Biomedical subjects

P Vescovi

Publications and source records attributed to P Vescovi.

At least 19 recordsLinked to original sources

PubMed2006

In vitro antifungal susceptibility to six antifungal agents of 229 Candida isolates from patients with diabetes mellitus.

The most common antifungal drugs in current clinical use for the treatment of oral candidosis are polyenes and azoles, mainly used topically. Poor glycaemic control in association with other local factors, such as the presence of oral dental prostheses, salivary pH, salivary flow rate and tobacco habits, may lead to the development of oral candidosis. Topical antifungal agents are frequently used to prevent the development of candidal infections in patients with poor metabolic control, particularly in the elderly wearing dentures. The aim of this study was to assess the antifungal susceptibility of Candida isolates to six antifungal agents using a commercially available kit, Fungitest. The isolated were collected from patients affected by diabetes mellitus from two different geographic localities (London, UK, and Parma, Italy) and from a group of healthy non-diabetic subjects. No differences in antifungal susceptibility to the six agents tested were observed between Candida isolates from diabetic and non-diabetic subjects. However, differences were observed between the two geographically different diabetes mellitus populations. Oral yeast isolates from diabetes mellitus patients in the UK more often displayed resistance or intermediate resistance to fluconazole (P=0.02), miconazole (P<0.0001), and ketoconazole (P=0.01) than did isolates from diabetes mellitus patients in Italy. In addition, more C. albicans isolates were found in diabetic and non-diabetic subjects that were susceptible to fluconazole (P=0.0008 and P=0.01, respectively) than non-albicans isolates. The difference in the antifungal resistance of isolates from the two populations of diabetes mellitus patients may be related to differences in the therapeutic management of candidal infections between the two centres.

Antifungal Agents↗

PubMed2006

In vitro evaluation of virulence attributes of Candida spp. isolated from patients affected by diabetes mellitus.

BACKGROUND: Diabetes mellitus is a common disease found worldwide and it has been previously suggested that oral candidal infections may be more frequent or severe in patients with this disease. Systemic and local factors may influence the balance between the host and yeasts, and favour the transformation of Candida isolates from commensal to pathogenic microorganisms. Candida species have developed specific virulence mechanisms that confer the ability to colonise host surfaces, to invade deeper host tissue, or to evade host defences. Few studies have investigated the expression of the virulence attributes of oral Candida isolates in patients with diabetes mellitus. MATERIAL AND METHODS: The in vitro extracellular proteinase production and the in vitro ability to adhere to fibronectin of 229 Candida isolates of two geographic different groups of patients with diabetes mellitus and of healthy subjects were assessed. RESULTS: Candida isolates of patients with diabetes mellitus expressed a higher ability to adhere than those of healthy subjects. Higher levels of adhesion were also recorded in patients with a lower oral Candida colonisation. No differences were observed in the in vitro expression of extracellular proteinase of Candida isolates of patients with diabetes mellitus and those of non-diabetic subjects. Isolates of patients with type 2 diabetes mellitus expressed greater levels of proteinase than isolates of type 1 diabetes mellitus. CONCLUSIONS: Diabetes mellitus could be considered as an additional variable that may influence not only oral Candida carriage but also the ability of isolates to enhance the expression of virulence attributes.

Candida↗

PubMed2006

Analysis of the strain relatedness of oral Candida albicans in patients with diabetes mellitus using polymerase chain reaction-fingerprinting.

To increase our understanding of Candida pathogenicity, the identification of those strains most frequently associated with infections is of paramount importance. Polymerase chain reaction (PCR)-based methods are extremely effective in differentiating and determining reproducibility, they require minimum starting material and are rapid and simple to perform. In this study, the genetic relatedness of Candida albicans was assessed for two geographically different patient groups (London, UK and Parma, Italy) affected by diabetes mellitus. C. albicans samples from the oral cavities of non-diabetic healthy subjects were also examined by PCR fingerprinting to evaluate the possible genetic differences among endogenous strains in individuals with and without diabetes mellitus. PCR fingerprinting, with subsequent phylogenetic analysis of C. albicans isolates from the diabetic patients from London and Italy and from the non-diabetic subjects, revealed that there were significant differences (P < 0.0001) between C. albicans isolates indicative of the distinct ecological niches that occur in the oral cavities of these patient cohorts. The most diverse group comprised the isolates from the diabetic patients in the UK, possibly reflecting the antifungal treatment that these patients had received. Further studies that include isolates from patient cohorts with systemic diseases other than diabetes mellitus, and from more diverse geographic localities are required to explain the relatedness of C. albicans isolates in the mouth.

Candida albicans↗

PubMed2005

In vitro activity of a monoclonal killer anti-idiotypic antibody and a synthetic killer peptide against oral isolates of Candida spp. differently susceptible to conventional antifungals.

BACKGROUND/AIMS: A monoclonal killer anti-idiotypic antibody (mAbK10) and a synthetic killer peptide, acting as internal images of a microbicidal, wide-spectrum yeast killer toxin (KT) have been recently shown to express candidacidal in vitro and an in vivo therapeutic activity against experimental mucosal and systemic candidosis models caused by a reference strain of Candida albicans (10S). MATERIAL AND METHODS: The in vitro candidacidal activity of mAbK10 and synthetic killer peptide was compared using a colony forming unit assay against a large number of isolates of different Candida spp., obtained from oral saliva of adult diabetic (type 1 and 2) and nondiabetic subjects from Parma (Italy) and London (UK). RESULTS: Both the KT-mimics exerted a strong dose-dependent candidacidal activity, probably mediated by the interaction with beta-glucan KT receptors on target yeast cells, against all the tested strains, regardless of their species and pattern of resistance to conventional antifungal agents. CONCLUSIONS: These observations open new perspectives in the design and production of candidacidal compounds whose mechanism reflects that exerted in nature by killer yeasts.

Adult↗

PubMed2005

Jaw bone necrosis without previous dental extractions associated with the use of bisphosphonates (pamidronate and zoledronate): a four-case report.

Jaw bone necrosis is a clinical condition associated with defects in vascularization of the maxilla or the mandibular bone, usually present following head and neck radiotherapy and/or oral surgical interventions. Bisphosphonates are synthetic analogues of pyrophosphate used in the treatment of patients with hypercalcemia as a result of malignancy, bone metastasis and for the treatment of other disorders such as metabolic bone diseases, Paget's disease and osteoporosis. Over last 10 years, cases of jaw bone necrosis have been associated with the use of bisphosphonate therapy. In particular, Ruggiero et al. (J Oral Maxillofac Surg 2004; 62: 527-534) in 2004 described a large group of patients (63) with jaw bone necrosis probably related to the use of these drugs. It should be noted that all the patients in the group described either underwent head and neck radiotherapy or had a dental extraction while taking bisphosphonates. In the present study, we reported four cases of jawbone necrosis in patients taking pamidronate (Aredia) and zoledronate (Zometa) without having undergone any kind of radiotherapy or dental surgery. All the patients were females between the ages of 56 and 71 years; three were treated with bisphosphonates for bone metastasis and one for multiple myeloma. All the patients received surgical treatment with bone curettage, with partial and/or temporary improvement of the lesions. Although a treatment for bisphosphonate-induced bone lesions has not yet been established, we suggest careful evaluation of the patients' oral health before prescribing bisphosphonate treatment.

Aged↗

PubMed2005

Langerhans-cell histiocytosis: a clinical case without bone involvement.

BACKGROUND: Langerhans-cell histiocytosis (LCH) is a group of rare disorders histologically characterized by the proliferation of Langerhans cells. Multiple organs and systems may be involved by the disease. Typically, there is bone involvement and, less frequently, lesions may be found in the lungs, liver, lymph nodes, skin, and mucosae. Oral soft tissue lesions without bone involvement are rare. METHODS: We report a case of a 23-year-old man with LCH detected by oral soft tissue, cutaneous, and lung lesions. RESULTS: Due to the oral lesion diagnosis, important procedures were performed, which determined the staging of the disease. CONCLUSION: Gingival lesions could be one of the first manifestations of LCH. The periodontist should recognize and detect this important pathology with oral involvement.

Adult↗

PubMed2004

Nevoid basal cell carcinoma syndrome: a review of the literature.

The nevoid basal cell carcinoma syndrome (NBCCS) or Gorlin-Goltz Syndrome is an autosomal dominant disorder principally characterized by cutaneous basal cell carcinomas, multiple keratocysts, and skeletal anomalies. The present report reviews current knowledge of this disorder that has profound relevance to specialists in Oral and Maxillo-Facial Surgery, Oral Medicine and Radiology.

Basal Cell Nevus Syndrome↗

PubMed2004

Update on diabetes mellitus and related oral diseases.

Diabetes mellitus (DM) is a group of complex multisystem metabolic disorders characterized by a relative or absolute insufficiency of insulin secretion and/or concomitant resistance to the metabolic action of insulin on target tissues. The chronic hyperglycaemia of diabetes is associated with long-term systemic dysfunction. The present article summarizes current knowledge of DM and details the oral and dental implications of this common endocrine disorder.

Diabetes Complications↗

PubMed2003

[Pathogenesis of cyclosporine induced gingival overgrowth].

Several studies, during the last 20 years, tried to explain the pathogenetic mechanisms of the cyclosporine (CS) induced gingival overgrowth (and in general, of the drugs induced gingival overgrowth), but they are still poorly understood. The relationship between the drug and the different pharmacokinetic variables (dosage, duration of therapy, plasmatic and salivary Cs concentration) is still on discussion. It is accepted that a threshold concentration is necessary, in the gingival tissues, to begin or to enhance the morphostructural changes of the gums, but the total Cs weight, from the beginning of the therapy to the time of clinical examinations, has to be evaluated. The pharmacokinetic variables are associated with many other factors (first of all the oral hygiene score) that are probably connected with the developing of the gingival lesions. Gingival inflammation could be very important in the pathogenesis of gingival overgrowth. It has been shown by several cross-sectional studies a strong association between plaque and gingival lesions, but it is not yet clear if plaque accumulation is a causal factor or a consequence of the morphological gums changes. It would seem that the morphological alterations, in drug-induced gingival overgrowth, could be started by the plaque induced inflammation, and this would lead to an hyperemic and edematous gingival tissue. Oral hygiene (professional and at home) is more difficult and represents an irritation factor that makes the pathological cycle to go on. Other factors, probably connected with the cyclosporine induced gingival overgrowth, are represented by age, gender, genetic predisposition, alterations of gingival connective homeostasis and metabolism, inflammatory alterations, interactions with the growth factors and protective or synergic effects of other drugs.

Adolescent↗

PubMed2000

[Burning mouth syndrome. Clinical experience with 75 patients].

The burning mouth syndrome (BMS) is a very common disorder frequently seen in practical dentistry. It is a particular condition with a complex of strange burning sensation localized in the oral mucosa which is clinically normal. It is very important for the dentist to recognize and classify this particular syndrome in order to exclude other factors which can cause the same symptoms. On the basis of personal experience on 75 patients, the complex management of this particular group of patients has been evaluated to make a right diagnosis and a correct treatment.

Burning Mouth Syndrome↗

PubMed2000

[Neoplastic transformation of oral lichen planus. I: Review of the literature].

Lichen planus is described like a well-characterized dermatological condition affecting the skin and the oral and genital mucosa. Over the years, different authors have expressed the possible oral lichen planus premalignant nature, but this is still controversial. This criticism is due to the insufficiency of the clinical and histopathological data to support the initial diagnosis of oral lichen planus, the occurrence of some wrong diagnostic criteria for this pathology, the contemporary presence in the same region of the oral lichen planus lesions and of neoplasia. The malignant transformation of oral lichen planus rate varies, according to authors, from 0.4 to 3.7%. The aim of this study is to review the literature from 1910 to 1999, focusing on the suggested possible premalignant nature of oral lichen planus.

Humans↗

PubMed2000

[Neoplastic transformation of oral lichen planus. II: association with risk co-factors].

The possible malignant transformation of oral lichen planus is still controversial. It is not clear if this is in fact due to the premalignant nature of oral lichen planus or to the presence of some risk-factors in patients with this pathology. The risk co-factors that may he involved in this malignant transformation are numerous. Some authors suggested a correlation between oral lichen planus and HCV or HGV, or with the presence of some oncogenic viruses (EBV, HSV, HPV). Cases of this malignant transformation on oral and genital mucosa with lichen are reported, hut none on the skin lesions. The aim of this study is to investigate, through the literature, these correlations that may have a role in the malignant transformation of oral lichen planus.

Humans↗

PubMed1999

[The effects of drugs on the oral cavity].

As shown by the growing numbers of users attending the public drug addiction services, drug abuse is a phenomenon that is constantly spreading. It is important that dentists are aware of the oral problems linked to drug abuse. This study examines the general effects and oral implications of the illegal substances used by the majority of drug addicts. The main dental complications of cannabinoids are the increased incidence of squamous cell carcinomas of the oral cavity, the presence of xerostomia and severe gingivitis. Depending on how it is taken, cocaine may cause ischemic necrosis of the palate, inflammation, ulceration and gingival retraction, as well as an increased incidence of bruxism. Hallucinogens have few direct oral effects, but among these it is worth recalling xerostomia, increased bruxism and oral problems linked to malnutrition caused by ecstasy. Turning to the opioids, heroin is the drug primarily used by the majority of drug addicts. Its oral effects mainly take the form of dental decay, showing a particular form and extent linked either directly or indirectly to heroin use. This results in "typical" or "atypical" caries pathologies directly linked to the effects of heroin. Given the extent of this phenomenon, it is important that dentists are aware of the problems linked to drug abuse that they may have to treat.

Cannabinoids↗

PubMed1997

[Gingival hypertrophy due to cyclosporine. A clinico-statistical study in 82 patients].

Eighty-two patients were observed at the Dental Department at Parma University. Seventy-six of them had renal transplant and 6 liver transplant. They were in immunosuppressive therapy with cyclosporina, 42 of them were also in calcium antagonist therapy. Gingival hypertrophy was observed in 52 subjects (63.4%) 25 (30%) patients underwent surgical operation, 6 of them (24%) showed a relapse about 3 months after the first operation. Clinical data were measured in accordance with 5 indicators: the level of oral hygiene, cyclosporinemia, contemporaneous use of calcium antagonist, the duration of therapy and the DMF index. By the results obtained, it's possible to suppose that the gravity of the disease is related to the contemporaneous use of calcioantagonist, but it wasn't highly significant (p < 0.05). The degree of oral hygiene was decidedly in relation to the most severe forms of gingival hyperplasia (grade 2-3), (p < 0.001). No relation was found for the duration of therapy, distribution of the DMF index and the level of drugs in the blood.

Adolescent↗

PubMed1996

[Oral lichen planus (OLP). Therapeutic guidelines and clinical experience with 71 patients].

The authors report the results of a study performed in 71 patients suffering from lichen planus of the mucous membranes and skin. They discuss dermatological and stomatological clinical data in relation to possible basal diseases (hepatopathies, dermopathies, diabetes, hypertension, gastrointestinal diseases, etc.) and other anamnestic data (psychological aspects, drug taking, working activity, etc.). Moreover, they report the results of the clinical protocol used (betamethasone in a gel and vitamin A base) with a follow-up of 5 years and examine the other therapeutic possibilities reported in the literature.

Administration, Topical↗

PubMed1996

[Gingival hypertrophy due to cyclosporine. A review of the literature].

Cyclosporine is now the elective drug for immunosuppressive treatment in organ transplant patients. Compared to traditional immunosuppressants this molecule offers the therapeutic advantage that it does not act indiscriminately on all components of the immune system. In addition to the primary pharmacological action, cyclosporine also presents a number of undesirable effects, among which it is worth mentioning short and long-term nephrotoxicity and the development of neoplasia, in particular lymphomas. Other undesired effects of the drug are the possibility of overinfection, thrombosis, hypertension, hypertrichosis, hepatotoxicity and the development of the hypertrophic and hyperplastic gingival pathology.

Collagen↗

PubMed1994

INTEGRATION OF POSITIVE AND NEGATIVE FEEDBACK LOOPS IN A CRAYFISH MUSCLE

It is now well established that in arthropods movement-related feedback may produce positive, as well as negative, feedback reflexes (Bassler, 1976; DiCaprio and Clarac, 1981; Skorupski and Sillar, 1986; Skorupski et al. 1992; Vedel, 1980; Zill, 1985). Usually the same motor neurones are involved in both negative feedback (resistance) reflex responses and positive feedback reflexes. Reflex reversal involves a shift in the pattern of central inputs to a motor neurone, for example from excitation to inhibition. In the crayfish, central modulation of reflexes has been described in some detail for two basal limb proprioceptors, the thoracocoxal muscle receptor organ (TCMRO) and the thoracocoxal chordotonal organ (TCCO) (Skorupski et al. 1992; Skorupski and Bush, 1992). Leg promotor motor neurones are excited by stretch of the TCMRO (which, in vivo, occurs on leg remotion) in a negative feedback reflex, but when this reflex reverses they are inhibited by the same stimulus. Release of the TCCO (which corresponds to leg promotion) excites some, but not all, promotor motor neurones in a positive feedback reflex. There are at least two ways in which the reflex control of a muscle may be modulated in this system. Firstly, inputs to motor neurones may be routed via alternative reflex pathways to produce different reflex outputs. Secondly, the pattern of inputs to a motor pool may be inhomogeneous, so that activation of different subgroups of the motor pool causes different outputs. Different crayfish promotor motor neurones are involved in different reflexes. On this basis, the motor neurones may be classified into at least two subgroups: those that are excited by the TCCO in a positive feedback reflex (group 1) and those that are not (group 2). Do these motor neurone subgroups have different effects on the promotor muscle, or is the output of the two promotor subgroups summed at the neuromuscular level? To address this question we recorded from the promotor nerve and muscle in a semi-intact preparation of the crayfish, Pacifastacus leniusculus. Adult male and female crayfish, 8-11 cm rostrum to tail, were decapitated and the tail, carapace and viscera removed. The sternal artery was cannulated and perfused with oxygenated crayfish saline, as described previously (Sillar and Skorupski, 1986).

Journal Article↗

PubMed1994

[11 cases of erythema multiforme. The etiological correlations and therapy].

Erythema multiforme (EM) is characterised by a polymorphous eruptive complex which many involve the cutis and oral, genital and conjunctival mucous. Its etiopathogenesis is unclear: it is thought to be associated with various viral or bacterial infective agents (herpes virus, Coxsackie virus, mycoplasmas, etc.), numerous drugs, physical therapy, systemic pathologies of various types. The authors report their experience in relation to 11 patients suffering from EM; the clinical characteristics of each case are reported, together with the course of disease, and the diagnostic and therapeutic protocol adopted. The discussion examines the possible cause of disease: in 5 patients the etiology was traced back to viral infections (4 herpes and 1 coxsackie) and to the administration of drugs in the remaining cases (4 in relation to anti-phlogistic agents and 2 regarding antibiotics).

Adolescent↗