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Biomedical subjects

S S Appleton

Publications and source records attributed to S S Appleton.

8 recordsLinked to original sources

Candidiasis: pathogenesis, clinical characteristics, and treatment.

Candida organisms live on the skin and mucous membranes of up to 75 percent of the population. They can live commensally without causing harm or can change to an aggressive form and invade tissue, causing both acute and chronic disease in the host. Oropharyngeal candidiasis manifests clinically as acute pseudomembranous, acute atrophic, chronic atrophic, chronic hypertrophic/hyperplastic, and angular cheilitis. Systemic infection leading to candidemia can be devastating and cause up to a 60 percent mortality rate in medical or post-surgical intensive care wards. Oral nystatin, clotrimazole, and fluconazole usually provide appropriate therapy; although resistance to medications is increasing, particularly in immunocompromised hosts.

Acute Disease↗

Cross-contamination potential with dental equipment.

Some types of reused dental equipment, especially handpieces and their attachments for drilling and cleaning teeth, might be responsible for cross-contamination if patient material were to lodge temporarily in difficult-to-disinfect internal mechanisms. This possibility is worrisome with respect to transmission of hepatitis B and human immunodeficiency viruses (HBV, HIV). Previous cross-contamination studies have relied on laboratory experiments with bacteria or dye tracers. To assess possible risk more thoroughly, we tested 30 new prophylaxis angles and 12 new high-speed handpieces to see whether they would take up and expel contaminants in laboratory and clinical trials. In treatments of three patients, including two infected with HIV, human-specific DNA (beta-globin, HLA DQ alpha) and HIV proviral DNA were detected inside or coming back from the devices. Similarly, when handpieces were operated in contact with blood pooled from HBV-infected patients, HBV DNA was detected in samples taken from inside the equipment and from their attached air/water hoses. When we used bacteriophage phi X174 as a model virus in laboratory tests, many infective viral particles were recovered from internal mechanisms of handpieces, their connecting air/water hoses, and from water spray expelled when the equipment was reused. We recommend that reused high-speed, air-driven handpieces and prophylaxis angles should be cleaned and heat-treated between patients. Further studies are needed to determine ways of eliminating the risks associated with exhaust hoses and air/water input lines.

Bacteriophages↗

Intraoral Hodgkin's disease.

An 85-year-old woman presented with an intraoral lesion involving the edentulous soft tissue of the mandibular alveolar crest between the first premolar and first molar teeth. Diagnosis was made with the aid of a biopsy. The gallium scan and CT scan were used successfully for noninvasive staging. However, initial treatment was delayed due to the patient's wishes, overall poor health, and decreased tolerance to both radiation and chemotherapy. This resulted in spread of the disease leading to her death.

Aged↗

Rhinolithiasis: a review.

A rhinolith is an object that has become lodged in the nose and has slowly calcified. It is seen on dental radiographs as a radiopaque object in the nasal fossa and may be confused with several pathologic entities that call for more invasive surgical procedures. A history of unilateral nasal stuffiness, obstruction, and discharge is common but not always present. Two clinically diverse cases are presented.

Adult↗