سم الله الرحمن الرحيم
الحمد لله و الصلاة على رسول الله
أما بعد :
أود أن أذكر هنا ما قالت به منظمة القلب الأمريكية و نقابة أطباء الأسنان الأمريكية بالعدول عن رأيها السابق بالتغطية بالصادات الحيوية قبل معالجة الأسنان لمرضى القلب
فإلى الأعضاء الأعزاء أود أن أنقل لكم هذا الموضوع ما تراجعت عنه منظمات أطباء الأسنان و القلب الأمريكية
American Heart Association (AHA) and (ADA) American Dental Association
حيث قالت أنه لا داعي للتغطية بالصادات الحيوية
و قد نشر مقال البحث في

• Journal of the American Dental Association (JADA) : Prevention of Infective Endocarditis: Guidelines from the American Heart Association (June 2007)

و في :

The AHA’s latest guidelines were published in its scientific journal, Circulation, in April 2007

و إليكم النص كاملاً :

Overview
Please note: Guidelines for patients who have total joint replacement have not been changed. For more information see A-Z Topic: Antibiotic Prophylaxis.
.................................................. .................................................. ............................
For decades, the American Heart Association (AHA) recommended that patients with certain heart conditions take antibiotics shortly before dental treatment. This was done with the belief that antibiotics would prevent infective endocarditis (IE), previously referred to as bacterial endocarditis. The AHA’s latest guidelines were published in its scientific journal, Circulation, in April 2007 and there is good news: the AHA recommends that most of these patients no longer need short-term antibiotics as a preventive measure before their dental treatment.
The American Dental Association participated in the development of the new guidelines and has approved those portions relevant to dentistry. The guidelines were also endorsed by the Infectious Diseases Society of America and by the Pediatric Infectious Diseases Society.
The guidelines are based on a growing body of scientific evidence that shows the risks of taking preventive antibiotics outweigh the benefits for most patients. The risks include adverse reactions to antibiotics that range from mild to potentially severe and, in very rare cases, death. Inappropriate use of antibiotics can also lead to the development of drug-resistant bacteria.
Scientists also found no compelling evidence that taking antibiotics prior to a dental procedure prevents IE in patients who are at risk of developing a heart infection. Their hearts are already often exposed to bacteria from the mouth, which can enter their bloodstream during basic daily activities such as brushing or flossing. The new guidelines are based on a comprehensive review of published studies that suggests IE is more likely to occur as a result of these everyday activities than from a dental procedure.
The guidelines say patients who have taken prophylactic antibiotics routinely in the past but no longer need them include people with:
• mitral valve prolapse
• rheumatic heart disease
• bicuspid valve disease
• calcified aortic stenosis
• congenital heart conditions such as ventricular septal defect, atrial septal defect and hypertrophic cardiomyopathy.
The new guidelines are aimed at patients who would have the greatest danger of a bad outcome if they developed a heart infection.
Preventive antibiotics prior to a dental procedure are advised for patients with:
1. artificial heart valves
2. a history of infective endocarditis
3. certain specific, serious congenital (present from birth) heart conditions, including
o unrepaired or incompletely repaired cyanotic congenital heart disease, including those with palliative shunts and conduits
o a completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first six months after the procedure
o any repaired congenital heart defect with residual defect at the site or adjacent to the site of a prosthetic patch or a prosthetic device
4. a cardiac transplant that develops a problem in a heart valve.
The new recommendations apply to many dental procedures, including teeth cleaning and extractions. Patients with congenital heart disease can have complicated circumstances. They should check with their cardiologist if there is any question at all as to the category that best fits their needs.
The full report is available below, along with supporting charts and information. If you have any questions about these guidelines, please feel free to contact the ADA Division of Science via e-mail or by calling 312-440-2878.
ADA members may use the Association’s toll-free number and ask for x2878.

بصراحة انصدمت بالحكي
يعني في اسئناءات من البروتوكول الوقائي بتصرع ... هلأ هدول مارح نعطيهون اي شي ابدا اذا في عندهون معالجة سنية؟ فيك تحط رابط لمصدر الموضوع؟

فعلاً حكي كتير قوي !! يعني التغييرات اللي علموها جريئة !! يا شباب بدنا الكلام الفاصل بهل الموضوع الله يرضى عليكم !!

غريب تغييرات جزرية
طيب هل هذه التغييرات سوف تغير ما كان قائم و هل سوف نعتمدها فيما يتعلق بفحص USMLE

بسم الله الرحمن الرحيم

الحمد لله و الصلاة و السلام على سيدنا محمد رسول الله

لقد نشرت الموضوع منذ أكثر من شهر و الآن تقومون بالرد عليه أين كان الأعضاء ؟؟؟؟
ماذا تفعلون في الإنترنت ؟؟؟
عفواً على هذه المقدمة ( تقومون بالرد على موضوعات قديمة و تنسون الموضوعات العلمية ) ( أنتم طلاب عليكم أن تبحثوا عن كل شيء جديد في عالم الطب و طب الأسنان و تضعوه في هذا المنتدى ...

عذراً مرة أخرى

الموضوع تم نشره على موقع نقابة أطباء الأسنان الأمريكية

على هذا الرابط http://www.ada.org/public/topics/antibiotics.asp

نعم تغييرات جذرية و لولا أن الموضوع مهم لما وضعته

( إذا كنت تريد العلم في عصرنا تعلم الإنكليزية ...
( إذا كنت تريد أن تعرف ما هو الجديد في العلوم تعلم الإنكليزية...
( إذا كنت تريد أن يكون صوتك مسموعاً عالمياً تعلم الإنكيزية ...
( إذا كنت تريد الجنـــة تعلم العربيــــــــة ....

مرحبا شباب ..

وعذرا دكتور حميدي إذا رجعنا فتحنا الموضوع القديم ..

لكن تأكيدا على أهمية هذا الموضوع ، فلقدت نشر في الـ BDJ في إذدارها الأول لشهر نوفمبر 2008 فيما يتعلق حول هذا الموضوع وأن القول الصل سيكون في شهر آذار/مارس 2008

تفاصيل المقالة :

BRITISH DENTAL JOURNAL VOLUME 204 NO. 3 FEB 9 2008

An end to antimicrobial prophylaxis against infective endocarditis for dental procedures

In 2005/6 a working party of the British Society for Antimicrobial Chemotherapy (BSAC), after considering the evidence for the use of antimicrobial prophylaxis for dental patients at risk of infective endocarditis, felt that it was not justifi ed. They considered that the total abolition of the current guidelines was too drastic and therefore only certain groups of patients were recommended to receive antimicrobial prophylaxis. This advice did not find favour with a number of medical professionals including some, but not all, cardiologists. In response to the controversy, consideration of the available evidence was referred to the National Institute for Clinical Excellence (NICE), who published their conclusions, not just for dentistry, but for other surgical interventions in November 2007 for consultation.
NICE considered the possibility of defining risk groups of patents who are more likely to develop IE and identifi ed four, those with: acquired valvular disease (including stenosis and regurgitation), valve replacement, structural congenital heart disease and hypertrophic cardiomyopathy. The evidence for these conclusions is clearly presented and documented, providing a major help to practising clinicians in defi ning risk.


THE ROLE OF BACTERAEMIAS

The role of bacteraemias in the pathogenesis of IE was also considered. In particular, the evidence as to whether IE is caused by bacteraemias after dental procedures, or other normal activities such as tooth brushing. The seminal work of Roberts played a large part in the conclusion by NICE that IE was unlikely to be caused by any single dental procedure.3 IE could occur at any time in individuals at risk without there being a single responsible surgical event. NICE recognised the essential and pivotal roles of the individual and the dental professional in maintaining the oral health of patients at risk of IE. This is the second scientific enquiry (the first was the BSAC in 2006) that recognised that the link between dentistry and IE is at best unproven and unsupported by science. The conclusion from this has to be that it is impossible to precisely defi ne a single dental procedure, whether it causes a bacteraemia or not, that is likely to cause IE.

NICE reported that there was no evidence to support the contention that antibiotic prophylaxis reduces bacteraemias, although it may reduce the frequency of their detection after the procedure; concluding that it was therefore not possible to determine its effect on bacteraemias. There is further consideration of the effect of chlorhexidine rinses on bacteraemias in patients at risk of IE. Again, NICE could not decide whether or not chlorhexidine reduces the incidence of post–operative bacteraemias. On the basis of this and other evidence NICE makes a clear and unequivocal recommendation in the consultation document that neither antibiotic prophylaxis, nor chlorhexidine should be given before any dental procedures in patients at risk of IE.
Having compiled all the available data on economic factors the group concludes that if amoxicillin prophylaxis was effective the cost of preventing one case of IE would be approximately £12 million. It was found impossible to calculate the cost of preventing one death from IE as no data could be found to support the contention that amoxicillin would be effective. The adverse affects of amoxicillin (ie anaphylaxis) are also discussed and found to far outweigh any benefits.

It is to be hoped that the consultation will have stimulated considered and scientifi cally-supported responses so the debate can move constructively forward. This is no time for emotion and unsupported contentions to cloud what is a substantial and unbiased consideration of the available science by a respected, unbiased group. NICE will publish their defi nitive recommendations next month and if there are no substantive scientifi c objections then effectively March 2008 will see an end to antimicrobial prophylaxis for patients who were considered at risk of IE after dental procedures. Perhaps it will also bring to an end both the threat of, and actual, litigation involving dentistry and IE.4 It will however pose some difficulties in communication for dentists who have previously recommended antimicrobial prophylaxis, as patients may need convincing that that there is no longer a need. Instead, perhaps NICE will focus the emphasis for dentists on where it should be, making sure patients with cardiac conditions have and maintain good oral health.