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Biomedical subjects

T Axéll

Publications and source records attributed to T Axéll.

At least 19 recordsLinked to original sources
PubMed1999

Oral mucosal lesions associated with betel quid, areca nut and tobacco chewing habits: consensus from a workshop held in Kuala Lumpur, Malaysia, November 25-27, 1996.

A variety of betel/areca nut/tobacco habits have been reviewed and categorized because of their possible causal association with oral cancer and various oral precancerous lesions and conditions, and on account of their widespread occurrence in different parts of the world. At a recent workshop in Kuala Lumpur it was recommended that "quid" be defined as "a substance, or mixture of substances, placed in the mouth or chewed and remaining in contact with the mucosa, usually containing one or both of the two basic ingredients, tobacco and/or areca nut, in raw or any manufactured or processed form." Clear delineations on contents of the quid (areca nut quid, tobacco quid, and tobacco and areca nut quid) are recommended as absolute criteria with finer subdivisions to be added if necessary. The betel quid refers to any quid wrapped in betel leaf and is therefore a specific variety of quid. The workshop proposed that quid-related lesions should be categorized conceptually into two categories: first, those that are diffusely outlined and second, those localized at the site where a quid is regularly placed. Additional or expanded criteria and guidelines were proposed to define, describe or identify lesions such as chewer's mucosa, areca nut chewer's lesion, oral submucous fibrosis and other quid-related lesions. A new clinical entity, betel-quid lichenoid lesion, was also proposed to describe an oral lichen planus-like lesion associated with the betel quid habit.

Areca↗
PubMed1999

Oral and ocular sicca symptoms and findings are prevalent in systemic lupus erythematosus.

The aims of this study were 1) to examine the frequency of oral and ocular sicca symptoms in patients with systemic lupus erythematosus (SLE); 2) to compare saliva and tear volume, salivary proteins, and features of the oral microflora and mucosa to a matched healthy control group; and 3) to relate the findings to disease parameters. Median disease duration was 5.5 (0.5-28) years, disease activity 5 (2-20), damage score 1 (0-7), and Schirmer I test 7.5 (0-30 mm). Seventeen and twelve patients complained of oral and ocular dryness, respectively. Unstimulated whole saliva and proline-rich proteins in submandibular saliva were significantly reduced in SLE. Oral microbial counts were generally higher in the patients than controls, and the number of oral mucosal changes was increased. The results show that sicca symptoms, although frequent, were not correlated to secretory rates of saliva or tears, but to oral microbial counts. There was no obvious correlation to patient's age, disease activity or duration.

Adolescent↗
PubMed1999

Sicca symptoms, saliva and tear production, and disease variables in 636 patients with rheumatoid arthritis.

OBJECTIVES: (1) To estimate the prevalence of ocular and oral sicca symptoms (SISY) or reduced saliva and tear production; (2) to relate SISY and sicca signs to measures of disease activity, damage, and health status; and (3) to examine the relation between symptoms and objective signs of tear and saliva production in a large sample of representative patients with rheumatoid arthritis (RA). METHODS: From an unselective county RA register 636 patients (age 20-70 years) were examined with Schirmer-I test (ST), unstimulated whole saliva (UWS), questions on SISY and measures of disease activity, damage and health status. RESULTS: Ocular sicca symptoms were reported in 38%, oral sicca symptoms in 50%, and a combination of both in 27%. Reduced tear production was present in 29%, and reduced saliva production in 17%. The minimum frequency of secondary Sjögren's syndrome was 7%. Measurements of exocrine disease manifestations were to variable extents bivariately correlated to disease activity measures, physical disability, pain, fatigue, and use of xerogenic drugs, but were not related to deformed joint count. Multivariate analyses revealed significant associations between disease activity and reduced saliva production. Only weak associations between SISY and tear or saliva production were observed. CONCLUSION: SISY, reduced tear and saliva production were frequent extra-articular manifestations in RA, but were only weakly intercorrelated. High disease activity and at least two SISY were independent predictors of reduced saliva production, but ocular and oral dryness did not seem to be closely related to disease duration, disease activity, damage or health status.

Adult↗
PubMed1997

A national epidemiological survey of oral mucosal lesions in Malaysia.

The prevalence of oral mucosal lesions in Malaysia was determined by examining a representative sample of 11,707 subjects aged 25 years and above throughout the 14 states over a period of 5 months during 1993/1994. A two-stage stratified random sampling was undertaken. A predetermined number of enumeration blocks, the smallest population unit in the census publication, was selected from each state. With the selected enumeration block, a systematic sample of living quarters was chosen with a random start. The survey instrument included a questionnaire on sociodemographic characteristics and a clinical examination. The clinical examination was carried out by 16 specially trained dental public health officers and the diagnosis calibrated with a final concordance rate of 92%. The age in the sample ranged from 25 to 115 years with a mean of 44.5+/-14.0. The sample comprised 40.2% males and 59.8% females; 55.8% were Malays, 29.4% Chinese, 10.0% Indians and 1.2% other ethnic groups. Oral mucosal lesions were detected in 1131 (9.7%) subjects, 5 (0.04%) had oral cancer, 165 (1.4%) had lesions or conditions that may be precancerous (leukoplakia, erythroplakia, submucous fibrosis and lichen planus) and 187 (1.6%) had betel chewer's mucosa. The prevalence of oral precancer was highest amongst Indians (4.0%) and other Bumiputras (the indigenous people of Sabah and Sarawak) (2.5%) while the lowest prevalence was amongst the Chinese (0.5%).

Adult↗
PubMed1997

Characteristics of rheumatoid arthritis patients with self-reported sicca symptoms: evaluation of medical, salivary and oral parameters.

OBJECTIVES: To examine the prevalence of sicca symptoms in rheumatoid arthritis (RA)-patients, and to evaluate medical, salivary, and oral parameters in matched subgroups of patients with and without sicca symptoms as well as in healthy controls. PATIENTS AND METHODS: The prevalence of self-reported sicca symptoms was examined by a postal questionnaire in a representative cohort of RA-patients (n = 105, aged 52-74 years, disease duration 10-20 years, 77% females, 56% RF-positive). Patient subgroups and controls (9-10 in each group) underwent examinations of disease activity, blood analyses, tests of tear and salivary secretion, and examination of oral mucosa and microflora. Analyses of salivary acidic proline-rich proteins (PRPs), statherin and histatins were performed. RESULTS: One or more sicca symptoms were reported by 65% of RA-patients. Sicca patients (having > or = 4 sicca symptoms) had a more active and severe disease with higher scores for disability, fatigue and tender joints than patients without such symptoms. Other significant findings in the sicca group were lower values of unstimulated whole saliva, output of PRPs, statherin and histatins in submandibular saliva, and higher counts of oral Candida species. CONCLUSIONS: Sicca symptoms were prevalent in RA. Qualitative and quantitative salivary tests distinguished between sicca and non-sicca RA-patients, though overlap was considerable for some parameters.

Aged↗
PubMed1996

Oral white lesions with special reference to precancerous and tobacco- related lesions: conclusions of an international symposium held in Uppsala, Sweden, May 18-21 1994. International Collaborative Group on Oral White Lesions.

An international group of epidemiologists, clinicians and pathologists with a special interest in oral white lesions and their precancerous significance has reviewed earlier work on this topic and identified some of the problems associated with previous definitions, descriptions and classifications. Modifications to these definitions, descriptions and classifications have been proposed, accompanied by explanations of the reasons for identifying the need for changes to be made. Leukoplakia may be a provisional or definitive diagnosis dependent upon the circumstances of oral examination and the availability of other information. Guidelines are provided to assist in the application of the definitions of oral leukoplakia and illustrations depict the homogeneous and non-homogeneous clinical variants. Consideration is also given to the importance of a red component in a white lesion, or a lesion that is entirely red (erythroplakia). A new clinical staging procedure for oral leukoplakia is also proposed.

Erythroplasia↗
PubMed1996

Adverse reactions in the oral mucosa associated with anterior composite restorations.

This is a descriptive study of patients with symptomatic lichenoid-like reactions of the lips in contact with composite restorations (n = 12). Clinically, the lesions appeared as symptomatic single or multiple erythematous areas that included white papules. Candida was found by cultivation or histopathological examination in 7 of the lesions. Patch testing (n = 7) did not reveal any reactions to composite components, except for one patient who showed a delayed hypersensitivity reaction to formaldehyde. Replacement of existing dental materials parallel to antifungal treatment resulted in healing or significant improvement in 7 of 9 patients. This study shows that resin components can be associated with adverse reactions in the oral mucosa of the lips and that these reactions may be accompanied by an infection with Candida.

Adult↗
PubMed1996

Training examiners for a national epidemiological survey of oral mucosal lesions.

Ensuring the validity and reliability of data collected in epidemiological surveys is an important consideration. The purpose of the present report is to describe a training and calibration programme for 16 examiners taking part in a national survey of oral mucosal lesions and to present an evaluation of the results. The programme included the distribution of a pictorial manual to participants and a series of lectures followed by three diagnostic sessions, two using slides and the last involving patients. At the final session, the trainees classified 88 per cent of 16 patients correctly in comparison with the definitive diagnoses of the trainer, and their sensitivity on recording oral carcinoma, leukoplakia and lichen planus was at least 0.88. However, correctly classifying submucous fibrosis on the basis of slides alone proved problematic. At the conclusion, the diagnostic accuracy of two examiners for all types of lesion remained appreciably lower than the majority. Training strategies for various types of study are discussed. The method reported is considered to represent a model approach to training and calibrating examiners for this type of survey work.

Dental Health Surveys↗
PubMed1995

Prevalence study of oral mucosal lesions in a selected Cambodian population.

The aim of this study was to investigate the epidemiology of oral mucosal lesions in a selected Cambodian population to obtain pilot data useful in planning an oral health data base for the country. Due to unstable conditions in Cambodia, the validity of population data related to present census information is highly questionable. Therefore, prior to this investigation a census registration was carried out using local health workers as registrars in nine villages of a commune. In the period July 4-31, 1991, a total of 1319 individuals (953 women, 366 men, 15-99 yr) were examined by one oral surgeon in the nine villages of Kok Trop Commune, Kandal Stung District, southwest of the capital Phnom Penh. Clinical diagnoses were based on WHO criteria. Information on smoking habits, betel nut chewing habits, and alcohol use was collected by 4 Khmer dental personnel. In total, 71 lesions were recorded in 64 (4.9%) individuals. Leukoplakia was found in 1.1%, lichen lesions in 1.8%, candidosis in 1.4%, submucous fibrosis in 0.2%, cancer in 0.1% and other diagnoses in 0.8%. The prevalence of leukoplakia was 2.2% and 0.6% among men and women respectively, a statistically significant difference (P < 0.05). There were significantly more smokers (P < 0.01) among subjects with leukoplakia (64.3%) than among those without this lesion (28.6%). All subjects with lichen lesions were women. The age-adjusted relative risk for developing lichen among betel nut chewers as compared to non-chewers was 3.3.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Reduction in nicotine intake and oral mucosal changes among users of Swedish oral moist snuff after switching to a low-nicotine product.

The purpose of this investigation was to assess nicotine regulation among users of portion-bag Swedish oral moist snuff (snus) when switching from an ordinary snus product (Brand A) to a low-nicotine product having only half the concentration of nicotine (Brand B). Two studies were performed to compare the short-term effects on consumption and nicotine intake of switching to low-nicotine snus with those of long-term effects. In Study 1, consumption data, soft tissue changes and nicotine intake were measured in a group of 24 habitual users of Swedish portion-bag snus, both during use of their ordinary snus (Brand A) for 2 weeks and during consumption of the low-nicotine product (Brand B) for 10 weeks. In study 2, the same data were measured during 2 weeks in a reference group of 18 snus users who had been habitual users of the low-nicotine snus (Brand B) for at least one year. Although there was no increase in number of hours of daily consumption, the amount of snus consumed increased on average by 2 grams a day (+15%) when switching from Brand A to the low-nicotine Brand B (Study 1). The Brand B reference group (Study 2) consumed about 3 grams less snus a day during the same number of hours as the subjects in Study 1 who had switched to Brand B. These results indicate that snus users compensate to a small extent for the lower nicotine delivery by increasing their consumption on short-term switching but the same does not apply to long-term users.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Evaluation of in vitro properties of films of saliva substitutes in contact with different surfaces. A comparative study with instruments for measurements of friction and rheologic properties.

An instrument based on friction measurement has been developed to evaluate oral mucosal dryness objectively. The purpose of this study was to compare the friction instrument with instruments measuring in vitro rheologic properties. Measurements were performed against steel and irreversible hydrocolloid after application of different concentrations of aqueous solutions of carboxymethylcellulose and chitosan lactate. The results of the measurements were logical, with inversely proportional values for the friction instrument as compared with values obtained using the instrument measuring rheologic properties; that is, increased viscosity led to decreased friction values.

Alginates↗
PubMed1994

Treatment of Candida-infected denture stomatitis with a miconazole lacquer.

The efficacy of a topically administered miconazole denture lacquer was compared with that of a placebo lacquer in the treatment of Candida-infected denture stomatitis. The study was a double-blind, randomized, controlled clinical trial with two parallel treatment groups. The lacquer was applied once on the fitting denture surface. Follow-up examinations took place on days 3, 7, 14, 21, 28, and 35. On day 14 the effect of the treatment was assessed. Thirty-six patients were included in the statistical analysis. Eighteen received miconazole and 18 received placebo lacquer. Primary efficacy endpoints were the number of colonies cultured from the palatal mucosa and denture surface on day 14. Thirteen of 16 patients in the miconazole group A showed < 10 colonies on culture medium on day 14 in the specimens from the palatal mucosa as did 5 of 18 patients in the placebo group B (p < 0.05). Corresponding results for the denture surface were 6 of 17 and 3 of 18, respectively (p < 0.05). Reapplication of lacquer was considered necessary (> 100 colonies in at least one sampling site within 14 days) in 35% of the patients from group A and in 83% of the patients from group B. The results indicate that a single application of a miconazole denture lacquer considerably reduces the number of Candida yeasts for a substantial period of time.

Aged↗
PubMed1993

Disappearance of smoker's melanosis after reducing smoking.

Besides genetic factors, tobacco smoking is known to be the main cause of oral melanin pigmentation. The present study compares the frequency of oral melanin pigmentation in a large number of former smokers with that of non-smokers. It also describes in two patients the disappearance of smoker's melanosis in the buccal mucosa following a considerable reduction in smoking.

Aged↗
PubMed1993

Objective and subjective efficacy evaluation of various polymer-based saliva substitutes.

Various polymer solutions with and without surfactants were evaluated regarding their lubricating properties on the oral mucosa. After rinsing with the solutions, the oral mucosal friction value was registered with a probe (objective effect). After each rinsing occasion at home, the patients answered a questionnaire (subjective effect). None of the tested polymers showed a longer, clinically significant effect than the other ones. Some of them had the same effect as substitutes available on the Swedish market.

Cellulose↗
PubMed1993

Oral mucosal friction and subjective perception of dry mouth in relation to salivary secretion.

Assessment of oral mucosal friction and subjective perception of dry mouth was performed during treatment with thiazide diuretic bendroflumethiazide (2.5 mg o.d.) or placebo in a randomized, double-blind, cross-over study (2 x 2 wk) in 34 healthy volunteers. Treatment with bendroflumethiazide was associated with a 10% reduction in the stimulated whole saliva secretion rate and a 15% reduction in the salivary sodium concentration, as compared with placebo. Oral mucosal friction was concomitantly measured on the buccal mucosa and on the mucosa of the lower lip by means of a newly developed sliding friction device. In addition, a questionnaire was used to evaluate how the treatment was subjectively perceived with regard to symptoms of dry mouth. Mucosal friction of the lower lip increased significantly during treatment with bendroflumethiazide, as compared with placebo. When the test subjects, regardless of pharmacologic treatment, were divided into groups according to subjective perception of dry mouth, the dry mouth group showed significantly lower resting and stimulated flow rate and higher mucosal friction in comparison to the nondry group. When, in addition, pharmacologic treatment was also considered, the differences between the dry and the nondry group were restricted to resting whole saliva flow rate and mucosal friction during bendroflumethiazide treatment. It is concluded that resting whole saliva flow rate is the best predictive factor for evaluating subjectively perceived dry mouth. However, the sensitivity of the developed sliding friction device is capable of detecting minor changes in salivary secretion rate. In addition, measurements of oral mucosal friction may serve as an easily available method to complement sialometry when evaluating, for example, drug-induced dryness of the mouth.

Adolescent↗