WordNet

suffering from tissue death (同)mortified
inflammation of the mucous membrane of the mouth

PrepTutorEJDIC

壊疽(えそ)の,壊疽にかかった

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/08/19 09:33:04」(JST)

wiki en

Noma is a rapidly progressive, polymicrobial, opportunistic infection that occurs during periods of compromised immune function.

Fusobacterium necrophorum and Prevotella intermedia are thought to be key players in the process and interact with one or more other bacterial organisms (such as Borrelia vincentii, Porphyromonas gingivalis, Tannerella forsynthesis, Treponema denticola, Staphylococcus aureus, and nonhemolytic Streptococcus spp).^[1]

The reported predisposing factors include:^[2]^[3]

malnutrition (particularly A-and B-vitamins) or dehydration
poor hygiene, particularly oral
unsafe drinking water
proximity to unkempt livestock
recent illness
an immunodeficiency disease, including AIDS.

Presentation and prognosis

The mucous membranes of the mouth develop ulcers, and rapid, painless tissue degeneration ensues, which can degrade tissues of the bones in the face.^[4]

In a condition sometimes called noma pudendi, noma can also cause tissue damage to the genitals.

The disease is associated with high morbidity and mortality^[5] and mainly affects children under the age of twelve in the poorest countries of Africa. Children in Asia and some countries of South America are also affected. Most children who get the disease are between the ages of two and six years old.^[6] The WHO estimates that 500,000 people are affected, and that 140,000 new cases are reported each year.^[7] Estimates claim that 80-90% of noma cases die from the disease.

Treatment

Known in antiquity to such physicians as Hippocrates and Galen, noma was once reported around the world, including Europe and the United States. With improvements in hygiene and nutrition, noma has disappeared from industrialized countries since the 20th century, except during World War II when it was endemic to Auschwitz and Belsen concentration camps.^[8] The disease and treatments were studied by Berthold Epstein, a Czech physician and forced-labor prisoner who had recommended the study under Josef Mengele's direction.^[8]

The progression of the disease can be halted with the use of antibiotics and improved nutrition; however, its physical effects are permanent and may require reconstructive plastic surgery to repair. Reconstruction is usually very challenging and should be delayed until full recovery (usually about one year following initial intervention). ^[9]

Children and other noma survivors in Africa are helped by a few international charitable organizations, such as Facing Africa, a UK registered charity that helps Ethiopian sufferers. There is one dedicated noma hospital in Nigeria, the Noma Children Hospital Sokoto, staffed by resident and visiting medical teams. In other countries, such as Ethiopia, international charities work in collaboration with the local health care system to provide complex reconstructive surgery which can give back facial functions such as eating, speaking and smiling. Teams of volunteer medics coming from abroad are often needed to support the local capacity to address the most severe cases, which can be extremely challenging even for senior maxillofacial surgeons.^[10] On 10 June 2010 the work of such volunteer surgeons was featured in a UK BBC Two documentary presented by Ben Fogle, Make Me a New Face: Hope for Africa's Hidden Children.^[11]^[12]

References

^ Neville, Brad. Oral and Maxillofacial Pathology (3rd ed.). Saunders Book Company. pp. 062008. 5.11.
^ "Noma--the ulcer of extreme poverty". N. Engl. J. Med. 354 (3): 221–4. 2006. doi:10.1056/NEJMp058193. PMID 16421362.
^ Enwonwu CO, Falkler WA, Phillips RS (2006). "Noma (cancrum oris)". Lancet 368 (9530): 147–56. doi:10.1016/S0140-6736(06)69004-1. PMID 16829299.
^ "AllRefer Health - Noma (Cancrum Oris, Gangrenous Stomatitis)". Retrieved 2007-07-12.
^ Barmes DE, Enwonwu CO, Leclercq MH, Bourgeois D, Falkler WA. The need for action against oro-facial gangrene (noma). Trop Med Int Health 1997; 2: 1111-1114.
^ "The European Noma-Network". Retrieved 2007-07-12.
^ Bourgeois DM, Leclercq MH. The World Health Organization initiative on noma. Oral Dis 1999; 5: 172-174.
^ ^a ^b Lifton, Robert Jay (1986). The Nazi Doctors: Medical Killing and Psychological Genocide. Basic Books. p. 361. ISBN 0-465-04905-2.
^ Neville, Brad. Oral and Maxillofacial Pathology, 3rd Edition. Saunders Book Company, 062008. 5.11.2
^ Project Harar - Medical care
^ Make Me a New Face: Hope for Africa's Hidden Children at bbc.co.uk
^ Ben Fogle » Blog Archive » Ben’s Documentary on Noma - BBC2

External links

The fight against noma
Fondation Sentinelles
NOMA-HILFE-SCHWEIZ(German)
Graphic Noma Images
All Refer Health article on Noma
Project Harar
The European Noma Network
Les Enfants du Noma(French)
Facing Africa
The Geneva Study Group on Noma
The Dutch Noma Foundation
Bertrand Piccard Winds of Hope Foundation
Gegen Noma e.V. - Against Noma organisation (German)
Noma awareness ad on YouTube "Just €10 can save a life" (German)

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. ノーマ（壊疽性口内炎） noma cancrum oris
2. 川崎病：臨床的特徴および診断 kawasaki disease clinical features and diagnosis
3. カプノサイトファーガ・カニモルサス感染症 capnocytophaga
4. 嫌気性感染症における病態生理、臨床的な手がかり、および微生物の回収方法 pathophysiology clinical clues and recovery of organisms in anaerobic infections
5. 好中球減少性腸炎（盲腸炎） neutropenic enterocolitis typhlitis

English Journal

Endothelial dysfunction and abnormal vascular structure are simultaneously present in patients with heart failure with preserved ejection fraction.

Kishimoto S1, Kajikawa M1, Maruhashi T1, Iwamoto Y1, Matsumoto T1, Iwamoto A1, Oda N1, Matsui S1, Hidaka T1, Kihara Y1, Chayama K2, Goto C3, Aibara Y4, Nakashima A5, Noma K4, Higashi Y6.
International journal of cardiology.Int J Cardiol.2017 Mar 15;231:181-187. doi: 10.1016/j.ijcard.2017.01.024. Epub 2017 Jan 5.
BACKGROUND: Endothelial dysfunction and abnormal vascular structure may be involved in the pathogenesis of chronic heart failure (HF). The purpose of this study was to evaluate simultaneously vascular function and vascular structure in patients with heart failure with preserved ejection fraction (HF
PMID 28082090

Quantifying indirect evidence in network meta-analysis.

Noma H1, Tanaka S2, Matsui S3, Cipriani A4, Furukawa TA5.
Statistics in medicine.Stat Med.2017 Mar 15;36(6):917-927. doi: 10.1002/sim.7187. Epub 2016 Dec 4.
Network meta-analysis enables comprehensive synthesis of evidence concerning multiple treatments and their simultaneous comparisons based on both direct and indirect evidence. A fundamental pre-requisite of network meta-analysis is the consistency of evidence that is obtained from different sources,
PMID 27917493

Endothelial function is impaired in relation to alcohol intake even in the case of light alcohol consumption in Asian men; Flow-mediated Dilation Japan (FMD-J) Study.

Oda N1, Kajikawa M2, Maruhashi T1, Iwamoto Y1, Kishimoto S1, Matsui S1, Hidaka T1, Kihara Y1, Chayama K3, Goto C4, Aibara Y5, Nakashima A6, Noma K6, Tomiyama H7, Takase B8, Yamashina A7, Higashi Y9.
International journal of cardiology.Int J Cardiol.2017 Mar 1;230:523-528. doi: 10.1016/j.ijcard.2016.12.065. Epub 2016 Dec 21.
BACKGROUND: Heavy drinking should be a predictor of endothelial dysfunction. However, there is little information on the effects of light to moderate alcohol consumption on endothelial function. The purpose of this study was to estimate the effects of dose-dependent alcohol consumption on endothelia
PMID 28057366