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Biomedical subjects

S Dreizen

Publications and source records attributed to S Dreizen.

At least 37 records · Page 2Linked to original sources
PubMed1986

Quantitative analysis of the oral complications of antileukemia chemotherapy.

Almost half of 1500 patients (46.9%) treated for acute leukemia developed chemotherapy-related oral infections, oral mucositis, and/or oral hemorrhages at some time during their hospitalization. The frequencies of 34.2% for infections, 16.3% for mucositis, and 13.6% for hemorrhages were each within 1.3% to 3.1% of those previously reported from this institution for smaller groups of patients. The stomatologic disruptions reflected the cytotoxic, myelosuppressive, and immunosuppressive properties of the antileukemia drugs. Because there are as yet no alternatives to the use of potent stomatotoxic drugs for the treatment of acute leukemia, it is essential that their side effects be kept to a minimum by early recognition and appropriate treatment.

Acute Disease↗
PubMed1985

Orofacial aspergillosis in acute leukemia.

The clinicopathologic characteristics of orofacial aspergillosis in thirteen hospitalized patients who developed the infection while receiving chemotherapy for acute leukemia are described. Clinically, the primary sites of infection, in decreasing order of frequency, were the paranasal sinuses, nasal cavity, mouth, and facial skin; the corresponding order for the secondary sites was orbit, nasal cavity, facial skin, and mouth. Pathologically, the fungal lesions in the nasal, oral and sinusoidal cavities were black, ulcerated, and escharotic due as a direct result of tissue destruction by the organism and an indirect result of thrombotic vascular infarction. The orbital lesions were deep red, granulomatous, and productive of proptosis and ectropion. Seven of the thirteen patients had concomitant pulmonary aspergillosis. The orofacial infections were not responsive to antifungal therapy in the absence of remission of the leukemia and restoration of depressed host defenses. In two patients who did achieve remission, the aspergillosis was controlled by the intravenous administration of amphotericin B.

Acute Disease↗
PubMed1984

Oral candidiasis.

Candidiasis is, by far, the most common mycotic infection of the human oral cavity. The usually manifested clinical expression of oral candidiasis at all ages from the newborn to the elderly is thrush. Other forms that affect the mouth include acute atrophic candidiasis associated with oral antibiotic therapy, chronic atrophic candidiasis attributable to the wearing of full upper dentures, candidal cheilosis ascribable to perlèche or decreased vertical dimension in the lower third of the face, chronic mucocutaneous candidiasis emanating from a T-lymphocyte deficiency, and candidal leukoplakia. Extensive use of antibiotics and immunosuppressive drugs have greatly increased the number of Candida-induced oral infections. Patients debilitated by irradiation, cancer chemotherapy, organ transplants, diabetes mellitus, and defects in cell-mediated immunity are particularly vulnerable. Fortunately, the vast majority of cases of oral candidiasis are not life-threatening and readily respond to appropriately administered anticandida agents. It must always be remembered, however, that the organism has the capacity to produce fulminating fatal infection by hematogenous dissemination from seemingly innocuous oral infections that serve as a portal of entry to the systemic circulation. Consequently, all oral candidal infections in compromised patients must be treated vigorously and effectively.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Chemotherapy-associated oral hemorrhages in adults with acute leukemia.

The frequency, nature, and management of chemotherapy-associated oral hemorrhages were studied in 1,093 adult inpatients undergoing treatment for acute leukemia or the blastic phase of chronic leukemia. Of this number, 163 (14.9%) manifested gross bleeding from the mouth during the course of treatment. The most common oral bleeding sites were the lips, tongue, and gingiva. Thrombocytopenia was the underlying cause in 88% of the cases, disseminated intravascular coagulation in 6%, and combinations of thrombocytopenia and hypofibrinogenemia and of thrombocytopenia and vitamin K deficiency in 5.5% and 0.6%, respectively. The vast majority of the patients with mouth bleeding had platelet counts below 40,000/mm3. Approximately 50% had indirect evidence of a coagulation factor deficiency in the blood. The oral hemorrhages were best managed by transfusions of HLA-compatible fresh platelets and fresh frozen plasma, together with topically applied clot-promoting agents, until hemostatic control was restored.

Acute Disease↗
PubMed1983

Chemotherapy-associated oral infections in adults with solid tumors.

The frequency of chemotherapy-associated oral infections in adult inpatients with solid tumors was determined in 825 subjects with carcinoma, 60 with sarcoma, and 115 with lymphoma. The total number of documented oral infections in the 1,000 patients was 97 (9.7 percent), with frequency rates of 8.4 percent, 11.7 percent, and 18.3 percent for the patients with carcinoma, sarcoma, and lymphoma, respectively. All but six of the infections were caused by a single organism. Microbiologically, 68.9 percent of the infections were ascribable to fungi, 10.7 percent to gram-negative bacilli, 10.7 percent to herpes simplex, and 9.7 percent to gram-positive cocci. The patients with solid tumors were less than one third as prone to oral infections as adults with acute leukemia treated in the same hospital. Among the solid tumor group, those with lymphoma were almost twice as likely to develop infections of the mouth during chemotherapy as those with carcinoma or sarcoma. The oral infection experience in the previously reported patients with acute leukemia and in the present series of patients with solid tumors strongly suggests that the more aggressive the malignancy and the more potent the chemotherapy, the greater the tendency to stomatologic infections.

Adolescent↗
PubMed1983

Malignant gingival and skin "infiltrates" in adult leukemia.

The clinicopathologic and histopathologic features of leukemic gingival and cutaneous "infiltrates" were studied in 1,076 adults hospitalized for cancer chemotherapy. Leukemic gingival hyperplasia was present in 3.6 percent and leukemia cutis in 3.1 percent of the patients. Only 7.6 percent of those with leukemic "infiltrates" had simultaneous gingival and skin involvement. Histologically, the lesions consisted of extravasated and proliferating monocytoid or myeloid cells. The infiltrative-proliferative tendency was most pronounced in patients with, in a sharply descending order, acute monocytic leukemia, acute myelomonocytic leukemia, and acute myelocytic leukemia. Formation of lesions in the skin and gingiva was unrelated to sex, age, and white blood cell count. Gingival lesions were particularly prone to infectious complications in patients with poor oral hygiene. Aside from the morphologic predisposition, the propensity for adults with leukemia to develop chemotherapeutically reversible malignant mucocutaneous lesions was highly individualistic and unpredictable.

Adolescent↗
PubMed1983

Effect of continuous fluoride gel use on plaque fluoride retention and microbial activity.

Twelve consecutive wk of daily five-minute topical applications of 1% NaF gel by non-cancer control subjects did not significantly affect plaque concentrations of Streptococcus mutans or Lactobacillus spp. Plaque F- levels increased 150% (P less than .001), while production of acetate and lactate decreased 40% (P less than .007) and 66% (P less than .001), respectively. Long-term (12 wk to more than five yr) fluoride gel use by post-irradiation xerostomic cancer patients was associated with increases in plaque F- and decreases in acidogenesis similar to those observed in the control subjects. Plaque concentrations of cariogenic organisms increased during the first yr of radiation-induced xerostomia and fluoride gel use, before starting to decline. Although sustained fluoride treatment increased (P less than .001) the ratio of fluoride-resistant to fluoride-sensitive strains, the number of patients harboring detectable S. mutans was diminished (P less than .001).

Acetates↗
PubMed1982

Isolation and characterization of inflammatory cells from the human periapical granuloma.

Twelve histologically-confirmed periapical granulomas were evaluated by conventional immunologic rosette assays for the presence of T-lymphocytes and complement receptor-bearing lymphocytes. A technique for dispersing the granuloma cells into suspensions was adopted to facilitate performance of the assays which were not applicable to tissue sections. Differential cell counts by an acridine orange vital dye method disclosed that the cell suspensions contained 30% macrophages, 44% lymphocytes, 15% plasma cells, and 12% neutrophils. Complement receptor-bearing cells comprised 17.9%, and T cells comprised 34.5% of the unseparated inflammatory cells. This study provides the first direct evidence of a predominance of thymic-derived lymphocytes in the lymphocyte compartment of the periapical granuloma. Analysis of the data shows that cell-mediated immunity most likely plays a role in the pathogenesis of the periapical granuloma.

Cell Count↗