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F K Spijkervet

Publications and source records attributed to F K Spijkervet.

At least 19 recordsLinked to original sources
PubMed2004

[Swelling of lips as a first sign of acromegaly].

A 65-year-old female patient with swelling of lips and submandibular glands was referred to the department of Oral and Maxillofacial Surgery of an academic hospital. The patient was worried about her changed appearance and her general fatigue. This condition had not changed during the last six months, although she slept more. Despite extensive investigations her complaints could not be diagnosed as of oral or maxillofacial origin. She thereupon was referred to the department of internal Medicine to screen for an endocrine aetiology. Laboratory tests were positive for acromegaly.

Acromegaly↗
PubMed2004

[The odontogenic abscess. Aetiology, treatment and involvement in the orofacial region].

Odontogenic infections are a common problem in daily practice. Occasionally, an odontogenic infection evolves an abscess. This article discusses the aetiology, the treatment and the involvement of odontogenic abscesses in the oro-facial region. Their occurrence, course and treatment are depending on the patient's immune response, and on microbial and environmental factors.

Abscess↗
PubMed2003

[Spontaneous blood blister formation swellings of the oral mucosa].

An 88 year-old man was hospitalized because of bullous pemphigoid of the skin with detectable autoantibodies against type XVII collagen. During his stay in the hospital, he developed easily bleeding hemorrhagic bullous lesions of the oral mucosa, which were thought to be an oral manifestation of bullous pemphigoid. A thorough blood examination showed acquired haemophilia A, related to the development of autoantibodies against factor VIII.

Aged↗
PubMed2001

Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation.

PURPOSE: To explore the relationship between oral mucositis and selected clinical and economic outcomes in blood and marrow transplant patients. PATIENTS AND METHODS: Subjects consisted of 92 transplant patients from eight centers who participated in a multinational pilot study of a new oral mucositis scoring system (Oral Mucositis Assessment Scale [OMAS]). In the pilot study, patients were evaluated for erythema and ulceration/pseudomembrane formation beginning on the first day of conditioning and continuing for 28 days. We examined the relationship between patients' peak OMAS scores and days with fever (body temperature > 38.0 degrees C), the occurrence of significant infection, days of total parenteral nutrition (TPN), and days of injectable narcotic therapy (all over 28 days), days in hospital (over 60 days), total hospital charges for the index admission, and vital status at 100 days. RESULTS: Patients' peak OMAS scores spanned the full range of possible values (0 to 5) and were significantly (P <.05) correlated with all of the outcomes of interest except days with fever (P =.21). In analyses controlling for type of graft (autologous v allogeneic) and study center, a 1-point increase in peak OMAS score was associated with (1) 1.0 additional day with fever (P <.01), (2) a 2.1-fold increase in risk of significant infection (P <.01), (3) 2.7 additional days of TPN (P <.0001), (4) 2.6 additional days of injectable narcotic therapy (P <.0001), (5) 2.6 additional days in hospital (P <.01), (6) $25,405 in additional hospital charges (P <.0001), and (7) a 3.9-fold increase in 100-day mortality risk (P <.01). Mean hospital charges were $42,749 higher among patients with evidence of ulceration compared with those without (P =.06). CONCLUSION: Oral mucositis is associated with significantly worse clinical and economic outcomes in blood and marrow transplantation.

Adult↗
PubMed2001

Morbidity from parotid sialography.

OBJECTIVE: Sialography is commonly used for the diagnosis of Sjögren's syndrome, although its invasive nature is often regarded as a serious drawback for routine usage. The aim of this study was to evaluate the morbidity and acceptability of parotid sialography using oil-based contrast fluid. STUDY DESIGN: Twenty-four consecutive sialographic procedures were evaluated in terms of morbidity and the patient's acceptance of the procedure, assessed with a standardized questionnaire. Information was also obtained by recording relevant physical parameters during the procedure. RESULTS: There was good acceptance of the sialographic procedure, and the morbidity was low. No signs of overfilling or false route were observed in any of the sialograms. On average, 0.74 mL of contrast fluid was infused with a velocity of 0.01 mL/s. The whole procedure was completed within 12 minutes. CONCLUSIONS: Parotid sialography appears less invasive than is often thought. It had a low morbidity rate and was well accepted by the patients.

Adult↗
PubMed2001

Sialometry and sialochemistry: diagnostic tools for Sjögren's syndrome.

BACKGROUND: The common occurrence of xerostomia in Sjögren's syndrome (SS) as well as the easy accessibility of saliva supports the use of sialometry and sialochemistry in the diagnosis of SS. Collection and analysis of whole saliva (oral fluid) is currently the routine technique for sialometry, despite the fact that it is rather inaccurate and impure. OBJECTIVE: To assess the value of glandular sialometry and sialochemistry as diagnostic instruments in SS. METHODS: In a group of 100 consecutive patients referred for diagnosis of SS, glandular secretory flow rates and a spectrum of salivary components (sodium, potassium, chloride, calcium, phosphate, urea, amylase, total protein) were assessed. The patients were classified as positive or negative for SS according to the revised European classification criteria. RESULTS: Patients with SS differed clearly from those who tested negative for SS, showing lower submandibular/sublingual (SM/SL) flow rates and an appreciably changed salivary composition of parotid and SM/SL saliva. Besides changes in salivary flow rate and composition, distinct sialometric profiles were observed, characteristic of either early or late salivary manifestation of SS, or of the xerogenic side effects of medication. CONCLUSIONS: Glandular sialometry and sialochemistry are not only useful tools for differentiating SS from other salivary gland disease in clinical practice, but they also have great potential as diagnostic criteria for SS, showing distinct sialometric and sialochemical changes as well as profiles. Being simple, safe (non-invasive), and sensitive (early disease detection), they have three major advantages over other oral tests for SS.

Adult↗
PubMed2001

[Oral medicine].

Oral medicine is the discipline in dentistry which deals with diagnosis and non-surgical treatment of lesions and diseases of the oral tissues, particularly those of a systemic, multiorgan or drug-induced nature. In the Netherlands, the oral and maxillofacial surgeon is usually the one who takes care of oral medicine. In the dental curriculum in the Netherlands oral medicine is not taught as a separate discipline, but is included in the courses of oral and maxillofacial surgery, oral pathology, periodontology and also, amongst others, in the course of biochemistry. In the Netherlands it is not a recognised speciality and it is questionable whether there really is a need for it. In the medical curriculum and in the training program for family doctors only a very few hours on oral diseases is included. Since many patients with oral diseases see their family doctor first, an extension of the numbers of hours on oral diseases in general and, more specific, in oral medicine, in the medical curriculum is recommended.

Curriculum↗
PubMed2001

[Diagnosis and therapy of non-odontogenic orofacial infections].

This article discusses the non-odontogenic inflammations of the oral mucosa, connective tissue, bone and temporomandibular joint. Their occurrence, course and treatment are related to the patient's immune status, and to microbial and environmental factors, as is always the case with infectious processes. The article concerns peculiarly several clinical and therapeutic consequences of non-dontogenic orofacial infections.

Candidiasis, Oral↗
PubMed2001

[Vesiculobullous lesions of the oral mucosa].

In general practice, the dentist can be confronted with a vesiculobullous lesion of the oral mucosa. In many cases the lesion can be classified as recurrent herpes labialis, but many other causes can induce a vesiculobullous lesion of the oral mucosa and perioral skin as well. This article gives an overview of the various vesiculous and bullous lesions of the oral mucous membranes. Special attention is given to the possible causes and their treatment.

Blister↗
PubMed2001

[Noma: 'the face of poverty'].

Noma (cancrum oris, water cancer) is an orofacial gangrene that may develop in malnutritioned children debilitated by concomitant diseases as measles. It has been hypothesized that the gangrene originates from acute necrotizing gingivitis, common in malnourished children in developing countries. In previous centuries noma was common in the Western world. The affection disappeared when economical progress permitted the poorest to feed their children sufficiently. The yearly incidence of noma in the world is estimated as 140,000. The mortality is +/- 90%. The facial deformities of those who survive noma are generally serious. Beside facial mutilations, oral functions are hampered (trismus, oral incontinence, impaired speech). Both prevention (improved feeding, measles vaccination) as the treatment of those who contract and survive noma are a challenge for the 'global village' of the modern world.

Africa↗
PubMed2000

A short-term study in sheep with the Groningen temporomandibular joint prosthesis.

As part of the pre-clinical testing process of a newly developed temporomandibular joint (TMJ) prosthesis, animal experiments were performed. In 14 sheep, the right TMJ was replaced by the developed TMJ prosthesis. The prosthesis consisted of a skull part, a mandibular part and an intervening polyethylene disc. In the first series (6 sheep), three designs were tested, differing in the applied metal (stainless steel or titanium) and in the fitting method of the skull part (a fitting member or bone cement). The sheep were sacrificed after 8-16 weeks. In the second series (8 sheep), the preferred titanium fitting member design was applied, and the sheep were sacrificed after 2-10 weeks. One sheep was excluded because no correct position of the prosthesis parts could be achieved. At sacrifice, the removal torque of the screws was measured, and the surrounding tissues were harvested for histologic examination. The sheep recovered well and functioned until the end of the scheduled sacrifice date. Encountered problems were two disc dislocations, one fistula formation, and one screw failure. All mandibular parts were clinically stable, as were most skull parts with a fitting member, and one of both skull parts fitted with bone cement. The clinically observed stability was confirmed by the removal torque values, which indicated well-integrated screws. It is concluded that the TMJ prosthesis could remain stable and functional over the initial healing period. The main restriction of the sheep model is the much larger translatory capacity compared with patients, which adversely influences tissue healing.

Animals↗
PubMed1999

Validation of a new scoring system for the assessment of clinical trial research of oral mucositis induced by radiation or chemotherapy. Mucositis Study Group.

BACKGROUND: An impediment to mucositis research has been the lack of an accepted, validated scoring system. The objective of this study was to design, test, and validate a new scoring system for mucositis that can be used easily, is reproducible, and provides an accurate system for research applications. METHODS: A panel of experts, convened to design an objective, simple, and reproducible assessment tool to evaluate mucositis with specific application to multicenter clinical trials, developed a scale that measured objective and subjective indicators of mucositis. Nine centers participated in the study's validation. Paired investigators at each center evaluated patients receiving chemotherapy or head and neck radiation. Objective measures of mucositis evaluated ulceration/pseudomembrane formation and erythema. Subjective outcomes of mouth pain, ability to swallow, and function were measured. Analgesia use for mouth sensitivity was recorded. RESULTS: One hundred eight chemotherapy and 56 radiation therapy patients were evaluated. Seventy-eight percent of chemotherapy patients and 64% of radiation therapy patients had clinically significant mucositis. Cumulative daily mucositis scores demonstrated a high correlation among observers. Using area under the curve analysis, it was found that for chemotherapy patients, the highest correlations (correlation coefficient > 0.92) occurred for the scores that selected the three highest daily values over the course of mucositis assessment. High interobserver correlations were noted for patients receiving radiation therapy. Objective mucositis scores demonstrated strong correlation with symptoms. CONCLUSIONS: The scoring system evaluated was easily used, showed high interobserver reproducibility, was responsive over time, and measured those elements deemed to be associated with mucositis. The use of concomitant symptomatic measurements appeared to be unnecessary.

Adult↗
PubMed1999

Arthroscopic findings in osteoarthritic temporomandibular joints.

PURPOSE: This article reports on the results of a study of the arthroscopic findings in the joint surfaces of osteoarthritic temporomandibular joints (TMJs). PATIENTS AND METHODS: Arthroscopy was performed in the upper joint compartment of 40 TMJs in 40 patients. Thirty-one TMJs that were diagnosed with osteoarthritis (OA) constituted the OA group. On the basis of the presence of symptoms related to disc displacement and perforation, OA subgroups were defined. Nine TMJs that were not involved with OA constituted the control group. During the examination, various arthroscopic variables were recorded. Differences between groups and between subgroups were tested statistically. RESULTS: In the OA group, several arthroscopic variables were found significantly more frequently than in the control group. These included retrodiscal tissue redundancy, adhesions, and heightened attachment to the posterior wall of the glenoid fossa; articular disc displacement and limited mobility; and cartilage degeneration in the articular eminence. Moreover, in the OA group, disc displacement was found significantly more frequently in the period after 6 months than during the first 6 months of clinical signs and symptoms. Anterodiscal hypervascularity was found significantly more frequently during the first year than after the first year, as well as more during the first 2 years than after the first 2 years of clinical signs and symptoms, whereas a lowered attachment on the anterior slope of the articular eminence was found significantly more often after 2 years than during the first 2 years of clinical signs and symptoms. CONCLUSIONS: The findings in this study suggest that OA of the TMJ may initially result in synovial tissue hypervascularity, creeping synovitis, and redundancy, and subsequently in adhesion formation and a reduction of the posterior and anterior recess. Because of cartilage fibrillation on the articular eminence, and the subsequently reduced surface smoothness, the articular disc may become displaced. Eventually, disc mobility is limited, and adhesions and a reduced posterior and anterior recess prevail.

Adult↗
PubMed1999

Primary sialoangiectasia--a diagnostic pitfall in Sjögren's syndrome: case report.

A case of primary sialoangiectasia, which in this case was initially misdiagnosed as Sjögren's syndrome, is described. Other diseases, including HIV infection, psoriatic arthritis, and acute parotitis, may cause glandular changes similar to the changes found in the syndrome. Therefore, sialography must be combined with other methods of assessment of the oral cavity when suspicion is high for Sjögren's syndrome. Properly applied, sialography provides essential information regarding the severity of glandular damage and the progression of the disease.

Diagnosis, Differential↗
PubMed1999

Phase I study of transforming growth factor-beta3 mouthwashes for prevention of chemotherapy-induced mucositis.

The purpose of this study was to establish the safety and tolerability of recombinant transforming growth factor-beta3 (TGF-beta3; CGP 46614) mouthwashes intended for prevention of chemotherapy-induced mucositis. Local effects were especially analyzed by objective and subjective measurements of mucositis. Secondary aims were analysis of potential systemic exposure and development of anti-TGF-beta3-antibodies. Eleven breast cancer patients received chemotherapy with 1.5 g/m2 cyclophosphamide i.v., 80 mg/m2 epirubicin i.v., and 1.0 g/m2 5-fluorouracil i.v. (n = 8) or 1.6 g/m2 carboplatin i.v., 480 mg/m2 thiotepa i.v., and 6 g/m2 cyclophosphamide i.v. divided over 4 days (n = 3). TGF-beta3 mouthwashes (10 ml; provided by Novartis, Basel, Switzerland) were administered for 4 days, four times a day, starting 1 day before chemotherapy. The dose was escalated in following patients from 25 microg/ml (n = 3) to 50 microg/ml (n = 3) and 100 microg/ml (n = 5). Clinically, the mucosa was scored objectively and according to WHO criteria. The percentage of viable oral epithelial cells was determined by trypan blue dye exclusion. Morphology of cells was assessed in buccal smears. Plasma samples were collected for determination of TGF-beta3 levels and anti-TGF-beta3-antibodies. Adverse events were recorded by the patient in a diary. Mouthwashes with TGF-beta3 were well tolerated. Three patients scored for mucositis > grade 0 (WHO grading criteria). The percentage of viable oral epithelial cells in patients treated with 1.5 g/m2 cyclophosphamide i.v., 80 mg/m2 epirubicin i.v., and 1.0 g/m2 5-fluorouracil i.v. was stable, whereas in patients treated with 1.6 g/m2 carboplatin i.v., 480 mg/m2 thiotepa i.v., and 6 g/m2 cyclophosphamide i.v. divided over 4 days, an increase was observed. The morphology of buccal cells showed a transient shift from mature to immature cells in the first week. Neither systemic absorption of TGF-beta3 nor development of TGF-beta3-antibodies was observed. TGF-beta3 mouthwashes were well tolerated and deserve further study in preventing chemotherapy-induced mucositis.

Administration, Oral↗
PubMed1998

New frontiers in the management of chemotherapy-induced mucositis.

About one-third of patients undergoing chemotherapy treatment suffer oral mucositis, an inflammatory-like change of the oral mucosa. Severe pseudomembranous/ulcerative mucositis can lead to secondary infection of lesions, sepsis and even cessation of treatment. Patients receiving curative head-neck irradiation are most susceptible and children undergoing chemotherapy are three times more likely to be affected. Mucositis is a costly side-effect of cancer therapy due to the extra time patients spend in hospital and currently there is no consistently effective treatment. Experimental studies with TGF-beta 3, a potent negative regulator of epithelial and haematopoietic stem cell growth, have shown that it is possible to temporarily arrest oral mucosal basal cell proliferation, and could therefore offer a new effective and safe form of preventative intervention for patients about to undergo aggressive regimens of cancer therapy.

Adult↗