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Biomedical subjects

E A Field

Publications and source records attributed to E A Field.

At least 55 records · Page 3Linked to original sources
PubMed1997

The establishment of a xerostomia clinic: a prospective study.

The study investigated the aetiological factors and management of patients who have xerostomia. The subjects were 100 consecutive patients referred to the Oral Medicine Unit for investigation of oral dryness. A detailed case history was recorded and patients underwent a systematic examination together with sialometry, haematological, biochemical and immunological investigations. Suspected cases of Sjögren's syndrome (SS) were referred for assessment by a rheumatologist and ophthalmologist. Objective evidence of salivary gland hypofunction was found in 39 patients. A definite diagnosis of primary and secondary SS was made in 24 and 15 patients respectively, a further five cases had possible primary SS. Other causes of xerostomia were: undiagnosed diabetes (3); drug-induced (11); therapeutic radiation (3); alcohol-related (3); psychogenic (15) and idiopathic (21). Patients complaining of a dry mouth should be questioned about non-oral symptoms. In total, 40% of patients attending the dry mouth clinic had a diagnosis of SS.

Adult↗
PubMed1997

Oral tylosis: a re-appraisal.

The oral lesions in patients with tylosis (palmoplantar keratoderma) associated with oesophageal cancer, are evaluated, based on their clinical presentation, histological features and long term follow-up. The terminology of these lesions is discussed, together with a proposed reclassification of some forms of palmoplantar keratoderma.

Adolescent↗
PubMed1997

An immunohistochemical analysis of p53 protein expression in pre-malignant and malignant tissues of the oral cavity.

This study looks at p53 protein expression in dysplastic and malignant lesions of the oral cavity using an immunohistochemical staining technique. Archival biopsy specimens of oral dysplasia of squamous cell carcinoma from 64 patients were analysed immunohistochemically. Sections from 90 oral biopsy specimens were examined in all. Positive immunohistochemical detection of the p53 protein, demonstrated by brown nuclear staining, was detectable in over 80% of mild, moderate and severe dysplastic tissues as well as carcinoma-in-situ and squamous carcinoma specimens. We concluded that p53 protein expression occurs frequently in both malignant and dysplastic lesions of the oral cavity, suggesting that abnormally detectable p53 protein is present at the very early stages of development of oral squamous carcinoma. Oral cancer may provide a good model for the study of multistage tumorigenesis in head and neck cancer as the lesions are frequently detected at the pre-invasive stage and are accessible to biopsy.

Carcinoma, Squamous Cell↗
PubMed1997

Benign mucous membrane pemphigoid presenting as desquamative gingivitis in a 14-year-old child.

A 14-year-old girl presented with painful, erythematous gingivae, which occasionally developed blisters. There were no other mucosal or skin lesions. Clinical, histopathological and immunofluorescence studies suggested a diagnosis of benign mucous membrane (cicatricial) pemphigoid, presenting as desquamative gingivitis. Benign mucous membrane pemphigoid in childhood is rare and only a few cases with exclusive oral mucosal involvement have been reported in the literature. The desquamative gingivitis responded well to a topical steroid regimen.

Adolescent↗
PubMed1997

Signs and symptoms in patients with salivary gland hypofunction.

Salivary gland hypofunction can have a devastating effect on oral health and may be an indicator of systemic disease such as Sjögren's syndrome. This prospective study investigates the oral and non-oral signs and symptoms in 120 patients with objective evidence of salivary gland hypofunction (ie, an unstimulated whole salivary flow of < 0.2 ml/min). Patients were questioned about symptoms associated with decreased oral function; non-oral symptoms were also noted. The underlying cause of salivary gland hypofunction was established on the basis of clinical and laboratory findings and further investigations. Eighty-five per cent of patients reported symptoms of decreased oral function in addition to oral dryness. Non-oral signs and symptoms were reported by 106 patients. Fifty-three per cent of patients were diagnosed as having Sjögren's syndrome. The prevalence of the following non-oral signs and symptoms were significantly higher in patients with Sjögren's syndrome, than in those without; a history of dry/irritated eyes, salivary gland swelling, dry skin and reduced lacrimal flow. Salivary gland hypofunction is associated with a wide range of oral and non-oral signs and symptoms. Several of these are of potential value as triggers for the clinician to identify patients with Sjögren's syndrome, and should serve to prompt referral for specialist investigation.

Adult↗
PubMed1997

An immediate (type I) hypersensitivity reaction during placement of a dental rubber dam.

A dental student developed swelling of the lips and peri-oral urticaria, immediately after placement of a dental rubber dam during a chairside demonstration of clinical dentistry. A provisional diagnosis of a Type I hypersensitivity reaction to natural rubber latex was made and an appointment organised for specialist investigations. The student reported an atopic history and allergy to peanuts. A Radioallergosorbent Test (RAST), to measure Ig-E antibodies to latex, was positive. The dental student was given advice concerning the avoidance of natural rubber latex. Dental staff must be aware of potentially serious reactions to natural rubber latex in the dental surgery.

Adult↗
PubMed1996

The use of an information leaflet for patients undergoing wisdom tooth removal.

Attempts to inform the patient about surgical procedures have increased for the purposes of ensuring informed consent and improving satisfaction with the service provided. Leaflets are being used as an additional aid in general practice and in hospital units. However, such written information is seldom evaluated. This study was conducted to assess the influence of using an information leaflet for patients attending oral surgery clinics at a local dental hospital. Sixty-six patients were included in the study and invited to complete a questionnaire to assess knowledge of wisdom tooth removal at the time of examination and just prior to surgery. The validity of the knowledge measure had been previously tested. At 1 month follow-up a patient satisfaction questionnaire was completed by the sample. Patients were randomised at the examination appointment into four groups. The first group was provided with the leaflet and prompted to read it by the dentist (WTL + Prompt). The second group was given the leaflet but not prompted (WTL only). The two other groups acted as controls. The third group was provided with a dental health education leaflet with no prompting (Control 1). The fourth and final group was given no additional written material (Control 2) but provided with verbal information and routine warnings in a similar way to all other groups participating in the study. The WTL + Prompt Group showed increased knowledge on retest (P < 0.001). The WTL Group showed a trend to greater knowledge (P < 0.06) however the control groups showed no improvement (P > 0.5). Patient satisfaction, although greatest in the group given a leaflet without prompting, was not simply related to leaflet provision.

Analysis of Variance↗
PubMed1995

Issues of latex safety in dentistry.

The prevalence of reported reactions to natural rubber latex products in both the general population and in dental personnel appears to parallel the rise in glove wearing by health professionals. This paper reviews the irritant and allergic reactions which may be associated with latex products, particularly gloves. The aetiology, pathogenesis, diagnosis and management of immediate Type I (IgE mediated) responses to latex are described in some detail. The paper provides the reader with an insight into factors that may lead to latex allergy and outlines measures for handling 'latex sensitised' individuals in the dental surgery.

Dentistry↗
PubMed1995

Oral mucosal screening as an integral part of routine dental care.

The principal aim of this study was to assess the feasibility of conducting a systematic examination of the oral mucosa, as an integral part of the routine dental check-up and in conditions comparable with those in NHS dental practice. A total of 1949 individuals, who were already registered as patients with an industrial dental clinic, were invited to attend for an oral screen as part of their dental examination. Of these, 1947 patients agreed to participate and were also asked to complete a 'habits' questionnaire relating to their tobacco and alcohol use. A systematic examination of the oral mucosa was undertaken as part of the routine dental inspection and mucosal lesions were recorded as either a positive or negative screening result. Lesions included as a positive result were those which may be associated with early cancer or precancer. Four patients (0.2%) were considered to have a positive screening result and these were referred for specialist evaluation. Of these, two had tobacco-related leukoplakia, one had oral lichen planus and the other had an early squamous cell carcinoma. This study has confirmed that a systematic and thorough examination of the oral mucosa can realistically be carried out as part of the routine dental inspection in NHS dental practice.

Adult↗
PubMed1995

Oral signs and symptoms in patients with undiagnosed vitamin B12 deficiency.

The oral manifestations of glossitis, stomatitis and mucosal ulceration in vitamin B12 deficiency have long been recognised. These oral changes may occur in the absence of symptomatic anaemia or of macrocytosis. The aim of this paper is to describe a retrospective study of the wide range of oral signs and symptoms reported by 14 patients found to have a previously undiagnosed vitamin B12 deficiency. None of the patients described in this study had generalised symptoms sufficiently advanced to arouse suspicions of vitamin B12 deficiency. The essential criteria for the diagnosis of pernicious anaemia are also discussed.

Anemia↗
PubMed1995

Salivary gland hypofunction in elderly patients attending a xerostomia clinic.

OBJECTIVES: To investigate the aetiological factors and the prevalence of salivary gland hypofunction (SGH) in patients complaining of xerostomia. DESIGN: Prospective, clinical study. SETTING: Xerostomia clinic in the Department of Oral Medicine at Liverpool University Dental Hospital. SUBJECTS: 100 consecutive patients, aged 60 years or older, referred for investigation of xerostomia. INTERVENTIONS: Patients were asked specific questions concerning their complaint of oral dryness and associated orofacial symptoms. A detailed medical history was recorded and patients underwent a systematic examination of the head, neck and oral structures. All patients underwent haematological, biochemical, immunological investigations, urinalysis and sialometry. Further investigations and referrals to other specialists were undertaken when appropriate. MAIN OUTCOME MEASURES: The causes of xerostomia were established on the basis of clinical and laboratory findings and SGH was defined as an unstimulated whole salivary flow rate of < 0.2ml/min, RESULTS: The causes of xerostomia were identified as: Sjögren's Syndrome (40), iatrogenic (22), psychogenic (14), idiopathic (19), diabetes (1), candidosis (3) and alcohol (1). Sixty five percent of the patients studied had SGH. CONCLUSIONS: This study has shown that 65% of patients whose presenting complaint was xerostomia had objective evidence of SGH. Several aetiological factors were identified, the most common of which was Sjögren's Syndrome. The possibility of associated systemic diseases should be considered when establishing the aetiology of SGH.

Aged↗
PubMed1995

Hypoallergenic gloves.

Hypoallergenic gloves have been introduced in response to the growing problems of occupationally acquired hand dermatitis. Such labelling can, however, be misleading and some gloves contain measurable allergen levels. Hypoallergenic gloves containing natural rubber latex will not address the problem of individuals suffering from latex allergy and their inappropriate use may provoke a potentially life threatening reaction. Regulatory authorities must ensure that manufacturers provide adequate labelling for gloves, with the appropriate warning about their allergen content. Dental health care workers must become more knowledgeable about gloves and staff should be given appropriate advice about the risks of latex sensitisation.

Allergens↗
PubMed1994

Delusional symptoms in dental patients: a report of four cases.

Patients with delusional symptoms may present to the dental surgeon and it is important that these are recognised and appropriate psychiatric assessment arranged. Four cases of dental patients who presented with delusional symptoms are described. Guidance is given to the GDP concerning management of this demanding group of patients.

Adolescent↗
PubMed1994

Trigeminal neuralgia: a cautionary tale.

Trigeminal neuralgia is one of the paroxysmal symptoms of multiple sclerosis and may appear in the prodromal stage of this degenerative disease. A patient is described who was diagnosed as suffering from idiopathic trigeminal neuralgia and subsequently developed symptoms of generalised neurological disease, diagnosed as multiple sclerosis. Clinicians should be cautious when diagnosing younger patients as suffering from idiopathic trigeminal neuralgia and all suspicious cases should be referred to a neurologist for full assessment.

Adult↗