Search PubMed⌕ Search

Biomedical subjects

A M Hegarty

Publications and source records attributed to A M Hegarty.

14 recordsLinked to original sources
PubMed2004

An update of the etiology and management of xerostomia.

Salivary gland disease gives rise to salivary gland enlargement, pain, and prolonged xerostomia (dry mouth). Xerostomia is the most common long-standing problem for the majority of affected patients. There are many causes of dry mouth, with long-standing xerostomia being a particular problem in Sjögren's syndrome and after radiation to the head and neck region. Xerostomia is usually managed with saliva substitutes, but a large number of potential systemic therapies of long-standing xerostomia now exist. Some-particularly immunosuppressants-are of fundamental interest for the potential reduction of gland damage in Sjögren's syndrome but as yet are of limited clinical usefulness. Others, particularly pilocarpine and cevimeline, are, or have the potential to be, clinically useful in stimulating salivation by virtue of their action on cholinergic receptors.

Cholinergic Agents↗
PubMed2004

Pyostomatitis vegetans.

Pyostomatitis vegetans is a rare oral disorder often associated with gastrointestinal and/or cutaneous diseases and sometimes with other disorders. The association of pyostomatitis vegetans with inflammatory bowel disease, particularly ulcerative colitis, is well known and in most cases bowel disease precedes the onset of oral lesions by months or years. A peripheral eosinophilia has been observed in most reported cases. Pyostomatitis vegetans is characterized by erythematous, thickened oral mucosa with multiple pustules and superficial erosions. Histopathologically, it is characterized by intraepithelial and/or subepithelial abscesses containing large numbers of eosinophils. The pathogenesis is as yet unknown although immunological and microbial factors have been suggested as possible aetiological factors. Management of pyostomatitis vegetans consists mainly of immunosuppression using topical or systemic corticosteroids with medical and/or surgical treatment of any underlying inflammatory bowel disease.

Diagnosis, Differential↗
PubMed2003

Patient-centred outcome measures for oral mucosal disease are sensitive to treatment.

The aim of this study was to evaluate the sensitivity of two patient-centred outcome measures to the topical application of a corticosteroid (betamethasone) in the treatment of oral lichen planus (OLP). Forty-eight patients with clinical and histological features of OLP were recruited to take part in a 6-week study of the effectiveness of topical betamethasone for the treatment of symptomatic OLP. Participants completed a questionnaire incorporating the 16-item UK Oral Health Related Quality Of Life measure (OHQOL) and the 14-item Oral Health Impact Profile (OHIP-14), rated their pain on 'global' and visual analogue scales (VAS) and underwent an oral examination, at the start and end of the trial. Four (8\%) patients failed to complete the study. The clinical signs of OLP had improved for half (22) of the patients following treatment. Twenty-nine (66%) reported that their oral pain had reduced ('global' scale). More objectively, there were significant differences in VAS ratings of pain (P =0.005), OHIP-14 scores (P =0.036) and OHQOL scores (P =0.003) between the start and end of the trial. In conclusion, both OHQOL and OHIP-14, patient-centred outcome measures are sensitive to the clinical effects of topical betamethasone in the treatment of oral lichen planus.

Betamethasone↗
PubMed2002

Patient-centred outcome measures in oral medicine: are they valid and reliable?

The present study evaluates the performance of patient-centred outcome measures in the oral medicine setting in patients with oral lichen planus. The study included 48 patients with a histologically confirmed diagnosis of oral lichen planus who completed a questionnaire incorporating two patient-centred outcome measures: the 16-item UK Oral Health Related Quality Of Life Measure (OHQOL-UK) and 14-item Oral Health Impact Profile (OHIP-14). They subsequently underwent an oral examination and rated the pain they experienced on a visual analogue scale (VAS). The impact of oral health on their life quality was considerable with physical, social and psychological consequences. Both OHQOL-UK (P<0.01) and OHIP-14 scores (P<0.01) were associated with clinical findings; demonstrating criterion validity. Patient rating of pain experienced (on a VAS) correlated with OHQOL-UK scores (P<0.01) and OHIP-14 (P<0.01); demonstrating construct validity. The mean inter-item correlation for OHQOL-UK was 0.93 and was 0.90 for OHIP-14; demonstrating high internal consistency reliability. Our results suggest both OHQOL-UK and OHIP-14, patient-centred outcome measures perform well in patients with oral lichen planus, demonstrating validity and reliability. This implies patient-centred outcome measures may be utilized in both oral medicine and oral and maxillofacial surgery to assess patient needs and opinions.

Adult↗
PubMed2002

Management of recalcitrant ulcerative oral lichen planus with topical tacrolimus.

OBJECTIVE: Our purpose was to investigate the efficacy and safety of 0.1% topical tacrolimus in erosive or ulcerative oral lichen planus. METHODS: This was an open-label, noncomparative study conducted in an outpatient oral medicine unit in London, United Kingdom. The study covered an 8-week period with a 22-week follow-up after cessation of therapy. Nineteen patients, aged 28 to 87 years with biopsy-proven oral lichen planus refractory to, or dependent on, systemic immunosuppressive agents, were enrolled. Seventeen patients (89%) completed the study. Application of 0.1% tacrolimus was administered to all symptomatic oral mucosal lesions. Clinical review took place 1, 3, 5, 7, and 8 weeks after commencing therapy. Alleviation of symptoms was evaluated by using a visual analogue scale as well as the McGill Pain and Oral Health Impact profile questionnaires. The extent of the oral mucosal erosion or ulceration was directly measured by the same clinician at all visits. Safety assessments included monitoring of adverse events, complete blood cell count, renal and hepatic clinical chemistry, and tacrolimus blood concentrations. RESULTS: Tacrolimus caused a statistically significant improvement in symptoms within 1 week of commencement of therapy. A mean decrease of 73.3% occurred in the area of ulceration over the 8-week study period. Local irritation (in 6 subjects, 35%) was the most commonly reported adverse effect. Laboratory values showed no significant changes with time. Therapeutic levels of tacrolimus were demonstrated in 8 subjects but were unrelated to the extent of oral mucosal involvement. Thirteen of 17 patients suffered a relapse of oral lichen planus within 2 to 15 weeks of cessation of tacrolimus therapy. CONCLUSION: Topical tacrolimus is effective therapy for erosive or ulcerative oral lichen planus.

Administration, Cutaneous↗
PubMed2002

Fluticasone propionate spray and betamethasone sodium phosphate mouthrinse: a randomized crossover study for the treatment of symptomatic oral lichen planus.

BACKGROUND: Symptomatic oral lichen planus (OLP) has been palliated with a wide spectrum of topical and systemic therapies. Although the majority of management strategies include corticosteroids, few have been evaluated in randomized controlled trials. OBJECTIVE: We investigated the acceptability and efficacy of topical fluticasone propionate spray (FP) and betamethasone sodium phosphate mouthrinse (BSP) upon the signs and symptoms of OLP, assessing patient quality of life changes as a consequence of these therapies. METHODS: We implemented a randomized, crossover study in which each drug was administered for a period of 6 weeks with an intervening washout period of 2 weeks at an outpatient oral medicine unit in London, United Kingdom. We treated 48 patients with biopsy-proven symptomatic OLP, and 44 patients (92%) completed the study. The dosage was 50 microg two dose unit sprays and BSP 500 microg, each 4 times daily. Symptomatic improvement was evaluated by means of a visual analogue scale (VAS), the McGill pain score, the Oral Health Impact Profile (OHIP), and Oral Health Quality of Life (OHQoL) questionnaires. The total surface area of the lesions, including all white, erythematous, and ulcerative lesions was measured at each visit. The efficacy, ease of application, and adverse effects associated with each medication were recorded. RESULTS: Both FP and BSP mouthwash caused both a statistically significant reduction in painful symptoms as measured by the VAS and improvement in quality of life as measured by the OHIP and OHoQL indices. There was no significant difference between the two corticosteroids in their efficacy in reducing painful symptoms (measured by the VAS) or in their effect on patient quality of life. Both FP and BSP significantly reduced the surface area of oral lesions. However, FP was statistically significantly better than BSP in reducing lesion surface area. There was no statistically significant difference between the patient-assessed effects of the 2 therapies. CONCLUSIONS: FP and BSP are both effective in the short-term clinical management of symptomatic OLP. FP is more acceptable to patients than BSP because of the convenience of the spray form.

Administration, Topical↗
PubMed1999

Applications of comparative genomic hybridisation in constitutional chromosome studies.

G band cytogenetic analysis often leads to the discovery of unbalanced karyotypes that require further characterisation by molecular cytogenetic studies. In particular, G band analysis usually does not show the chromosomal origin of small marker chromosomes or of a small amount of extra material detected on otherwise normal chromosomes. Comparative genomic hybridisation (CGH) is one of several molecular approaches that can be applied to ascertain the origin of extra chromosomal material. CGH is also capable of detecting loss of material and thus is also applicable to confirming or further characterising subtle deletions. We have used comparative genomic hybridisation to analyse 19 constitutional chromosome abnormalities detected by G band analysis, including seven deletions, five supernumerary marker chromosomes, two interstitial duplications, and five chromosomes presenting with abnormal terminal banding patterns. CGH was successful in elucidating the origin of extra chromosomal material in 10 out of 11 non-mosaic cases, and permitted further characterisation of all of the deletions that could be detected by GTG banding. CGH appears to be a useful adjunct tool for either confirming deletions or defining their breakpoints and for determining the origin of extra chromosomal material, even in cases where abnormalities are judged to be subtle. We discuss internal quality control measures, such as the mismatching of test and reference DNA in order to assess the quality of the competitive hybridisation effect on the X chromosome.

Chromosome Banding↗
PubMed1995

Hemispatial and directional performance biases in motor neglect.

Motivationally responsive motor deficits may occur in isolation or as part of more general neglect syndromes. We describe three patients with two discrete syndromes of isolated motor neglect, differentiated primarily by their performance in motor tasks enacted within or toward the contralesional hemispace. The lesions in our patients likely disrupted attentional interactions with two separable sensorimotor processing subsystems. Physiologic data support the existence of a parietal-lateral premotor circuit that processes information encoded in spatial coordinates referenced to the extrapersonal environment and of a basal ganglionic-mesial premotor circuit that processes information mostly encoded in egocentric skeletomotor coordinates. The correlation of ischemic lesions resulting in hemispatial and directional biases in motor neglect with disruption of known physiologic subsystems may provide the basis for rational cognitive rehabilitation of these higher-order motor deficits. These observations are supported by recent PET studies that document the presence of specific attentional-motoric interactions within discrete processing components of a distributed sensorimotor attentional network.

Attention↗
PubMed1993

Erosion and compressive strength of hybrid glass ionomer cements when light activated or chemically set.

It is claimed that light-activated hybrid glass ionomer cements offer advantages over the conventional glass ionomer lining materials. The compressive strengths and erosion rates of two hybrid glass ionomer lining cements, when light activated and chemically set, were compared with conventional glass ionomer cements. The results demonstrated that the erosion rates of the light-activated materials were comparable with those of the conventional materials. The conventional material, Ketac-Bond, was stronger than the light-activated hybrids. When the hybrid materials were allowed to set chemically alone, their performance was inferior to the conventional glass ionomer lining cements.

Glass Ionomer Cements↗
PubMed1989

Infective endocarditis.

Explore the source record for details and available documents.

Dental Care for Persons with Disabilities↗