Noma (Nomas)

A severe gangrenous process occurring predominantly in debilitated and malnourished children, especially in underdeveloped countries. It typically begins as a small vesicle or ulcer on the gingiva that rapidly becomes necrotic and spreads to produce extensive destruction of the buccal and labial mucosa and tissues of the face, which may result in severe disfigurement and even death. Various bacteria have been implicated in the etiology. (Dorland, 27th ed)

Also Known As:

Networked: 106 relevant articles (5 outcomes, 15 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hemorrhage
2.	Stroke (Strokes)
3.	Noma (Nomas)
4.	Infection
5.	Myocardial Infarction

Experts

1.	Sacco, Ralph L: 10 articles (04/2014 - 03/2008)
2.	Elkind, Mitchell S V: 9 articles (04/2014 - 06/2008)
3.	Rundek, Tatjana: 6 articles (04/2013 - 06/2008)
4.	Paik, Myunghee C: 5 articles (04/2014 - 06/2008)
5.	Wright, Clinton B: 4 articles (04/2013 - 05/2011)
6.	Schmidt, Andreas B: 4 articles (02/2012 - 09/2004)
7.	Giessler, Goetz A: 4 articles (02/2012 - 09/2004)
8.	Gardener, Hannah: 3 articles (02/2013 - 01/2009)
9.	Phillips, Reshma S: 3 articles (07/2006 - 01/2005)
10.	Enwonwu, Cyril O: 3 articles (07/2006 - 01/2005)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Noma:

1.	nomegestrol acetateIBA 11/01/1999 - "We have previously shown in postmenopausal women that a 19-nor-progesterone derivative, nomegestrol acetate (NOMA) had a strong antigonadotropic activity and that this effect was not mediated via the androgen receptor. " 12/01/1998 - "This study investigated the efficacy of mifepristone, 10 mg/day for 15 days, followed by nomegestrol acetate (NOMA), 5 mg/day for the next 13 days, for inhibiting ovulation and maintaining regular bleeding cycles in 10 surgically sterilized volunteers. " 12/01/1998 - "The effectiveness of a sequential regimen consisting of mifepristone, 10 mg/day for 15 days, followed by nomegestrol acetate (NOMA), 5 mg/day for the next 13 days, for inhibiting ovulation and maintaining regular bleeding cycles was assessed in 10 surgically sterilized volunteers who were followed for one pretreatment and three treated cycles. " 12/01/1996 - "To further study the mechanism of the antigonadotropic activity of progestins, the effects of a 19-nortestosterone derivative, norethisterone acetate (NETA), and a 19-norprogesterone derivative, nomegestrol acetate (NOMA), were compared. "
2.	Mifepristone (RU 486)FDA Link 12/01/1998 - "This study investigated the efficacy of mifepristone, 10 mg/day for 15 days, followed by nomegestrol acetate (NOMA), 5 mg/day for the next 13 days, for inhibiting ovulation and maintaining regular bleeding cycles in 10 surgically sterilized volunteers. " 12/01/1998 - "The effectiveness of a sequential regimen consisting of mifepristone, 10 mg/day for 15 days, followed by nomegestrol acetate (NOMA), 5 mg/day for the next 13 days, for inhibiting ovulation and maintaining regular bleeding cycles was assessed in 10 surgically sterilized volunteers who were followed for one pretreatment and three treated cycles. "
3.	Anti-Bacterial Agents (Antibiotics)IBA 09/01/2015 - "With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. " 01/01/2015 - "However, in the case of noma, there is no in silico model available for its use in the discovery of efficacious antibacterial agents. " 01/01/2010 - "The management of noma with active disease requires antibiotics followed by reconstructive surgery. " 01/01/1995 - " Without the timely intervention of appropriate antibiotics, noma is almost always quickly fatal. " 01/01/2015 - "Treatment of acute noma includes transfusion of blood and intravenous fluids, administration of antibiotics, putting the patient on a high protein diet and debridement of necrotic areas. "
4.	Acute necrotizing ulcerative gingivitisIBA 04/01/1999 - "In order to study the microbiology of the staging and infection periods of noma 62 Nigerian children, aged 3-14 years, 22 children had acute necrotizing ulcerative gingivitis (ANUG) and were also malnourished, 20 exhibited no acute necrotizing ulcerative gingivitis but were malnourished and 20 were free of acute necrotizing ulcerative gingivitis and in good nutritional state) were evaluated for the presence of viruses and oral microorganisms. " 01/01/1988 - "Acute necrotizing ulcerative gingivitis (ANUG), oral yeast infections, and noma occurred in 10% (p less than 0.01), 4%, and 1%, respectively, of the study group of 72 animals but were found in none of the control animals. " 03/01/2006 - "Poor oral hygiene, measles and malnutrition have been implicated as predisposing factors to Acute Necrotizing Ulcerative Gingivitis (ANUG) and cancrum oris, common oral diseases prevalent among children ages 3-6 years in rural communities. "
5.	AdiponectinIBA 02/01/2013 - "We examined the cross-sectional association between adiponectin, vascular risk factors and race-ethnicity in the population-based Northern Manhattan Study (NOMAS). " 02/01/2013 - "In NOMAS, low-moderate adiponectin was associated with a decreased risk of vascular events despite the fact that low adiponectin levels were associated with an elevated vascular risk profile. " 02/01/2013 - "We examined the association between adiponectin, an adipocytokine secreted by adipose tissue, and vascular events (stroke, myocardial infarction (MI), vascular death) in the multi-ethnic prospective population-based Northern Manhattan Study (NOMAS). "
6.	Glucose (Dextrose)FDA LinkGeneric 06/01/2008 - "Diabetes, fasting glucose levels, and risk of ischemic stroke and vascular events: findings from the Northern Manhattan Study (NOMAS)." 01/01/2009 - "240 patients with clinical signs of non-alcoholic fatty liver disease, who were gathering medical history, blood chemistry, lipid spectrum estimation blood, an oral glucose tolerance test, determination of Noma-test, transabdominal ultrasonography of abdominal organs, morphological study of liver with followed morphometric evaluation of the material. "
7.	ZincIBA 02/01/1999 - "This study showed that impoverished Nigerian children at risk for cancrum oris (noma) had significantly reduced plasma concentrations of zinc (< 10.8 micromol/L), retinol (< 1.05 micromol/L), ascorbate (< 11 micromol/L), and the essential amino acids, with prominently increased plasma and saliva levels of free cortisol, compared with their healthy counterparts. " 01/01/2005 - "Evaluation of random cases of the village and noma children showed marked depletion (p<0.05 or 0.001) of the plasma antioxidant micronutrients (retinol, ascorbic acid, zinc) as well as albumin and blood hemoglobin in the latter, relative to the former group. " 08/01/2006 - "This article will review the cutaneous findings and recent literature regarding B12, niacin, zinc, vitamin A, kwashiorkor, biotin and selenium deficiencies, along with the clinical entities of noma and phrynoderma. "
8.	Vitamin A (Retinol)FDA LinkGeneric 02/01/1999 - "This study showed that impoverished Nigerian children at risk for cancrum oris (noma) had significantly reduced plasma concentrations of zinc (< 10.8 micromol/L), retinol (< 1.05 micromol/L), ascorbate (< 11 micromol/L), and the essential amino acids, with prominently increased plasma and saliva levels of free cortisol, compared with their healthy counterparts. " 01/01/2005 - "Evaluation of random cases of the village and noma children showed marked depletion (p<0.05 or 0.001) of the plasma antioxidant micronutrients (retinol, ascorbic acid, zinc) as well as albumin and blood hemoglobin in the latter, relative to the former group. " 08/01/2006 - "This article will review the cutaneous findings and recent literature regarding B12, niacin, zinc, vitamin A, kwashiorkor, biotin and selenium deficiencies, along with the clinical entities of noma and phrynoderma. "
9.	GonadotropinsIBA 12/01/1996 - "In the patients with CAI, the pulsatile study of gonadotropins was performed before and on day 12 of NOMA and NETA treatments. " 11/01/1999 - "In women with FHA, NOMA decreased the gonadotropin stimulation induced by pulsatile GnRH administration. "
10.	1-Alkyl-2-acetylglycerophosphocholine Esterase (PAF Acetylhydrolase)IBA 10/01/2009 - "Serum samples were collected at 4 annual intervals in 52 stroke-free participants from the Northern Manhattan Study (NOMAS) and assayed for hsCRP and Lp-PLA2 mass and activity levels using standard techniques. "

Therapies and Procedures

1.	Transplants (Transplant) 05/01/2005 - "The authors recommend consideration of the supraclavicular island flap in combination with mucosal or skin grafts as a reliable and safe option for covering most facial defects in noma patients. " 05/01/2005 - "Noma is a disfiguring disease requiring a complex therapeutic strategy involving a range of approaches, from skin grafts to local flaps, pedicled flaps, and free flaps. " 01/01/1978 - "A commonly fatal condition, by virtue of the malignant infectious syndrome which it causes initially, facial noma leaves sequellary mutilitations which may be treated surgically using a panoply of technical procedures from maxillofacial surgery (skin flap, skin and mucosal graft, oestotomy, bone graft, plasty, mechanotherapy by mobilisers, facial massage etc.)."
2.	Gas Lasers 04/01/2014 - "To define the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carci noma. "
3.	Prenatal Care 07/08/2006 - "Noma can be prevented through promotion of national awareness of the disease, poverty reduction, improved nutrition, promotion of exclusive breastfeeding in the first 3-6 months of life, optimum prenatal care, and timely immunisations against the common childhood diseases."
4.	Free Tissue Flaps 07/01/2007 - "The authors' concept for complex central noma defects is a staged approach using free flaps for soft-tissue reconstruction of the upper lip and maxillary vicinity. " 08/01/2005 - "Free flaps can be a suitable and safe closure for complex noma defects even in underprivileged circumstances, if patient profile and own microsurgical routine allows it. " 08/01/2005 - "Microsurgical reconstruction of noma-related facial defects with folded free flaps: an overview of 31 cases." 09/01/2004 - "In 4 years the authors have gained increasing experience with folded free flaps for simultaneous closure of outer and inner lining of large noma defects and the maintenance and training of re-established jaw function by the use of a dynamic external distractor fixed between the zygoma and the mandibular body. " 01/01/1999 - "The authors report a case of a patient affected by Noma, with a very evident left face dismorphism, where we found a brilliant solution using a left radial forearm fasciocutaneous free flap, appropriately shaped."
5.	Oral Hygiene (Dental Hygiene) 04/01/1999 - "The overall data indicated that living in substandard accommodations, exposure to debilitating childhood diseases, living in close proximity to livestock, poor oral hygiene, limited access to potable water and poor sanitary disposal of human and animal faecal waste could have put the children in the Northwest at higher risk for noma than the children in the Southwest. " 04/01/2005 - "Noma can be prevented by vaccinating children against infectious diseases, by controlling malnutrition and by improving their oral hygiene. " 01/01/1995 - " Accordingly, malnutrition, poor oral hygiene, and debilitation resulting from HIV infection, measles, and other childhood diseases prevalent in the tropics are factors associated with an increased probability of developing noma. " 01/01/1995 - "The risk factors associated with an increased probability of noma developing include the following: malnutrition, poor oral hygiene, and a state of debilitation resulting from human immunodeficiency virus (HIV) infection, measles, and other childhood diseases prevalent in the tropics. " 03/01/1998 - "Cancrum oris (noma) has been most commonly described in malnourished debilitated children with poor oral hygiene following systemic childhood infections such as measles, pertussis or scarlet fever. "