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Problematiche clinico-diagnostiche e terapeutiche odontoiatriche e stomatologiche nei pazienti HIV positivi e con AIDS.
No full textDuring the last decade, scientific studies and new knowledges concerning HIV infection and AIDS, have constituted one of the main topics for discussion in the fields of biology and medicine. AIDS is a serious disease and it is unfortunately characterized by a very high death rate. In spite of all the efforts deployed by researchers and scientists, there is at present no effective therapy capable of restoring a proper immunological balance in the affected subjects. In the field of odontostomatology all diagnostic, clinical or therapeutic operation in HIV patients, is to be considered as particularly complex and characterized by some degree of real risk. It is therefore necessary to develop a whole set of health-care models which must provide a broad range of different interventions in order to assure a rational and technically profitable service. We point to the various diagnostic, clinical and therapeutic methods and approaches to be recommended in the case of HIV and AIDS patients, and we add some reference to health care activities at the "San Luigi Center" of the Scientific Istitute San Raffaele Hospital in Milan
Aspetti eziopatogenetici, clinico - diagnostici e terapeutici della sindrome della bocca bruciante: protocolli di ricerca e cura su un gruppo di pazienti.
No full textBACKGROUND: Burning mouth syndrome (BMS) is a frequently seen pathology characterised by burning tongue and oral pain without macroscopic structural lesions to the mucose. BMS etiopathology isn't known and therapy is merely empirical and unsatisfactory. METHODS: To evaluate the hypothesis that this syndrome would originate by a small diameter peripheral neuropathy combined to a mucosal trophic lesion, 37 patients, (7 male, 30 female, between 36 and 79 years, mean 54 years) affected by BMS, consecutively observed in our dispensary were submitted to a series of examinations and to therapeutical approach used in neuropathic painful syndromes. All patients were submitted to a complete stomatological exam and X-ray pantomography to exclude mucosal macroscopical lesions and dentistry illnesses. All patients executed sierological exams (glycemia, etc.), neurological exam, tongue and foot dorsum quantitative sensory examination, tongue and face telethermography. A few patients (3 male, 10 female; age 34 to 53, mean 49) were submitted to mucosal tongue biopsy, analyzed by optic microscopy and immunofluorescency following treatment with anticytoplasmatic neuronal proteins antibodies (protein gene product 9.5). RESULTS: These examinations showed subclinical polyneuropathy in 50% of patients. In particular, a loss of function in small diameter nervous fibres in about 50% of patients was observed. Histological examination of tongue mucose revealed a moderate atrophy in 70% patients. CONCLUSIONS: All patients were submitted to an antalgic therapy, with non-antiflammatory drugs used in neuropathic painful syndromes (quercetine, antiepileptic drugs benzodyazepinein and gabaergic, topical application of capsaicine solutions)
Considerazioni eziopatogenetiche e cliniche della BMS. Preliminari su un protocollo di ricerca.
No full text
Candidosi delle mucose oro-faringee. Aspetti clinici ed epidemiologici in un gruppo di pazienti HIV positivi e con AIDS.
No full textImmune system deficiencies, particularly cell-mediated immunity are the main events of HIV infection. The resulting syndrome is removies: AIDS. This immune deficiency encourages neoplasms such as the Kaposi sarcoma and non Hodgkin lymphoma, above all, it explains the reason why infections supported by opportunist germs, normally not pathogenic for immuno-competent people, are the main reason for morbidity and mortality in this kind of patients. Since among mycotic infections, the main one in these patients is candidiasis, particularly oro-pharyngeal candidiasis, we have carried out a research with the aim of evaluating the main mucosae oris pathologies in HIV and AIDS patients and, among them, the most directly correlated to HIV infection with reference to oro-pharyngeal candidiasis. We have based our research on the analysis of 237 patients case-histories. From January 1993 to December 1994 these patients have been examined at the Odontological Surgery by the "Centro San Luigi" for HIV-correlated pathologies researches and treatments (Istituto Scientifico Ospedale San Raffaele-Milano
Phenotypes of Candida spp. isolates in HIV-infected and AIDS patients.
No full textThe phenotypic strain variations among isolates of Candida spp. from single patients were studied. From the oral cavity of 5 asymptomatic and 5 AIDS patients with oral candidiasis 39 Candida spp. were collected. After the macroscopic and microscopic features of colonies were recorded, the following 6 examinations were performed: germ-tube test, auxanogram, morphotype, resistogram, adhesivity to human keratinocytes and susceptibility to 6 antifungal compounds. Replacement of C. albicans either with C. tropicalis or C. glabrata was found for 3 patients. A strain of C. albicans (case 1) differed from the others in all the tests studied MICs on isolates recovered from AIDS patients were higher, or grew over time, than MICs on those from asymptomatic subjects. No correlation was demonstrable between the antifungal susceptibility and the other parameters. Strain variations in the oral microflora of HIV-positive and AIDS patients really may occur
Atrofia delle mucose oro-faringee da carenza di vitamina B12 ed acido folico.
No full textBACKGROUND: By atrophy, the decrease in volume of the cell due to loss of cell substances is intended. When a sufficiently high number of cells is involved, the whole tissue or organ decreases in volume or becomes atrophic. The oropharyngeal mucous membrane can be the site of processes of mainly atrophic type whose causes can be found in various pathologies. These pathologies can be caused by alterations in the endocrin-metabolic conditions, such as vitamin deficiencies, especially of vitamin B12 and folic acid. MATERIALS AND METHODS: Twenty-three patients who on objective examination were affected by mucous atrophies, both of the oral cavity and of the oropharyngeal area probably due to vitamin B12 and/or folic acid deficiency have been identified. Indicatively the therapies prescribed consisted of administration of N5calcium methyltetrahydrofolate for 1 month, and of pharmaceutical products containing vitamin B12, again for 1 month. After a month of therapy, the overall clinical situation of all the patients who were included in our protocol was reassessed. RESULTS AND CONCLUSIONS: On clinical examination, 20 patient showed pink oral mucous membrane. The patients also reported disappearance of pyrotic symptoms and the laboratory tests showed values within normal limits. The erethistic ulcers on the lips had disappeared even if the vermilion did not appear fully re-epithelialized in 9 patients. The other 3 patients, who still had values under normal limits, were subjects who had undergone long-term chemotherapy. For these patients the therapy was continued for a further month. At the third check-up and careful objective examination, the lingual mucous membrane appeared pink and re-epitheliated. The patients reported disappearance of the painful oral symptoms. The laboratory tests were repeated again for all the patients and these confirmed values within normal limits for vitamin B12 and folic acid
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