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[Necrolytic migratory erythema as the first manifestation of glucagonoma].

A 49-year-old woman suffered from recurrent episodes of necrolytic migratory erythema over the lower legs, lower abdomen, and buttocks for more than two years. Stomatitis, glossitis and vaginitis were the accompanying symptoms and signs during each episode. The result of skin biopsy revealed superficial necrosis in the upper half of the epidermis. Laboratory examinations revealed mild glucose intolerance and hypoaminoacidemia. Fasting plasma glucagon level measured by radioimmunoassay was 890 pg/mL. Oral glucose loading test showed a paradoxical increase in plasma glucagon level up to 1,500 pg/mL. Abdominal echo, computerized axial tomography, and celiac angiography demonstrated a hypervascular tumor, 4 cm in diameters, located at the pancreatic head. Glucagonoma syndrome was confirmed and diagnosed. The patient underwent surgical resection of the tumor mass. Necrolytic migratory erythema disappeared thereafter, and the plasma glucagon level declined to 120 pg/mL. Histologically, the tumor revealed an islet cell carcinoma composed of moderately uniform cells with a few mitosis, arranged in cords and nests. Abundant characteristic secretory granules of the pancreatic A cell were found within the tumor cells by electron microscopic examination.

Erythema↗

Black hairy tongue associated with olanzapine treatment: a case report.

Olanzapine is an atypical antipsychotic drug approved for acute and long-term treatment of bipolar disorder. Although relatively safe as compared to other classical antipsychotic medications, there are a number of uncommon adverse effects of olanzapine such as oral cavity lesions. In addition to the relatively common side effect of dry mouth, several articles have reported an association between olanzapine treatment and the development of oral lesions such as apthous stomatitis, pharyngitis, glossitis and oral ulceration. Although there are several cases in which the tongue was affected in conjunction with stomatitis or pharyngitis, we could not find a case report indicating a direct relationship between olanzapine use and a tongue lesion. We present here the case of a patient with bipolar disorder, who developed recurrent black hairy tongue on two different occasions following the addition of olanzapine to lithium treatment. In the present case, xerostomia (dry mouth), which is an adverse reaction of both olanzapine and lithium, may have played a role in the development of black hairy tongue. All agents with a possible side effect of xerostomia may predispose patients to black hairy tongue, especially when they are administered in combination. To preclude the development of this complication with such drugs, extra time and effort should be given to improving oral hygiene.

Adult↗

Tongue piercing: case report of a local complication.

Historically, wearing adornments on pierced body parts has been associated with many cultures as manifestations of religious or cultural identities. Currently, its use has a broad acceptance among young people. The most common sites for piercings are the tongue and lower lip in the oral cavity. Several complications may be associated with this practice with the most frequently observed being halitosis, periodontitis, tooth fracture, glossitis, and the formation of abscesses. This paper is a case report of a patient who had a complication from a piercing on the tongue located under the overlying mucosa. It also suggests a local habit was a possible initiator of this complication.

Adolescent↗

Riboflavin deficiency: mucocutaneous signs of acute and chronic deficiency.

Mucocutaneous lesions are present in both acute and chronic riboflavin deficiency. The distribution of the lesions varies with the age and gender of the patient. Lesions of acute riboflavin deficiency are similar to those observed in protein-energy malnutrition of the kwashiorkor type. In chronic riboflavin deficiency the cutaneous lesions resemble monilial intertrigo and the mucous membrane lesions include a characteristic glossitis. Prompt resolution of lesions after therapeutic doses of the vitamin are given confirms the diagnosis. Biochemical changes caused by riboflavin deficiency, which explain the dermatoses and mucous membrane lesions, have not as yet been determined. Lack of information in this area is explained by the difficulty of separating cutaneous changes caused by the deficiency from those caused by trauma or other proximate etiologic agents.

Acute Disease↗

[The interrelation between allergic reactions to dentures made of stainless steel and the skin hypersensitivity to Cr and Ni].

Twenty-two patients with stainless steel dentures, suffering from skin sensitization to chromium and nickel, were examined. The majority of these patients wore the dentures without complaining of local or general pathologic reactions. In three allergic catarrhal glossitis, aphthous stomatitis, and dermatitis were diagnosed. Replacement of stainless steel dentures with identical dentures made of other material resulted in complete cure.

Adult↗

[The results of a study of chemical-induced disease in children in Chernovtsy].

A clinical study of children inhabiting Chernovtsy and Chernovtsy Province, examination of the qualitative composition of inorganic admixtures in the hair and their microscopy indicates that the revealed symptom complex allowed to diagnose mild forms of chemical disease in children with focal alopecia. The criteria were: mucosal lesions (conjunctivitis, pharyngitis, glossitis, cheilitis); alopecia; hematological syndrome: eosinophilia, lymphocytosis, relative neutropenia; neuro-psychic disorders; cutaneotrophic disorders; presence of black inclusions in longitudinal and transverse light microscopy. Association of focal alopecia with the above symptoms even in absence of changes of the qualitative composition of inorganic microadmixtures allows to think about the chemical etiology of the diseases apparently caused by compounds of different chemical substances with inclusion of thallium.

Adolescent↗

[Infectious erythema of yersiniosis etiology].

A study is presented of 14 patients (9 adults, 5 children) with infectious erythema interpreted as one of the clinical variants of generalized skin form of yersiniosis. Along with typical signs of erythema, signs were found characteristic of yersiniosis, namely, mesadenitis, acute hepatitis, desquamative glossitis, changes in the ileocecal region, dyspeptic phenomena, tendency to a wave-like course. The clinical signs and symptoms of infectious erythema of yersiniosis etiology are illustrated by cases from the practice. The diagnosis was confirmed in 13 patients serologically in the reaction of agglutination with living cultures of yersiniae, in 1 patients bacteriologically and serologically.

Adult↗

Oral candidosis in HIV-infected patients.

Over 80% of all HIV-infected patients develop oral candidosis at some stage during their disease. This provides a marker for the development of fullblown AIDS--in one study more than 50% proceeded to the full syndrome within three months of the development of buccal lesions, although some of these may have had asymptomatic oesophageal candidosis at the time of initial presentation. Oral candidosis appears to be particularly common in young children and Africans who are HIV-infected. Both pseudomembranous and atrophic forms occur, but the atrophic manifestation, which is often asymptomatic, often occurs earlier and is frequently missed. Median rhomboid glossitis and angular cheilitis are common. Topical treatment appears to be sufficient for atrophic candidosis and many cases of pseudomembranous infections also respond, although many clinicians would prefer to use a systemic antifungal agent in this situation because of the risk of oesophageal infection. Fluconazole, ketoconazole and itraconazole are all effective agents. In a prospective double-blind control study comparing itraconazole and ketoconazole, clinical response, mycological clearing and relapse rate were similar with both drugs. More than 95% of patients were free of symptoms within three weeks.

Candidiasis, Oral↗

[Anemia caused by iron deficiency and pagophagia. Apropos of a case].

The authors report a case of a 17 year old young man, who entered our hospital for a severe iron lack anemia reported to ice cubes ingestion (Pagophagia). Such cases are reported in the literature. Usually, Pagophagia is a compulsive eating (Pica) caused by iron deficiency. Pagophagia could improve non hematologic symptoms of iron deficiency such as stomatitis and glossitis.

Adolescent↗

The diagnostic challenge of styloid elongation (Eagle's syndrome).

Eagle's syndrome is a relatively common disorder that is frequently misdiagnosed. It occurs more frequently in women. Presenting symptoms generally include posterior oropharyngeal pain, intermittent glossitis, and phantom foreign body discomfort of the pharynx. Surgical removal of elongated styloid processes generally provides relief of symptoms.

Aged↗

Use of a liquid diet as the sole source of nutrition in six dysphagic horses and as a dietary supplement in seven hypophagic horses.

Six horses with dysphagia (attributable to botulism, glossitis, or guttural pouch mycosis) were given a commercially available liquid diet as the sole source of nutrition. Seven horses with hypophagia caused by severe bacterial pleuropneumonia or peritonitis were given the liquid diet to supplement food consumed voluntarily. The liquid diet was administered through a nasogastric tube 2 or 3 times daily. Body weight did not change significantly, and pertinent laboratory values remained at satisfactory concentrations throughout the feeding period. Serious complications were not encountered. Three horses developed loose, low-volume feces, but did not require treatment.

Animals↗

Complications of topical steroid therapy for asthma.

The oropharyngeal complications of IS therapy are seldom a serious problem. They may be avoided or ameliorated by inhaling the drug via a spacer and/or reducing the dosing frequency. Severe esophageal candidiasis or atrophic glossitis are rare and generally require discontinuation of IS therapy. Reflex cough or bronchospasm triggered by the inhaled drug occur fairly commonly, but are easily corrected by appropriate treatment. The systemic complications of IS therapy are inconsequential in most patients treated with conventional low doses. Higher doses are more effective but also more active systemically. Despite this, the ratio of systemic-to-antiasthmatic activities may be more favorable with high dose IS than with oral prednisone when the two treatments are compared at equivalent levels of asthma response. The potential risk of adverse systemic effects accruing from the long-term use of intermediate or high doses of IS needs to be rigorously studied.

Administration, Inhalation↗

[Present-day course of vitamin B 12 deficiency anemia].

By recent data, B12-deficiency anemia occurs in 14% of overall anemia cases. It arises mostly from gastrointestinal lesions, atrophic gastritis being the main etiological factor. Common clinical signs of the disease (glossitis, nervous disturbances, hemolysis) manifest in only 10-23% of the patients, hematological evidence of pancytopenia is registered in about half of the cases. The early diagnosis may be established with spinal puncture. That of the iliac bone tubera is a method of choice in elderly subjects.

Adult↗

[Aging and the oral cavity].

Like all tissues in the human body, those within the buccal cavity undergo changes with ageing, which are observable in clinical practice. Such changes include the appearance of lingual varicosities, glossitis, atrophy of the taste papillae and of the salivary glands, with variable degrees of xerostomia, periodontal disease and predisposal to develop malignancies. Dental units may also be affected, with occurrence, among other processes, of abrasion, attrition, caries and lowered dentarian sensibility, phenomena of interest for the odontologist in handling geriatric patients.

Aged↗

Cefroxadine in the treatment of children affected by respiratory and ENT diseases. A multicentre study involving 1072 in-patients.

In this multicentre trial, 1072 hospitalized children, 573 boys and 499 girls (847 of whom were aged less than 6 years), affected by respiratory tract (376 patients) or ENT (696 patients) infections were treated for 10 days with cefroxadine per os, at an average dose of 650 mg/day (325 mg every 12 h corresponding to 25 mg/kg b.w.). Most patients (1047; 97.7%) completed the trial, while 25 patients were withdrawn from the study (20 patients for viral diseases and 5 for side-effects). Of the patients affected by respiratory tract infections, 361 completed the trial and 342 of them (94.7%) were cured in 6.0 days on average. Of the patients affected by ENT infections, 686 completed the trial and 649 of them (94.6%) were also cured in an average of 6.0 days. In the two groups the signs and symptoms of the disease significantly (p less than 0.001) decreased by the end of the study. Some patients (80; 7.6%) complained of side-effects, mainly gastric discomfort (4.9%), skin rash (2.2%) and glossitis (0.5%). In conclusion, cefroxadine exerts a satisfactory antibacterial action with only a few days of treatment, and it appears to be very well tolerated.

Bacterial Infections↗

Oral manifestations of acute promyelocytic leukemia.

A study was conducted of 16 patients with acute promyelocytic leukemia. The most common oral manifestations were hemorrhagic diathesis and leukemic involvement. There was gingival bleeding, petechiae, and ecchymosis of the oral mucosa, massive infiltration-induced gingival swelling, ulcerative glossitis, swelling of the tonsils, and facial palsy. Inflammatory stomatitis also occurred. Patients with acute promyelocytic leukemia had a higher incidence and severity of oral bleeding than those with other types of acute leukemia. However, the oral findings in our series were not necessarily specific for acute promyelocytic leukemia because the same oral symptoms occur in other forms of acute leukemia.

Humans↗

Protection of newborn calves against fatal multisystemic infectious bovine rhinotracheitis by feeding colostrum from vaccinated cows.

To determine whether consumption of colostrum with high levels of serum neutralizing antibody to bovine herpesvirus 1 would protect neonatal calves from the frequently fatal multisystemic form of infectious bovine rhinotracheitis, Holstein calves were fed for 48 h after birth with either pooled colostrum from seropositive vaccinated cows or colostrum from seronegative unvaccinated cows. The serum neutralizing antibody achieved in the former calves was between 64 and 256 and the titer in the latter calves was below 8. At 48 h of age the calves were challenged by aerosolization with bovine herpesvirus 1. All five seronegative calves died or were euthanized in a moribund state between days 5 and 7 of the trial, whereas all five seropositive animals remained healthy throughout the study. Twice daily clinical examination revealed significantly lower scores in the seronegative group from 60 h postinfection. Relative lung weights were greater in the seronegative group, associated with a severe acute necrotizing bronchiolitis with fibrin exudation. The seronegative group of calves also demonstrated an acute necrotizing rumenitis, pharyngitis, glossitis, esophagitis, laryngitis and tracheitis. The seropositive animals had only small areas of subacute necrotizing fibrinopurulent rhinitis. Bovine herpesvirus 1 virus was isolated from all nasal passages of all calves but isolation of virus in the seronegative calves was made from the trachea (5/5), lung (4/5), bronchial lymph nodes (4/5), spleen (4/5), thymus (3/5), liver (2/5), rumen (2/5) and brain (1/5).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intranasal↗