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PubMed1976

Oral signs of aging and their clinical significance.

A look in the patient's mouth can give clues to his overall health. For instance, atrophic glossitis--or breakdown of the tongue's papillary structure--reveals that there may be incomplete absorption of vitamin B complex or some other nutritional deficiency. Tenderness and impaired motion in the jaw can mean any of a number of problems related to other joints of the body. Osteoarthritis is often to blame. Or the disablement may be due to rheumatoid arthritis or to sclerosis of joint surfaces. Atrophy of the alveolar bone, which progresses slowly during normal aging, is speeded up in persons with osteoporosis. Even after all teeth are gone, bone loss continues. It's likely to be excessive and uneven, and the resultant sharp ridges and spicules sometimes cause so much pain and irritation that the patient can't tolerate dentures.

Adult↗
PubMedDate not supplied

Oral candidiasis in children with immune suppression: clinical appearance and therapeutic considerations.

Children and adolescents with immune compromise and suppression are particularly susceptible to the development of oral candidiasis. In fact, oral candidiasis is the most common oral manifestation in HIV-infected children. Oral candidiasis has been linked to a depressed immune system, more rapid progression to AIDS, more advanced stage of disease in AIDS, and decreased survival. Several different forms of candidiasis may be recognized clinically. These forms are 1) pseudomembraneous candidiasis; 2) erythematous (atrophic) candidiasis; 3) papillary hyperplasia; 4) chronic hyperplastic candidiasis; 5) angular cheilitis; and 6) median rhomboid glossitis. Diagnosis of candidiasis is primarily based upon clinical appearance; in some cases, however, exfoliative cytology and/or biopsy of the lesion may be necessary. It is also possible to culture the lesion to determine the specific subtype of candidia and to evaluate the susceptibility of the fungus to specific antifungal agents. Both topical and systemic treatment by antifungal medications are readily available.

Antifungal Agents↗
PubMed1999

Glucagonoma syndrome: a case report.

Glucagonoma is a very rare islet cell tumor of the pancreas. We present a case of pancreatic tail tumor with the typical glucagonoma syndrome of necrolytic migratory erythema (NME), diabetes mellitus (DM), anemia, weight loss and glossitis. After complete resection of the pancreatic tumor, the glucagonoma syndrome subsided. In reviewing 120 cases of glucagonoma in the literature, the average tumor diameter was 3.6 cm. Most (68.1%) of the tumors occurred in the pancreatic tail. Two-thirds of the reported glucagonomas were malignant and 53.5% metastasized to other organs. The curative resection rate was 45.8%. A triad of pancreatic tumor, NME and DM should lead to the diagnosis of glucagonoma.

Glucagonoma↗
PubMed1976

Oral Candida, debilitating disease and atrophic lesions of the tongue.

Central papillary atrophy of the tongue (CPA) was significantly more common in diabetics than in non-diabetic control subjects. Candida species were cultured from 46% of diabetics. The only species insolated from diabetics with atrophic glossitis was Candida albicans. Almost one in five of the diabetics gave positive smears for candidal mycelia. The correlation between atrophic lesions and the finding of candidal mycella in smears was statistically highly significant (P less than 0.01) but a cause-and-effect relationship was not established. Histological examination of a case of diabetic CPA suggest that this may be predisposed by micro-vascular degeneration.

Adolescent↗
PubMed1999

Evaluation of metronidazole toxicity: a prospective study.

Metronidazole is an antimicrobial, antiprotozoal agent that has been widely used in the treatment of a variety of infections. Some therapeutic indications necessitate prolonged treatment with metronidazole. Peripheral neuropathy is a potential metronidazole-induced toxicity, which has been reported in only a few isolated retrospective studies. This prospective study was designed to determine the toxic profile of metronidazole in patients undergoing long-term treatment with this drug. In the present study, 17 patients of both sexes, aged between 20 and 50 years, with body weights ranging from 46 to 62 kg and who were suffering from various medical ailments were recruited. The patients received 400 mg t.i.d. oral metronidazole in a total dose of 16.8-39.6 g for 2-4 weeks. It was found that patients usually suffered from some of the toxic symptoms of metallic taste, headache and dry mouth and to a lesser extent nausea, glossitis, urticaria, pruritus, urethral burning and dark colored urine. Symptoms were irrespective of sex and directly proportional to duration of therapy. Deep tendon ankle jerks were maximally reduced in four patients and sense of vibration at the level of olecranon and patella was affected in two patients. Distal latency and velocity of the sural and posterior tibial nerves were significantly affected (p < 0.01) compared with control values. These results indicate possible motor-sensory neurotoxicity involving the lower limbs due to long-term metronidazole therapy.

Adult↗
PubMed1999

Non neoplastic tongue diseases. An epidemiological investigation and diagnostic criteria.

BACKGROUND: Few clinical-epidemiological data regarding tongue diseases were showed in recent literature. The aim of this study was to evaluate the prevalence of non neoplastic tongue pathologies, and to perform an epidemiological, clinical and etiopathogenetic comparable data system on Non-Neoplastic Glossitis (NNG). METHODS: A total of 215 subjects (90 males and 125 females, age range: 6-72 years) have been examined) at the Dental Clinic of the University of Brescia over a period of 2 years. From this group, patients with tongue non neoplastic lesions were selected. Each selected patient with NNG was examined, following the Diagnostic Protocol of the "Department of Oral Pathology and Medicine" of the Dental Clinic of Brescia University. RESULTS: 84 cases of NNG (39%) were observed from January 1997 to October 1998. CONCLUSIONS: The selected group of patients with NNG has been stratified following clinical and etiological criteria, and the results discussed, emphasizing the importance of careful and correct examination of the tongue, in order to bring to light morphological and pathological changes often neglected or misdiagnosed. One should never exclude, moreover the possibility of malignant evolution of some lingual lesions requiring a close follow-up.

Adolescent↗
PubMed1975

Tryptophan/nicotinic acid pathway during levodopa treatment of Parkinsonism.

The behaviour of some urinary metabolites of tryptophan/nicotinic acid pathway was studied in 7 patients with Parkinson's disease during a 24-day period of levodopa treatment. Corresponding to the appearance of side-effects (agitation, anorexia, dysphagia, glossitis, abdominal pains) in 5 patients there was an increase in urinary Ky, AA, AAG, o-AHA, and 3-HK, while 3-HAA excretion fell. Since no other drugs were given, it was presumed that this effect was due to levodopa administration.

Adult↗
PubMed2002

[Incidence of diabetes mellitus in patients with malignant tumors of the oral cavity].

Diabetes mellitus affects 5% of the population of Hungary. Its complications in the oral cavity include parodontosis and changes in the oral mucosa (leukoplakia, lichen oris and glossitis). The incidence of leukoplakia (the most frequent precancerous state in the oral cavity) is 2.2% in the normal population, 6.2% among diabetics, and 11.5% among diabetic who smoke. The various forms of leukoplakia in the oral cavity become malignant in 5-20% of the cases, while the erosive, ulcerative lesions do so in 15-20% of the cases. These data led us to examine the blood glucose levels in 318 patients with histologically confirmed malignant tumours in the oral cavity. Diabetes mellitus was found in 56 of them (17.5%), the blood glucose level being elevated in 31 cases (9.75%). The fact that the incidence of diabetes mellitus among these patients was more than 3 times higher than that for the normal population demonstrates that further studies should be performed on the connection between diabetes mellitus and malignant tumours in the oral cavity.

Adult↗
PubMed2003

Pellagra may be a rare secondary complication of anorexia nervosa: a systematic review of the literature.

Pellagra is a nutritional wasting disease attributable to a combined deficiency of tryptophan and niacin (nicotinic acid). It is characterized clinically by four classic symptoms often referred to as the four Ds: diarrhea, dermatitis, dementia, and death. Prior to the development of these symptoms, other nonspecific symptoms insidiously manifest and mostly affect the dermatological, neuropsychiatric, and gastrointestinal systems. A review of the literature reveals several case reports describing pellagra in patients with anorexia nervosa. The most common features of pellagra in patients with anorexia nervosa are cutaneous manifestations such as erythema on sun-exposed areas, glossitis, and stomatitis. Health care providers might consider a trial of 150-500 mg niacin if anorexic patients exhibit these cutaneous findings. Pellagra can be diagnosed if cutaneous symptoms resolve within 24-48 hours after oral niacin administration. To further corroborate a diagnosis of pellagra in anorexic patients, specific 24-hour urine tests for niacin metabolites and 5-hydroxy-indole-acetic acid could be run prior to treatment with niacin being instituted. Other factors, such as mycotoxins, excessive dietary leucine intake (although not in anorexia), estrogens and progestogens, carcinoid syndrome, and various medications, might also lead to the development of pellagra. Although pellagra appears to be a rare, yet possible secondary complication of anorexia nervosa, it should be considered in the work-up of patients who exhibit cutaneous manifestations subsequent to sunlight exposure.

Anorexia Nervosa↗
PubMed2003

Accidental fatal poisoning of a dog by Dieffenbachia picta (dumb cane).

A single case of accidental fatal poisoning by Dieffenbachia picta, (dumb cane) (Araceae) in a 9-y-old female Poodle is described. Clinical signs included severe, locally extensive erosive/ulcerative glossitis accompanied by marked dyspnea of acute onset. The animal did not respond to emergency procedures to relieve severe respiratory distress; fatal asphyxiation ensued from edema of the glottis a few hours after the first clinical signs were observed. According to the owner, the dog had access to a tall, potted dumb cane plant and chewed the thick stem of the plant intensely. The owner did not authorize a necropsy of the animal. The diagnosis of Dieffenbachia picta poisoning was based on the history of accidental consumption of dumb cane and clinical signs. A comparison of this single case with other reports of dumb cane poisoning suggests that dogs poisoned by Dieffenbachia species usually recover uneventfully with conservative management and that death from asphyxiation is a rare but possible consequence of this intoxication. Severe edematous swelling of the glottis with occlusion of the larynx airway passage can occur in those cases in which large amounts of sap are quickly squeezed from the plant during intense chewing. Death would occur if owners do not seek veterinary care immediately and if emergency procedures are not instituted on time.

Animals↗
PubMed2003

Plummer-Vinson syndrome: a report of three cases.

Plummer-Vinson syndrome is characterised by dysphagia, anaemia, glossitis and oesophageal web. We report our findings in three patients with membranes in the upper oesophagus. All patients underwent endoscopic dilatation and iron replacement therapy, with good results. We review the literature of this syndrome.

Administration, Oral↗
PubMedDate not supplied

Developmental malformations of human tongue and associated syndromes (review).

The development of the tongue begins as known, in the floor of the primitive oral cavity, when the human embryo is four weeks old. More specifically, the tongue develops from the region of the first three or four branchial arches during the period that the external face develops. Malformations of the tongue, are structural defects, present at birth and happening during embryogenesis. The most common malformations are: 1. Aglossia 2. Microglossia, which is always combined with other defects and syndromes, like Moëbius syndrome 3. Macroglossia, which is commonly associated with cretinism, Down's syndrome, Hunter's syndrome, Sanfilippo syndrome and other types of mental retardation 4. Accessory tongue 5. Long tongue 6. Cleft or Bifid tongue, condition very usual in patients with the orodigitofacial syndrome 7. Glossitis Rhombica Mediana, a developmental malformation? 8. Lingual thyroid. Malformations are extensively analysed and discussed.

Abnormalities, Multiple↗
PubMed1992

Dentures, prosthetic treatment needs, and mucosal health in an institutionalised elderly population.

A survey of 359 elderly residents of rest homes and geriatric hospitals in the Manawatu and Horowhenua regions showed that 80.5 percent were fully edentulous. Full upper and lower dentures were worn by 64 percent of the total sample, and 31 percent of the dentate group wore one or more partial dentures. Prosthetic treatment needs were dominated by full dentures: 18 percent of upper dentures and 26 percent of lower dentures were considered to need replacement. A further 24 percent of full lower dentures required relining. Only 7 percent of the dentures were named. One third of the subjects had mucosal lesions, the most common lesions being angular cheilitis (present in 18 percent of subjects), traumatic ulcers (14 percent), atrophic glossitis (12 percent), and leukoplakia (present in 8 percent of subjects). No malignant lesions were found.

Aged↗
PubMed2004

Clinical experience in diagnosis and treatment of glucagonoma syndrome.

BACKGROUND: Pancreatic endocrine tumors are uncommon neoplasms and can lead to systemic disorder including glucagonoma syndrome, a very rare prototypical paraneoplastic phenomenon. The aim of this study was to assess the diagnosis and surgical strategy for the treatment of glucagonoma syndrome. METHODS: The clinical data of a case of pancreatic head tumor with typical glucagonoma syndrome of necrolytic migratory erythema (NME), diabetes mellitus (DM), anemia, and glossitis were retrospectively analyzed. RESULTS: Cutaneous eruption occurred mainly in the groin, extremities, thighs, buttocks, and perineum. A highly elevated level of serum glucagon was detected by radioimmunoassay. A tumor located in the head of the pancreas was well-defined by pre and intra-operative ultrasonography, contrast enhanced computed tomography, and magnetic resonance imaging. Tumor enucleation was performed, showing significantly improved symptoms. Near complete resolution of NME was shown one week after surgery. Surgical complications or recurrence was not found. CONCLUSIONS: The diagnosis of glucagonoma syndrome is established by marked clinical features such as NME as the hallmark clinical finding, hyperglucagonemia, and radiographically demonstrated neuroendocrine tumor. The topographic diagnosis of glucagonoma can be achieved by combined imaging methods. Enucleation of tumor is a valuable treatment for solitary pancreatic tumor without peripancreatic invasion, liver metastasis, and pancreatic duct compression.

Glucagonoma↗
PubMed2004

[Stomatologic diseases in young men with constitutionally related malnutrition].

The stomatologic investigation has revealed multiple caries in the youths of pre-conscription age with constitutionally conditioned malnutrition (CCM). Its specific features are the following: the high affection of incisor and molar teeth, the involvement as a rule of 3 dental surfaces, the high incidence of complicated caries (especially when the bode mass index is 16.69 + /- 0.25 kg/ m2), with the prevalence of acute apical periodontitis of pulpar origin and chronic periodontitis. The "bad" mark of oral cavity hygiene was more often noted in CCM youths, that causes the high incidence of gingivitis severe forms among them. The wide spread and high intensity of dental-and-maxillary anomaly and deformity connected with permanent lower molar early removal as well as the high incidence of desquamative glossitis are registered in the given patient group. The revealed patterns of incidence and intensity of oral and dental diseases in CCM youths show the necessity of more detailed study of their stomatologic status with the use of special clinical-and-laboratory methods in order to develop the optimal rehabilitation programs.

Adolescent↗
PubMed2005

The efficacy and tolerability of iron protein succinylate in the treatment of iron-deficiency anemia in pregnancy.

The aim of this study was to evaluate the efficacy and tolerability of iron protein succinylate in the treatment of iron-deficiency anemia in pregnancy. One hundred and thirty anemic pregnant women were studied. Inclusion criteria were iron-deficiency type of anemia, and hemoglobin levels below of 11.5, 10.9 and 10.3 g/dl for the three trimesters of pregnancy, respectively. Twenty-five women who presented pregnancy-related complications were excluded during treatment. The remaining 105 were treated with 1600-mg iron protein succinylate per os daily for a period of four months. A group of anemia-related clinical signs and symptoms, and hematological parameters were recorded at the beginning of treatment, as well as two and four months later. They included epidermis and mucosal paleness, skin and nail lesions, glossitis, heart pulse, sickness, anorexia, apathy, ataxia, polypnea, insomnia, nervousness, paresthesias and other neurological symptoms; the hematological parameters included Hgb, hct, RBCs, WBCs, MCV, MCH, MCHC, PLTs, serum Fe and ferritin. Possible side or adverse effects were considered during treatment. The majority of symptoms and signs of anemia were gradually improved. There was a statistically significant increase in the means of Hgb, hct, WBCs, MCV, MCH, PLTs and serum ferritin (p < 0.05). Anemia was effectively treated in 100/105 (95.2%) women, but not in five patients (4.8%) who displayed poor compliance to the therapeutic protocol. There were transient and mild side-effects in seven (6.6%) treated women, namely diarrhea, epigastralgia, vomiting, and nausea, which however, did not necessitate discontinuation of the therapeutic protocol. Iron protein succinylate is an effective and well tolerated treatment of iron-deficiency anemia in pregnancy.

Adult↗
PubMed2005

Oral health status in a population of Nigerian diabetics.

Oral manifestations of diabetes mellitus have been documented, but the effect of glycemic control on the oral tissues has been scantily reported. The oral health status of 65 metabolically controlled adult diabetic patients attending the Diabetes Clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, was prospectively assessed over six months and compared with that of 54 non-diabetic acting as controls. The mean duration of diabetes was 100.5+/-85.1 months. The difference in periodontal status of the patients and control, assessed using the Community Periodontal Index of Treatment Needs (CPITN), was not statistically significant (p=0.07). The degree of hyposalivation between the two groups was, however, statiscally significant (p<0.05). No significant difference was observed in the altered taste, burning mouth sensation, angular cheilitis, glossitis, and stomatitis status of the two groups. We conclude, with adequate metabolic control, the oral health status of a diabetic may not be significantly different from that of a non-diabetic except for xerostomia. A good understanding of the interactions between systemic diseases and oral health is imperative for physicians and dental practitioners. The need for early detection and closer linkages between the dental and medical professions in managing diabetic patients is emphasized.

Adult↗
PubMed2005

Plummer-Vinson syndrome and dilation therapy: a report of two cases.

Plummer-Vinson syndrome is known as the association of postcricoid dysphagia, upper esophageal web, and iron deficiency anemia. Although correction of iron deficiency may result in resolution of dysphagia and sometimes disappearance of the webs, dilation therapy is usually necessary to remove webs and relieve dysphagia. We report two cases of Plummer-Vinson syndrome. Both patients presented with significant and longstanding dysphagia, sideropenia, glossitis and koilonychia. Our two patients had occasional choking and aspiration episodes at eating and endoscope did not pass through at the level of the upper esophagus. Patients' esophagograms revealed the presence of webs in part of the post-cricoid region. Both patients were treated with esophageal bougienage or balloon dilation, and iron supplementation. The patients were examined periodically for two years after the initial treatment and found to be in good general condition.

Catheterization↗