PubMed Health⌕ Search

Biomedical subjects

A Vissink

Publications and source records attributed to A Vissink.

At least 19 recordsLinked to original sources
PubMed2006

Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome.

OBJECTIVE: To assess the value of the parotid biopsy as a diagnostic tool for primary Sjögren's syndrome (pSS), and to compare the parotid biopsy and the labial biopsy with regard to diagnostic value and biopsy-related morbidity. METHODS: In 15 consecutive patients with pSS and 20 controls, the parotid biopsy was assessed as a diagnostic tool based on the presence of lymphocytic foci, benign lymphoepithelial lesions and lymphoid follicles. These new histological criteria were compared with established diagnostic criteria for the labial biopsy in 35 consecutive patients suspected for pSS who underwent simultaneous biopsies from both sites. In addition, both biopsies were compared for morbidity. RESULTS: The first analysis revealed a focus score of >or=1 or lymphocytic infiltrates (not fulfilling the criterion of a focus score of 1) combined with benign lymphoepithelial lesions as diagnostic criteria for pSS. When comparing the parotid biopsy with the labial biopsy sensitivity and specificity were comparable (sensitivity 78%, specificity 86%). Level of pain was comparable and no loss of motor function was observed. No permanent sensory loss was observed after parotid biopsy, while labial biopsy led to permanent sensory loss in 6% of the patients. Malignant lymphoma was detected in one parotid biopsy by chance, without involvement of the labial salivary gland. CONCLUSION: A parotid biopsy has a diagnostic potential comparable with that of a labial biopsy in the diagnosis of pSS, and may be associated with less morbidity.

Biopsy↗
PubMed2006

Progression of salivary gland dysfunction in patients with Sjogren's syndrome.

BACKGROUND: Salivary gland dysfunction is one of the key manifestations of Sjögren's syndrome. OBJECTIVES: (1) To assess prospectively loss of function of individual salivary glands in patients with primary and secondary Sjögren's syndrome in relation to disease duration and use of immunomodulatory drugs. (2) To study changes in sialochemical and laboratory values and subjective complaints over time. METHODS: 60 patients with Sjögren's syndrome were included in this study. Whole and gland-specific saliva (parotid and submandibular/sublingual (SM/SL)), samples were collected at baseline and after a mean of 3.6 (SD 2.3) years of follow-up. Disease duration was recorded for all patients. RESULTS: Patients with Sjögren's syndrome with short disease duration had significantly higher stimulated flow rates at baseline than those with longer disease duration (p<0.05). When compared with healthy controls, the decrease in SM/SL flow rates at baseline was more prominent than that in parotid flow rates (p<0.05). Over time, there was a significant further decrease of stimulated flow rates, especially of the parotid gland, accompanied by increasing problems with swallowing dry food (p<0.05). The decrease was independent of the use of corticosteroids or disease-modifying antirheumatic drugs (DMARDs). Sialochemical variables remained stable. CONCLUSIONS: Early Sjögren's syndrome is characterised by a decreased salivary gland function (parotis>SM/SL), which shows a further decrease over time, regardless of the use of DMARDs or steroids. Patients with Sjögren's syndrome with longer disease duration are characterised by severely reduced secretions of both the parotid and SM/SL glands. These observations are relevant for identifying patients who would most likely benefit from intervention treatment.

Adult↗
PubMed2006

[Acute sialoadenitis of the parotid gland].

An 88-year-old diabetic women was hospitalized because of a pheripheral vascular disorder. During her hospitalization she developed a right-sided facial swelling which was not limited by anatomical structures in this area. Ultrasound and computertomographic scanning supported the clinical diagnosis acute sialoadenitis of the parotid gland. The swelling resolved shortly after starting antibiotic therapy.

Acute Disease↗
PubMed2006

[Medical-dental interaction].

Dentists are frequently faced with medical problems and physicians are often consulted by patients with dental problems. This special issue of the Dutch Dental Journal describes several examples of medical-dental interaction elucidating the importance of this topic. In addition, a series of papers on subjects with medical as well as dental aspects will be published in future issues of this journal on a regular basis.

Dentist-Patient Relations↗
PubMed2006

[The importance of adequate medical history taking in dentistry].

A patient's medical history is a vital part of his or her dental history and increases the dentist's awareness of diseases and medication which might interfere with the patient's dental treatment. This article describes the essential characteristics of a solid medical history, according to the Dutch Guidelines for Dental Education published in 1997. In future the importance of patients' medical histories will increase along with the number of medically complex patients who visit the dental general practice.

Dentistry↗
PubMed2006

[Saliva: more than just a factor in oral health].

Several salivary proteins are involved in the antimicrobial defence within the oral cavity, and are able to eliminate or inhibit a great number of microorganisms that enter the body via the oral cavity. Thus changes in the composition of saliva may not only affect people's oral health, but also have consequences for their general health. Based on salivary proteins, antimicrobial peptides have been synthesized. Potentially, these could be used as a new class of antibiotics. The antimicrobial peptides are hardly cytotoxic to human cells and do not evoke any or only very little resistence in microorganisms.

Anti-Infective Agents↗
PubMed2006

[Links between periodontal disease and general health. 1. Pneumonia and cardiovascular disease].

The possible link between oral and general health is based on an old concept. This paper summarizes current ideas on the role of translocation of oral pathogens to other parts of the body in the development of systemic disease. It appears that colonisation of the oral cavity by respiratory pathogens is a risk factor in the development of pneumonia in institutionalised elderly and intensive care patients. Using a chloorhexidine oral rinse may reduce the risk of pneumonia. Furthermore, periodontal disease is associated with an increased risk of cardiovascular disease. Translocation of oral microorganisms and an increase in serum concentrations of inflammatory mediators are considered to play a role in the development of cardiovascular disease. Potentially, preventive oral health care and periodontal intervention could play a part in preventing cardiovascular disease.

Bacterial Translocation↗
PubMed2006

[Links between periodontal disease and general health. 2. Preterm birth, diabetes and autoimmune diseases].

The condition of the periodontium may effect people's general health. There is evidence of a correlation between periodontal disease and preterm birth or low birth weight. In pregnant women with periodontal disease, scaling and root planing seems to reduce the risk of preterm birth or low birth weight. Furthermore, periodontal disease appears to have an adverse effect on glycemic control in diabetics. However, periodontal treatment as a means to glycemic control is restricted unless it includes the use of systemic antibiotics. Slowly, a possible correlation between periodontal disease and autoimmune diseases is emerging. Further research into the correlations between periodontal disease and systemic health is desirable and might well result in new therapeutic options.

Autoimmune Diseases↗
PubMed2006

[A schizophrenic patient with loss of teeth].

A 53-year-old woman, known with a schizophrenic disorder and a history of drug addiction, was referred because of progressive hematomas of the lower extremities and fatigue. Her medical history included hyperplastic gums, tooth hypermobility and anaemia. Scurvy was diagnosed as a result of an insufficient diet due to drug addiction and a paranoid psychosis. After suppletion of vitamin C and starting highly nutritious food a rapid amelioration of the scurvy related complaints was observed. While dreaded and often fatal in earlier eras, in the 21st century scurvy is easily treatable if this diagnosis is recognised.

Anemia↗
PubMed2006

[Oral pemphigus].

A 33-year-old man suffered from spontaneously developing blisters at the oral mucosa. Firstly, the bullous lesions were observed in the third molar region, but they spread progressively over the buccal and palatal mucosa. The bullous lesions ruptured spontaneously, resulting in erosive lesions and pain. Before being referred to an oral and maxillofacial surgeon, the patient consulted his family doctor, his family dentist, as well as an ear-nose-throat-specialist. The oral and maxillofacial surgeon took a biopsy in order to confirm the clinical diagnosis pemphigus vulgaris. The patient was referred to a dermatologist for treatment with systemic corticosteroids and a non-steroid immunosuppressive drug. Subsequently, the mucosal lesions healed.

Adrenal Cortex Hormones↗
PubMed2006

[Treatment of snoring by a Herbst-activator. Satisfaction of patient and bedfellow].

Snoring is primarily a social problem which for instance brings considerable pressure on someone's conjugal relationship. Often treatment is demanded by the bedfellow. Patient as well as bedfellow needs to be involved in the treatment of the problem. In this study, twenty-three habitual snorers and their bedfellows completed a questionnaire concerning the effect of the treatment of snoring by a Herbst-activator before treatment and 3 and 6 months after treatment. Two-thirds of the patients and bedfellows were satisfied with the therapy results. The bedfellows exhibited an even more positive therapy effect than the patients.

Adult↗
PubMed2005

Bone quality at the implant site after reconstruction of a local defect of the maxillary anterior ridge with chin bone or deproteinised cancellous bovine bone.

The purpose of this study was to investigate the quality of bone at grafted implant sites in the anterior maxilla. Grafting of these sites was necessary because of insufficient bone volume in a buccopalatinal direction (width at the top of the crest 1-3mm). Reconstruction was performed with chin bone (N=5), chin bone and a resorbable Bio-Gide GBR membrane (N=5) or Bio-Oss spongiosa granules in combination with a Bio-Gide GBR membrane (N=5). Biopsies were taken prior to implantation, i.e. 3 months after grafting with chin bone, and 6 months after grafting with Bio-Oss. Evaluation was done by assessing the histological and histomorphometric characteristics of full-length biopsies taken from the actual implant site. Both areas with non-vital bone and areas with apposition of bone and remodelling phenomena were observed in the chin bone group at the time of placement of the implants. Similar results were observed at implant sites reconstructed with a chin bone graft covered by a membrane. In the chin bone group without and with a GBR membrane, the mean total bone volume (TBV) was 55.2+/-6.8% and 57.7+/-11.5%, respectively; the marrow connective tissue volume (MCTV) was 44.8+/-6.8% and 42.3+/-11.5%, respectively. Remnants of the resorbable GBR membrane were not detected. In the Bio-Oss((R)) group, at implant placement some newly formed bone was observed in the connective tissue surrounding the Bio-Oss((R)) particles (mean TBV (newly formed bone) 17.6+/-14.5%), but most particles were surrounded by connective tissue. No convincing signs of remodelling were observed (mean remaining Bio-Oss volume 40.5+/-9.3%; mean MCTV 41.9+/-13.1%). No implants were lost during follow up (12 months). At the time of placement of the implants the grafting material (either chin bone or Bio-Oss is still not fully replaced by new vital bone. In case of Bio-Oss, most of the grafting material is even still present. Despite these differences, the 1-year clinical results were very good and comparable between the various grafting techniques applied.

Adolescent↗
PubMed2005

Rituximab treatment in patients with primary Sjögren's syndrome: an open-label phase II study.

OBJECTIVE: To investigate the safety and efficacy of B cell depletion treatment of patients with active primary Sjögren's syndrome of short duration (early primary SS) and patients with primary SS and mucosa-associated lymphoid tissue (MALT)-type lymphoma (MALT/primary SS). METHODS: Fifteen patients with primary SS were included in this phase II trial. Inclusion criteria for the early primary SS group were B cell hyperactivity (IgG >15 gm/liter), presence of autoantibodies (IgM rheumatoid factor, anti-SSA/SSB), and short disease duration (<4 years). Inclusion criteria for the MALT/primary SS group were primary SS and an associated MALT-type lymphoma (Ann Arbor stage IE) localized in the parotid gland. Patients were treated with 4 infusions of rituximab (375 mg/m2) given weekly after pretreatment with prednisone (25 mg) and clemastine. Patients were evaluated, using immunologic, salivary/lacrimal function, and subjective parameters, at baseline and at 5 and 12 weeks after the first infusion. RESULTS: Significant improvement of subjective symptoms and an increase in salivary gland function was observed in patients with residual salivary gland function. Immunologic analysis showed a rapid decrease of peripheral B cells and stable levels of IgG. Human anti-chimeric antibodies (HACAs) developed in 4 of 15 patients (27%), all with early primary SS. Three of these patients developed a serum sickness-like disorder. Of the 7 patients with MALT/primary SS, complete remission was achieved in 3, and disease was stable in 3 and progressive in 1. CONCLUSION: Findings of this phase II study suggest that rituximab is effective in the treatment of primary SS. The high incidence of HACAs and associated side effects observed in this study needs further evaluation.

Adult↗
PubMed2005

Morbidity of chin bone transplants used for reconstructing alveolar defects in cleft patients.

OBJECTIVE: The aim of this study was to evaluate the objective and subjective morbidity of symphyseal chin bone harvesting used for reconstruction of alveolar defects in young cleft patients. DESIGN: All patients who had undergone chin bone harvesting for alveolar cleft reconstruction in the period from 1992 through 2000 at the Department of Oral and Maxillofacial Surgery of the University Hospital Groningen, Groningen, The Netherlands, were invited to participate in this retrospective study.Patients' acceptance, perioperative and postoperative morbidity were evaluated. A survey of the medical records was performed. In addition, the patients completed a questionnaire for their appreciation of the procedure. They were also subjected to a clinical and radiographic examination. PATIENTS: Thirty patients (21 males and 9 females; mean age 11.8 +/- 3.6 years) participated in this study. RESULTS: Neither the medical records nor the experiences of the patients showed significant morbidity. The procedure was appreciated with 6.8 +/- 3.5 (scale 0 to 10). Postoperative pain was scored as 1.2 +/- 2.5 (scale 0 to 10). Three patients reported transient sensory disturbances at the donor site. Two patients showed a slight sensibility disorder in the symphyseal region. In three patients, an endodontic problem had developed in a lower incisor. CONCLUSION: This study showed that chin bone harvesting for reconstructing alveolar cleft in young patients is a well-accepted procedure with low objective and subjective morbidity. Notwithstanding this low morbidity, the patients (and their parents) have to be informed about the risk of objective and subjective disturbances of the sensibility in the donor region and the risk of dental pulp necrosis.

Adolescent↗
PubMed2005

[Sports and orofacial injuries].

Many people enjoy sports, it is healthy and relaxing. There is, however, an inherent risk of sustaining injuries and fractures of the maxillofacial skeleton. Adequate diagnostics and treatment are mandatory to minimize the possible long-term consequences of injuries. Dentists may become primary involved in the diagnosis of such traumas, particularly when injuries are limited to the orofacial region. In addition, they can play an important role in caring for sportsmen with orofacial injuries, for instance by endodontic, restorative, and prosthodontic treatments. This paper discusses the assessment and treatment of fractures of the mandible, the zygoma, the mid-face, the orbital bones, the nose, and the frontal sinus. The assessment must followed by treatment as soon as possible. Treatment options of orofacial fractures are conservative treatment by exercising and/or oral splints and surgical reposition, either or not using osteosynthetic materials.

Athletic Injuries↗
PubMed2005

[How the dental treatment for medically complicated patients can be improved].

This article is primarily an adapted translation in Dutch of an editorial paper in the journal Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. The editorial paper described the increasing need to prepare future practitioners for a more medical-based mode of oral health care and medically complicated patients. The current dental education in the United States has some shortcomings in this respect. Several steps are necessary to start improving dental treatment for patients with medical disorders. Second part of this article describes the current dental education regarding this topic in the Netherlands and how to improve this. Besides optimizing the dental-1 medical education of future dentist, also the mutual need of optimizing the medico-dental training of physicians is mentioned as, at least in the Netherlands, many patients visit their physician instead of their dentist with a non-teeth related oral problem.

Chronic Disease↗
PubMed2004

Changes in salivary gland immunohistology and function after rituximab monotherapy in a patient with Sjogren's syndrome and associated MALT lymphoma.

OBJECTIVES: To report the successful use of rituximab on salivary gland immunohistology and function in a patient with Sjogren's syndrome (SS) and associated MALT lymphoma. CASE REPORT: The patient was a 42 year old woman with primary SS and associated MALT lymphoma located in the parotid gland and the hard palate. Four infusions of rituximab (375 mg/m(2)) weekly resulted in complete remission of the lymphoma. An incision biopsy of the parotid gland before and after treatment showed improvement of the (immuno)histopathological characteristics of SS, with possible regeneration of salivary gland tissue. Furthermore, salivary analysis showed decreased inflammatory characteristics and increased stimulated salivary flow. DISCUSSION: Rituximab is a promising agent in the treatment of SS associated MALT lymphoma. In addition to the effect on MALT lymphoma, B cell depletion by rituximab may also attenuate the activity of SS. This case report is the first to describe the effect of rituximab on histological and sialometric/chemical characteristics of SS. The efficacy of rituximab in the treatment of SS warrants further investigation.

Adult↗