111 research outputs found
Can atrophic-erosive oral lichen planus promote cardiovascular diseases? A population-based study
No full textObjective: Lichen planus has been recently associated with an increased risk of cardiovascular diseases (CVDs). The oral manifestations can be divided into white hyperkeratotic lesions (WL) and atrophic and erosive lesions (RL). The aim of this report was to compare the presence of CVDs between patients affected by WL or RL, to test the hypothesis that RL are associated with an increased incidence of CVDs. Subjects and methods: Patients were analysed through a complete collection of all the risk factors for CVDs. The primary endpoint was the occurrence of a cardiovascular event—acute coronary syndrome (ACS), any revascularization or stroke/TIA. A multivariable logistic regression model, adjusted for age at diagnosis, body mass index, smoking, alcohol consumption, diabetes, hypertension, CVDs familiarity and periodontitis, was performed. Results: A prospective cohort of 307 patients has been evaluated; 185 (60.3%) had WL and 122 RL (39.7%). Twenty-four patients had a CVD. ACS occurred more frequently in RL (adjusted odds ratio 5.83; 95% CI: 1.16—29.39), mainly due to the higher risk of it after the histological diagnosis of Oral lichen planus OLP (odds ratio 4.23; 95% CI: 0.66—27.23). Conclusion: Patients with RL could possibly have a higher risk of developing ACS. Further analysis on larger cohort is however warranted
Tumor angiogenesis and progression are enhanced by Sema4D produced by tumor-associated macrophages
No full textIncreased evidence suggests that cancer-associated infiammation supports tumor growth and progression. We have previously shown that semaphorin 4D (Sema4D), a ligand produced by different cell types, is a proangiogenic molecule that acts by binding to its receptor, plexin B1, expressed on endothelial cells (Conrotto, P., D. Valdembri, S. Corso, G. Serini, L. Tamagnone, P.M. Comoglio, F. Bussolino, and S. Giordano. 2005. Blood. 105:4321 - 4329). The present work highlights the role of Sema4D produced by the tumor microenvironment on neoplastic angiogenesis. We show that in an environment lacking Sema4D, the ability of cancer cells to generate tumor masses and metastases is severely impaired. This condition can be explained by a defective vascularization inside the tumor. We demonstrate that tumor-associated macrophages (TAMs) are the main cells producing Sema4D within the tumor stroma and that their ability to produce Sema4D is critical for tumor angiogenesis and vessel maturation. This study helps to explain the protumoral role of infiammatory cells of the tumor stroma and leads to the identification of an angiogenic molecule that might be a novel therapeutic target
Favourably effective formulation of sodium iodide and salicylic acid plus professional hygiene in patients affected by desquamative gingivitis
No full textThe aim of this prospective pilot study was to evaluate the efficiency of an oral hygiene protocol, in combination with a solution of sodium iodide associated to salicylic acid (SISA), in patients affected by desquamative gingivitis (DG). Twenty patients not totally responding to conventional topical therapies, were selected. They received oral hygiene instructions with non-surgical periodontal therapy in a 21-day cohort study (during 3 weekly appointments). The SISA was used at the end of each session, with an impregnated gauze (with 5 ml of the solution) applied for 15 minutes for the upper jaw, and for a further 15 minutes with a new gauze for the lower. Evaluated clinical outcome variables included the full mouth plaque (FMPS) and bleeding (FMBS) scores, probing depth, patient related outcome and clinical gingival signs. Two months after concluding the planned protocol, a statistically significant reduction was observed for FMPS (P=0.032), FMBS (P=0.038), reported pain (P=0.000) and gingival clinical improvement (P=0.005). Topical application of SISA and professional oral hygiene procedures are connected with improvement of gum status, and decrease of related pain in subjects affected by severe DG
LLLT in combination with non-surgical periodontal therapy in patients with gingival oral lichen planus: a pilot study
No full textExclusively oropharyngeal histoplasmosis leading to diagnosis of AIDS: a singular case report and review of literature
No full text
Localized oral amyloidosis of the palate
No full textBACKGROUND:
Amyloidosis is a rare disease with multifactorial pathogenesis. Localized amyloidosis affecting the head and neck region is an uncommon and benign process, which has almost no clinical consequences. The most reported characteristic features of localized oral amyloidosis appear as multiple soft nodules of the tongue, lip and cheek.
METHODS:
We report the case of a 68-year-old woman suffering from a primary localized amyloidosis presenting as a purple patch on the palate.
CONCLUSIONS:
The presence of systemic amyloidosis or underlying plasma cell dyscrasia have to be ruled out in patients presenting with a diagnosis of amyloidosis of the oral mucosa. If a primary localized amyloidosis is proven, the surgical therapy may be useful to eliminate a functional impairment
Population-based cohort study to assess the gingival lesions in 1319 patients with lichen planus
No full textAims Oral lichen planus (OLP) is a chronic immune disease. In this paper, we evaluated the overall characters, clinical presentation, and outcome of gingival lesions in OLP Italian patients. Methods and Results A retrospective cohort study was accomplished: a total of 1319 charts were investigated, of whom 922 were female (69.9%): 617 patients (46.8%) manifested white lesions and 702 red ones (53.2%). While most patients had several oral sites of involvement, the gingiva was the unique location in 103 cases. Symptoms were reported in 480 patients (36.4%): 286 patients with erosive OLP, 103 with atrophic form, and 91 with a white form. Long-lasting surveillance showed that only 40 patients (3.03%) had a total clinical signs remission. Regarding OLP medical treatment provided, patients attending less frequently a dental office underwent more often a specific therapy. Conclusions To the best of our knowledge, this is the biggest collections of patients with gingival OLP ever described; exclusive gingival lesions are, however, rare and unlikely to undergo a malignant transformation. Moreover, gum lesions seemed to anticipate the appearance of oral lesions and a higher rate of OLP therapy was observed in patients with less frequent dental check-ups and oral hygiene instructions
The prompt use of rituximab could decrease adverse effects in patient with pemphigus vulgaris: a preliminary evaluation
No full textBackground: The systemic use of corticosteroid is the treatment of choice for pa-
tients with pemphigus vulgaris (PV), but adverse effects are frequent. To date, the
use of rituximab (RTX) for PV patients is usually indicated when they failed first-line
immunosuppressive therapies. The early use of RTX could theoretically lessen ad-
verse effects.
Methods: We performed a single-center study on patients with predominantly oral
PV, treated with systemic corticosteroid and the prompt use of 1000 mg of intra-
venous RTX two weeks apart. We evaluated the clinical response and the reported
adverse effect during a period of 24 months, comparing those with a previously pub-
lished series.
Results: The study group comprised 11 patients, while the control group com-
prised 98 patients. The average time to achieve complete clinical remission was
3.2 ± 2.72 months. Study group took steroids for a mean time of 11.09 ± 2.02 months,
and they are all actually disease-free with no medication. Only three patients (27.3%)
developed plain side effects. The effect of the length of the corticosteroid therapy
on the side effects (also adjusted by sex, age, and clinical oral involvement) was sta-
tistically different in the two groups: the prompt use of RTX reduced of 94% the
chance to have adverse effects (P = .001).
Conclusions: This is the first report of the use of RTX as first line of therapy for
PV patients with predominantly oral involvement. With the proposed regimen, the
adverse effects have been minimized compared with classic systemic corticosteroid-
centered therapy. Multi-center randomized controlled trail is however necessary
A randomized controlled trial on efficacy of surgical excision of nondysplastic leukoplakia to prevent oral cancer
No full textThe aim of this study was to evaluate the effectiveness of surgical excision to prevent cancer in patients with nondysplastic oral leukoplakia (OL). This study was the first randomized controlled clinical trial comparing surgical treatment with standard care in this group of patients. Patients were divided into two groups. The first group underwent standard care, that is smoking counseling, follow-up visits every 6 months, and control biopsy when indicated. The second group underwent surgical excision, together with standard care. Oral cancer onset was the primary outcome; secondary outcomes included healing, recurrence after surgery, onset of new lesions, and worsening of the primary lesions. The differences in distribution of the patients' and lesions' characteristics were investigated through nonparametrical tests (Wilcoxon rank-sum and Fisher exact). Univariate and multivariate logistic regressions have been performed to estimate the odds ratio of the treatment on the recurrence or worsening of the lesions. A total of 260 patients took part in the study of which 132 were women (50.8%); during the follow-up period, two subjects developed oral cancer, one for each arm. Surgical treatment, when compared with standard care, was associated with a lower probability of the treated zone to remain healed during the follow up period (OR = 7.43; 95% confidence interval, 2.96-22.66). In conclusion, it is possible to assumed that regular clinical follow-up could be considered a reliable standard of care among patients with nondysplastic OLs. Prevention Relevance: Oral white patches can transform into cancer and none has provided clinical guidelines to prevent it. For the first time ever, we have showed that the clinical follow up of non dysplastic lesions was able to provide benefits if compared with surgical excision
- …
