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Biomedical subjects

C L Pankhurst

Publications and source records attributed to C L Pankhurst.

At least 19 recordsLinked to original sources
PubMed2005

A 3-year longitudinal, controlled clinical study of a gallium-based restorative material.

AIM: The aim of this three-year longitudinal controlled study was to compare the clinical performance of Galloy versus a high copper, mercury based Dispersalloy filling material. METHODS: Moderate to large class I and class II cavities or replacement restorations were selected and 25 Galloy restorations and 25 Dispersalloy controls were placed in 14 adult patients by a single operator. Restorations were photographed and a silicone impression recorded at baseline, 6 months, 1 year, 2 years and 3 years. RESULTS: At 3 years all 22 Dispersalloy restorations but only 4 Galloy restorations were still in situ. Three Dispersalloy restorations were lost to follow-up. Tooth fracture was observed in 15 (60%) of the Galloy restorations by the end of the 3 years, compared to one (4%) Dispersalloy restoration, which failed due to tooth fracture. A further six Galloy restorations had to be removed due to complaints of persistent pain. Four teeth restored with Galloy required endodontic treatment but none of the Dispersalloy restored teeth required endodontics. Of the four Galloy restorations remaining in situ, three were relatively small restorations and the fourth a moderate sized restoration required a marginal repair. CONCLUSION: The clinical performance of Galloy restorations was so grossly inferior to the Dispersalloy controls that Galloy cannot be recommended for clinical use in moderate to large or multi-surface cavities.

Adult↗
PubMed2003

Prevalence of legionella waterline contamination and Legionella pneumophila antibodies in general dental practitioners in London and rural Northern Ireland.

OBJECTIVES: To determine the prevalence of legionellae in dental unit waterlines (DUWL) in general dental practices in London and rural Northern Ireland and whether the organism occurs at a high enough frequency and magnitude in DUWL to represent a threat to dentists' health. MATERIALS AND METHOD: Two hundred and sixty six (166 London, 100 Northern Ireland) randomly selected dental surgeries were recruited. Standardised 250 ml water samples were taken from the DUWL and 1 litre samples from the surgery cold water tap to measure the prevalence of legionellae. The dentists provided a blood sample for legionella serology. RESULTS: The prevalence of legionellae was very low (0.37%). Legionellae were not isolated from DUWL or surgery basin taps in Northern Ireland. Legionella spp were isolated from the DUWL and surgery basin of one practice in London and from the cold water supply of a further three practices. The prevalence of Legionella pneumophila antibodies was less than that seen in a comparable group of London blood donors. CONCLUSION: The risk to dentists' health from potential exposure to legionellae in this cohort of dentists was very low and this was confirmed by the very low seroprevalence and antibody titres to legionella detected in the dentists.

Antibodies, Bacterial↗
PubMed2000

Sialochemical markers of salivary gland involvement with Sjögren's syndrome secondary to rheumatoid arthritis and primary biliary cirrhosis.

Sjögren's syndrome is an autoimmune condition affecting the lacrimal and salivary glands and can be associated with rheumatoid arthritis and primary biliary cirrhosis. Parotid salivas collected from patients and normal controls were analysed for lactoferrin, IgA and beta2-microglobulin (measured by ELISA), and cystatin (measured by a enzyme inhibition assay). Output data provided less variable means, whilst expressing results as a proportion of the total protein provided greater specificity as markers for Sjögren's syndrome. Levels of specificity for IgA, lactoferrin and beta2-microglobulin were all high (100, 95 and 100%, respectively). Sensitivity levels of these markers (but not cystatin) tended to be similar for Sjögren's syndrome secondary to primary biliary cirrhosis (IgA, 25%; lactoferrin, 63%; and beta2-microglobulin, 50%), compared to Sjögren's syndrome secondary to connective tissue diseases such as rheumatoid arthritis (IgA, 50%; lactoferrin, 86%; and beta2-microglobulin; 38%).

Arthritis, Rheumatoid↗
PubMed1999

Lectin binding studies of parotid salivary glycoproteins in Sjögren's syndrome.

Human parotid salivas were collected from patients with secondary Sjögren's syndrome and controls without disease or with drug-induced xerostomia. Parotid glycoproteins were separated by gradient sodium dodecyl sulphate gel electrophoresis (SDS-PAGE), electroblotted onto nitrocellulose membrane and probed with biotinylated lectins of characterised sugar specificities. The binding patterns of lectins from Maclura pomifera (MPA) and Arachis hypogaea (PNA) indicated that many parotid glycoproteins have sialylated O-linked glycans and that sialylation is not affected by disease. Binding by lectins from Ricinus communis (RCA-1), Limax flavus (LFA), Lotus tetragonolobus (LTA) and Ulex europaeus (UEA-1) appeared unaltered in secondary Sjögren's syndrome, suggesting no obvious change in N-glycosylation of parotid glycoproteins. Variations in binding patterns of most lectins was attributable to subject-to-subject variations in recognised polymorphic proteins. Dolichos biflorus agglutinin (DBA) consistently showed increased binding to a 75 kDa (Mr) protein in salivas from patients with secondary Sjögren's syndrome. The binding protein was identified as lactoferrin but found not to contain N-acetylgalactosamine, the sugar to which DBA binds. Binding of DBA to lactoferrin was dependent upon its saturation with iron, modified SDS-PAGE under nonreducing conditions resolved iron-free and iron-saturated lactoferrins and demonstrated increased levels of the iron-saturated form in secondary Sjögren's syndrome. Lectin binding studies of purified lactoferrins from saliva, milk, and polymorphonuclear neutrophils suggested that raised levels of lactoferrin in saliva originate from salivary cells and not from inflammatory cells. These results suggest that DBA binding provides greater specificity as an indicator of salivary gland disease than measurement of lactoferrin levels alone.

Biotinylation↗
PubMed1998

Oral health behaviour and the prevalence of oral manifestations of HIV infection in a group of HIV positive adults.

The objectives of this study were to assess the prevalence of oral manifestations of HIV infection, the periodontal health status and the oral health behaviour of a group of 51 HIV infected adults. The design was a cross-sectional descriptive study which took place in a community dental clinic in south London dedicated to treatment of this group of patients. Data were collected through a self-administrated questionnaire, interview and clinical examination and results showed that 76.5 per cent had one or more oral manifestations of HIV infection. Intra-oral herpes, papilloma and non-Hodgkin's lymphoma were not identified. A very positive attitude towards oral hygiene was identified. Plaque levels were low. All individuals studied had some evidence of bleeding gums.

AIDS-Related Opportunistic Infections↗
PubMed1998

Microbial contamination of dental unit waterlines: the scientific argument.

The quality of dental unit water is of considerable importance since patients and dental staff are regularly exposed to water and aerosols generated from the dental unit. The unique feature of dental chair water lines is the capacity for rapid development of a biofilm on the dental water supply lines combined with the generation of potentially contaminated aerosols. The biofilm, which is derived from bacteria in the incoming water and is intrinsically resistant to most biocides, then becomes the primary reservoir for continued contamination of the system. Dental water may become heavily contaminated with opportunistic respiratory pathogens such as Legionella and Mycobacterium spp. The significance of such exposure to patients and the dental team is discussed. There is at the present time, no evidence of a widespread public health problem from exposure to dental unit water. Nevertheless, the goal of infection control is to minimise the risk from exposure to potential pathogens and to create a safe working environment in which to treat patients. This paper evaluates the range of currently available infection control methods and prevention strategies which are designed to reduce the impact of the biofilm on dental water contamination, and are suitable for use in general practice. Bacterial load in dental unit water can be kept at or below recommended guidelines for drinking water (less than 200 colony forming units/ml) using a combination of readily available measures and strict adherence to maintenance protocols. Sterile water should be employed for all surgical treatments.

Aerosols↗
PubMed1997

Controversies in the aetiology of temporomandibular disorders. Part 1. Temporomandibular disorders: all in the mind?

The aetiology of temporomandibular disorders (TMDs) is now considered to be multifactorial but the relative importance of individual aetiological factors is still controversial. Psychosocial factors play an important role in the aetiology of TMDs, in adaptation to pain and eventual recovery. TMD patients exhibit a variety of psychological and behavioural characteristics including increased somatization, stress, anxiety and depression. Subcategorisation of TMD patients into joint-related and muscle-related groups reveals psychological differences. Myogenic patients have increased severity of pain and suffer enhanced psychological distress. Within this group of patients are a minority of refractory cases who show marked overlap with those suffering from chronic pain syndrome; such patients benefit from psychiatric assessment and treatment. However, no common TMD personality profile has emerged from the psychometric test research. Recent knowledge of the molecular pathways induced by stress and the evaluation of stress-response substances may, in the future, provide diagnostically valuable biochemical markers of disease susceptibility. The role of psychological factors in the development of TMDs in the general population is critically examined.

Diagnosis, Differential↗
PubMed1996

Glycoproteins in human parotid saliva assessed by lectin probes after resolution by sodium dodecyl sulphate-polyacrylamide gel electrophoresis.

Human parotid salivary glycoproteins separated by gradient sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and electroblotted onto nitrocellulose have been investigated using a battery of biotinylated lectin probes of characterized sugar specificity. Lectin binding, detected on blots using avidin-biotin complex (ABC) and a chemiluminescence generating substrate, was recorded on photographic film and compared with the original fluorescein isothiocyanate (FITC) stained blots or with Coomassie Brilliant Blue R-250-stained gels run in parallel. A number of glycoprotein bands which were undetected by protein stains or the periodic acid Schiff reaction were revealed by lectins. Binding by lectins from Concanavalia ensiformis, Lens culinaris, Limax flavus, Phaseolus vulgaris, Ricinus communis, Triticum vulgaris, Lotus tetragonobulus and Ulex europaeus indicated that sialylated and fucosylated triantennary and bisected, N-linked complex sugar chains were present on many glycoproteins in addition to the major glycosylated proline-rich glycoprotein (GI). Binding with lectins from Arachis hypogaea and Dolichos biflorus indicated that the O-linked sugar chains were confined to the alpha-heavy chain of Ig A. Comparison of lectin binding in samples from five healthy individuals revealed differences in a number of glycoproteins in addition to the previously characterized G1 and CON 1/CON 2 polymorphisms and demonstrated that the H blood group antigen was expressed mainly on G1 in parotid saliva. This study will be used as a basis upon which to study salivary glycoproteins in diseases affecting parotid glands.

Adult↗
PubMed1996

The environmental risk factors associated with medical and dental equipment in the transmission of Burkholderia (Pseudomonas) cepacia in cystic fibrosis patients.

Transmission of Burkholderia (Pseudomonas) cepacia by close contact with colonized patients is well documented, and minimizing social contact between cystic fibrosis (CF) patients by segregation and cohorting of B. cepacia colonized patients has achieved some success in controlling the nosocomial and community spread of this organism. However, direct and indirect environmental transmission still occurs. There is evidence for transmission of B. cepacia to CF patients via pulmonary test equipment, nebulizers and other respiratory equipment used both in CF centres and for homecare, but little or no evidence of spread through aerosols, dental equipment, hands, contaminated disinfectants and water supplies. Infection control procedures for reducing the transmission of B. cepacia are discussed.

Burkholderia Infections↗
PubMed1996

Diagnosis and management of the dry mouth: Part 1.

Dry mouth is a relatively common problem, often neglected by patients and dentists alike. This article reviews the symptoms, causes and treatment of xerostomia and provides guidelines for recognizing the condition at an early stage.

Adult↗
PubMed1995

Activity of sucralfate (sucrose octa-sulphate), an anti-ulcer agent, against opportunistic gram-negative bacilli.

The in-vitro activity of sucralfate (sucrose octa-sulphate) in suspension was examined against 128 strains of Gram-negative bacilli. Inhibitory activity was demonstrated against all isolates and bactericidal activity was demonstrated for 68. Sucralfate has inhibitory and bactericidal antibacterial activity which may contribute to its in-vivo clinical efficacy.

Anti-Ulcer Agents↗
PubMed1995

Evaluation of contamination of the dentist and dental surgery environment with Burkholderia (Pseudomonas) cepacia during treatment of children with cystic fibrosis.

Pulmonary colonization with Burkholderia (Pseudomonas) cepacia in cystic fibrosis (CF) patients has been associated with high morbidity and mortality. The aim of this study was to investigate whether the dentist and the dental surgery environment become contaminated during treatment of CF patients colonized with B. cepacia. Extensive environmental sampling was carried out during aerosol-generating treatment sessions on four CF patients whose sputum was persistently colonized with B. cepacia. Samples of surgery air, and of water from the air-turbine, three-in-one syringe and their supply-lines, were tested before and after an aerosol-generating treatment session with each patient. Settle plates were placed on the bracket table and work-surfaces, and within the portable suction unit's exhaust housing unit during treatment, and swabs were obtained from various items of dental equipment at the end of treatment. Swabs of the buccal mucosa were obtained from each patient before treatment, and from the dentist before and after treatment. B. cepacia was isolated from the swabs of three of the patients, but not from those taken from the dentist or from any of the environmental samples. The results suggest that CF patients colonized with B. cepacia appear to constitute a low risk for environmental contamination and are unlikely to be an important means of transmission between CF patients.

Adolescent↗