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Biomedical subjects

Michaell A Huber

Publications and source records attributed to Michaell A Huber.

15 recordsLinked to original sources
PubMed2007

Osteogenesis imperfecta.

Osteogenesis imperfecta is a relatively common hereditary connective tissue disorder characterized by bone fragility and fractures. Other frequently affected tissues include tendons, ligaments, skin, sclera, teeth, and middle and inner ear. Molecular studies have demonstrated that most cases result from mutations affecting the genes responsible for the formation of type 1 collagen. The phenotypic presentation varies from mild to lethal. Commonly observed dental abnormalities include dentinogenesis imperfecta and malocclusion. Medical therapies using bisphosphonates have resulted in reduced fracture risk and decreased bone pain. To date, no cases of bisphosphonate-associated osteonecrosis have been reported. With appropriate precautions, the patient with osteogenesis imperfecta can tolerate and benefit from the delivery of necessary dental care to control oral disease, improve function, and improve esthetics.

Bone Density Conservation Agents↗
PubMed2006

Cost analysis of hand hygiene using antimicrobial soap and water versus an alcohol-based hand rub.

Proper hand hygiene is acknowledged as the most critical element of an adequate infection control program in the oral healthcare setting. However, adherence to proper hand hygiene protocols is often lacking. Poor compliance with hand hygiene protocols has been attributed to such factors as lack of time, hand irritation, hand dryness, forgetfulness, skepticism over importance, understaffing, perceived low risk of cross-infection, inconvenience, and the belief gloves alone offer protection. In the medical environment the use of alcohol-based hand rubs now represent the preferred method of performing hand hygiene when delivering non-surgical care. In this study we compared the costs associated with traditional hand washing against an alcohol-based hand rub protocol in the dental setting. The results indicate an alcohol-based hand rub protocol is less costly and less time consuming when compared to traditional handwashing in the dental setting, creating a new paradigm for hand hygiene in the dental office.

Alcohols↗
PubMed2006

Adverse reactions to latex products: preventive and therapeutic strategies.

Evidence-based infection control/exposure control practices are evolutionary in nature. Elements of historical note were first recorded with the suggestions of Lister for guidelines on aseptic procedures. Others, like Semmelweis, promoted the practice of hand washing by medical students and physicians prior to leaving autopsy suites and before entering the labor and delivery areas of hospitals. Halstead is credited with being the first to use surgical gloves in a clinical setting. While the use of latex surgical gloves became routine by the end of World War I, it wasn't until the adoption of universal precautions by the Centers for Disease Control in 1987 that the use of gloves was officially expanded to cover virtually all aspects of patient care. The ubiquitous use of latex gloves and other latex products in healthcare has resulted in a parallel increase in latex-associated adverse reactions. To provide for a safe environment for both oral healthcare providers and patients alike, clinicians must understand the basis for latex-related adverse reactions, recognize associated signs and symptoms, and initiate appropriate preventive and therapeutic strategies. The recommendations for preventing/minimizing latex allergy in the oral healthcare setting are based on current knowledge and a common sense approach to the problem. Evolving manufacturing technology and improvements in measurement methods (for latex proteins) may lead to changes in these recommendations in the future.

Anaphylaxis↗
PubMed2006

The use of COX-2 inhibitors for acute dental pain: A second look.

BACKGROUND: On the basis of their perceived better safety profile compared with other analgesic agents, cyclo-oxygenase-2 (COX-2) inhibitors have been prescribed frequently as first-line agents to treat acute dental pain. However, recently identified cardiovascular adverse reactions associated with these drugs mandate a reappraisal of their use in dental practice. TYPES OF STUDIES REVIEWED. The authors reviewed 18 clinical studies that evaluated the efficacy of a COX-2 inhibitor for the treatment of acute dental pain. All of the studies used the widely established third-molar surgical extraction model to induce postsurgical inflammatory based pain, and all were randomized, double-blinded and placebo-controlled. However, numerous vagaries in overall study design made direct comparisons difficult. RESULTS: None of the studies established any of the COX-2 inhibitors as clearly better than ibuprofen, the current gold standard for the treatment of surgically induced dental pain. However, in single-dosing scenarios, the COX-2 inhibitor often demonstrated a longer duration of action compared with ibuprofen. CLINCAL IMPLICATIONS: The evidence to date fails to demonstrate any therapeutic advantage to using a COX-2 inhibitor to treat acute dental pain compared with ibuprofen. In the rare event that a COX-2 inhibitor may be appropriate, the clinician must inform the patient of the potential risks, and the drug should be used for the shortest possible time.

Analgesics↗
PubMed2005

Squamous cell carcinoma of the oral tissues: a comprehensive review for oral healthcare providers.

North Americans in 2004 were projected to die from oral and pharyngeal cancer at a rate of 1.2 per hour. Oral healthcare providers can be instrumental in reducing the incidence of oral and pharyngeal premalignant and malignant lesions by identifying patients with high-risk behavior, educating their patients about the consequences of their high-risk behavior, and by early detection of premalignant and malignant conditions. The fact only 34% of the cancers of the oral cavity and larynx are localized at the time of diagnosis and evidence that at least one third of the patients diagnosed with an oral or pharyngeal malignancy have undergone oral cancer screening within the past three years suggests the current protocol for the early detection of pre-malignant or malignant changes appears to be deficient. To facilitate early diagnosis, oral healthcare providers must take into consideration the capriciousness of oral cancer and must be familiar with the availability and application of diagnostic modalities beyond conventional visual inspection and palpation of oral soft tissues. This article provides a comprehensive review of the disease for healthcare professionals.

Carcinoma, Squamous Cell↗
PubMed2005

The medical oncology patient.

Chemotherapy may be either an effective alternative to surgery or a valuable adjunct to surgery and/or radiotherapy in the treatment of cancer. The care of medical oncology patients is a multidisciplinary effort. Oral health care providers can expect to be called on to care for patients with cancer undergoing chemotherapy. Early, active participation in developing preventive and therapeutic strategies, in implementing the plan, and in the education and rehabilitation of patients is paramount in addressing quality of life issues. To provide timely and competent care, oral health care providers must understand the disease, its treatment, and the impact the disease and/or its treatment may have on these patients. Oral health care providers should develop and implement preventive and therapeutic strategies with the same ethical, moral, and professional standards of care as may be appropriate in the management of any other patient.

Antineoplastic Agents↗
PubMed2004

Biovigilance.

Explore the source record for details and available documents.

Bioterrorism↗
PubMed2004

Acetic acid wash and chemiluminescent illumination as an adjunct to conventional oral soft tissue examination for the detection of dysplasia: a pilot study.

Population-based oral cancer screening appears to be a promising health promotion strategy (especially in high-risk individuals) with significant increases in quality-adjusted life years saved. However, the current protocol, conventional visual inspection, and palpation of oral soft tissues for the early detection of pre-malignant or malignant changes, appears to be deficient. The adjunctive application of technology to highlight such lesions may increase the diagnostic yield. The purpose of this pilot study was to collect data, which might support the hypothesis that oral soft tissues exhibit features similar to the cervical epithelium following an acetic acid wash and visual inspection under chemiluminescent illumination. The data provides strong evidence to support the hypothesis. Epithelium with hyperkeratinization, hyperparakeratinization, and/or chronic inflammatory infiltrate reflects the diffuse, low-level, blue-white chemiluminescent light more strongly and appears amplified. Similarly, epithelium with an altered nuclear-cytoplasmic ratio also reflects the diffuse, low-level, blue-white chemiluminescent light. In such cases, the lesions become clinically discernible and appear "acetowhite." Large-scale studies are required to further refine issues related to the selectivity and specificity of the technology.

Acetic Acid↗
PubMed2004

Oral lichen planus.

Lichen planus is the most common dermatologic disease with oral manifestations, and oral lichen planus (OLP) is one of the more common mucosal conditions a clinician is likely to encounter in his or her practice. It is an immunologically based, chronic, inflammatory, mucocutaneous disorder of undetermined etiology. While research over the past decade has dramatically improved the overall understanding of the underlying pathogenesis of OLP, specific details of its pathogenesis and a clear understanding of why certain patients are afflicted while others are not, remains elusive. The care and management of patients with OLP continues to challenge even the most experienced clinician, and strongly suspected associations with chronic liver disease and oral squamous cell carcinoma further complicate matters. To provide prudent and competent care, oral health care providers must have a basic understanding of the impact the disease and/or its treatment may have on their patients.

Carcinoma, Squamous Cell↗
PubMed2003

Herpes simplex type-1 virus infection.

Oral infection caused by the herpes simplex virus represents one of the more common conditions the dental practitioner will be called upon to manage. Unique in its ability to establish latency and undergo subsequent recurrence, it is an ubiquitous infectious agent for which a cure does not exist. For the immunocompetent patient, herpes virus simplex infection typically represents nothing more than a nuisance. However, for the immunocompromised patient, this infection is associated with increased morbidity and mortality. Recently introduced antiviral drug regimens may reduce the morbidity and potential mortality of the herpes simplex virus, especially in immunocompromised patients. The value of antiviral therapy in the management of recurrent herpes simplex virus infection in the immunocompetent patient remains an area of contentious debate.

Antiviral Agents↗
PubMed2003

The head and neck radiation oncology patient.

Radiotherapy may be either an effective alternative to surgery or a valuable adjunct to surgery and/or chemotherapy in the locoregional treatment of malignant head and neck tumors. The care of patients with head and neck cancer undergoing radiotherapy or who have completed treatment is a multidisciplinary effort. Oral health care providers can expect to be called upon to care for patients with head and neck cancer undergoing radiotherapy. Early, active participation in developing preventive and therapeutic strategies, in implementing the plan, and in the education and rehabilitation of the patients is paramount in addressing quality of life issues. To provide timely and competent care, oral health care providers must understand the disease, its treatment, and the impact the disease and/or its treatment may have on these patients. Oral health care providers should develop and implement preventive and therapeutic strategies with the same ethical, moral, and professional standards of care as may be appropriate in the management of any other patient.

Candidiasis, Oral↗
PubMedDate not supplied

The patient with a transient bacteremia.

A significant percentage of antibacterial agents that dentists prescribe are used for the prevention of, rather than the treatment of, an established infection. In general, when a single effective drug is used to prevent infection from a specific microorganism--or to eradicate it either immediately or soon after it has become established--chemoprophylaxis frequently is successful. Consequently, chemoprophylaxis may be appropriate for preventing secondary bacterial infection in patients who are ill with other diseases. In situations where bacteremia is highly predictable, it would seem wise to administer prophylactic antibiotics for high-risk patients to minimize morbidity and mortality; however, clinicians should avoid "reflex prescribing" or "rational activism." Before instituting antibacterial chemotherapy to prevent illness, dentists should weigh the benefits and risks to the patient as well as to the community.

Antibiotic Prophylaxis↗
PubMedDate not supplied

The patient with actinic cheilosis.

Recent research has greatly enhanced the understanding of the etiopathogenic pathways underlying squamous cell carcinoma (SCC) of the skin. The predominant etiologic agent is ultraviolet radiation. Excessive exposure to sunlight may lead to the development of sunburn, premature aging of the skin, cataracts, immune suppression, and skin cancer. Actinic keratoses represent an early clinical stage of a continuum that ultimately may progress to become SCC of the skin. Actinic cheiloses represent actinic keratoses that occur on the lip vermilion. While numerous therapeutic measures are available for managing actinic cheilosis, close follow-up, combined with strict measures to reduce future sun exposure, is mandatory. Oral health care providers are in a prime position to identify patients at risk for actinic cheiloses, educate patients on preventive measures to reduce and negate the damaging effects of sunlight, and (if necessary) manage early actinic cheiloses.

Cheilitis↗