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E A Field

Publications and source records attributed to E A Field.

99 records · Page 6Linked to original sources

The effect of fluticasone propionate aqueous nasal spray on eosinophils and cytokines in nasal secretions of patients with ragweed allergic rhinitis.

Cytokines active on eosinophils are important in the pathogenesis of allergic diseases. A study was conducted to determine if nasal eosinophilia in allergic rhinitis is associated with an increase in eosinophil-active cytokines in nasal secretions and to compare the effects of fluticasone propionate aqueous nasal spray with astemizole and placebo on the levels of these cytokines. Forty-five patients with moderately severe ragweed allergic rhinitis were randomly assigned to receive 2 weeks of treatment with fluticasone propionate aqueous nasal spray 200 micrograms once daily, astemizole 10 mg once daily, or placebo. Nasal lavage was performed in July (preseason), August (peak season), September (after 2 weeks of treatment), and October (postseason). The number of eosinophils, the amount of eosinophil-derived neurotoxin (EDN), and the amount of eosinophil survival-enhancing activity were measured. Total mean nasal symptom scores, concentrations of nasal eosinophils and EDN, and eosinophil survival-enhancing cytokine activity in nasal secretions were significantly lower after 2 weeks of treatment with fluticasone propionate compared with astemizole or placebo. Survival-enhancing activity was detected in the nasal secretions of 25 patients. By blocking activity with monoclonal antibodies, specific cytokines were identified (granulocyte macrophage-colony stimulating factor, 3 samples; interleukin-3, 2 samples; interleukin-5, 5 samples). In conclusion, eosinophil-active cytokine concentrations parallel the nasal symptoms of patients with ragweed allergic rhinitis. Unlike astemizole, fluticasone propionate significantly lowers cytokine activity in nasal tissue, which may contribute to the therapeutic efficacy of the drug.

Adult↗

The use of powdered gloves in dental practice: a cause for concern?

OBJECTIVES: To critically review the potential hazards associated with the use of powdered, natural rubber latex (NRL) gloves in dental practice and to report some practical difficulties which may be encountered when handling dental materials with powdered NRL gloves. DATA SOURCES: Articles published in the international literature over the last 10 years. STUDY SELECTION: A number of recent studies in the medical and surgical literature have confirmed that NRL proteins leach out of latex gloves and bind to surgical glove powders. The most serious, potential hazard associated with the continued use of powdered NRL gloves in dental practice is that of latex sensitization by exposure to aerosolized NRL proteins. Hand dermatitis is now recognized as an occupational hazard in dentistry and has been associated with the continuous wearing of protective gloves. Studies, in the dermatological literature, have suggested that glove powders may exacerbate an irritant dermatitis and enhance the potential for adverse reactions to other components of NRL gloves. The surgical literature has already highlighted the risks of post-operative granuloma formation, due to glove powder contamination of the surgical wound. The possible effects of powder contamination of dental implant sites, on the outcome and success of implants has yet to be established. Recent in vitro studies have investigated the effect of latex glove contamination on the shear-bond strength of porcelain laminate veneers: one study demonstrated that starch powder significantly affected the bond strength, whereas the other showed that latex glove contamination of the porcelain surface did not have any significant effect. Long-term, in vivo studies are now required. CONCLUSIONS: Dental practitioners should consider the potential health risks which are associated with the use of powdered NRL in dental practice. Powder contamination may affect the long-term results and success of clinical procedures in dentistry.

Dental Bonding↗

The protein content of dental rubber dams.

OBJECTIVES: The purpose of this study was to analyse the protein content of 17 commonly used rubber dams and to determine if they contained known allergenic proteins. METHODS: Proteins were eluted with buffer from 17 brands of commercially available rubber dams. The quantity of eluted protein was measured and expressed in micrograms in every gram of rubber. The molecular weights of the individual proteins eluted were then measured after resolution on sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and compared with those of known allergens. RESULTS: The rubber dams were shown to contain significant amounts of protein (950-5850 micrograms). The subsequent analysis of these proteins using SDS-PAGE confirmed that some of these proteins were of the same molecular weight as known allergens. CONCLUSIONS: The results of this study confirm that all the rubber dams tested contained significant amounts of protein. The molecular weights of these proteins correspond with those of known allergens, and they could, therefore, be a cause of hypersensitivity reactions to dental rubber dams.

Allergens↗

Fluconazole therapy of oropharyngeal candidiasis in a patient with multiple endocrine failure does not correlate with Candida albicans susceptibility to fluconazole in vitro.

We report a case of oropharyngeal and oesophageal candidiasis in a 23-year-old man with endocrinopathy syndrome. Multiple episodes of infection were treated with topical miconazole, oral ketoconazole (200 mg daily) or oral fluconazole (50 mg daily) over a period of 7 years. The final episode failed to respond to ketoconazole (200 mg daily) or fluconazole (200 mg daily), but was treated successfully by increasing the fluconazole dose to 400 mg daily for 6 months. The patient was maintained on fluconazole 200 mg daily without relapse. Serial Candida albicans isolates from the oral cavity were clonally related by RFLP analyses of genomic DNA, and were resistant to fluconazole, ketoconazole and itraconazole in vitro. We conclude that fluconazole 400 mg daily is effective against oropharyngeal and oesophageal candidiasis in a patient with endocrinopathy syndrome, despite the infecting Candida albicans strains being resistant to azole antifungals in vitro.

Adult↗

Practical gloving and handwashing regime 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↗