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Biomedical subjects

E A Field

Publications and source records attributed to E A Field.

At least 73 records · Page 4Linked to original sources
PubMed1994

Nasal cytology in patients with allergic rhinitis: effects of intranasal fluticasone propionate.

BACKGROUND: Nasal cytograms of patients with allergic rhinitis contain increased numbers of eosinophils and basophilic cells. Neutrophils are also more numerous in cytograms of allergic persons. Topical intranasal corticosteroid therapy for allergic rhinitis has been shown to decrease the numbers of some inflammatory cell types. Fluticasone propionate aqueous nasal spray, a potent synthetic corticosteroid preparation, is effective therapy for seasonal and perennial allergic rhinitis. METHODS: Nasal mucosal scrapings were obtained with a Rhinoprobe (Apotex Scientific, Inc. Arlington, Texas) before and after therapy with fluticasone propionate aqueous nasal spray at several doses in patients with either seasonal allergic rhinitis (2 to 4 weeks' therapy) or perennial allergic rhinitis (24 weeks' therapy). More than 1000 paired nasal cytograms obtained from patients participating in five multicenter studies were evaluated. RESULTS: The percentage of patients with nasal eosinophils (p < 0.01, most studies) and basophilic cells (p < 0.05, most studies) decreased significantly after treatment with fluticasone propionate compared with placebo-treated patients. Similar findings were observed with beclomethasone dipropionate in one study. The number of neutrophils remained relatively unchanged after treatment with the intranasal corticosteroids or placebo. CONCLUSIONS: These findings suggest that the therapeutic benefits of topical intranasal fluticasone propionate and beclomethasone dipropionate for the therapy of seasonal and perennial allergic rhinitis are reflected by the decrease in inflammatory cells in the nasal mucosa.

Administration, Intranasal↗
PubMed1994

The sensitivity to chlorhexidine and cetyl pyridinium chloride of staphylococci on the hands of dental students and theatre staff exposed to these disinfectants.

The aim of this investigation was to study the possible emergence of resistant isolates of the genus Staphylococcus on the hands of dental personnel who use 'Hibiscrub' (chlorhexidine-detergent preparation) and cetyl pyridinium-coated gloves. Resistance was determined by a rate-of-kill technique. In four dental student groups (first, second, third and fourth years) no microorganisms survived 30 min exposure to cetyl pyridinium chloride (CPC) or to chlorhexidine diacetate (CDA). In a theatre staff group, no microorganisms survived 30 s exposure to CPC; and only one of 23 isolates survived 30 min exposure to CDA, but was killed after 60 min exposure. It is concluded that staphylococci resistant to either of these disinfectants do not present a problem in dental students or theatre staff.

Aerosols↗
PubMed1994

Fluticasone propionate: an effective alternative treatment for seasonal allergic rhinitis in adults and adolescents.

BACKGROUND: Topical corticosteroids are widely regarded as the reference standard in allergic rhinitis therapy because they are well tolerated and effective against all rhinitis symptoms. We evaluated the efficacy, onset of action, and safety of two dosing regimens of the new corticosteroid fluticasone propionate compared with that of beclomethasone dipropionate in patients with moderate to severe seasonal allergic rhinitis. METHODS: In this double-blind, randomized multicenter trial, 110 adolescents and 128 adults were treated for 4 weeks with one of the following regimens: fluticasone aqueous nasal spray 100 micrograms twice daily or 200 micrograms once daily, beclomethasone aqueous nasal spray 168 micrograms twice daily, or placebo. RESULTS: Patient-rated scores for nasal obstruction, rhinorrhea, and combined nasal symptoms indicated that the two fluticasone regimens were equally effective and that both were superior to beclomethasone during most of the study (P < or = .05) and to placebo throughout the study (P < or = .01). Both fluticasone regimens also demonstrated significant clinical efficacy by 24 hours after the first dose. Clinician-rated mean total nasal symptoms scores for all three active treatments were superior to placebo at most time points but were not significantly different from each other. All treatments were well tolerated, with similar incidence and type of adverse events in all treatment groups and no apparent effects on hypothalamic-pituitary-adrenal (HPA) axis function. CONCLUSIONS: Fluticasone aqueous nasal spray was effective in relieving nasal symptoms in adolescents and adults with seasonal allergic rhinitis. Fluticasone administered once or twice daily was superior to beclomethasone administered twice daily in relieving nasal obstruction and rhinorrhea and in reducing nasal symptoms more quickly.

Administration, Topical↗
PubMed1993

Developmental toxicity evaluation of diethyl and dimethyl phthalate in rats.

Diethyl phthalate (DEP) and dimethyl phthalate (DMP), phthalic acid ester (PAE) plasticizers, were evaluated for developmental toxicity because of reports in the literature that some PAE were embryotoxic and teratogenic. A previous study (Singh et al., '72) suggested that an increased incidence of skeletal defects in rats might result from gestational exposure to DEP (0.6-1.9 g/kg) or DMP (0.4-1.3 g/kg), ip, on gestational days (gd) 5, 10, and 15. In the current study DEP (0, 0.25, 2.5, and 5%) or DMP (0, 0.25, 1, and 5%) in feed (approximately 0.2-4.0 g/kg/day) were supplied to timed-mated rats from gd 6 to 15. Treatment with 5% DMP resulted in increased relative maternal liver weight. Also, animals exhibited reduced body weight gain during treatment (5% DEP or DMP) and during gestation (5% DEP). Weight gain corrected for gravid uterine weight was also reduced in animals fed 5% DEP. However, high-dose treatment with either DEP or DMP resulted in changes in food and water consumption paralleling the body weight reductions, suggesting that apparent toxic effects on maternal body weight may reflect PAE/feed unpalatability. Treatment with 2.5% DEP resulted in only transient changes in body weight during early treatment. The only maternal effects at 0.25 or 1% DMP were minor changes in food and/or water consumption, and there were no effects at 0.25% DEP. Thus, the NOAELs for maternal toxicity were 1% DMP and 0.25% DEP. In contrast to the observed maternal toxicity, there was no effect of DEP or DMP treatment on any parameter of embryo/fetal development, except an increased incidence of supernumerary ribs (a variation) in the 5% DEP group. These results do not support the conclusion of other investigators that DEP and DMP are potent developmental toxicants. Rather, they suggest that the short-chain PAE are less developmentally toxic than PAE with more complex substitution groups, e.g., di(2-ethylhexyl) phthalate, mono(2-ethylhexyl) phthalate, and butyl benzyl phthalate.

Abnormalities, Drug-Induced↗
PubMed1993

Knowledge of wisdom tooth removal: influence of an information leaflet and validation of a questionnaire.

Different methods are now being employed to increase patient's knowledge of operative procedures for the purpose of ensuring informed consent and improving satisfaction with the service provided. Information leaflets are being used as an additional aid in general practice and in hospital units but many are ambiguous and poorly designed. The evaluation of such written information is seldom conducted. Where evaluation has been reported, the measures employed to assess the benefit of the intervention are poorly validated. This study was conducted to help validate a measure of knowledge concerning removal of impacted third molar and to assess in the longer term the effect of the introducing an information leaflet for patients attending the oral surgery clinic at a dental teaching hospital. Predictions were made about how the knowledge scale would perform under certain conditions. These predictions were subsequently tested in a sample of 156 subjects: dental students (n = 55), sixth-formers (n = 50) and relatives of patients attending a dental hospital (n = 51). All the predictions made about the behaviour of the new scale were confirmed, thereby strengthening the validity of the newly designed measure. This approach of conducting preliminary work to gain an understanding of a new measure's behaviour is advocated as an essential first step in the evaluation of initiatives to provide patient information about dental and oral surgical procedures.

Adolescent↗
PubMed1993

Basal cell carcinoma: a diagnostic opportunity for the dental surgeon.

Basal cell carcinoma is the most common form of skin cancer and usually occurs in the head and neck region. Most basal cell carcinomas grow slowly and behave in a relatively benign, nonaggressive fashion, but a proportion of them grow rapidly and infiltrate the structures beneath the skin. The dental surgeon may well come across this tumour and is in an ideal situation to recognize it. The aim of this article is to describe the clinical features of this common skin tumour and to provide a differential diagnosis. Early recognition of a basal cell carcinoma by the dental practitioner means that the patient can be referred for a specialist opinion and the tumour treated while it is still small.

Basal Cell Carcinoma↗
PubMed1993

Halitosis: a review.

Offensive or 'bad' breath (foetor ex ore) has traditionally become known as halitosis and can be very distressing for the individual concerned. This paper reviews the causes and management of halitosis for the general practitioner, who is in an ideal situation to help such patients.

Halitosis↗
PubMed1992

A practical gloving and handwashing regimen for dental practice.

The debate concerning the re-use of gloves in dental practice continues, despite the fact that recent guidelines on cross-infection control recommend that a new pair of gloves should be used for each patient. Whichever policy for glove use is adopted, it is important to take the maximum possible precautions in hand care. This paper presents a practical regimen for hand/glove washing which is simple, quick and effective. The importance of establishing a hand-care regimen in dental practice is emphasised.

Cross Infection↗
PubMed1992

Developmental toxicity of boric acid in mice and rats.

Boric acid (BORA), an ingredient of many cosmetics, pharmaceuticals, and pesticides, was tested for developmental toxicity in timed-pregnant Swiss mice and Sprague-Dawley rats (n = 26-28/group). BORA (0, 0.1, 0.2, or 0.4% in feed) was provided throughout gestation to attain steady-state exposure as early as possible during prenatal development. Average doses (mg/kg/day) were 248, 452, or 1003 in mice, and 78, 163, or 330 in rats. To limit prenatal mortality, BORA (0.8% or 539 mg/kg/day) was provided to an additional group of rats on Gestational Days (GD) 6 to 15 only. On GD 17 (mice) or 20 (rats), fetuses were weighed and examined for malformations (external, visceral, skeletal). Mouse dams exhibited mild renal lesions (greater than or equal to 0.1%), increased water intake and relative kidney weight (0.4%), and decreased weight gain (0.4%) during treatment. There was a reduction of fetal body weight (greater than or equal to 0.2%) and an increased incidence of resorptions and malformed fetuses per litter (0.4%). Morphological changes included an increased incidence of short rib XIII (a malformation) and a decreased incidence of rudimentary or full rib(s) at lumbar I (an anatomical variation). Maternal rats exhibited increased liver and kidney weights at greater than or equal to 0.2%, altered water and/or food intake at greater than 0.2%, and decreased weight gain at greater than 0.4%. Average fetal body weight/litter was reduced at all doses. Prenatal mortality was increased only at 0.8%. The incidence of fetal malformations was significantly increased at greater than or equal to 0.2%. The most frequently observed malformations were enlarged lateral ventricles of the brain and agenesis or shortening of rib XIII. In rats, the no-observable-adverse-effect level (NOAEL) for maternal toxicity was 78 mg/kg (0.1%), while in mice the low dose of 248 mg/kg (0.1%) approached the maternal NOAEL with mild renal lesions in only 2 of 10 females. Embryo/fetal toxicity occurred in all groups of rats at greater than or equal to 78 mg/kg (greater than or equal to 0.1%) while the NOAEL for developmental toxicity in mice was 248 mg/kg (0.1%). Thus developmental toxicity occurred below maternally toxic levels in rats as well as in the presence of maternal toxicity in mice and rats.

Abnormalities, Drug-Induced↗
PubMed1992

Sarcoidosis of the tongue.

A 43-year-old man with an 8-month history of swelling of the tongue is described. Biopsy of the tongue revealed numerous epithelioid cell granulomata. A positive Kveim test, elevated angiotensin converting enzyme level and bilateral hilar lymphadenopathy confirmed the diagnosis of sarcoidosis. Sarcoidosis presenting in the tongue is extremely rare.

Adult↗
PubMed1992

Recurrent aphthous ulceration in children--a review.

The clinical presentation or recurrent aphthous ulceration in children is described together with current views on the aetiology and pathogenesis of the disease. Factors that predispose to this type of oral ulceration are discussed and a rational approach to the management of recurrent aphthous ulceration in children is proposed.

Child↗
PubMed1991

Prophylactic antibiotics for patients with artificial joints undergoing oral and dental surgery: necessary or not?

Prophylactic antibiotic cover for certain oral and dental procedures for patients with artificial joints is a controversial issue. This paper examines the evidence supporting the use of antibiotic cover and concludes that routinely, for the majority of patients with artificial joints, it is not justified. Certain medically compromised patients with artificial joints have a slightly increased risk of infection and, under these circumstances, antibiotic prophylaxis may be justified. The antibiotic recommended for this group is cephradine or in the case of penicillin allergy, clindamycin. Preoperative dental fitness is mandatory for all patients who are to receive artificial joints. This information will be of interest to the oral and maxillofacial surgeon in his own clinical practice, and when giving advice to local general dental practitioners.

Anti-Bacterial Agents↗
PubMed1990

Skin problems associated with routine wearing of protective gloves in dental practice.

Guidelines on cross-infection control recommend the wearing of operating gloves by dental practitioners whilst carrying out routine examinations and treatment on all patients. However, there are a number of dermatological problems that may be associated with the routine wearing of protective gloves in dental practice. This paper describes the aetiology and clinical features of three types of contact dermatitis, ie irritant contact dermatitis, allergic contact dermatitis and contact urticaria. The management of these skin conditions is discussed. Advice is given concerning routine handcare for all dental practitioners.

Dentists↗