoplasia should brush at least three times a day for two minutes each time.  It is also a good idea to floss regularly.  Flossing removes plaque that collects between the teeth – even the best tooth brushing cannot access the plaque between teeth.  It is extremely important that children with poorly developed teeth be kept plaque free as much as possible to minimize the chance of decay.  Also, it is important to brush with a fluoridated toothpaste.  Specialty toothpastes do exist that have an increased amount of fluoride.  These pastes are a good option for children who are more prone to decay.
  3. It is more crucial for children with Enamel Hypoplasia to avoid a regular diet of sweets, candies, soda, etc.  Regular consumption of dairy products such as milk, cheese, and yogurt and some proteins from meats (if possible) will help to prevent or slow down the decay process.  Once a tooth begins to decay, however, even a healthy diet cannot restore or repair the area of damaged tooth structure.

 

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Fetal Alcohol Syndrome and Dental Health Data Sheet by Joanna LiVecchi

Posted by worldorphanrelief on July 30, 2012

Joanna LiVecchi

FETAL ALCOHOL SYNDROME and DENTAL HEALTH

 

HOW DOES FETAL ALCOHOL SYNDROME AFFECT DENTAL HEALTH?

 

  1. Dental abnormalities are very common with this condition.  Children may have a small jaw as well as missing, malformed, or misaligned teeth.
  2. Mouth breathing occurs frequently, due to misaligned facial structure and can lead to Xerostomia (dry mouth).
  3. Patients often have weak oral muscles that make eating, sucking on a straw, and other movements difficult.
  4. Children with Fetal Alcohol Syndrome are often born with cleft lip and palate.
  5. Patients with Fetal Alcohol Syndrome may be more sensitive to different tastes and textures.

 

SUGGESTIONS FOR THOSE CARING FOR CHILDREN WITH FETAL ALCOHOL SYNDROME

 

  1. Toothbrushing may be a challenge due to misaligned teeth, small jaw, and weak oral muscles.  The smallest toothbrush size possible should be used.  A Sulcabrush – a special offset tiny brush head – is perfect for accessing crowded or angled teeth.   Children suffering from this disorder have difficulty focusing and cooperating at times. They may need extra help and patience when showing them how to brush.  Also, it’s a good idea to try to have them brush at the same time every day.  Children suffering from this disorder do best when they have a specific routine.
  2. Children suffering from Fetal Alcohol Syndrome are often sensitive to various flavors and tastes.  In some cases, children may not be able to brush with regular toothpaste.  Dipping the brush bristles in water and thoroughly removing plaque around the gums may be the best idea.  Floss should be used as well. Try to avoid mint flavored or waxed flosses. As long as visible plaque is physically removed, the risk of developing gum disease and cavities is greatly reduced.
  3. Try to keep oral tissues hydrated as much as possible.  Avoid alcohol based oral products and advise child to drink water frequently.

 

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Nutrition for Oral Health Data Sheet by Joanna LiVecchi

Posted by worldorphanrelief on July 30, 2012

Joanna LiVecchi

NUTRITION FOR ORAL HEALTH

 

OVERVIEW OF NUTRITION’S ROLE IN ORAL HEALTH

 

A healthy balanced diet is necessary for good oral health.  Proteins, vitamins, minerals, and some fats aid the development of the jaw and teeth and help keep the gums and oral tissues healthy.  Often times, the first signs of malnutrition show up in the mouth.  This is because the cells of the oral tissues rapidly turnover and are replaced by new cells.  A deficiency of vitamins and minerals impacts this cycle of cell repair and contributes to gingivitis, gum disease, and poorly formed enamel.

 

WHAT ARE SOME VITAMINS AND MINERALS THAT ARE IMPORTANT?

 

  1. Calcium and Fluoride are both minerals that strengthen the enamel and bone.  Calcium is found in many dairy products such as cheese, milk, and yogurt.  Fluoride is a naturally occurring mineral that can be applied to the teeth topically in a gel or rinse form or can be ingested systemically when it is added to drinking water.
  2. Vitamin C is very important to the health of the gums.  Vitamin C helps white blood cells fight harmful oral bacteria.
  3. Vitamin D is very important during the development of the teeth and jaw bones.  A deficiency leads to an interruption of the process of enamel formation and can result in very poorly formed enamel that is highly susceptible to tooth decay.
  4. Vitamin A helps aid in oral tissue repair and regeneration.

Unfortunately, the teeth are very different from other organs and tissues.  Once the tooth structure has been completely formed it can no longer be strengthened by eating healthy foods or vitamins.  Only fluoride that is applied topically to the teeth can seep into the tooth and help mineralize the tooth crystals.  Balanced nutrition is most crucial for young children and infants, since it is in their early years that tooth development occurs.

A vitamin chart will be added to this blog shortly.

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Down Syndrome and Dental Health Data Sheet by Joanna LiVecchi

Posted by worldorphanrelief on July 30, 2012

Joanna LiVecchi

DOWN SYNDROME and DENTAL HEALTH

 

HOW DOES DOWN SYNDROME AFFECT DENTAL HEALTH?

 

  1. Most severe oral effect of Down Syndrome is the increased risk of gum disease.  Patients with Down Syndrome have a weakened immune system and are more vulnerable to oral diseases caused by bacteria. Many patients with Down Syndrome lose their teeth due to gum disease before they even reach adulthood.
  2. Xerostomia (dry mouth) is a condition that occurs when there is not enough saliva to hydrate the oral tissues.  In Down Syndrome patients it is usually caused by mouth breathing.  Mouth breathing is common in Down Syndrome because patients often have difficulty breathing because of smaller nasal passages and a large protruding tongue.  Often present is a fissured/cracked tongue, lips, and other oral tissues.
  3. Increase in sticky plaque and hard bacterial deposits due to dry mouth and decreased dexterity with tooth brushing and flossing.
  4. Patients often have misaligned teeth or missing teeth and a large overbite.
  5. Patients may break out more often with sores and ulcers in the mouth.

 

SUGGESTIONS FOR THOSE CARING FOR CHILDREN WITH DOWN SYNDROME

 

  1. It is very important to make sure that oral bacteria in the form of plaque (the white sticky film that builds up on teeth near the gum line) be removed regularly.  This should be done by thoroughly brushing all surfaces of the teeth with a toothbrush and toothpaste.  Many patients with Down Syndrome can brush on their own, but may need some assistance.  Since many children with Down Syndrome have a strong gag reflex, it may be easiest to use a very small toothbrush with a tiny head.  Flossing should be done as well, if possible (see section on flossing for technique and various aids).
  2. A mouthwash that kills bacteria is really helpful in reducing infections in the mouth.  The best choices are antibacterial mouth rinses that are alcohol free (alcohol can dry the oral tissues, and worsen dry mouth problems).  Some children with Down Syndrome have difficulty swallowing and might not be able to rinse with mouthwash, in which case you can dip a toothbrush in mouthwash and rub the bristles along the gums.
  3. Try to keep oral tissues moist.  Children Down Syndrome should drink water regularly (if they have access to a clean source). Sugarless chewing gum is a great way to stimulate saliva flow.
  4. There are several kinds of oral gels that can be applied with a cotton swab to lessen discomfort from dry cracking tissues and tongue.
  5. It is also really important to make sure that children with Down Syndrome do not regularly eat sugary and/or sticky foods such as honey, raisins, or other similar foods that will stick to the teeth.  Since there may not be enough saliva present to loosen food debris, cavities may develop much more quickly in children with Down Syndrome.

 

OTHER RESOURCES

 

Most of this information was collected from various dental websites and textbooks including the NIDCR (National Institute of Dental and Craniofacial Research). http://www.nidcr.nih.gov/OralHealth/Topics/DevelopmentalDisabilities/PracticalOralCarePeopleDownSyndrome.htm

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Tuberculosis Data Sheet by Joanna LiVecchi

Posted by worldorphanrelief on July 30, 2012

Joanna LiVecchi

TUBERCULOSIS

 

Someone in the world is newly infected with tuberculosis every second.” WHO

 

Tuberculosis (TB) is a highly infectious disease of the lungs that can be transmitted via

inhalation.  A person infected with active Tuberculosis can spread the disease to others by coughing and sneezing.  It is important that anyone with active Tuberculosis receive prompt medical treatment and be isolated during the infectious stage of the disease.

 

HOW TO IDENTIFY TUBERCULOSIS

 

The clinical signs and symptoms of TB are often very similar to other illnesses.  These symptoms are:

 

  • Fever
  • Persistent cough (lasting more than 3 weeks)
  • Rapid weight loss and loss of appetite
  • Coughing up blood
  • Malaise

 

A definitive diagnosis can only be made by a sputum culture (a sample of the fluid coughed up from the lungs).  It is important that anyone presenting with most of the above symptoms, especially if they are coughing up blood, be seen by a doctor to rule out active tuberculosis.

 

TUBERCULOSIS INFECTION vs. TUBERCULOSIS DISEASE

 

Tuberculosis Infection:  A person with a healthy immune system may be exposed to the bacteria causing Tuberculosis, but may be successful in fighting off the infection. The white blood cells in the lungs engulf the bacteria and surround them in an almost cocoon like structure.  The bacteria are never completely destroyed, but remain dormant, unable to destroy lung tissue.  A person who has been previously exposed to TB is always considered to have TB infection.  They are more susceptible to developing active Tuberculosis later on, should they ever become immune suppressed. They are not, however, carriers for the disease and are not at all a risk for spreading the infection.  They will also be asymptomatic.

 

Tuberculosis Disease:  Tuberculosis Disease is an active infection. This stage occurs when a person’s immune system fails to isolate the bacteria.  A person with disease will exhibit the symptoms mentioned above and is highly contagious.

 

HOW TO PREVENT THE SPREAD OF TUBERCULOSIS DISEASE

 

  1. If you suspect that you or someone you know have become infected with TB seek medical attention right away.
  2. Once a positive diagnosis for TB has been confirmed, isolation for 3 weeks is necessary.
  3. A person with active TB needs to strictly comply with medical treatment.  In most cases, a person is no longer contagious after 3 weeks of anti-bacterial medications.  However, it is vital that medications and treatment be continued for 1 year.  If the treatment is stopped early, drug resistant strains of TB can develop.

 

WHO IS MOST AT RISK FOR TUBERCULOSIS?

 

  • Elderly
  • Infants
  • Anyone who is already immune suppressed.
  • Anyone who is HIV positive.
  • Anyone who is extremely underweight and malnourished
  • Health care workers who are regularly exposed to TB

 

* Crowded living conditions, lack of nutritious food, and poorly ventilated areas all strongly contribute to the spread of tuberculosis. 

 

LINKS

 

World Health Organization, Global Tuberculosis Programme: Tuberculosis Fact Sheet:  http://www.who.intlmediacentre/factsheets/fs104/en/index.html

 

Centers for Disease Control:  Tuberculosis (TB):  http://www.cdc.gov/tb/

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HIV/AIDS Awareness Data Sheet by Joanna LiVecchi

Posted by worldorphanrelief on July 30, 2012

Joanna LiVecchi

HIV/AIDS AWARENESS

 

HOW TO PREVENT THE SPREAD OF INFECTION

HIV is a major health concern worldwide.  It is estimated that there are currently 34 million people suffering from HIV and of this staggering number,  3.4 million are children under the age of 15 (WHO 2011 HIV Data).  There are millions of newly infected people every year, with the hardest hit populations located in Sub-Saharan Africa and Central and Southeast Asia.  Many villages in Africa have been completely debilitated or wiped out from the disease, and many young children have been orphaned due to one or both parents dying from AIDS.  HIV can be effectively managed if it is diagnosed early on and if medical treatment is promptly administered.  It is important to be aware of the early symptoms of HIV and how to prevent the spread of the virus, in order to control the epidemic and insure that there are fewer and fewer cases of people newly infected with HIV.

WHAT IS HIV?

 

HIV (Human Immunodeficiency Virus) is a virus that weakens the body’s immune system and destroys T-cells and CD4 cells. This leaves the immune system compromised and vulnerable to various opportunistic infections that can be fatal, such as Tuberculosis (which is a serious concern for persons infected with HIV).

HIV is the initial or early stage of the virus. If left untreated, HIV will eventually progress to AIDS.  AIDS is the end stage of illness, and it is during this period that a person’s body begins to break down and serious symptoms become evident.

WHAT ARE THE SYMPTOMS OF HIV?

Once a person has been exposed to the HIV virus and has become infected, they may experience flu like symptoms 2-12 weeks after exposure.  Since the symptoms of HIV are very similar to other illnesses, a definitive diagnosis can only be made from a blood test. The initial symptoms of HIV are:

  • Fever
  • Malaise
  • Night sweats
  • Diarrhea
  • Headaches
  • Joint pain
  • Rash
  • Swollen glands
  • Weight loss
  • Oral Candidiasis (yeast infection of the mouth commonly known as Thrush, which presents as a whitish, cottage cheese like texture on the tongue, and insides of the cheeks)

These flu like symptoms generally only last for a short time (a few weeks at most).  After that, a person infected with HIV may be completely asymptomatic for years.  It is during this stage that a person is most likely to infect others with the virus, as they are highly contagious and may be unaware that they are infected.  It is important to have yourself tested for HIV if you have experienced the above symptoms and have reason to believe you may have been exposed to HIV.

* Early diagnosis of HIV is key to effectively managing the disease and preventing the

   spread of infection.

HOW IS HIV INFECTION SPREAD?

HIV is not contracted through casual contact with a person infected.  It is not spread by sneezing, coughing, or even sharing eating utensils.  In order for HIV to cause infection, the virus must enter a person’s blood stream.  The virus can be transmitted the following ways:

  • Tainted blood transfusions
  • Sharing needles for drug injections
  • Unprotected sex with partners that may be infected
  • Transmission from an HIV positive mother to child through the birthing process and breastfeeding

Children who have become infected with HIV are at a great risk for suffering from severe forms of common childhood illnesses such as Measles and Chicken Pox.  Although these illnesses are usually not fatal in children with normal immune systems, they can cause death in a child suffering from HIV.

TREATMENT

 

Treatment for HIV consists of a regimen of anti-retroviral drugs.  These drugs must be taken exactly as prescribed and for a person’s entire life.  If medical treatment is started early on, HIV can be managed and the progression to AIDS can be halted.

LINKS

The following links provide very detailed and helpful information on HIV/AIDS:

http://www.uptodate.com/contents/patient-information-symptoms-of-hiv-infection-beyond-the-basics

http://bodyandhealth.canada.com/channel_condition_info_details.asp?disease_id=1&channel_id=1020&relation_id=70907

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An Appeal from Fishermen Spokesperson Natalie Reeves

Posted by worldorphanrelief on July 29, 2012

Fishermen spokesperson Natalie Reeves

 

The people of the Democratic Republic of the Congo need your help.  As one of my mission areas I have been researching recent developments and as a result immediately requested that The Fishermen begin a focused campaign to provide humanitarian aid to children in eastern DRC.

Since April, 2012, fighting in the North Kivu province between rebel groups and Congolese government forces has displaced over 470,000 people.  Some reports, including those from UN agencies such as the UNHCR (http://www.unhcr.org/cgi-bin/texis/vtx/home/opendocPDFViewer.html?docid=4ec230f816&query=congo), places the number of IDPs closer to 1.7 million, of which only 70,000 are currently being assisted by aid agencies.  Of primary concern are reports from refugees in Rwanda and Uganda claiming widespread abuses including mass executions, rapes, and torture.  UN staff members also mentioned that children have been seen being forced to fight for rebel groups.  This is all occurring despite the presence of 17,000 MONUSCO (http://monusco.unmissions.org/) peacekeepers operating within the DRC.

Please help us raise funds for aid supplies.  We need basic hygiene kits (soap, toothbrush, toothpaste, q-tips, tissue, hand sanitizer), feminine hygiene products, pre-packed first aid kits, and lightweight toys and/or coloring books for the children.  All of these items can be purchased inexpensively at Target, WalMart, or similar stores.  Your help will make a huge difference in the lives of the children in these refugee camps, I promise.  Thank you!

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