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Biomedical subjects

D Greenspan

Publications and source records attributed to D Greenspan.

161 records · Page 9Linked to original sources
PubMed1984

Oral "hairy" leucoplakia in male homosexuals: evidence of association with both papillomavirus and a herpes-group virus.

An outbreak of a new form of oral leucoplakia, found principally on the lateral borders of the tongue, is reported in male homosexuals in the San Francisco area. Many of the patients showed evidence of immunosuppression, and candida was often found in the lesions. The characteristic histology is similar to that of the flat wart of skin. There was immunocytochemical evidence of papillomavirus core antigen in 77% of 30 biopsy specimens, but no papillomaviruses were detected by electron microscopy in samples from 6 randomly selected patients. In 5 of these 6 patients there was evidence of a herpes-type virus. Pneumocystis carinii pneumonia has developed in 8 of 37 patients in a 33-month period. This leucoplakia may presage AIDS, may be associated with both papillomavirus and a herpes-type virus, and may offer clues to the pathogenesis of other forms of oral epithelial hyperplasia and dysplasia.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Antibody to early and late antigens of herpes simplex virus type 1 in patients with oral cancer.

HEp-2 cells were infected with herpes simplex virus type 1 (HSV-1) and harvested at selected times thereafter. IgG, IgA, and IgM antibody to virus antigens present in these cells at each time was measured in sera from oral cancer patients, and in matched controls. The IgA response of oral cancer patients was significantly greater than that of controls both at 8 and at 48 hours after infection, but showed no difference in response to HSV-1 virus particles. IgM antibody detected two peaks of antigen synthesis, at 4 and 48 hours after infection. Oral cancer patients had a stronger IgM response than did controls to both early and late peaks; the latter was significant at the 5% level. Oral cancer patients also had a significantly higher IgM response to the virus particle. These results imply the existence of at least two different HSV-1 antigens associated with oral cancer. Both are late antigens; one is recognized by IgA, and the other is recognized by IgM antibody.

Adult↗
PubMed1984

Root caries.

Explore the source record for details and available documents.

Dental Caries↗
PubMed1983

Immunoglobulin class of antibody to herpes simplex virus in patients with oral cancer.

An enzyme-linked immunosorbent assay was used to measure antibody of the IgG, IgA, and IgM classes against Herpes simplex virus type 1 (HSV-1) in human sera. Patients with untreated oral cancer had higher levels of IgM antibody to HSV-1 than did either patients with acute or recurrent herpetic infections or age-matched control subjects. Levels of IgM antibody to cytomegalovirus and total serum IgM concentrations were similar in all groups. Patients who had been treated successfully for oral cancer more than one year earlier did not have higher levels of IgM antibody to HSV-1. The results are consistent with the hypothesis that cancer of the mouth is associated with expression of HSV-1 antigens that stimulate IgM rather than IgG antibody responses.

Adult↗
PubMed1983

Metastatic chordoma to the mandible.

The chordoma is a slowly growing spinal cord tumor that rarely metastasizes. This is the first report in the literature of a chordoma with metastasis to the mandible. The mandibular involvement occurred 4 years after the primary sacral chordoma was controlled by excision and radiation. The jaw lesion did not respond to radiation but has been controlled by resection.

Chordoma↗
PubMed1983

Tobacco usage in patients with head and neck carcinomas: a follow-up study on habit changes and second primary oral/oropharyngeal cancers.

One hundred and sixty patients with head and neck carcinomas were followed from one to 15 years to assess the associations between tobacco usage and the development of multiple head and neck cancers. Seventy-three percent had tobacco habits, with nine of ten users smoking cigarettes. In almost one in five patients (18.1%), second primary oral/oropharyngeal cancers developed in a mean time of five years. Those who did not change their original tobacco habits incurred the greatest risk, as a second primary cancer developed in 30%. Reducing or discontinuing smoking appeared to have a beneficial effect. There was also an increased risk for multiple cancers in males, probably because of their larger amount of daily smoking.

Adult↗
PubMed1982

Neutralizing antibody to herpes simplex virus type 1 in patients with oral cancer.

Neutralizing antibody to Herpes simplex virus type 1 (HSV-1), type 2, and measles virus was measured in the serum of patients with oral cancer, patients with oral leukoplakia, and in control subjects who were smokers and nonsmokers. Significantly higher titers to HSV-1 were found in controls who smoked than in controls who did not smoke. Patients with untreated oral cancer had HSV-1 neutralizing titers similar to those of the controls who smoked, but those with later stage tumors had higher titers than those with earlier stage tumors. In patients who were tumor free after treatment for oral cancer, higher antibody titers to HSV-1 were associated with longer survival times. No association was found between clinical status and antibody to measles virus. The data are consistent with a role for both HSV-1 and smoking in the pathogenesis of oral cancer.

Antibodies, Viral↗
PubMed1981

Osteonecrosis in patients irradiated for head and neck carcinoma.

One hundred patients irradiated for cancers of the oral cavity, oropharynx, and nasopharynx were evaluated for the occurrence of osteonecrosis and associated predisposing factors. Selection was based on availability of complete dental records, a minimum of six months follow-up, and treatment fields, which included maxilla and/or mandible. Bone doses were calculated by using radiotherapy treatment records, port films, and isodose distributions. Osteonecrosis developed in 19 of 78 dentulous patients and in 3 of 22 edentulous patients. The time of development of osteonecrosis varied; in 15 cases osteonecrosis occurred more than one year after treatment. The most important risk factor for the development of osteonecrosis was the radiation dose to bone, particularly in the less vascular mandible. Osteonecrosis 7500 rads to the bone. None of the patients who received less than 6500 rads developed osteonecrosis. The risk was significantly greater when teeth were removed after therapy compared with those individuals with extractions before radiation or no extractions at all.

Head and Neck Neoplasms↗
PubMed1979

Study of a bland dentifrice for persons with radiation-induced mucositis and vesiculo-erosive disease.

Althought the patient group was limited to persons with radiation-induced mucositis, lichen planus, and erythema multiforme, the study indicates the potential usefulness of a bland dentifrice to other patients with sensitive mouths. Although it is presumed that regular brushing habits will aid in oral hygiene and health, the specific effect of a bland dentifrice on control of plaque, caries, and periodontal disease cannot be assessed in this preliminary study. Also, no comparison was made with cleaning techniques in which dentifrice is not used. Therefore, this study indicated only that dentifrice with reduced flavor, like the one used in this study, may encourage better oral hygiene through continued brushing when irritation from regular dentifrices discouages it.

Adult↗
PubMedDate not supplied

Factors influencing oral mucositis in patients receiving chemotherapy.

PURPOSE: Oral mucositis is a painful complication of chemotherapy and can greatly affect patients' morbidity and mortality. Findings from two previous studies suggested a decrease in the prevalence of chemotherapy-induced mucositis in patients with solid tumors. The purposes of this study were to follow a large cohort of outpatients to determine the prevalence of mucositis and to identify whether certain clinical factors were significant in the development of mucositis. DESCRIPTION OF STUDY: In this prospective study, a convenience sample of 199 outpatients was followed for three cycles or until mucositis developed. The clinical factors monitored included the following: pretreatment dental examination/repair; initial standard chemotherapy dosage; prophylactic use of colony-stimulating factors; and use of preventive mouthwashes or other prophylactic measures. RESULTS: Oral mucositis developed in 50 patients (25.1%). Prechemotherapy dental examination/repair and initial standard chemotherapy dosage were equivalent among both groups. Of the 48 patients in whom mucositis developed, 10 (20.8%) received prophylactic colony-stimulating factors. Of 134 patients in whom mucositis did not develop, 46 (34.3%) received prophylactic colony-stimulating factors. This difference was statistically nonsignificant. CLINICAL IMPLICATIONS: Differences in the clinical factors investigated could not explain the lower prevalence of oral mucositis among the current patient cohort. The reason for the diminishing prevalence of this side effect remains unclear, and additional parameters, particularly detailed oral hygiene practices, should be evaluated. In the meantime, oncology clinicians should consider the teaching of patients and urging them to use good oral hygiene practices as necessary and potentially preventive measures against chemotherapy-induced mucositis.

Ambulatory Care↗
PubMedDate not supplied

Oral health care issues in HIV disease: developing a core curriculum for primary care physicians.

BACKGROUND: Given the high occurrence of oral manifestations in patients infected with human immunodeficiency virus (HIV), the relative ease in recognizing these manifestations on physical examination, and their potential impact on the health care and quality of life in these patients, it is critical to provide adequate training for primary care physicians in this area. METHODS: Based on a review of the published literature and the consensus of a national panel of primary care physicians and dentists with clinical and research expertise in this area, a core curriculum was developed for primary care physicians regarding oral health care issues in HIV disease. RESULTS AND CONCLUSIONS: We describe the process of developing the core curriculum of knowledge, skills, and attitudes regarding oral health care issues in HIV disease. The final curriculum is in a format that allows for easy accessibility and is organized in a manner that is clinically relevant for primary care physicians.

Clinical Competence↗
PubMedDate not supplied

Risk factors for HIV-related orofacial soft-tissue manifestations in children.

A retrospective review of the medical records of 492 children perinatally exposed to the human immunodeficiency virus (HIV) compared the prevalence of orofacial soft-tissue manifestations in HIV-infected and noninfected children, identified risk factors for occurrence of orofacial lesions in HIV-infected children, and investigated specific orofacial lesions as indicators of progression of HIV disease. Application of eligibility criteria and the Centers for Disease Control classification of pediatric HIV infection resulted in selection of a study group of 91 HIV-positive children and a control group of 185 HIV-seronegative children who had seroreverted. Analysis of oral lesions showed that 67% of the study group and 8% of the control group had oropharyngeal candidiasis (OPC), 4% of the study group and 0% of the control group had parotid enlargement, and 3% of the study group and 0% of the control group had herpes simplex; all three differences were significant at P < 0.04. No statistically significant association was found between OPC and the risk factors of gender, ethnicity, or mode of delivery (vaginal versus cesarean). However, OPC was associated significantly with all progression markers examined: failure to thrive, use of antiretroviral agents, lower CD4 counts, and development of acquired immunodeficiency syndrome (AIDS). Orofacial manifestations are common in pediatric HIV infection and may serve as markers of infection and predictors of progression of HIV disease to AIDS.

AIDS-Related Opportunistic Infections↗