'Angina bullosa haemorrhagica: a complication of long-term steroid inhaler use'.
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Biomedical subjects
Publications and source records attributed to S R Porter.
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A patient with lingual metastasis of alveolar soft-part sarcoma, which originated in the brachioradial muscle, is presented and the literature, is reviewed.
The hematologic status of 144 consecutive patients in the United Kingdom with oral disease (69 with recurrent aphthous stomatitis; 75 with other disorders) was examined in an attempt to resolve the controversy as to whether levels of hemoglobin, blood cell numbers and indices, and blood film are adequate in the screening of patients with aphthae. Though hemoglobin levels and red blood cell indices were normal in patients with recurrent aphthous stomatitis, there was still a small minority of patients with deficiencies of iron (low serum ferritin), folate (low red blood cell levels), or vitamin B12 (low serum levels) that would have remained undetected. Full hematologic screening of patients with recurrent aphthous stomatitis thus reveals latent deficiency states, at least in some parts of the world, and there are good reasons for elucidating the underlying cause and correcting these deficiencies, particularly vitamin B12 deficiency. Therapeutic studies are now required to establish the frequency with which deficiencies actually predispose to recurrent aphthous stomatitis.
The careers of doubly-qualified dentists have been re-examined, 12 years after the report by Henderson, Liversedge and James (1977). Three groups of medically qualified dentists were analysed. (a) those qualifying before 1960; (b) those qualifying between 1960 and 1975; (c) those qualifying since 1975. An increased proportion of those embarking on a medical qualification fail to return to a dental career, despite a stated intention to do so. There appears to be a 'wastage' to dentistry of approximately 40% of those dentists who subsequently obtain a medical qualification. Of those who do return, most practice hospital specialties at consultant level.
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Referrals of patients with oral squamous cell carcinomas to an oral medicine clinic were assessed with regard to the sources, delays, and pattern of referrals from general medical practitioners and general dental practitioners. Slightly more patients were referred by dental practitioners than by medical practitioners, but general medical practitioners were far more likely to see advanced tumours and to request an urgent second opinion or suggest a diagnosis of malignant disease. The greatest delay overall was caused by the patients in seeking advice from their practitioner, particularly those who attended a general medical practitioner. Both groups of practitioners requested a hospital opinion within roughly a month--a reasonable interval. Subsequent delays were minimal. Delays occur mainly because the patients are slow in seeking professional advice and, in general, do not appear to have been reduced over the decade since a previous British study on referral patterns was carried out. This study emphasises the importance of educating patients about oral cancer since it is they who appear to be mainly responsible for the delays in diagnosis. The results also help to dispel the myth that general medical practitioners might be less competent at diagnosis and referral of patients with oral cancer than are dental practitioners, though we are aware of misdiagnoses from both groups.
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HLA-A, B, C, DR antigen frequencies and Properdin factor B (Bf) allotypes were studied in a group of 44 patients with rapidly progressive periodontitis. HLA-A9 (A24) was the only antigen with a frequency statistically significantly different from the control population. An increased frequency of HLA-A9 was previously reported in periodontal diseases. Our results in a well characterised group of patients adds to the evidence that HLA-A9 plays a role in the susceptibility to severe periodontitis.
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