Biomedical subjects

F S Younai

Publications and source records attributed to F S Younai.

6 recordsLinked to original sources

PubMed1997

Obstacles encountered in application of the Centers for Disease Control and Prevention guidelines for control of tuberculosis in a large dental center.

BACKGROUND: The Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration have designated five categories of workplaces as carrying higher than normal risk for exposure to tuberculosis (TB); "health care facilities" is one of these categories. To assist all health care facilities in developing an appropriate and effective control plan, the CDC has listed various components to be included in the overall plan-however, the components needed cannot be determined until the level of risk has been determined. The published criteria for risk assessment are more appropriately applicable to a hospital-based facility. In complying with CDC's guidelines and adopting the recommended components of the TB control program at a large, educational, ambulatory care dental facility, several obstacles were identified. METHODS: As part of the risk assessment for TB transmission and to determine the significance of purified protein derivative of tuberculin (PPD) skin-test conversions observed among the student and employee populations, we implemented a strategy that consisted of surveying all accredited dental schools in the country, performing a controlled PPD screening study involving predoctoral dental students in their junior year, and reviewing and evaluating all patient registration records for the same period. RESULTS: Forty-four percent of the dental schools contacted agreed to participate in the survey. Of these, 58% had no information available on student PPD conversion rates and 29% either had no data available yet or were unwilling to share their information. Three schools (12%) that had some data and were willing to share it reported PPD conversion rates for faculty, students, or staff of 1% to 2%. The student PPD study showed a 10.7% conversion rate, but the registration record reviews showed no convincing evidence of patients with active TB having been registered at the dental school for the period of the student PPD study. CONCLUSION: Development of a TB control program relies heavily on assessment of risk within a health care facility. The sporadic reports of PPD conversion rates among dental care workers are not adequate to determine the magnitude of exposure to TB in educational dental settings. Further studies are necessary to establish the true risk and to assist dental care facilities in developing TB control programs.

Centers for Disease Control and Prevention, U.S.↗

PubMed1997

Oral mucositis with features of psoriasis: report of a case and review of the literature.

An unusual case of oral mucositis with features of psoriasis is reported along with a review of the cases of oral psoriasis in the literature. The case reported involved a crusted lesion on the upper lip and erythematous lesions on the labial mucosa, buccal mucosa, and denture-bearing palatal mucosa. In addition, lesions resembling geographic tongue and ectopic geographic tongue were present. All lesions exhibited multiple small pustules. The review of the literature compares the distribution and clinical appearance of previously reported cases of oral psoriasis.

Aged↗

PubMed1997

TB and dentistry.

Tuberculosis (TB) has reemerged as a major public health problem. Although dental care providers are considered to be at low risk of exposure to patients with active TB, they should be familiar with the recent recommendations for preventing transmission of tuberculosis in health care settings. Dental practitioners should be able to recognize and evaluate signs and symptoms of active TB in their patient population and initiate appropriate medical referrals for any patient in whom active TB is suspected. Furthermore, education of the dentist and the office staff about the transmission, signs and symptoms of the disease, and methods of protection is one of the most effective components on an overall TB control program.

Centers for Disease Control and Prevention, U.S.↗

PubMed1997

Risk of tuberculosis transmission in dentistry. Results of a retrospective chart review.

This pilot project was conducted for the purpose of performing a retrospective chart review on selected clients and using the results for evaluating purified protein derivative (PPD) conversion rates among the student population. The occupational risk of exposure to active tuberculosis was assessed in a large dental educational setting. Charts of clients seen in the College's Oral Medicine Clinic, referred out for health care consultation for one of several reasons potentially associated with active tuberculosis disease over a 1 year period, were reviewed. Data sources included the medical consultation log and the tuberculosis log, which were maintained by faculty in the Oral Medicine Clinic. Ninety-six clients met the authors' criteria. However, compiling data was severely hampered for two reasons: missing charts (19 of 96, or 19.8%) and non-returning clients (55, or 57%). Four clients with potentially active cases of tuberculosis were identified. Follow up revealed, however, that none of these four clients was contagious when seen at the Dental Center. The protocol and definition recommended by the Centers for Disease Control and Prevention 1994 Guidelines, and the results of PPD screening and chart audit conducted by the authors, suggest that the employees and students of the College of Dentistry are at low risk for workplace exposure to active tuberculosis.

Adolescent↗

PubMed1996

Challenges associated with assessment of risk for tuberculosis in a dental school setting.

BACKGROUND: Reported risk among health care workers, related to tuberculosis exposure, motivated us to accurately assess this occupational risk at our College of Dentistry. METHODS: Our sample population included all dental students entering their junior (third) year (beginning of maximum patient exposure). Screening for tuberculosis infection, with the standardized Mantoux test (purified protein derivative [PPD]), was conducted by the authors; several variables, previously associated with inaccurate test results in the literature, were controlled for during the study. RESULTS: Among the study population of 158 students, the PPD conversion rate, as determined by one-step testing, after one academic year was 10.6%. To further investigate factors (other than possible workplace exposure) contributing to PPD conversion in the study population, the authors also examined PPD results from previous employee and student screenings and conducted a retrospective chart review of selected patients registered at the college for the same period. CONCLUSIONS: We found that being born outside of the United States and having previously received bacille Calmette-Guérin vaccine are associated with positive PPD test results. In addition, PPD conversion among the study group may not be associated with occupational exposure at the College but, in fact, may be related to other factors, including community- and hospital-based clinical exposure. Finally, we recommend further research that examines the possible systemic effects of periodic testing with PPD on test subjects.

Adult↗

PubMed1996

Postexposure protocol.

This article offers an overview of the major bloodborne and communicable diseases. The organisms are classified based on the level of risk they pose to the dental care worker (DCW) in the occupational settings. Most recent epidemiologic findings and scientific information on occupational exposures are discussed. Postexposure management to bloodborne pathogens, including the counseling, date collection, serologic testing, and post-exposure prophylaxis, is described.

Antibiotic Prophylaxis↗