Biomedical subjects

F Femiano

Publications and source records attributed to F Femiano.

At least 19 recordsLinked to original sources

PubMed2006

Burning mouth syndrome (BMS): evaluation of thyroid and taste.

BACKGROUND: Burning mouth syndrome (BMS) is a chronic, intraoral burning sensation seen mainly in middle-aged and post-menopausal females, without identifiable oral lesions or abnormal laboratory findings, but often associated with psychogenic disorders such as depression. The latter can have a range of causes, including hormonal. OBJECTIVE: Since there may be connections between BMS, psychogenic changes, hormonal changes and taste abnormalities, we have examined aspects of taste and thyroid function. PATIENTS AND METHODS: We selected 50 patients with BMS (study group) and 50 healthy subjects (control group) and analysed their ability to taste bitter, acid and spicy substances and analysed their thyroid function and Undertook thyroid echography. RESULTS: Taste sensation was normal in all controls. However, 30 of the patients with BMS reported ageusia for bitter taste and 2 had ageusia for acid. The use of pepper sauce (Tabasco) (spicy substance) produced a strong burning to the tongue in 28 patients of the BMS group but only in 10 controls. No control patients showed abnormality of thyroid function or echograpic abnormality. Five patients in the BMS group had biochemical evidence of hypothyroidism, 4 patients had raised levels of thyroid auto-antibodies and, of the 41 remaining BMS patients, most (34) had thyroid echographic changes indicative of nodularity. CONCLUSIONS: Hypothyroidism may be responsible for a negative influence on taste and consequent increase in trigeminal sensorial sensation (tactile, thermal and painful sensation).

Burning Mouth Syndrome↗

PubMed2006

Matrix metalloproteinase gene expression in oral lichen planus: erosive vs. reticular forms.

BACKGROUND: Oral lichen planus (OLP) is an autoimmune disease of unknown aetiology. The pathogenesis is characterized by apoptosis of basal keratinocytes, triggered by contact between CD8+ -activated lymphocytes and an unknown antigen expressed on the surface of the basal cells. Basement membrane (BM) degradation, which allows lymphocytes to migrate, involves proteolytic enzymes known as matrix metalloproteinases (MMPs). OBJECTIVES: This study aimed to evaluate the expression of a series of MMPs in biopsies from OLP patients, to reveal correlations with different clinical forms of OLP. METHODS: Twenty-six patients diagnosed with OLP (14 reticular and 12 erosive) were studied, together with seven healthy patients as negative controls. RESULTS: Reverse transcriptase polymerase chain reaction (RT-PCR) showed that the overall levels of expression of MMP mRNAs were higher in erosive lichen planus (E-OLP) than in the reticular forms (R-OLP). Moreover, MMP-1 and MMP-3 may be principally associated with erosion development. The expression of specific tissue inhibitors of metalloproteinases (TIMPs) was also evaluated. CONCLUSIONS: The different clinical appearances of OLP are associated with significant differences in MMP mRNA levels.

Aged↗

PubMed2005

Recurrent herpes labialis: a pilot study of the efficacy of zinc therapy.

BACKGROUND: The objective of this study was to investigate the effect of zinc on recurrent herpes labialis. MATERIALS/METHODS: Twenty patients (12 females; median age 26.6 years) with a history of recurrent herpes labialis >6 episodes each year were treated with systemic zinc sulphate 22.5 mg twice daily for the months of February, March, September and October. All patients were followed for 12 months. RESULTS: Herpetic lesions reduced to <4 episodes (average 3) for the 12 months and the duration was <7 days for each episode (average 5.7). CONCLUSIONS: Systemic zinc sulphate appeared to reduce both the number of episodes and the time to recovery of herpes labialis.

Adolescent↗

PubMed2004

Burning mouth syndrome: the efficacy of lipoic acid on subgroups.

OBJECTIVE: We have examined the effect of alpha-lipoic acid (ALA, tioctic acid; Tiobec), a free radical scavenger, on the discomfort of burning mouth syndrome (BMS) in patients who had used tranquillizers previously, compared with those who had not. METHODS: In this study we gave lipoic acid for 2 months to two groups of 20 BMS patients, one of which had previously been treated with tranquillizers. RESULTS: The results showed greater effectiveness of lipoic acid in BMS patients who had not previously used tranquillizers. CONCLUSIONS: The patients with BMS who had previously been treated with tranquillizers responded poorly to therapy with lipoic acid compared with those who had not received previous psychotropic therapy.

Adult↗

PubMed2004

Damage to taste system and oral pain: burning mouth syndrome.

The burning mouth syndrome (BMS) is an oral pain disorder. Central or peripheral pain mechanisms may play a role in the oral burning of BMS. Various local, systemic and psychological factors have been found to be associated with BMS, but its etiology is not fully understood. This syndrome mostly affects middle-aged women and is frequently accompanied by taste complaints. This association of symptoms suggests an interaction between the mechanisms of nociception and gustation, 2 senses with strong hedonic components. There are connections between taste and oral pain in the central nervous system and it is possible that BMS and other oral pain phantoms result from damage to the taste system. This suggests that individuals who suffer from BMS are likely to be supertasters.

Burning Mouth Syndrome↗

PubMed2003

[Mucocutaneous bullous pemphigoid induced by valsartan. A clinical case].

In the presence of immune-mediated vesiculo-bullous diseases, the oral pathologist should focus his attention not only on the diagnosis and treatment of the case, but should particularly investigate the state of genetic predisposition in relation to the HLA haplotype structure and look for the possible trigger factors for the disease. The detection of the trigger may guarantee a faster cure with a minimum therapeutic contribution. In the search for triggering factors, the drugs that are traditionally incriminated such as ACE inhibitors, Fans, antibiotics (penicillin and penicillamine), substances with -SH groups, tranquillisers, are not always involved in inducing vesiculo-bullous diseases. Substances considered innocuous are often to blame. We present a case of mucous-cutaneous bullous pemphigoid induced by an anti-hypertensive of the sartan group, valsartan.

Aged↗

PubMed2002

Burning mouth syndrome (BMS): double blind controlled study of alpha-lipoic acid (thioctic acid) therapy.

BACKGROUND: Burning mouth syndrome (BMS) has features of a neuropathy and could be related to the production of the toxic free radicals that are released in stress situations. Alpha-lipoic acid is an antioxidant able to increase the levels of intracellular glutathione and eliminate free radicals. This study aimed to examine the effectiveness of alpha-lipoic acid in the therapy of BMS. METHOD: This was a double blind, controlled study conducted for two months on 60 patients with constant BMS. Comparing alpha-lipoic acid (test) with cellulose starch (placebo), there was no laboratory evidence of deficiencies in iron, vitamins or thyroid function and no hyperglycaemia. RESULTS AND CONCLUSION: Following treatment with alpha-lipoic acid, there was a significant symptomatic improvement, compared with placebo, with the majority showing at least some improvement after 2 months, thus supporting the hypothesis that burning mouth syndrome is a neuropathy. This improvement was maintained in over 70% of patients at the 1 year follow-up.

Adult↗

PubMed2002

Pemphigus vulgaris with oral involvement: evaluation of two different systemic corticosteroid therapeutic protocols.

BACKGROUND: Pemphigus vulgaris is a potentially life-threatening disease characterized by cutaneous and mucosal blistering. Systemic corticosteroids remain the mainstay of therapy, transforming an invariably fatal disease into one with a mortality that is now less than 10%. Nevertheless, oral lesions are often recalcitrant and corticosteroid therapy can provoke adverse effects. OBJECTIVE: To determine whether two different regimens of systemic corticosteroid therapy based on prednisone gave different benefits. METHOD: We examined two different regimens of systemic corticosteroid therapy based on prednisone in an open study. Ten patients (group A) were treated with systemic corticosteroids, in a therapeutic protocol made up of orally administered prednisone. Ten matched patients (group B) were treated with systemic corticosteroids alternating a pulse of intravenous betamethasone with orally administered prednisone. RESULTS AND CONCLUSIONS: The pulse protocol appeared to have some advantages both in a shorter time to resolution of symptoms and oral lesions, and in terms of minor adverse effects.

Administration, Oral↗

PubMed2002

Idiopathic dysgeusia; an open trial of alpha lipoic acid (ALA) therapy.

We selected two homogenous groups, each of 22 patients with idiopathic dysgeusia, an altered perception of taste, matched for age and sex, for an open trial of alpha lipoic acid compared with placebo. The 22 patients in the study group were treated with alpha lipoic acid for 2 months. The 22 patients in the control group were treated for 2 months with carboxymethylcellulose. The latter group was then treated with alpha lipoic acid for 2 months. The results showed significant symptomatic improvements compared with placebo, in both groups of patients with dysgeusia treated with alpha lipoic acid, suggesting that idiopathic dysgeusia may be a neuropathy comparable to the burning mouth syndrome.

Adolescent↗

PubMed2002

[Statistical survey of afferent pathologies during a 5-year study in the oral pathology Department at the Second University of Naples].

BACKGROUND: Oral pathologies represent an increasingly frequent clinical entity and are often the local manifestations of systemic pathologies. The purpose of this study was to carry out a statistical and epidemiological survey of the afferent pathologies in the department of oral pathology at the Second University of Naples from December 1995 to December 2000. METHODS: A total of 2112 patients were studied, divided by pathology and on the basis of valid epidemiological criteria. A statistical survey was carried out using different tests based on the nature of data available. RESULTS: This survey showed a marked predominance of lichen cases (347), but it is important not to underestimate the significant incidence of BMS (burning mouth syndrome) (284) which exceeded the frequency of aphthous lesions (258) and leukoplakial lesions (218). CONCLUSIONS: Mouth diseases account for a significant part of the disorders found in clinical dentistry. This study focused on those pathologies with the highest frequency, basing this analysis on etiological and clinical criteria and stimulating the interest of the dentist in individual forms by highlighting their incidence during normal professional activities.

Adult↗

PubMed2002

Burning mouth syndrome (BMS): an open trial of comparative efficacy of alpha-lipoic acid (thioctic acid) with other therapies.

BACKGROUND: Alpha-lipoic acid (ALA) is a potent antioxidant mitochondrial coenzyme, trometamol salt of thioctic acid, shown in clinical studies to be neuroprotective and in a preliminary study to have an effect on the symptomatology of Burning Mouth Syndrome (BMS). METHODS: We were interested in extending our studies as to whether alpha-lipoic acid might improve the symptomatology in BMS and therefore carried out a larger open controlled clinical study on the effects of alpha-lipoic acid on BMS symptomatology. RESULTS: We have examined the effects on 4 groups of 20 patients with BMS of ALA, compared with bethanecol, Biotene and placebo, and found ALA of remarkable benefit with minimal adverse effects. CONCLUSIONS: These results suggest that double-blind randomized controlled multicenter studies of ALA are indicated.

Administration, Oral↗

PubMed2001

Benign fibrous histiocytoma (BHF) of the cheek: CD 68-KP1 positivity.

We present a case of fibrous histiocytoma of the cheek in a 32-year-old male with no evidence of any regional invasion or distant metastasis. Pathologic analysis and diagnosis of these lesions is often challenging, and usually based on a combination of light microscopy and immunohistochemistry. In this study the diagnosis was confirmed using immunostaining with the antibody CD 68-KP1 that is positive in any lesion containing lysosomal granules or phagolysosomes.

Adult↗

PubMed2001

Oral proliferative verrucous leukoplakia (PVL); open trial of surgery compared with combined therapy using surgery and methisoprinol in papillomavirus-related PVL.

Proliferative verrucous leukoplakia (PVL) is a unique oral white lesion in which human papillomavirus (HPV) may play a role. PVL behaves far more aggressively than other forms of leukoplakia with a high rate of recurrence after surgical excision, and relentless progression to verrucous hyperplasia and to verrucous or squamous cell carcinomas. The treatment of PVL is usually by surgery, but there is often early recurrence. This study was an open trial of surgery in 25 patients with oral HPV-positive PVL, compared with combined therapy using surgery and methisoprinol in another group of 25 patients with oral PVL. Six months postoperatively there was a significant difference, with 18 recurrences in the patients treated by surgery alone compared to only two recurrences in the patients treated also with methisoprinol (isoprinosine or inosine pranobex), a synthetic agent with immunomodulatory properties and some antiviral activity against HPV. Eighteen months postoperatively there were no further recurrences in the patients treated by surgery alone but another two recurrences in the patients treated with methisoprinol. Overall, by 18 months follow-up, there were 18 recurrences in the group treated by surgery alone, compared with four in those also receiving methisoprinol. The use of this antiviral agent appeared to offer a significant enhancement to the surgical management of PVL.

Adult↗

PubMed2001

Oral leukoplakia: open trial of topical therapy with calcipotriol compared with tretinoin.

The aim of the current study was to evaluate, in an open trial, the clinical efficacy of topical calcipotriol compared with tretinoin in the therapy of hyperkeratotic oral lesions (leukoplakia). The study group consisted of 40 patients with histologically proven oral leukoplakias, 20 treated with calcipotriol, the other 20 with tretinoin. The treatment was for 5 weeks and follow-up at 4 months, with clinical assessments at 2, 4 and 5 weeks and regular laboratory assessments. The results showed a significant reduction in lesions (80%), in both calcipotriol and tretinoin groups, with no documented topical or systemic adverse reactions, results maintained at 4 months. Tretinoin however, potentially can induce erythema, angular cheilitis and xerostomia. The study suggests that topical calcipotriol is as effective in the therapy of oral leukoplakia as is topical tretinoin.

Administration, Topical↗

PubMed2001

Recurrent herpes labialis: efficacy of topical therapy with penciclovir compared with acyclovir (aciclovir).

This study compares the effects of topical acyclovir and penciclovir in the treatment of recurrent herpes labialis. The study patients were a population of 40 patients with in excess of five recurrences annually, and were separated into four homogeneous groups each of 10 subjects. The antiviral creams were used to achieve total lesional cover, every 2 h during waking hours. The effects on the time to lesion crusting and to resolution of pain, were assessed. The results not only confirmed that aciclovir is ineffective, but confirmed that penciclovir is effective, and that penciclovir is superior to aciclovir.

Acyclovir↗

PubMed2001

Sjogren's syndrome: direct immunofluorescence in diagnosis.

BACKGROUND: Sjogren's syndrome (SS) is an autoimmune inflammatory exocrinopathy. In the classical clinical presentation, diagnosis is readily achieved but this is less easy in early disease or oligosymptomatic forms. METHODS: We have used direct immunofluorescence (d.i.f.), with IgG antibodies, comparing salivary gland biopsies from subjects with SS compared with control subjects. RESULTS: Direct immunofluorescence, using antibodies anti-IgG and demonstrating positivity for all the examined champions of SS while it is negative for control biopsies. CONCLUSIONS: Direct immunofluorescence, on salivary glands by biopsy, can be considered a valid additional aid to the diagnosis of subclinical SS.

Adult↗

PubMed2001

Geographic tongue (migrant glossitis) and psoriasis.

BACKGROUND: The aim of this study was to examine the relationship of geographic tongue to psoriasis. METHODS: We report a comparative study on two groups of patients: the first (20 patients) with cutaneous psoriasis and lesions of the oral mucosa similar to geographic tongue; the second (20 patients), with benign migratory glossitis only. Biopsy samples of the lingual mucosa were taken from both groups. RESULTS: The histologic examination of oral biopsies from the first groups showed typical features of psoriasis. The second group showed the same features of psoriasis in 80% of patients. CONCLUSIONS: The clinical and histopathologic findings support the hypothesis that migrant glossitis can be considered an expression of oral psoriasis.

Adult↗

PubMed2000

Acitretin and treatment of the oral leucoplakias. A model to have an active molecules release.

AIMS: The aim of this study was to investigate the effectiveness of acitretin in a new topical formulation (mucoadhesive two-layer tablets) for the treatment of oral leucoplakias. METHODS: Twenty-one volunteers, 16 men, five women, with oral leucoplakia (histologically diagnosed), were included in this double-blind placebo-controlled study. Patients were randomized in three groups (A, B, C) of seven patients each. Groups A and B received tablets with different in vitro release profiles, and group C subjects (controls) received tablets without acitretin. The acitretin dose was 20 mg/day (two 10 mg tablets daily). Serum aspartate aminotransferase, alanine aminotransferase, cholesterol and triglycerides were evaluated before and after treatment. At the end of therapy the concentrations of acitretin in plasma, saliva and tissue were measured by high-performance liquid chromatography. RESULTS: At the end of the study 71% (groups A and B) of patients showed clinical remission or marked improvement. No improvement was noted in the control subjects (group C). These results were further confirmed by histological findings. There were no significant changes in laboratory values in the three groups. The acitretin concentration in plasma and tissue ranged from 0 to 50 mg with no difference between groups A and B, and it was very high in saliva (ranging from 4.9 to 43 mg) with higher concentrations in group A than in group B (due to a longer adhesion time in group A). Patients' compliance was excellent. The results show that mucoadhesive tablets of topical acitretin are efficacious in the treatment of oral leucoplakia without systemic side-effects.

Acitretin↗