Carriage of Candida species in the oral cavity in diabetic patients: relationship to glycaemic control

To study the possible relationship between the quality of glycaemic control in diabetes mellitus and the carriage of Candida species, the Candidal carrier status of 412 diabetic patients was examined using an oral rinse technique and correlated with measurements of random blood glucose and total glycosylated haemoglobin. Candida was isolated in 210 diabetics (51%) with 13 patients (6%) carrying more than one species. The positive isolates were: Candida albicans (89%), Candida krusei (2.8%), Candida glabrata (2.8%), Candida tropicalis (6.2%), Candida stellatoidea (2.8%) and Candida parapsilosis (0.5%). No association was identified between carriage rates and the type of treatment of diabetes, or with the quality of glycaemic control. As in non-diabetic subjects, the carriage rates were higher in diabetic patients wearing dentures. Thus, the oral carriage of Candida in diabetic patients was independent of glycaemic control but in certain sub-groups the carriage rates were higher, and involved uncommon candidal species.     

Pemphigus vulgaris precipitated by glibenclamide therapy

Pemphigus vulgaris (PV) is a rare but potentially fatal autoimmune bullous disorder which frequently affects the oral mucosa. Although the essential cause of PV is unclear, its onset has occasionally been associated with drug therapy, in particular penicillamine. The patient described in this paper was a 78-year-old diabetic man who developed oral lesions of PV following institution of glibenclamide therapy.     

Linear IgA disease (LAD): immunoglobulin deposition in oral and colonic lesions

Two cases of adult linear IgA disease (LAD) with oral and colonic involvement are presented. Oral findings, for both patients, were of widespread painful ulceration present for two to three months and diagnosis was confirmed by biopsy and direct immunofluorescence. Colonic symptoms preceded oral symptoms in both cases and a number of investigations were undertaken, including routine histological examination, which suggested either lymphocytic colitis or Crohn's disease. Immunofluorescence studies showed linear IgA deposition confined to the distal colon. These cases highlight that large bowel involvement can be a feature of linear IgA disease and for the first time demonstrate IgA deposition at that site.     

Sonographic diagnosis of a uterine defect in a pregnancy at 6 weeks' gestation with a history of curettage.

We present the early diagnosis and successful surgical treatment of uterine perforation. This was a rare case of cystic change of a uterine perforation, which was diagnosed by sonography during the first trimester of pregnancy. Surgical closure of the uterine wall defect was successful.     

The efficacy of amelxanox OraDiscTM on the prevention of recurrent minor aphthous ulceration

BACKGROUND: The study was designed to determine the efficacy of OraDisc (active component 2 mg amlexanox) on the prevention of aphthous ulcers treated at the prodromal stage. METHODS: Thermographic imaging was used to confirm the presence of a prodromal ulcer. Fifty-two patients were randomized to receive OraDisc (N = 26) or vehicle patches (N = 26). Patches were applied four times a day for 72 h over the prodromal area. The percentage of subjects who developed an ulcer at 72 h was compared between groups using the Fisher's exact test. Results: About 50% of subjects in the OraDisc group developed an ulcer by day 4 compared with 69% in the vehicle group. Erythema score, ulcer size, pain scores and thermographically active area and temperature all showed trends towards healing in the OraDisc group. CONCLUSION: The OraDisc prevents ulcers from developing when compared with the vehicle patch.     

Antioxidant status of oral mucosal tissue and plama levels in smokers and non-smokers

The antioxidant status of an individual is thought to be important in the development of potentially malignant oral lesions (PMOL) and oral squamous cell carcinoma (OSCC). To date, little detailed information on mucosal antioxidant status is available in a United Kingdom population and neither has the relationship between smoking and mucosal antioxidant status been established. Furthermore, it has been implied that serum levels of antioxidants and tissue levels in the oral mucosa should be equivalent, but that is unproven. To address these deficiencies in our knowledge we studied 60 individuals, all of whom had an oral mucosal biopsy and simultaneous venous blood sampling. Antioxidant levels were measured using high performance liquid chromatography. Smokers (n= 19) were found to have significantly lower levels of plasma beta-carotene (P<0.05) and significantly lower levels of tissue alpha-carotene (P<0.05) than non-smokers (n=41). Tissue alpha-carotene correlated with plasma levels, but this was not the case with alpha-tocopherol, retinol, lycopene or beta-carotene. This is the first data on oral mucosal antioxidant levels and provides baseline data from which to study patients with potentially malignant oral lesions and oral squamous cell carcinoma.     

Type 3 burning mouth syndrome: psychological and allergic aspects

A subgroup of patients with burning mouth syndrome was investigated. The clinical history of these patients differed from the norm in that symptoms were intermittent and affected unusual sites. In addition, routine investigations were supplemented with a more detailed psychological evaluation than reported previously and also a possible allergic component was studied by patch testing. The study has shown that this subgroup differs from burning mouth syndrome patients overall in that emotional instability and allergic reactions, particularly to food additives, are of etiological significance and require to be taken into consideration in terms of patient management.     

A comparative study of Thai massage and Swedish massage relative to physiological and psychological measures

Many cultures have a massage or touch-based therapy that has been influenced by the development of culture over time. The origins of Thai massage (TM) can be traced to oriental medicine and yoga. Swedish massage (SM), the most popular type of massage practiced in the US, is based on anatomy learned from dissection. To date TM has been largely unexplored. The purpose of this study was to compare and contrast a single general massage treatment, using one of two different styles of massage, on physiological and psychological outcomes.Fifty-three participants enrolled in the study and were randomly assigned to receive one TM or SM treatment. Dependent variables included blood pressure, heart rate, range-of-motion, perceived anxiety, and mood. Physiological assessments (blood pressure, heart rate, range of motion) were conducted immediately before (T1) and after the massage (T2). Psychological assessments (anxiety and mood) were conducted at T1, T2, and at 48-h follow-up (T3).A multivariate analysis of variance (MANOVA) revealed overall significant differences for the massage. However, there were no differences between the treatment groups. Repeated measures analysis of variance (ANOVA) for individual dependent variables found significant improvement between T1 and T2 in resting heart rate, ankle plantar flexion, ankle dorsiflexion, and shoulder abduction/rotation. Significant overall improvement was noted in mood at T2, and in tension-anxiety as well as confusion-bewilderment at T2 and T3 compared to T1. The findings suggest that a single treatment of TM is as effective as SM on general physiological and psychological outcomes.     

Oral disorders associated with diabetes mellitus.

The protean manifestations of diabetes include various associated oral disorders such as sialosis, xerostomia, impairment of taste, and localized infections of which oral candidosis is the most commonly observed. The association of specific oral diseases and diabetes is of importance both in the detection of undiagnosed diabetes and in the elucidation of the pathogenesis of various oro-facial diseases. The clinical features and possible causes of oral disorders recognized to be associated with diabetes are reviewed with emphasis on good oral hygiene in the diabetic patient.