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Biomedical subjects

S Mintz

Publications and source records attributed to S Mintz.

At least 19 recordsLinked to original sources

Anterior lingual mandibular salivary gland defect--a dilemma in diagnosis.

Anterior lingual mandibular salivary gland defects are very rare. These lesions present as non-definitive bony radiolucencies. There are several other radiolucent entities which present in the anterior mandible with greater frequency and this creates a diagnostic dilemma for the practitioner. The ultimate and proper treatment of non-treatment depends on a correct diagnosis of these lesions. The correctness of the diagnosis and avoidance of unnecessary traumatic procedures may be aided by more sophisticated radiographic studies, such as a CAT scan and/or Magnetic Resonance Imaging. A case of a very unusual appearing anterior lingual mandibular salivary gland defect is presented and the diagnosis, management and recommendation for more complex radiographic studies are discussed.

Choristoma

Unusual physiologic melanin pigmentation of the tongue.

A patient had extensive congenital oral hyperpigmentation of the tongue. The clinical and histologic features set this case apart from any well-delineated disease. Clinically, the congenital onset, the appearance of large black-brownish lesions, the lack of associated systemic abnormalities, and the histologic findings of prominent deposition of melanin in the basal layer support the diagnosis of physiologic melanosis. The macular lesions of the tongue represent discrete depositions of melanin and exemplify soft tissue pigmentation of developmental origin.

Child

Changes in hospital admissions pattern in patients with human immunodeficiency virus infection in the era of Pneumocystis carinii prophylaxis.

BACKGROUND: Pneumocystis carinii pneumonia (PCP) was the leading cause of hospital admissions in patients with human immunodeficiency virus (HIV) infection before the widespread use of PCP prophylaxis. We studied retrospectively the changes in annual hospital admission patterns after the start of a population-based PCP prophylaxis program in Toronto. The purpose of the study was to identify the cogent diseases requiring hospitalization of HIV patients in the current era of PCP prophylaxis. This information is important for the allocation of health care resources in the future as well as for targeting research in the prevention of specific HIV-related diseases. METHODS: The annual HIV-related hospital admissions before and after the start of the Toronto aerosol pentamidine program (May 1989) were studied. All admission records due to AIDS-defining illnesses or occurring in patients with known HIV status in three major referral centers were reviewed. The two periods for comparison were May 1988 through April 1989 and May 1989 through April 1990. The data obtained were stratified according to the following: (1) cause of the illness prompting hospital admission; (2) PCP admissions; and (3) admissions according to the major organ system involved. These categoric data were compared by nonparametric chi 2 tests. RESULTS AND CONCLUSIONS: Population-based prophylaxis of PCP with aerosol pentamidine resulted in a significant reduction in the total number of PCP hospital admissions. Infection remains the principal cause of hospital admission in HIV patients after the start of the PCP prophylaxis program. However, there was an increase in the proportion of hospital admissions due to nonrespiratory-related infections. There was also a modest increase in admissions due to neurologic and gastrointestinal diseases. Central nervous system lymphoma and cytomegalovirus retinitis accounted for the majority of the rise in the nervous system. These data suggest there is a changing pattern of the diseases leading to the hospitalization of patients with HIV infection in the era of PCP prophylaxis.

AIDS-Related Opportunistic Infections

The distal lacrimal ductal system and traumatic epiphora.

While transient epiphora is well documented in the literature, the incidence of permanent epiphora associated with maxillofacial procedures (Le Fort I, II, III, osteotomies, nasal atrostomies and mid-face fractures) is rare. However, little attention has been paid to the distal lacrimal ductal system and its relationship to permanent epiphora. The distal nasolacrimal ductal system was studied in adult dry skulls and cadaver specimens. These findings were correlated by clinical observation. Specific areas of emphasis within this complex include the length, width, and angulation of this system. Clinical applications are discussed based on an anatomical rationale for the limitation of the superior repositioning of the maxilla as well as for proper placement of the antral window in nasal antrostomy procedures and what anticipated post-residual effects of mid-facial trauma are on the ductal system.

Adult

Bacterial contamination of human milk: container type and method of expression.

Common questions from nursing women include: is the bacterial contamination of expressed milk different if collected manually versus mechanically and is there a large increase in bacterial contamination if the milk is collected into clean versus sterile containers. Similarly, there are mixed reports, and secondarily confusion, among lactating women regarding the benefit of discarding the initial portion of a milk expression to limit bacterial contamination with skin flora. To answer these concerns, we have measured the number of colony-forming units (CFU)/milliliter in expressed milk from 16 women. The experimental design, used in a randomized fashion with each woman, employed both sterile and clean containers for collection and both the manual and mechanical techniques for milk expression. The number of milk specimens containing greater than 10(4) CFU/ml was not different between those collected in clean versus sterile containers or between those collected with a manual versus a mechanical technique. Finally, the initial milk expressed did not have a significantly greater amount of bacterial contamination than the milk collected later in the milk expression.

Adult

Peripheral ameloblastoma of the gingiva. A case report.

Reports of gingival peripheral ameloblastoma are extremely rare and have been sporadic. This paper reports a pertinent case of a 40-year-old woman who for 2 years had a progressively enlarging asymptomatic firm mass in the buccal gingival region of the lower premolars. Cupping of the underlying bone was radiographically demonstrated. The lesion was excised surgically together with extraction of the first premolar, and no evidence of recurrence was seen 5 years later. The clinical, radiological, and histopathological characteristics of gingival peripheral ameloblastoma were analyzed in the 33 previously reported cases. The differential diagnosis and treatment of this case report are discussed.

Adult

Comparison of health of occupants and characteristics of houses among control homes and homes insulated with urea formaldehyde foam. I. Methodology.

The methodology of a study in which a comparison is made of the health and house characteristics of the occupants of 231 control homes and 571 houses containing urea formaldehyde foam insulation (UFFI) is described. All homes and occupants were examined on two occasions separated by an interval of 12 months, during which two-thirds of the UFFI houses performed remedial work. The occupants were examined using a health questionnaire and a series of objective tests including pulmonary function, nasal airway resistance, sense of smell, nasal surface cytology, and patch tests. The houses were assessed using a questionnaire and measurements of indoor formaldehyde and carbon dioxide levels. No obvious bias has been identified in this survey with respect to the representativeness of the population studied, the classification of the UFFI and control groups, and the input from both the respondents and observers. The symptom responses made by individuals within the same households were not correlated. Quality control assessment of the objective health tests and formaldehyde sampling and assays demonstrated that these procedures remained stable over the two phases of the study, with the exception of the expected decrease in the pulmonary flow rates over 1 year and a small unexpected increase in the forced vital capacity and the forced expiratory volume in 1 s.

Airway Resistance

Comparison of health of occupants and characteristics of houses among control homes and homes insulated with urea formaldehyde foam. II. Initial health and house variables and exposure-response relationships.

A health survey was conducted on 1726 occupants of urea formaldehyde foam insulated (UFFI) houses and 720 residents of control homes. The occupants of the UFFI houses showed a modest excess of many symptoms relative to the controls. This excess of complaints was contributed mainly by the residents of households which were intending to have their UFFI removed and by onsets which followed the installation of UFFI. There were no associated abnormalities in nasal airway resistance, sense of smell, pulmonary function, or patch tests for allergy to formaldehyde. However, the UFFI subjects intending to have their UFFI removed demonstrated a small increase in nasal epithelial squamous metaplasia. The indoor formaldehyde levels of the UFFI houses were about 20% higher than in the controls, while the carbon dioxide levels were similar in both groups. The UFFI subjects showed positive relationships between level of formaldehyde exposure and the presence of a number of symptoms, which were largely dependent on a small group of formaldehyde values that were in excess of 0.12 ppm. A number of the exposure-response relationships were enhanced by UFFI. These results suggested that some adverse health effects of UFFI were explained by formaldehyde alone while others were related to the combined effects of formaldehyde and an additional UFFI-related factor(s) which was not identified.

Carbon Dioxide

Six-month double-blind, controlled trial of high dose, concentrated beclomethasone dipropionate in the treatment of severe chronic asthma.

A six-month double-blind controlled trial compared a 2,000 microgram per day dose of beclomethasone dipropionate aerosol (BDP), with current upper level doses of 800 micrograms per day of the standard BDP, in asthmatics requiring oral corticosteroids in addition to BDP and bronchodilators. Both groups showed a significant reduction in their oral steroid requirements during the study, with a 34 percent reduction in the lower dose group and a 57 percent reduction in the high dose BDP group while maintaining good symptomatic control of asthma; there was an associated improvement in baseline serum cortisol levels. Over the same period, the pulmonary function of the lower dose group showed significant worsening relative to that of the group receiving the high dose BDP which improved. There was no increase in dysphonia or oropharyngeal candidiasis among those using the concentrated BDP. We conclude that high dose concentrated BDP appears to be a safe medication in long-term steroid-dependent asthma, and is effective in reducing dependence on the use of oral corticosteroid with associated improvement both in pulmonary and adrenal function.

Administration, Inhalation