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Biomedical subjects

S Silverman

Publications and source records attributed to S Silverman.

At least 73 records · Page 4Linked to original sources
PubMed1996

Herpes simplex and cytomegalovirus coinfected oral ulcers in HIV-positive patients.

Four HIV-positive patients with herpes simplex virus and cytomegalovirus coinfected oral ulcers are presented. All patients had persistent oral pain associated with nonhealing mucosal ulcers. Lesions occurred on the palate, retromolar pad, tongue, and lip, and the clinical appearance of the ulcers was nonspecific. Histologic and immunohistochemical stains showed herpes simples virus alterations in keratinocyte nuclei and cytomegalovirus alterations in mesenchymal/endothelial cell nuclei and cytoplasm. Lesions in one patient responded to ganciclovir therapy. One patient improved with acyclovir, and another healed normally after excisional biopsy. Each virus alone has been described as causing oral ulcerations; their appearance together in the same lesion would suggest a synergistic relationship.

AIDS-Related Opportunistic Infections↗
PubMed1996

Intraoral non-Hodgkin's lymphoma in seven patients with acquired immunodeficiency syndrome.

Since the appearance of AIDS, there has been a significant increase in the number of cases of oral non-Hodgkin's lymphoma. Rarely seen in the oral cavity before, non-Hodgkin's lymphoma is now seen with some frequency in HIV-positive patients. Oral HIV-related lymphomas exhibit an aggressive course and can mimic other oral tumors and infections, which makes early recognition and diagnosis important and difficult. We report on the clinical findings in seven homosexual men in whom the oral cavity was the first site in which non-Hodgkin's lymphoma appeared and the only site involved at the time of diagnosis. Treatment consisted of chemotherapy with or without radiation therapy. The relatively short survival in these patients averaged 8 months. All patients died of complications from their tumor.

Adult↗
PubMed1996

Clinical characteristics and management responses in 85 HIV-infected patients with oral candidiasis.

Eighty-five consecutively seen HIV-positive persons with oral candidiasis were evaluated for clinical characteristics, staging of HIV disease, quantitation of candidal colony formation, and response to systemic antifungal treatment with Nizoral (ketoconazole). Fifty-five had CD4 counts less than 200. There was an inconsistent association between clinical signs, patient symptoms, CD4 counts, and candidal colony-forming units. However, there was a trend toward higher colony-forming unit counts (> 500) in patients with lower CD4 cells (< 200). Sixty-five patients had a complete clinical response to the ketoconazole treatment (200 mg daily for 7 days), even though 81% of posttreatment cultures remained positive. Nonsmokers were more likely to respond to antifungal treatment when compared with smokers, and there was a slight tendency for complete responses when colony-forming unit counts were low. The most common lesion presentation was a combination of the white (pseudomembranous) and red (erythematous) forms. Forty-nine percent had complaints of pain. The variable responses indicated the importance of flexible dose-time and drug considerations in antifungal management. Candida albicans was the predominant species.

AIDS-Related Opportunistic Infections↗
PubMed1996

The impact of HIV and AIDS on dentistry in the next decade.

There is no end in sight for the HIV/AIDS pandemic. Therefore, with or without knowledge of their own serologic status, HIV-infected patients will be seeking dental care in increasing numbers in the decade ahead. Additionally, the diagnosis and management of frequently occurring HIV-associated oral lesions will add to dental responsibilities. By following infectious disease guidelines for blood-borne pathogens, dental clinicians, office workers and patients will have an extremely low risk for HIV transmission.

AIDS-Related Opportunistic Infections↗
PubMed1995

Late effects of radiation therapy in the head and neck region.

The head and neck region is composed of numerous structures, each with an inherent response to radiation that is largely governed by the presence or absence of mucosa, salivary glands, or specialized organs within that site. Irradiated mucocutaneous tissues demonstrate increased vascular permeability that leads to fibrin deposition, subsequent collagen formation, and eventual fibrosis. Irradiated salivary tissue degenerates after relatively small doses, leading to markedly diminished salivary output. This, in turn, effects the teeth by promoting dental decay which, in turn, effects the integrity of the mandible. Details of these changes are presented, including their pathophysiology, clinical syndromes, and potential treatment.

Capillary Permeability↗
PubMed1995

Oral histoplasmosis in HIV-infected patients. A report of two cases.

Histoplasmosis is a fungal infection caused by the organism Histoplasma capsulatum. Disseminated disease usually occurs in immunosuppressed patients or in patients with chronic illnesses. Although relatively uncommon, histoplasmosis has been reported in patients with AIDS, and oral lesions have been noted on multiple sites and in various clinical presentations. We present two HIV-positive cases with oral lesions as the initial signs of histoplasmosis. Both patients responded well to IV amphotericin B but later suffered recurrences despite being maintained on systemic antifungal therapy.

AIDS-Related Opportunistic Infections↗
PubMed1995

Skill-related task structures, explicitness, and accountability: relationships with student achievement.

The purpose of this study was to determine relationships of task structures, explicitness, and accountability with student achievement in physical education. The subjects were teachers of 10 physical education classes and their 202 students. Each class participated in instruction that was videotaped, and the students were pre- and posttested. Videotapes were coded to collect data on each skill-related task including the task presentation time, skill being taught, explicitness of the task presentation, primary and secondary accountability systems used, level of student participation, and total task time. Among the many results, for the volleyball forearm pass, significant relationships were found for the total number of tasks and time spent in tasks when expectations included outcome, situation, and criteria-product. For the volleyball underhand serve, significant relationships were found for the total number of tasks and time spent in tasks when accountability included teacher feedback with follow-up and monitoring of off-task behavior.

Achievement↗
PubMed1995

p53 protein expression in sequential biopsies of oral dysplasias and in situ carcinomas.

Immunohistochemically detectable levels of p53 may be seen early in the malignant transformation of some neoplasms. To determine if p53 is immunocytochemically detectable, and therefore presumptively abnormal, in oral dysplasias and in situ carcinomas, and to explore the natural history of p53 protein expression in these lesions, sequential biopsies from patients with lesions occurring in the same anatomic site were examined. Formalin-fixed, paraffin-embedded sections from 19 patients were evaluated immunohistochemically for p53 protein using antibody clones Pab1801 and BP53-12. With two exceptions, comparable results were observed with these antibodies. p53 protein was detected immunocytochemically in 6 of 13 patients with dysplasias; 3 of these progressed to p53-positive invasive carcinoma, one advanced to a more severe grade of p53-positive dysplasia, one developed into a p53-negative verrucous carcinoma, and one represented a p53-positive dysplasia developing five years after treatment of a p53-positive carcinoma. The p53-positive dysplasias, which were found in all subtypes (mild, moderate, severe), preceded histologic malignant change by months to years. p53 detection was evident in 4 of 6 patients with in situ lesions. Sequential biopsies of three of these lesions showed no change in lesion histology or p53 staining, and one lesion advanced to a p53-positive carcinoma. It is concluded that p53 protein may be detected early in the development of a subset of p53-positive oral squamous cell carcinomas. This phenomenon may be seen in dysplasias and in situ lesions, and it may have prognostic implications.

Carcinoma in Situ↗
PubMed1995

Association between proliferative verrucous leukoplakia and infection with human papillomavirus type 16.

Proliferative verrucous leukoplakia (PVL) is a recently described clinical entity characterized by multifocal oral lesions that frequently progress to oral cancer despite abstinence from tobacco use by most patients. To determine if this condition is associated with human papillomavirus (HPV), a polymerase chain reaction (PCR) for HPV DNA was performed on 9 lesions from 7 patients with PVL, histologically diagnosed with focal keratosis (1), papilloma (1), epithelial dysplasia (5) and squamous cell cancer (2). Eight (89%) were HPV positive, 7 for HPV 16. For comparison, we studied 55 non-PVL-associated oral specimens, including 24 oral squamous cell cancers. Of the cancers, 8 (33%) were HPV positive, 4 for HPV 16. These data suggest that HPV 16 infection may play an important role in the pathogenesis of PVL-associated oral dysplasia and possibly cancer, but is found in only a small proportion of the more common, non-PVL associated-oral lesions.

Aged↗
PubMed1995

Use of hyperbaric oxygen in rheumatic diseases: case report and critical analysis.

Hyperbaric oxygen has been used in patients with rheumatic disease for many years without reports of untoward or unusual complications for a variety of non-rheumatic indications. Recent evidence that hyperbaric oxygen inhibits the actions of certain cytokines, acts as an immune modulator and may help cognitive dysfunction has resulted in a re-examination of its potential role in rheumatic diseases. A case report of a lupus/scleroderma crossover patient is presented whose cognitive dysfunction improved after hyperbaric oxygen therapy. The history of hyperbaric oxygen and its physiology are related, along with a focused review of its effects on the immune and central nervous systems. Areas which might warrant further consideration by rheumatologists are outlined, as well as areas of concern.

Cognition Disorders↗
PubMed1994

Evaluation of serum and tissue levels of beta-carotene.

Interest in beta-carotene (BC) has increased as studies show that low dietary or serum BC is associated with increased risk of cancer. Patients with oral epithelial dysplasia had serum and oral mucosa punch biopsy samples taken before supplementation of 30 mg/day of beta-carotene and after 6 and 9 months of supplementation. BC was analyzed for 28 patients by high-performance liquid chromatography. At baseline, serum BC and gender accounted for 48% of tissue BC variance: Tissue BC = -0.13 + 0.08(Serum BC) + 1.21(Sex) with sex as male = 0 or female = 1. Following supplementation, serum BC had an exponential relationship to tissue BC which accounted for 52% of tissue variance: Tissue BC = 1.15 + 5.7 x 10(-5)(Serum BC)2 + 3.91(Sex). Women had higher mean concentrations of serum and oral mucosal BC before and during supplementation. The need for oral mucosal sampling may be eliminated by the correlation between serum and tissue BC.

Carotenoids↗
PubMed1994

Clinical and lymphocyte responses to beta-carotene supplementation in 11 HIV-positive patients with chronic oral candidiasis.

Eleven HIV-positive patients with chronic oral candidiasis were supplemented with 60 to 120 mg of beta-carotene daily for 3 to 7 months. Lymphocyte profiles were evaluated at intervals to help assess immune competence. Although there was a modest increase in some lymphocyte values at 2 months, there was a significant decrease in numbers of CD4 and CD8 cells and CD4 percentage of lymphocytes after 6 months of beta-carotene supplementation. Serum triglyceride and liver enzyme levels were not affected by the beta-carotene supplementation. No improvement was observed in the control of the oral candidiasis. Under the conditions of the study, there was no indication that daily beta-carotene supplements enhanced immune competence or was of benefit in managing oral candidiasis.

AIDS-Related Opportunistic Infections↗