Search PubMed⌕ Search

Biomedical subjects

Crispian Scully

Publications and source records attributed to Crispian Scully.

At least 55 records · Page 3Linked to original sources
PubMed2005

The role of the dental team in preventing and diagnosing cancer: 4. Risk factor reduction: tobacco cessation.

UNLABELLED: Tobacco use contributes to many oral and general health disorders.While cigarette smoking is the most hazardous and prevalent form of tobacco use in the industrialized countries, consideration also needs to be given to non-cigarette use such as bidi smoking in India, reverse smoking by several rural populations and use of snuff and chewing tobacco. CLINICAL RELEVANCE: Health professionals should encourage and aid cessation of tobacco use as a part of prevention of oral and other cancers.

Dental Staff↗
PubMed2005

The role of the dental team in preventing and diagnosing cancer: 5. Alcohol and the role of the dentist in alcohol cessation.

Alcohol use contributes to many health disorders and social problems which may affect both the individual and the community, and is a major risk factor for oral cancer and potentially malignant lesions - leukoplakia and erythroplakia. Counselling by doctors and dentists can increase users' motivation to stop alcohol use but is not often applied in a systematic or frequent manner to people presenting with potentially malignant oral lesions. This paper makes recommendations for interventions by health professionals to encourage and aid cessation of alcohol use as a part of prevention of oral cancer.

Alcohol Drinking↗
PubMed2004

Oral mucositis: a challenging complication of radiotherapy, chemotherapy, and radiochemotherapy. Part 2: diagnosis and management of mucositis.

BACKGROUND: Oral mucositis is a common sequel of radiotherapy, chemotherapy, and radiochemotherapy in patients with cancer or patients requiring hemopoietic stem cell transplants. Mucositis has a direct and significant impact on the duration of disease remission and cure rates, because it is a treatment-limiting toxicity. Mucositis also affects survival because of the risk of infection and has a significant impact on quality of life and cost of care. METHODS: This article reviews publications on the diagnosis and management of oral mucositis accessible from a MEDLINE search using as key words mucositis, radiotherapy, chemotherapy, hemopoietic stem cell transplant, and oral. CONCLUSIONS: Conventional care of patients with mucositis is currently essentially palliative, with good oral hygiene, narcotic analgesics, and topical palliative mouth rinses.

Antineoplastic Agents↗
PubMed2004

Editorial.

Explore the source record for details and available documents.

Journal Article↗
PubMed2004

Proliferative verrucous leukoplakia: unusual locations of oral squamous cell carcinomas, and field cancerization as shown by the appearance of multiple OSCCs.

Proliferative verrucous leukoplakia (PVL) is an uncommon entity with a high tendency to develop oral squamous cell carcinomas (OSCCs). The objective of this study was to analyse the presence of various OSCCs in the same patient with PVL. We studied 19 patients with PVL who had developed at least one OSCC. We analysed how many of these developed more than one OSCC over a period between 24 and a maximum of 130 months, indicating the location of their OSCC, clinical type and the time lapse between the appearance of each of the different OSCCs in the same patient. Of the 19 patients, 10 presented more than one of these cancers, one of whom even went on to develop five different cancers. The most frequent location of OSCC was the gingiva and the palate; the least common was the tongue/floor of mouth. Ninety percent were women and 20% were smokers. The average time elapsed between the detection of the first tumour and the appearance of the second was 19.20 months (SD 13.41). Our patients with PVL developed a high frequency of OSCCs, on many occasions manifesting several cancers at different oral locations, thus demonstrating the field cancerization of this entity. The OSCC in PVL patients were at sites quite uncommonly affected in patients who develop OSCC in the absence of PVL.

Aged↗
PubMed2004

Keratosis follicularis of the oral mucosa with oral squamous cell carcinoma.

Darier's disease or keratosis follicularis is a genodermatosis which may involve the oral mucosa. Malignant degeneration is rare. We report the first case of the combined manifestation of oral keratosis follicularis and oral squamous cell carcinoma and discuss the possible involvement of ATP2A2 (located in 12q23-24.1) which encodes the sarco/endoplasmic reticulum Ca(2+)-ATP isoform 2 (SERCA2), in the pathogenesis.

Calcium-Transporting ATPases↗
PubMed2003

Oral mucositis: a challenging complication of radiotherapy, chemotherapy, and radiochemotherapy: part 1, pathogenesis and prophylaxis of mucositis.

BACKGROUND: Oral mucositis is a common sequel of radiotherapy, chemotherapy, and radiochemotherapy in patients with cancer or patients requiring hemopoietic stem cell transplants. Mucositis has a direct and significant impact on the duration of disease remission and cure rates, because it is a cancer treatment-limiting toxicity. Mucositis also affects survival because of the risk of infection and has a significant impact on the quality of life and cost of care. METHODS: This article reviews publications on the etiopathogenesis and prevention of oral mucositis accessible from a MEDLINE search using as key words, mucositis, radiotherapy, chemotherapy, hemopoietic stem cell transplant, and oral. CONCLUSIONS: Of the current available products, ice chips and benzydamine have the strongest scientific evidence of support for prophylaxis of mucositis.

Antineoplastic Agents↗
PubMed2003

Prions and the human transmissible spongiform encephalopathies.

The last 5 years have seen the emergence of a new disease in humans (vCJD), mainly in the United Kingdom. This emergence has been accompanied by an explosion of scientific data on a novel group of the responsible infectious agents called prions and has profound implications for infection control and transfusion policies. Also of concern is the finding of prions in neural, gingival, pulpal, and salivary tissue in animal models and significant titers of infectivity from extraneural organs (particularly, in cases of vCJD, in lymphoreticular tissues). There is limited information on the presence of prion proteins in the oral tissues from human studies. Because of the differences in patterns of disease in animal models and in strains of prion protein, it is difficult to extrapolate directly these findings to humans, but it illustrates a potential for transmission by way of the dental route. High levels of infectivity may be present in tissues early in the incubation period and before clinical signs and symptoms. The dental profession must turn its attention to the routine decontamination of dental instruments to ensure that these procedures are performed to the highest regulatory standard. Clinicians and manufacturers must work closely together to develop instruments that are either single use or can be presented in a form that can be more easily decontaminated. Clinicians must pay close attention to manufacturers' decontamination instructions and must not reuse items designated as single use, such as endodontic files. Improvements in compliance with these requirements will not only reduce the risk of transmission of TSEs but also other less tenacious infectious agents.

Animals↗
PubMed2003

Neck disease and distant metastases.

While the implementation of multi-modality neoadjuvant therapy for the treatment of head and neck cancer has resulted in an improvement in local regional control, there has been a resultant increase in the reported incidence of distant metastasis. This shift in the pattern of patient treatment failure highlights the importance of identifying patients at high risk of developing metastasis, accurately detecting metastasis, and improving treatment strategies for advanced disease. Currently, metastatic lesions from head and neck primaries portend a poor prognosis; however, molecular biologic techniques offer a promising approach to the diagnosis and treatment of micrometastasis and distant metastatic lesions. The identification of tumor-specific gene mutations and the cell surface antigens may play a key role in the future management of head and neck cancer. The following review outlines just several of the current issues related to the contemporary diagnosis and management of metastatic lesions of the head and neck.

Carcinoma, Squamous Cell↗
PubMed2003

Current management of tonsillar cancer.

Traditionally, risk factors for the development of tonsil cancer include the use of alcohol and/or tobacco, however a significant proportion of new cases develop in young patients without these risk factors. Recent investigation suggests that human papilloma virus (HPV) may serve as an etiology in such cases and represent a unique risk factor in a sub-set of patients. Irrespective of the etiology, in the majority of cases early carcinoma of the tonsil can effectively be treated using single modality therapy. While local-regional control and survival are similar following surgery or radiotherapy, primary surgery can be accomplished with minimal functional morbidity while reserving radiation for recurrent disease. In contrast, surgical salvage following external beam radiotherapy can be technically challenging and is often associated with a significant increase in surgical complications and functional morbidity. In contrast to early tonsillar disease, advanced tonsil cancer represents a clinical challenge that requires multimodality therapy. While advanced lesions are often treated with a combination of radiation, chemotherapy, and surgical ablation, management of the neck and distant metastases continues to present a therapeutic dilemma.

Carcinoma↗
PubMed2003

Proliferative verrucous leukoplakia: high incidence of gingival squamous cell carcinoma.

BACKGROUND: Proliferative verrucous leukoplakia (PVL) is a multifocal and progressive lesion of the oral mucosa, often associated with papillomavirus, seen mainly in older females, and characterized by a high recurrence rate and high rate of transformation into verrucous or oral squamous cell carcinoma (OSCC). The aim of this study was to analyse the clinical characteristics of a substantial group of patients with PVL, evaluating the characteristics of those who developed cancer, and comparing them with a group of patients with OSCC but no preceding PVL. METHODS: A group of 30 patients with PVL was studied for the clinical aspects and characteristics, age, sex, location, recurrence, the appearance of new lesions, and the frequency of development of oral cancer. A disease control group was formed with 110 patients with OSCC chosen randomly from among those treated in the same Service in this period of time. The patients were grouped as PVL and no cancer (Group 1); PVL developing cancer (Group 2) and patients with OSCC without clinical lesions associated with PVL (Group 3). RESULTS: The average age of the PVL patients (Groups 1 and 2 combined) was 70.97 +/- 12.73 years, of which 80% were women. Only 23.3% were cigarette smokers. The area most frequently affected with PVL was the lower gingiva. Recurrence after treatment was seen in 86.7%, and new lesions appeared in 83.3%. Many (63.3%) developed cancer (Group 2). Comparison of Groups 2 and 3 patients showed that those with PVL developing cancer were more likely to develop gingival carcinoma and also to be older, more often females, and less likely to smoke tobacco. CONCLUSION: Cancer developing in patients with PVL manifested particularly on the gingiva.

Age Factors↗
PubMed2003

Oral erosive/ulcerative lichen planus: preliminary findings in an open trial of sulodexide compared with cyclosporine (ciclosporin) therapy.

OBJECTIVE: To study the effect of the heparinoid sulodexide systemically, compared with topical cyclosporine (ciclosporin), on chronic oral erosive/ulcerative lichen planus. STUDY DESIGN: An open nonrandomized trial was conducted in two groups of 10 Italian patients with lichen planus, with subjective assessment of pain and assessment of ulceration amelioration by nonblinded clinicians. RESULTS: Comparable pain relief and amelioration of erosions/ulcers were seen in patients on sulodexide and in those on ciclosporin, but with faster healing in those on sulodexide. CONCLUSIONS: Sulodexide appears to be as effective, and perhaps more effective, than topical ciclosporin in the therapy of oral lichen planus, and is less expensive, but full double-blind placebo-controlled studies are required.

Adult↗
PubMed2003

Recurrent aphthous stomatitis unresponsive to topical corticosteroids: a study of the comparative therapeutic effects of systemic prednisone and systemic sulodexide.

BACKGROUND: Recurrent aphthous stomatitis (RAS) is a common oral condition, the etiology of which remains largely unclear. Numerous therapeutic protocols have been tried. Apart from immunomodulators, no therapy is unequivocally effective, and many systemic therapies have potential adverse effects. OBJECTIVE: To compare, in patients with frequent RAS unresponsive to conventional therapies, the therapeutic effectiveness of systemic prednisone with that of systemic sulodexide, a low-molecular-weight heparin with immunosuppressive activity but few adverse effects. METHODS: The study involved a group of 30 patients suffering from frequent minor RAS over >or= 4 months unresponsive to topical corticosteroids. Patients were randomly assigned to one of three study groups: blind therapy with systemic sulodexide or systemic prednisone and control (no treatment). The outcomes were assessed blind on the basis of the days to recovery from pain and days to recovery from ulceration (epithelialization) during the first month of therapy; the number of aphthae appearing during the second month of therapy; and the number of aphthae appearing in the 2 months after the end of the 2-month treatment cycle. RESULTS AND CONCLUSIONS: The effectiveness of systemic sulodexide was almost comparable with that of systemic prednisone in patients with frequent RAS, without significant adverse effects.

Administration, Topical↗
PubMed2003

Linear IgA dermatosis induced by a new angiotensin-converting enzyme inhibitor.

A 68-year-old female patient treated with benazepril for arterial hypertension developed oral and cutaneous blistering. Biopsy of the oral and cutaneous lesions showed neutrophilic microabscesses in the mesenchymal papillae, with epitheliomesenchymal separation. Direct immunofluorescence revealed linear immunoglobulin deposits at the epithelial basement membrane zone, consisting predominantly of IgA. The histologic results supported the clinical diagnosis of drug-induced linear IgA disease. The substitution of benazepril with a beta blocker resulted in complete resolution of all mucocutaneous lesions.

Aged↗
PubMed2003

Sweet's syndrome: recurrent oral ulceration, pyrexia, thrombophlebitis, and cutaneous lesions.

We report a case of Sweet's syndrome with recurrent oral ulceration, pyrexia, skin lesions, and migratory thrombophlebitis, with no detectable systemic cause, during a 2-year follow-up. Biopsy examination both of oral lesions and the skin eruption showed a characteristic dense, perivascular, neutrophilic infiltrate in the lamina propria. Laboratory investigations confirmed an inflammatory syndrome with an increased erythrocyte sedimentation rate, but no underlying cause was found. Sweet's syndrome is a rare immunologically mediated condition that belongs to the group of neutrophilic dermatoses that must be differentiated particularly from Behcet's disease. It is characterized by red-brown plaques and nodules that are frequently painful and occur primarily on the head, neck, and upper extremities. Often the patients also have neutrophilia and fever and may have oral ulceration. In approximately 10% of patients with Sweet's syndrome, there is an associated malignancy--most commonly acute myelogenous leukemia--but some cases, as here, are unassociated with detectable malignant or other disease, although the syndrome may precede the onset of definable systemic disease.

Adult↗