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Biomedical subjects

F K Spijkervet

Publications and source records attributed to F K Spijkervet.

35 records · Page 2Linked to original sources
PubMed1997

[Sjögren's syndrome. Consequences for oral health].

Sjögren's syndrome is an auto-immune disease involving exocrine glands causing amongst others xerostomia and dry eyes. Many other tissues may be affected as well. Early recognition of this disease may help to alleviate signs and symptoms and is, thus, important. The aim of this paper is to provide the dentist with knowledge to enable him to timely diagnose the oral component of Sjögren's syndrome as well as to give guidelines for the treatment.

Diagnosis, Differential↗
PubMed1997

[Changes in secretion and composition of saliva with aging].

About 30% of the elderly suffer from oral dryness and related complaints. Therefore, it is often assumed that salivary secretion reduces with age. Nevertheless, salivary flow rate data in healthy elderly--that are persons without any medication and not suffering from any (treatment related) salivary gland disorder--revealed no significant age-related decrease other than a slight decrease of the secretion from the (sero)mucous glands under conditions of minimal or extended stimulation. No age-related changes were observed in the secretion of parotis saliva. In contrast, some age-related changes occur in the organic composition of saliva. The reported decrease in the concentrations of kallikrein, sIgA, low-molecular mucin and high-molecular mucin might be related to a somewhat decreased immunologic and non-immunologic defense of the oral cavity in the elderly.

Age Factors↗
PubMed1996

[Arthroscopy, arthroscopic surgery and arthrocentesis of the temporomandibular joint].

The understanding of the pathogenesis of TMJ disorders is increased by arthroscopic techniques; especially the prominent role of cartilage degeneration has become visible. During arthroscopy a clear view is produced of the different joint surfaces, the anatomic relationship between articular disc and mandibular condyle, and the degree of cartilage degeneration. Arthroscopic surgery results in pain relief, increased joint mobility and function improvement. The arthrocentesis technique is developed based upon the understanding of the underlying therapeutic mechanisms of arthroscopy. The therapeutic effects of arthroscopic procedures and arthrocentesis need to be further evaluated in prospective randomized studies. Future development of arthroscopic techniques will have an increasing impact on the treatment of TMJ disorders.

Arthroscopy↗
PubMed1996

[Angioedema due to medication treatment].

Patients with hypertension can be treated by inhibition of angiotensin-converting enzyme (ACE). A major side-effect of the use of ACE-inhibitors is the development of a life threatening dyspneu by angioedema of oropharyngeal and laryngeal tissue. This severe complication is caused by interaction of ACE-inhibitors with prostaglandin and bradykinin metabolisms. Minor manifestations of angioedema can be followed by severe reactions. It is wise to stop ACE-inhibitors immediately.

Aged↗
PubMed1992

Protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy.

In addition to the desired antitumor effects, head and neck radiation therapy induces damage in normal tissues that may result in oral sequelae such as mucositis, hyposalivation, radiation caries, taste loss, trismus, soft-tissue necrosis, and osteoradionecrosis. These sequelae may be dose-limiting and have a tremendous effect on the patient's quality of life. Current policies to prevent these sequelae primarily are based on clinical experience and show great diversity. A protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy, based on fundamental research and data derived from the literature, is presented. The protocol is particularly applicable in centers with a dental team. This team should be involved at the time of initial diagnosis so that a successful preventive regimen is an integral part of the overall cancer treatment regimen.

Clinical Protocols↗
PubMed1991

Effect of selective elimination of the oral flora on mucositis in irradiated head and neck cancer patients.

Recently it has been reported that chlorhexidine 0.1% rinsing was not successful in eradication of gram-negative bacilli in patients who have head and neck cancer. These bacilli could play a role in irradiation mucositis. This study reports the effect of lozenges containing 2 mg polymyxin E, 1.8 mg tobramycin, and 10 mg amphotericin B qid on the oropharyngeal flora in 15 irradiated head and neck cancer patients. The results were compared with those of a previous study in two groups of 15 patients comparing chlorhexidine rinsing with placebo. In all patients using lozenges, eradication of gram-negative bacilli and yeasts was achieved within 3 weeks. A significant increase of enterococci was found. Mucositis was significantly reduced compared with the previous two groups. All patients showed erythema only, whereas 80% of both the placebo and chlorhexidine rinsing patients suffered from severe mucositis, with signs of pseudomembranes developing from the third week of conventional irradiation protocol. The effect of selective elimination of gram-negative bacilli from the oropharynx and the prevention of severe mucositis may be explained by the eradication of these bacteria and/or neutralization of salivary endotoxin, released by gram-negative bacilli, mediating the inflammatory processes.

Adolescent↗
PubMed1990

Chlorhexidine inactivation by saliva.

Chlorhexidine mouth rinsing is commonly used for oral flora reduction. Indigenous microorganisms (viridans streptococci) are significantly suppressed, while "hospital-acquired" gram-negative bacilli are not affected in vivo. To explain the discrepancies between good in vitro and poor in vivo activity of chlorhexidine, minimum bactericidal concentration values for 120 isolates were studied by means of a standard dilution method in fresh whole saliva, broth, and glucose 5%. Both saliva and broth significantly reduced the bactericidal activity of chlorhexidine against all microorganisms tested as compared to glucose 5% (p less than 0.01). Minimum bactericidal concentrations for indigenous flora were significantly lower than the values obtained for the "hospital-acquired" microorganisms (p less than 0.05). These observations of chlorhexidine inactivation by saliva may explain why chlorhexidine mouth rinsing is of limited value in decontaminating the oral cavity.

Analysis of Variance↗
PubMed1990

Mucositis prevention by selective elimination of oral flora in irradiated head and neck cancer patients.

Mucositis induced by irradiation is the reactive inflammatory-like process of the oropharyngeal mucous membranes following irradiation. Bacteria colonizing the oral tissues are thought to contribute to this inflammatory process. The eradication of Gram-negative bacilli (selective elimination of oral flora) in fifteen comparably irradiated head and neck cancer patients was found to be associated with a significant reduction in mucositis compared with two groups of 15 patients receiving either placebo or chlorhexidine rinsing. Criteria used were the extent of local mucositis signs (mucositis score), as well as generalized side-effects such as the need of nasogastric tube feedings following severe feeding problems. Mucositis signs were confined to erythema only in all selectively decontaminated patients. No pseudomembranes were observed and artificial feeding was completely prevented. These promising results need further confirmation in larger (multicenter) studies.

Adult↗
PubMed1990

[Prevention of oral mucositis in head and neck irradiation].

Head-neck irradiation is associated with oral complications. During the irradiation period patients are most burdened by mucositis. Changes of the oral flora with colonisation with the more pathogenic aerobic Gram-negative bacilli seems crucial in the development and severity of mucositis. Prevention of mucositis is reported to be successful during selective oral flora elimination.

Gram-Negative Bacteria↗
PubMed1989

Effect of chlorhexidine rinsing on the oropharyngeal ecology in patients with head and neck cancer who have irradiation mucositis.

Oral flora is thought to contribute to irradiation mucositis in patients with head and neck cancer. Neglect of oral hygienic care may also contribute to mucositis. The purpose of this prospective, randomized, placebo-controlled, double-blind study was to evaluate the effect of chlorhexidine 0.1% mouthrinses on oral flora and irradiation mucositis. This study included 30 patients with head and neck cancer who had comparable irradiation portals. One group (N = 15) rinsed four times daily with chlorhexidine 0.1%, the other group (N = 15) with a placebo. The oral flora was cultured (oral washing technique) twice before and three times per week during the period of radiotherapy. On the same days, the severity of mucositis was determined. The colonization index of viridans streptococci was significantly reduced only after 5 weeks of chlorhexidine 0.1% treatment. The colonization patterns of Candida species, Streptococcus faecalis, staphylococci, and Enterobacteriaceae, Pseudomonadaceae, and Acinetobacter species were not influenced by 5 weeks of use of chlorhexidine rinses when compared with the placebo. No differences were seen between the two study groups in the development and severity of mucositis. In conclusion, suppression of oral flora and a lowering of the severity of mucositis by means of disinfecting mouthrinses were not successful.

Adult↗
PubMed1989

Scoring irradiation mucositis in head and neck cancer patients.

Irradiation mucositis is defined as an inflammatory-like process of the oropharyngeal mucosa following therapeutic irradiation of patients who have head and neck cancer. Clinically, it is a serious side effect because severe mucositis can cause generalized problems (weight loss, nasogastric tube feedings) and interferes with the well-being of the patient seriously. Grading mucositis is important for the evaluation of preventive and therapeutic measures. The object of this study was to develop a scoring method based on local mucositis signs only. Four clinical local signs of mucositis were used in this score: white discoloration, erythema, pseudomembranes and ulceration. Mucositis of the oral cavity was calculated during conventional irradiation protocol for 8 distinguishable areas using the 4 signs and their extent. A prospective evaluation of this method in 15 irradiated head and neck cancer patients displayed an S-curve reflecting a symptomless first irradiation week, followed by a rapid and steady increase of white discoloration, erythema and pseudomembranes during the second and third week. Oral candidiasis, generalized symptoms such as weight loss and the highest mucositis scores were seen after 3 weeks irradiation. The novel mucositis scoring method may be of value in studying the effect of hygiene programs, topical application of disinfectants or antibiotics on oral mucositis.

Adult↗
PubMedDate not supplied

Aging and saliva: a review of the literature.

It is often assumed that salivary secretion reduces with age. About 25% of the elderly suffer from oral dryness and related complaints. Nevertheless, data on stimulated salivary flow rate in healthy elderly revealed no significant age-related decrease other than a slight decrease of the secretion from the (sero)mucous glands under conditions of minimal or extended stimulation. With regard to salivary gland morphology and composition of saliva, age-related changes have been reported in healthy individuals, too. With increasing age, the number of acini reduces and the amount of fatty and fibrous tissue increases. Moreover, animal studies revealed that the synthesis of proteins is reduced by 60% in advanced years. These data indicate that changes might occur in concentration and/or activity of the organic components of saliva. In human studies, the concentration of sIgA in labial saliva and the concentrations of high-molecular and low-molecular mucins in mucous saliva appeared to be reduced with age. Since sIgA and mucins are important in the immunologic and non-immunologic defense of the oral cavity, both defense systems are reduced in healthy elderly. Analysis of these data suggests that the oral soft tissues may become somewhat more susceptible to environmental factors due to a reduction of the immunological and non-immunological defense systems.

Age Factors↗