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Aphthous Ulcers (aphthou + ulcer)
Selected AbstractsClinical application of wireless capsule endoscopyJOURNAL OF DIGESTIVE DISEASES, Issue 2 2003Zhi Zheng GE BACKGROUND: Diagnostic modalities for identifying lesions within the small bowel have been quite limited. Wireless capsule endoscopy (WCE) is a new, innovative technique that can detect very small mucosal lesions in the entire small bowel and can be used in the outpatient setting. The present study explored the diagnostic value, tolerance and safety of WCE in the identification of small bowel pathology that was not detected with conventional small bowel imaging studies. METHODS: From May through September 2002, 15 patients with suspected small bowel diseases were prospectively examined, Of them, 12 presented with persistent obscure gastrointestinal bleeding and negative findings on upper endoscopy, colonoscopy, small bowel radiography, and bleeding-scan scintig-raphy or mesenteric angiography. RESULTS: Wireless capsule endoscopy identified pathologic small bowel findings in 11 of the 15 patients (73%): angioectasias, Dieulafoy's lesion, polypoid lesion, submucosal mass, Crohn's disease, carcinoid tumor, lipoma, aphthous ulcer, and hemorrhagic gastritis; four of the patients had two lesions. The images displayed were considered to be good. The capsule endoscopes remained in the stomach for an average of 82 min (range 6,311 min) and the mean transit time in the small bowel was 248 min (range 104,396 min). The mean time of recording was 7 h 29 min (from 5 h to 8 h 30 min). The mean time to reach the cecum was 336 min (180,470 min). The average number of the images transmitted by the capsule was 57 919 and the average time the physician took to review the images transmitted by the capsule was 82 min (range 30,120 min). The average time of elimination of the capsule was 33 h (range 24,48 h). All 15 patients reported that the capsule was easy to swallow, painless, and preferable to conventional endoscopy. No complications were observed. CONCLUSIONS: Wireless capsule endoscopy is safe, well tolerated, and useful for identifying occult lesions of the small bowel, especially in patients who present with obscure gastrointestinal bleeding. [source] Diagnostic difficulties in inflammatory bowel disease pathologyHISTOPATHOLOGY, Issue 2 2006R K Yantiss This review summarizes some of the common diagnostic problems encountered by pathologists when evaluating patients with chronic colitis and in whom inflammatory bowel disease (IBD) is either suspected or within the differential diagnosis. Both ulcerative colitis (UC) and Crohn's disease (CD) show characteristic, but non-specific, pathological features that may overlap and result in a diagnosis of ,indeterminate colitis' (IC). However, other reasons why pathologists may entertain a diagnosis of IC include failure to recognize or accept certain ,hardcore' histological features as indicative of CD, an attempt to classify cases of chronic colitis based on mucosal biopsy material or in the absence of adequate clinical and radiographic information, and the presence of other disease processes that mask, or mimic, IBD. In addition, some cases of UC may show unusual CD-like features, such as discontinuous or patchy disease, ileal inflammation, extracolonic inflammation, granulomatous inflammation in response to ruptured crypts, aphthous ulcers, or transmural inflammation. Furthermore, other forms of colitis, such as microscopic colitis, diverticulitis and diversion colitis may, on occasion, also show IBD-like changes. The clinical and pathological features that aid in the distinction between these entities, and others, are covered in detail in this review. [source] Clinical significance of granuloma in Crohn's diseaseINFLAMMATORY BOWEL DISEASES, Issue 3 2002Dr. Nizar N. Ramzan Abstract Crohn's disease (CD) is diagnosed from information obtained clinically, pathologically, and radiologically. One important pathologic finding is a granuloma, which is helpful when a positive diagnosis of CD will affect treatment. Whether the presence of a granuloma has any clinical implication is not clear. We conducted a retrospective study to determine whether a granuloma found on a biopsy sample is associated with disease severity, fistulizing or perianal disease, frequent relapses, and extraintestinal manifestations. Eighty-two patients were identified who had a biopsy or bowel resection for CD between 1990 and 1994 at a tertiary referral center; 21 (25.6%) had a granuloma. This group was compared with a group of 61 patients without a granuloma. Forty-five percent were male (n = 37), mean age at diagnosis was 42.6 years (median, 39.5 years), mean disease duration at presentation was 8.8 years (median, 4.8 years), and mean follow-up duration was 2 years (range, 1 day to 10.2 years). No significant differences were demonstrated between the two groups by the Fisher exact test with regard to fistulizing or perianal disease, oral aphthous ulcers, disease severity, axial or peripheral arthralgia, episcleritis, anterior uveitis, erythema nodosum, or pyoderma gangrenosum. [source] Severe aphthous stomatitis associated with oral calcineurin and mTOR inhibitorsINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2010Nancy Habib BS Background, Aphthous stomatitis, a common mucocutaneous disorder, is a well accepted complication of sirolimus therapy. This association has been reported less frequently with tacrolimus. Case, We present an 11-year old male with Budd-Chiari syndrome who experienced profound worsening of chronic aphthous ulcers after immunosuppressive therapy was changed from tacrolimus to sirolimus. Conclusion, Since these drugs are used widely in the pediatric transplantation population, this report serves to heighten awareness of this debilitating phenomenon, and to stress the importance of exercising caution when sirolimus and tacrolimus are administered in combination to pediatric patients. [source] Pimecrolimus versus placebo in genital aphthous ulcers of Behcet's disease: a randomized double-blind controlled trialINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 3 2010Cheyda CHAMS-DAVATCHI Abstract Background:, Genital aphthous ulcers of Behcet's disease (BD) are painful and usually resistant to local treatments. Pimecrolimus is an ascomycin macrolactam, used in inflammatory skin diseases. Objective:, To discover if pimecrolimus can accelerate the healing of BD genital aphthous ulcers. Methods:, Ninety patients with genital aphthous ulcers were enrolled. Only patients treated with colchicine alone were selected. All patients signed a written consent form. Patients were randomly assigned to pimecrolimus or placebo cream, applied twice daily for 1 week. The primary outcome was the healing period. Up to 7 days, it was considered as a positive result. Results were compared by chi-square test. The mean healing time was compared by analysis of variance. Analyses were done both by the ,intention-to-treat' and ,treatment-completed' methods. Results:, Both groups were similar at the entry (gender, age, ulcer size, pain intensity and treatment delay). By intention-to-treat analysis, in the pimecrolimus group, 18 patients had positive and 27 negative results. In the control group, four had positive and 41 negative results. The difference was significant (,2 = 10.167, P = 0.001). By treatment-completed analysis, with pimecrolimus, 18 patients had positive and 22 negative results. With placebo, four had positive, and 41 negative results. The difference was significant (,2 = 12.574, P = 0.0004). Comparison of mean healing time in the pimecrolimus versus placebo group, demonstrated a significant acceleration both in intention-to-treat analysis (10.7 vs. 20.7 days, F = 17.466, P < 0.0001) and treatment-completed analysis (8.3 vs. 20.7 days, F = 29.289, P < 0.0001). Conclusion:, Pimecrolimus is safe and efficient in the treatment of BD genital ulcers, by accelerating the healing process. [source] Bacterial diversity in aphthous ulcersMOLECULAR ORAL MICROBIOLOGY, Issue 4 2007L. Marchini Introduction:, Recurrent aphthous ulcers are common lesions of the oral mucosa of which the etiology is unknown. This study aimed to estimate the bacterial diversity in the lesions and in control mucosa in pooled samples using a culture-independent molecular approach. Methods:, Samples were collected from ten healthy individuals and ten individuals with a clinical history of recurrent aphthous ulcers. After DNA extraction, the 16S ribosomal RNA bacterial gene was amplified by polymerase chain reaction with universal primers; amplicons were cloned, sequenced and matched to the GenBank database. Results:, A total of 535 clones were analyzed, defining 95 bacterial species. We identified 62 putative novel phylotypes. In recurrent aphthous ulcer lesions 57 phylotypes were detected, of which 11 were known species. Control samples had 38 phylotypes, five of which were already known. Only three species or phylotypes were abundant and common to both groups (Gemella haemolysans, Streptococcus mitis strain 209 and Streptococcus pneumoniae R6). One genus was found only in recurrent aphthous ulcer samples (Prevotella) corresponding to 16% of all lesion-derived clones. Conclusion:, The microbiota found in recurrent aphthous ulcers and in the control groups diverged markedly and the rich variety of genera found can provide a new starting point for individual qualitative and quantitative analyses of bacteria associated with this oral condition. [source] Scope of practice, referral patterns and lesion occurrence of an oral medicine service in AustraliaORAL DISEASES, Issue 4 2008CS Farah Aim:, The purpose of this study was to examine the scope of practice, lesion occurrence and utilisation of referral-based hospital and private practice oral medicine and oral pathology (OMP) services in Australia. Materials and methods:, Clinical records of patients referred to a hospital (n=500) and private (nbequals;1104) OMP clinic were audited. For each patient, the following parameters were recorded: age, gender, source of referral, reason for referral, site of lesion/condition if applicable, medical and drug history, diagnostic services utilised, clinical and histopathological diagnoses rendered, medications prescribed and further treatment required. Results:, A majority of the referrals were generated by general dental practitioners. The most commonly seen problems were epithelial hyperplasia/hyperkeratosis, oral candidosis, oral lichen planus, xerostomia, recurrent aphthous ulcers and burning mouth syndrome. OMP specialists requested diagnostic imaging for 13% of hospital and 9.42% of private patients, diagnostic biopsies were required for 18.4% of hospital and 19.3% of private patients, blood tests were ordered for 14.4% of hospital and 12.13% of private patients, while medications were prescribed for approximately 36% of hospital and 51% of private patients. Conclusions:, This study is the first to detail the scope of practice, lesion occurrence and utilisation of services offered by OMP specialists in Australia. The demand for OMP services is strong. [source] Antimicrobial and antioxidant activities of traditional Thai herbal remedies for aphthous ulcersPHYTOTHERAPY RESEARCH, Issue 10 2010Chantana Mekseepralard Abstract Four medicinal plants (Quercus infectoria, Kaempferia galanga, Coptis chinensis and Glycyrrhiza uralensis) as well as one traditional Thai treatment for aphthous ulcers based on these four plants were tested for antimicrobial activity. MIC values for a range of bacteria and Candida albicans were determined, with both type strains and clinical isolates being used. Antioxidant activity was determined using the ABTS radical scavenging assay. Among the four plants, Q. infectoria showed antimicrobial activity against Staphylococcus aureus with an MIC of 0.41,mg/mL, while C. chinensis showed antifungal activity against C. albicans with an MIC of 6.25,mg/mL. Activity was also shown against a range of other organisms including Salmonella typhi, Serratia marcescens, Vibrio cholerae, Vibrio parahaemolyticus, Pseudomonas aeruginosa and Enterococcus faecalis. The antimicrobial activity of the traditional aphthous ulcer preparation (a powder) was comparable to that for the individual plant extracts, however, incorporation of the powder into a gel formulation resulted in the loss of almost all activity. All extracts, with the exception of K. galanga, also showed good antioxidant activity. This study supports the traditional use of these plants and suggests that they may also be useful in the treatment of other infections. Copyright © 2010 John Wiley & Sons, Ltd. [source] | ||||||||||