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Biomedical subjects

G Ficarra

Publications and source records attributed to G Ficarra.

At least 91 records · Page 5Linked to original sources
PubMed1990

Oral melanotic macules in patients infected with human immunodeficiency virus.

A group of 217 patients seropositive for human immunodeficiency virus (HIV) were studied for 2 years, during which time pigmented lesions of the oral mucosa developed in 14 (6.4%) of them. The lesions were well circumscribed in some cases and diffuse in others. In some patients the macules enlarged or recurred after surgical excision. In two patients the macules appeared during the administration of zidovudine. Clinical and laboratory evidence of adrenal insufficiency was not detected in any of the patients examined. The histologic appearances were those of melanotic macules. No ultrastructural alterations of the melanocytes were observed. Two of these macules also contained Epstein-Barr virus, and in one case normal oral mucosa was examined and also contained Epstein-Barr virus in the epithelial cells. As a control group we examined 180 health care workers who did not belong to any risk category, and 30 intravenous drug abusers who tested seronegative to HIV. Oral melanotic pigmentation was found in eight of the control subjects (3.6%). The difference was not statistically significant (p = 0.3097). Our study shows that oral macules do not occur more frequently in HIV-infected patients. However, the clinical behavior of these lesions appears to be different during the course of HIV infection. In some HIV-infected patients the cause of the macules might relate to the administration of zidovudine and antifungal or antibacterial drugs. In others the cause remains unknown and could be due to multiple factors.

Adult↗
PubMed1990

Hyaline ring granuloma: a distinct oral entity.

Hyaline ring granuloma (HRG) is a distinct oral entity. In this study, 64 cases from the literature are analyzed and two new cases are reported. The lesions could be classified by location as central hyaline ring granuloma (42%) and peripheral hyaline ring granuloma (53%). Radiographically, a radiolucent area irregularly outlined by well-formed trabeculae of bone was found in central HRG, and a poorly defined erosion at the crest of the alveolar ridge was often found in peripheral HRG. Occasionally, the lesion occurred in the connective tissue wall of cysts (5%). The etiology of this condition is controversial, but most lesions were in edentulous areas and most patients had a history of tooth extraction or other trauma. The majority of cases (83%) occurred in the mandible, usually posterior to the premolar. The mean age of patients at diagnosis was 43 years, and the male/female ratio was 1.9:1. Pain was not a symptom, although local discomfort, such as recurrent swelling and tenderness, was noted in many cases. Hyaline rings with giant cell inclusions are the significant features for histopathologic diagnosis. HRG is treated by curettage or surgical excision, care being taken to remove the entire lesion. The removal of a peripheral HRG in an edentulous jaw should be followed by careful smoothing of the bone surface, since the lesion tends to infiltrate and is not well demarcated. Recurrence, probably due to incomplete excision, is uncommon.

Aged↗
PubMed1990

Prevalence of oral lesions among HIV-infected intravenous drug abusers and other risk groups.

To study the prevalence of oral manifestations, we examined 217 patients infected with the human immunodeficiency virus (HIV). Most of our patients were intravenous drug abusers (IVDAs) (65%). Other risk categories were represented by IVDAs who were also male homosexuals or bisexuals (11%), male homosexuals and bisexuals (16%), sexual partners of HIV-infected patients (5%), and hemophilic persons and recipients of blood transfusions (3%). Forty-six patients were women and 171 were men, with a median age of 27 years (range, 11 to 65 years). At the time of first examination, 38% of patients had asymptomatic HIV infection, 36% had lymphadenopathy syndrome, 17% had AIDS-related complex, and 9% had AIDS. Oral manifestations were observed in 89 (41%) patients. Of these, 15 had asymptomatic infection, 23 had lymphadenopathy syndrome, 27 had AIDS-related complex, and 24 had AIDS. Increasing severity of disease was significantly associated with higher prevalence of oral lesions (p less than or equal to 0.0001). Candidiasis was the most common oral lesion, followed by hairy leukoplakia. Kaposi's sarcoma, melanotic macules, herpes labialis, condyloma acuminatum, perioral molluscum contagiosum, and bacterial glossitis due to Escherichia coli infection were found in a small number of patients. Results of culture for fungi, available for 203 patients, revealed that 51% of patients with positive Candida cultures had clinical evidence of candidiasis. Our study demonstrates that oral lesions are also important signs of HIV infection among IVDAs. Early diagnosis of these manifestations is becoming increasingly significant in the practice of dentistry.

Adolescent↗
PubMed1990

Morphology and membrane antigens of nonlymphoid accessory cells in oral hairy leukoplakia.

We have investigated the features and distribution of accessory cells (ACs) and the relationship of these cells to each other and to lymphocytes in the epithelium and lamina propria of oral hairy leukoplakia (HL), with the objective of better defining the differentiation and mutual interactions of immune-response cells within HL as a preliminary step to understanding the onset and significance of this lesion during human immunodeficiency virus (HIV) infection. Twenty-four HIV-infected patients with HL, two asymptomatic HIV-positive subjects, and three HIV-negative subjects were studied by immunohistochemistry; five HIV-positive patients with HL and three asymptomatic HIV-positive subjects were studied by electron microscopy. In both the epithelium and the lamina propria of HL, we found cells with the immunohistochemical and ultrastructural features of variably differentiated ACs; differences were found between the epithelium and lamina propria. In the lamina propria, ACs were characterized by dendritic shape, multiple contacts with lymphocytes, expression of CD1a antigen, and ultrastructural features of fully differentiated ACs. Conversely, in the epithelium ACs showed bluntly dendritic shape, low expression of CD1a, absent expression of HLA-DR, constant expression of CD11c and CD14 antigens, only occasional contacts with lymphocytes, and ultrastructural features of variably, but always incompletely, differentiated cells of monocyte-dendritic lineage. Seventy-nanometer wide intracisternal particles, closely resembling A particles described in retroviral infections, were found in the intraepithelial ACs in two patients with HL. The defective differentiation of ACs in the epithelium of HL--possibly influenced by the perturbation of the epithelial microenvironment induced by Epstein-Barr virus, and following the direct HIV infection of these cells--and the exceptional finding of close contacts with lymphocytes suggest that the lesional epithelium of HL may constitute a pathway for the entry of foreign antigens which circumvent monitoring by ACs and can induce immune tolerance. The impairment of the local immune response in HL may contribute to the development of full blown, systemic immunodeficiency.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Estrogens modulate the circadian rhythm of hypothalamic beta-endorphin contents in female rats.

The aim of the present study was to evaluate the changes in the diurnal rhythm of the hypothalamic beta-endorphin (beta-EP) contents in female rats as a function of circulating estrogens. With this purpose we evaluated the diurnal hypothalamic beta-EP changes (1) during the estrous cycle, and (2) in ovariectomized rats with and without acute and chronic estrogen replacement. Ovariectomized rats were treated either acutely with 10 micrograms of estradiol benzoate (EB) or chronically with 2 micrograms/day of EB for 15 days. beta-EP concentrations were measured in acid extracts of medial basal hypothalamus by a specific radioimmunoassay. During the estrous cycle, hypothalamic beta-EP concentrations showed a significant nocturnal increase, with no difference between the 4 days of the cycle. On the day of estrus, beta-EP concentrations between 12.00 and 18.00 h resulted significantly lower than in the other days of the cycle. After ovariectomy, the night-related changes in hypothalamic beta-EP disappeared. The acute administration of EB induced a significant increase in hypothalamic beta-EP after 21 h (18.00 h). On the other hand, the chronic replacement restored the nocturnal peak of hypothalamic beta-EP (18.00, 21.00, 24.00 h). The present data emphasize the role of central beta-EP in regulating the reproductive functions. Moreover, the effect of estrogen in modulating the circadian changes in hypothalamic beta-EP supports the important role of estrogens in brain function.

Animals↗
PubMed1990

[Oral hairy leukoplakia in patients with HIV infection].

Oral hairy leukoplakia is a new clinicopathological entity. Little is known about its etiology, pathogenesis and natural history. It is considered a specific marker of HIV infection, although it has been also reported in HIV-negative patients. The etiology appears related to Epstein-Barr virus. Hairy leukoplakia has a characteristic clinical and histopathological aspect, but it is not specific. Because hairy leukoplakia may be easily confused with other lesions of the tongue, the dentist should be very careful in making the final diagnosis. Hairy leukoplakia is usually asymptomatic and treatment is not necessary. In cases of extensive lesions or psychological intolerance of the patient, useful drugs are acyclovir and vitamin A derivatives.

Diagnosis, Differential↗
PubMed1990

[Odontogenic botryoid cyst].

The clinical and histopathological features of two cases of botryoid odontogenic cyst are reported. The lesion is an uncommon variant of the lateral periodontal cyst and differs from this with regard to the histopathological features and the biological behaviour.

Aged↗
PubMed1989

[Multiple osteomas of the maxillary sinus. Presentation of a case].

This case report concerns a case of multiple osteomas of the maxillary sinus which probably arise from flogosis and discusses the clinical features. The review of the literature on the histogenesis of these rare lesions remains controversial and it is still difficult to formulate a precise definition.

Facial Pain↗