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Biomedical subjects

Crispian Scully

Publications and source records attributed to Crispian Scully.

At least 37 records · Page 2Linked to original sources
PubMed2006

Attitudes and awareness of final-year predoctoral dental and medical students to medical problems in dentistry.

An increasing proportion of the population is medically compromised. Dental and medical staff need to communicate and cooperate to afford these patients the best possible health care. In this study, the attitude towards and awareness of medical problems were examined in final-year predoctoral (undergraduate) dental and in final-year medical students. The results revealed that most dental students felt their knowledge of and training in medical problems in dentistry to be moderate to good. In contrast, most medical students thought both their knowledge and training in medical problems in dentistry to be only poor to moderate. Dental students rated the importance of medical problems in dentistry higher than did medical students.

Attitude↗
PubMed2005

Referral guidelines for suspected cancer of the head and neck.

OBJECTIVE: To identify the impact of referral guidelines for head and neck cancer on the economics and effectiveness of the delivery of care. METHODS: A retrospective review of the literature was performed to examine the current referral guidelines and referral models that have impacted the delivery of care. RESULTS: Advances in technology and changes in the diagnostic work up of head and neck cancer require that common symptoms and presentations of head and neck cancer are made available to primary care physicians to improve the expeditious referral of head and neck cancer patients. CONCLUSION: Physician awareness and symptom guidelines may prove effective in expediting the care of patients with head and neck cancer.

Head and Neck Neoplasms↗
PubMed2005

Toluidine blue uptake in potentially malignant oral lesions in vivo: clinical and histological assessment.

To assess the histological features of in vivo toluidine blue (TB) uptake in potentially malignant oral lesions (PML) and to determine whether any were related to clinical Dark versus Pale Royal Blue stain and/or to the malignant/dysplastic nature of the lesions. Frozen sections were used to evaluate TB extra- and intra-epithelial distribution, depth of penetration and nuclear or extra-nuclear uptake. Eighteen lesions were studied. The clinical appearance of a Dark Royal Blue stain was significantly related to the nuclear uptake of the dye. Conversely Pale Royal Blue staining was unrelated to any histological feature. Dark Royal Blue-malignant lesions had more nuclear uptake than benign lesions. The results suggest that Dark Royal Blue staining is the true positive outcome of a TB test and showed that Dark Royal Blue-malignant and Dark Royal Blue-benign lesions have a different histological pattern of uptake.

Carcinoma, Squamous Cell↗
PubMed2005

Functions of the cytokines in relation oral lichen planus-hepatitis C.

BACKGROUND: Lichen planus (LP) is a chronic common mucocutaneous inflammatory disorder of uncertain aetiology. An association between hepatitis C virus (HCV) infection and LP has been recognised, particularly in Italy, Spain and Japan. The pathogenesis of such an association is unclear, but it may be due to cell-mediated cytotoxicity to an epitope shared by HCV and damaged keratinocytes. Recent studies using in situ hybridization suggest that HCV may replicate in the oral mucosa. OBJECTIVES: The aim of the present study was to examine the oral epithelium of patients with oral LP for evidence of HCV-RNA by polymerase chain reaction (PCR) and to examine the relationship to cytokines including interferon (INF-gamma), interleukins (IL-1, IL-2, IL-4, IL-6, IL-8 , and IL-10), tumour necrosis factor (TNF-alpha) and transforming growth factor (TGFbeta-1). PATIENTS/METHODS: We selected 100 Italian patients, and divided them into 4 groups. Group A consisted of 25 HCV+ve patients with erosive oral LP. Group B was a control group constituted by 25 healthy HCV -ve subjects with no LP. Group C consisted of 25 HCV-ve patients with oral reticular LP and Group D was made of 25 HCV-ve patients with oral erosive LP. The patients of group A (test group) were submitted to oral biopsy with 2 samples of epithelium, lesional and non-lesional, and a 10 ml peripheral blood sample was taken. The patients of group B (negative control), C and D (comparison groups) were submitted to oral epithelial biopsy and a 10 ml peripheral blood sample was collected. PCR was used to search for HCV-RNA in biopsy material. Cytokines INF-gamma ,IL-1, IL-2, IL-4, IL-6, IL-8 , IL-10 and TNF-alpha and TGFbeta-1 were assayed in serum. RESULTS AND CONCLUSIONS: PCR did not detect the viral genome in oral epithelium of the patients with oral LP and HCV+ve (group A), but there was an increase in levels of TNF-alpha and a reduction of IL-1, INF-gamma and IL-8 compared to patients who had oral reticular LP but HCV-ve and to patients who had oral erosive LP but HCV-ve, and compared to negative controls. The results indicate that patients of group A showed a reduction of pro-inflammatory but an increase in immunomodulant cytokines. The results suggest the possibility that HCV exerts an indirect effect, mediated possibly by the induction of cytokines and lymphokines.

Cytokines↗
PubMed2005

DNA cytometry of oral leukoplakia and oral lichen planus.

BACKGROUND: DNA cytometry is a technique that allows densitometric analysis of nuclear DNA of cells and in this way the evaluation of DNA ploidy. OBJECTIVE: The purpose of the present study was the evaluation of DNA ploidy in oral leukoplakia and oral lichen planus and correlation with histological dysplasia. METHODS: We analyzed oral incisional biopsies from a group of 40 patients with oral leukoplakias (20 homogeneous and 20 non-homogeneous) and 45 patients with oral lichen planus (25 erosive, 20 reticular), by DNA cytomorphometry, after conventional histological examination of sections stained with haematoxylin and eosin. RESULTS AND CONCLUSIONS: Eight of 20 non-homogeneous leukoplakias showed aneuploidy; (3 showed mild aneuploidy) and only 2 specimens of erosive lichen planus showed moderate aneuploidy, while all 20 cases of reticular lichen planus were diploid. There was not concordance between DNA ploidy and the degree of histological assessed dysplasia.

Aneuploidy↗
PubMed2005

Criteria to rationalize population screening to control oral cancer.

Screening populations for the early detection of asymptomatic malignancies and potential malignancies are intuitively attractive strategies to control or reduce the burden of oral cancer on society. Subsequent preventive and/or therapeutic measures must, however, be substantiated by prospective randomized controlled trials (RCT) to markedly improve patient outcomes to reconcile such usages of 'scarce' healthcare resources. This strategic objective is more likely to be achieved by adopting the precedent established by cardiology, where prevention is emphasized over the treatment of occult lesions. For example, the screening identification of individuals at high oral carcinogenic risk will offer potential educational opportunities to change their behaviors, and/or optimize the implementation of contemporary preventive and therapeutic measures for non-compliant individuals. The imperative to substantiate the effectiveness of the screening assays (tests) by prospective RCT also cannot be ignored to safeguard the public against potential false-negative or false-positive diagnoses.

Carcinoma, Squamous Cell↗
PubMed2005

Tobacco, oral cancer, and treatment of dependence.

Tobacco dependence is recognised as a life-threatening disorder with serious oral health consequences which responds to treatment in the form of behavioural support and medication. While cigarette smoking is the most hazardous and prevalent form of tobacco use in the west, consideration also needs to be given to other forms such as bidi smoking in India, reverse smoking by several rural populations and use of snuff and chewing tobacco. The evidence that the use of tobacco is the major risk factor for oral cancer and potentially malignant lesions of the mouth is clear. Counseling to quit smoking is not applied in a systematic or frequent manner to people presenting with potentially malignant lesions of the oral cavity. This review makes recommendations for interventions by health professionals to encourage and aid cessation of tobacco use as a part of prevention of oral cancer.

Antidepressive Agents↗
PubMed2005

Oral cancer: the association between nation-based alcohol-drinking profiles and oral cancer mortality.

The unclear association between different nation-based alcohol-drinking profiles and oral cancer mortality was investigated using, as observational units, 20 countries from Europe, Northern America, Far Eastern Asia, with cross-nationally comparable data. Stepwise multiple regression analyses were run with male age-standardised, mortality rate (ASMR) as explanatory variable and annual adult alcohol consumption, adult smoking prevalence, life expectancy, as explanatory. Large between-country differences in ASMR (range, 0.88-6.87 per 100,000) were found, but the mean value was similar to the global estimate (3.31 vs. 3.09 per 100,000). Differences in alcohol consumption (2.06-21.03 annual litres per capita) and in distribution between beverages were reported. Wine was the most prevalent alcoholic beverage in 45% of cases. Significant increases in ASMR for every litre of pure ethanol (0.15 per 100,000; 95 CI, 0.01-0.29) and spirits (0.26 per 100,000; 95 CI, 0.03-0.49), non-significant effects for beer and wine were estimated. The impact of alcohol on oral cancer deaths would be higher than expected and the drinking profile could affect cancer mortality, probably because of the different drinking pattern of spirit drinkers, usually consuming huge alcohol quantities on single occasions, and the different concentrations of ethanol and cancer-preventing compounds such as polyphenols, in the various beverages.

Adult↗
PubMed2005

Current controversies in oral lichen planus: report of an international consensus meeting. Part 2. Clinical management and malignant transformation.

Despite recent advances in understanding the immunopathogenesis of oral lichen planus (LP), the initial triggers of lesion formation and the essential pathogenic pathways are unknown. It is therefore not surprising that the clinical management of oral LP poses considerable difficulties to the dermatologist and the oral physician. A consensus meeting was held in France in March 2003 to discuss the most controversial aspects of oral LP. Part 1 of the meeting report focused on (1) the relationship between oral LP and viral infection, with special emphasis on hepatitis C virus (HCV), and (2) oral LP pathogenesis, in particular the immune mechanisms resulting in lymphocyte infiltration and keratinocyte apoptosis. Part 2 focuses on patient management and therapeutic approaches and includes discussion on malignant transformation of oral LP.

Cell Transformation, Neoplastic↗
PubMed2005

Current controversies in oral lichen planus: report of an international consensus meeting. Part 1. Viral infections and etiopathogenesis.

Despite recent advances in understanding the immunopathogenesis of oral lichen planus (LP), the initial triggers of lesion formation and the essential pathogenic pathways are unknown. It is therefore not surprising that the clinical management of oral LP poses considerable difficulties to the dermatologist and the oral physician. A consensus meeting was held in France in March 2003 to discuss the most controversial aspects of oral LP. Part 1 of the meeting report focuses on (1) the relationship between oral LP and viral infection with special emphasis on hepatitis C virus (HCV), and (2) oral LP pathogenesis, in particular the immune mechanisms resulting in lymphocyte infiltration and keratinocyte apoptosis. Part 2 focuses on patient management and therapeutic approaches and includes discussion on malignant transformation of oral LP.

Apoptosis↗
PubMed2005

Oxpentifylline is not effective for symptomatic oral lichen planus.

BACKGROUND: There are no reliably effective therapies for oral lichen planus (OLP). The aim of the present work was to determine the potential efficacy of oxpentifylline in the management of OLP. METHODS: Fifteen patients (six males, median age for the group 52 years, ranging from 33 to 72) with clinically and histopathologically confirmed OLP were treated with oxpentifylline at a dose of 400 mg three times daily. RESULTS: Only 10 patients completed an 8 week course, the other five having to stop therapy because of adverse effects. Only three patients had any relief of their signs and symptoms of OLP. CONCLUSION: The results indicate that oxpentifylline is unlikely to be of benefit for the treatment of OLP.

Adult↗
PubMed2005

Pemphigus mimicking aphthous stomatitis.

BACKGROUND: The aim of this report is to highlight the case that pemphigus vulgaris (PV) may mimic aphthous stomatitis. Pemphigus classically causes persistent oral ulceration. METHODS AND RESULTS: We report five patients from southern Europe, who presented with recurrent oral ulceration mimicking aphthous stomatitis, but who proved by histology, immunostaining and antibodies against epithelial intercellular substance to have PV. CONCLUSION: It is advisable to assay antibodies against desmoglein 3 in patients who appear to suffer recurrent aphthous stomatitis (RAS) with atypical ulceration for location and in adulthood.

Adult↗
PubMed2005

The role of the dental team in preventing and diagnosing cancer: 1. cancer in general.

Prevention and early detection are integral components of the Health Agenda and areas taking on increasing importance and emphasis. Members of the dental profession have an important role to play and, indeed, a duty to advise on the prevention of, not only oral diseases and notably oral cancer, but also on other potentially malignant conditions and their prevention. They are in a position to advise and help protect their patients, staff, colleagues, families and acquaintances. Apart from prevention, early detection and prompt referral for diagnosis offer the best hope to the patient with cancer, providing the best chance of a cure. The signs and symptoms of cancer often resemble less serious conditions and prompt referral to an appropriate specialist usually allows for the best management.

Alcohol Drinking↗
PubMed2005

The role of the dental team in preventing and diagnosing cancer: 2. Oral cancer risk factors.

UNLABELLED: Oral cancer is among the ten most common cancers world-wide, and is especially seen in disadvantaged older males. Cancer arises as a consequence of DNA mutations causing multiple molecular genetic events in many chromosomes and genes, leading to cell dysregulation. Tobacco and alcohol use are extremely important in oral mutagenesis. Environmental factors such as infective agents and genetic factors are implicated in a minority of patients. CLINICAL RELEVANCE: Dental staff can advise on lifestyle changes for the prevention of potentially malignant oral disease and thereby protect their patients, staff, colleagues, families and acquaintances, having the opportunity to make an impact on improving the survival rate and morbidity of oral cancer by detecting both potentially malignant and malignant oral lesions.

Alcohol Drinking↗