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Biomedical subjects

R Steelman

Publications and source records attributed to R Steelman.

At least 19 recordsLinked to original sources
PubMed2000

Increased susceptibility to gingival colonization by specific HACEK microbes in children with congenital heart disease.

It is well established that infective endocarditis (IE) involving the HACEK (Hemophilus, Actinobacillus, Cardiobacter, Eikenella, Kingella) group of microbes occurs in patients with congenital heart defects (CHD) and in those with prosthetic grafts. Dental caries and gingival disease have been presumed to be the focus of microbial shedding. The purpose of this study was to determine if children with CHD had a more severe gingival inflammatory condition and harbored the HACEK group of microbes to a greater extent than normal children. Two groups of 12 age and sex matched children were selected for this study. The experimental group consisted of twelve children with CHD, 1-1/2 to 8 years of age. The control group consisted of 12 healthy children 2 to 8 years of age. Each child had a gingival index score recorded as described by Massler. Subgingival cultures were obtained. Gingival samples were cultured for HACEK microbes and total Streptococcus (spp) using standard techniques. Fisher's exact test was performed with significance defined at P < 0.05. Children with CHD had more severe gingival inflammatory index than the control group (P < 0.05). 8/12 CHD patient had Actinobacillus actinomycetemcomitans (A.a.) as compared with 2/12 controls (P < 0.05). Furthermore, all cyanotic CHD patients (4/4) had A.a. whereas, only 2/12 controls did (P < 0.05). 4/12 CHD patients harbored Eikenella corrodens (E.c.) compared to 1/12 controls (N.S.). There was no significant difference in colonization with E.c. or A.a. between cyanotic and acyanotic patients. No significant difference in total Streptococcus (spp) was found between the two groups. This study suggests that children with CHD have a more severe gingival inflammatory index and are colonized with specific HACEK microbes more so than normal children.

Actinobacillus↗
PubMed1996

Chlorhexidine spray effects on plaque accumulation in developmentally disabled patients.

Chlorhexidine gluconate has been studied as an adjunct to standard oral hygiene techniques in developmentally disabled patients in reducing plaque accumulation. The purpose of this double blind crossover study was to determine the efficacy of two concentrations of chlorhexidine spray (0.12% and 0.06%) on plaque accumulation in developmentally disabled patients. Informed consent was obtained for 8 developmentally disabled patients 12 to 33 years of age. Patients were randomly assigned to one of two groups of four each. One group received twice daily 0.12% chlorhexidine spray while the other received the 0.06% chlorhexidine spray for 30 days, followed by twice daily chlorhexidine spray (0.12% and 0.06%) alternating groups, for a period of 30 days. Final plaque indices were determined. Normal oral hygiene practices continued throughout the study. Significant plaque reduction occurred with the 0.12% and 0.06% spray solutions. No significant differences occurred between the two concentrations. The results of this study suggest that twice daily chlorhexidine spray at a concentration of 0.06% is as effective in reducing plaque accumulation as a 0.12% chlorhexidine concentration.

Adolescent↗
PubMed1992

Pregnancy tumor in a 16-year-old: case report and treatment considerations.

A sixteen-year-old female in the third trimester of pregnancy was evaluated for treatment of a pregnancy granuloma. No surgical treatment was rendered. The patient was given a thorough dental prophylaxis and oral hygiene instructions. The tumor was noted to have decreased in size four weeks post partum. Observation of such lesions in conjunction with standard oral hygiene procedures is warranted in lieu of surgical removal.

Adolescent↗
PubMed1991

Parotitis in a three-year-old.

Facial swelling cannot routinely be attributed to dento-alveolar infections until a thorough head, neck and oral examination has been completed. Facial swelling from parotitis is not commonly encountered in the pediatric patient. The purpose of this report was to document a case of unilateral parotid gland infection presumably secondary to traumatic obstruction of Stenson's duct. The parotitis resolved following a course of oral penicillin VK and lemon juice to stimulate salivary flow. Several parotid gland disorders which involve facial swelling were discussed.

Child, Preschool↗
PubMed1991

Traumatic avulsion of the mandibular right primary lateral incisor and cuspid.

Premature loss of the primary mandibular cuspid has been considered rare. When this occurs, however, space maintenance should be considered to prevent distal drifting of the lateral incisor. The purpose of this case report was to document traumatic avulsion of the mandibular right lateral and cuspid. A lingual arch appliance with a spur was fabricated to maintain space and prevent movement of the mandibular incisors. Sequelae of premature loss of primary teeth is presented.

Child, Preschool↗
PubMed1978

Plasma, apolipoprotein, A-I and A-II levels in hyperlipidemia.

Some of the component moieties of high density lipoproteins (HDL) were analyzed in normal subjects and in patients with hyperlipidemia. Apoproteins A-I and A-II were quantified by radioimmunoassay, HDL cholesterol and triglycerides were assessed on heparin-MnCl2 supernates of fasting plasmas. We found that HDL is enriched in triglycerides in all forms of hyperlipidemia, while the proportion of ApoA-II is unaltered and the proportion of ApoA-I is decreased. Thus, the composition of HDL is altered in hupertirglyceridemia. The molecular associations of ApoA-I and ApoA-II in plasma were also examined by assaying the apoprotein contents of plasma fractions prepared by ultracentrifugation and by gel filtration column chromatograpy. The ApoA-I contents of d smaller than 1.063 fraction increased in hyperlipidemia from smaller than 0.5% to approximately 2%, but the ApoA-I contents of the d greater than 1.21 fraction remained at less than 12% of total plasmas with triglyceride levels smaller than 1500 mg/dl. d greater than 1.21 ApoA-I rose to 23% in one plasma with a triglyceride level of greater than 1700 mg/dl. On column chromatography, ApoA-I eluted with the lipoproteins and also in a fraction whose molecular weight (MW) appeared to be approximately 50,000 daltons. The proportion of plasma ApoA-I which eluted in the 50,000 MW peak was positively correlated with plasma triglyceride levels, but at triglyceride levels of less than 1500 mg/dl, less than 20% of ApoA-I was in the 50,000 MW peak. Between levels of approximately 2000 and 12,000 mg/dl, the percentage "50,000 M.W. ApoA-1" was 20-25%. The ApoA-II contents of d smaller than 1.063 fractions were also increased in hyperlipidemia, but greater than 95% of ApoA-II was found in the HDL fractions in both normal and hyperlipidemic plasma both by column chromatography and ultracentrifugation. Thus, the molecular association of ApoA-I appears to be altered in hyperlipidemia.

Apolipoproteins↗
PubMedDate not supplied

Idiopathic myelofibrosis: dental treatment considerations.

Idiopathic myelofibrosis is a myeloproliferative disorder of unknown origin. The bone marrow becomes fibrotic with an associated decrease in hematopoiesis resulting in anemia, bleeding problems, splenomegaly, and other secondary abnormalities. Although idiopathic myelofibrosis is usually diagnosed in middle age, there have been a few reports of the disorder in the pediatric population. This case report documents dental treatment considerations in a 6-year-old female with idiopathic myelofibrosis, severe anemia, and abnormal blood coagulation studies. The patient was successfully treated in a hospital after medical consultation, transfusion of packed red blood cells, and administration of prophylactic antibiotics. Local hemostatic measures following multiple extractions of carious teeth controlled bleeding. No postoperative sequelae occurred.

Anemia↗
PubMedDate not supplied

Suspected inappropriate secretion of antidiuretic hormone in a male with mental retardation.

The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is a disorder in which a sustained release of antidiuretic hormone occurs because of certain diseases, pharmacological agents, or trauma. Fluid volume expands with a resultant hyponatremia which, depending on the degree, may be asymptomatic or result in death. This case report describes a 38-year-old male in whom SIADH was strongly suspected secondary to Tegretol therapy to control a seizure disorder. Medical consultation is imperative for these patients before administering a fluid challenge during general anesthesia.

Adult↗
PubMedDate not supplied

Aspiration of a primary tooth in a patient with a tracheostomy.

Aspiration of a foreign object is uncommon in a patient with a tracheostomy. The following case history describes the consequences of failure to diagnose an aspirated object and how the aspiration of an exfoliated tooth can occur despite the presence of a tracheostomy tube. Dentists play an important role in preventing foreign body aspiration in debilitated patients.

Bronchi↗