26 results on '"Johnson NW"'
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2. Viruses and oral diseases in HIV-infected individuals on long-term antiretroviral therapy: What are the risks and what are the mechanisms?
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Johnson NW, Anaya-Saavedra G, and Webster-Cyriaque J
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- Comorbidity, Humans, Papillomaviridae, Anti-Retroviral Agents adverse effects, Anti-Retroviral Agents therapeutic use, HIV Infections complications, HIV Infections drug therapy, HIV Infections epidemiology, Mouth Diseases epidemiology, Mouth Diseases virology, Neoplasms epidemiology
- Abstract
As a result of the extension of life span produced by increasing access to combined antiretroviral therapy, people living with HIV/AIDS (PLWH) face new challenges from comorbidities. Although advances in medical care for HIV infection have dramatically reduced opportunistic infections and AIDS-defining cancers, some non-AIDS-defining cancers (NADC) and specific oral diseases such as periodontitis and salivary gland disease are now more prevalent. Cancer prevention is, therefore, a priority issue in care of PLWH, stressing both restoration of immune function and reduction of non-HIV cancer risk factors (tobacco in all its forms; areca nut; heavy alcohol consumption; diets lacking antioxidant vitamins and minerals; and oncogenic virus infections) through specific interventions, especially tobacco and areca nut cessation and alcohol moderation. Detection of oral high-risk human papillomaviruses (HR-HPV) and the universal preventive HPV vaccination among PLWH should be promoted to reduce the malignancy burden, along with routine oral examinations which remain the cheapest, most reliable, most reproducible, and non-invasive tool to identify suspicious lesions. Also, considerations of oral inflammation and periodontal health are important to replication and gene expression of viruses in the mouth. Considering that a key risk factor for this scenario is the presence of oncogenic virus infection such as several members of the human herpesvirus and human papillomavirus families, here we analyze the variables involved in the seeming increase in comorbidities in PLWH., (© 2020 The Authors. Oral Diseases published by John Wiley & Sons Ltd.)
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- 2020
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3. Oral cancer in Papua New Guinea: looking back and looking forward.
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Kelwaip RA, Fose S, Siddiqui MS, Molumi CP, Apaio LM, Conway DI, Johnson NW, Thomas SJ, Lambert DW, and Hunter KD
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- Areca, Humans, Male, Papua New Guinea epidemiology, Prevalence, Mouth Diseases, Mouth Neoplasms epidemiology
- Abstract
Oral diseases, including cancers, affect 3.5 billion people globally and remain largely untreated in low- to middle-income countries because of lack of resources. In Papua New Guinea (PNG), oral cancer has, for many decades, been identified as the most common cancer in men, but as the GLOBOCAN 2018 data are estimates extrapolated from surrounding countries, the real prevalence of this disease is not known. The PNG National Health Plan (2011-2020) highlights the need to improve health care, but oral health is not identified as a priority. Alcohol, tobacco, and areca nut/betel quid, which are the social and commercial determinants of oral cancer, are common risk factors, and there are robust data linking these risk factors to oral cancer in PNG. Our recent Global Challenges Research Fund Workshop on Oral Cancer, held in Port Moresby, PNG, brought together a number of researchers in oral cancer epidemiology and translational science with clinicians from PNG to assess the current situation and plan ways to move forward. In this article, we will review the literature on oral cancer in PNG, and make suggestions as to how, collaboratively, we can address the issues identified, ultimately, for the benefit of the people of PNG., (Copyright © 2020 Elsevier Inc. All rights reserved.)
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- 2020
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4. Nonneoplastic diseases and disorders of the oral mucosa: A contemporary overview.
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Ariyawardana A and Johnson NW
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- Humans, Mouth Mucosa, Quality of Life, Mouth Diseases, Periodontal Diseases
- Abstract
Oral mucosal diseases encompass a diverse array of conditions and disorders arising from malignant, potentially malignant, and nonneoplastic processes. Considerable attention has been paid to the former in recent years, much less to the wide range of nonneoplastic disease processes, which constitute a sizeable proportion of the oral disease burden globally. Many nonneoplastic disease processes of the oral mucosa significantly affect the patient's quality of life. Fortunately, timely identification and intervention can reduce the associated morbidity and, sometimes, mortality. As such, it is of utmost importance that dentists are familiar with early identification and management of this wide range of oral mucosal diseases. This volume of Periodontology 2000 provides a comprehensive contemporary review of such diseases and disorders through 15 chapters. We cover all relevant disease categories: developmental anomalies, infections, white and red lesions, vesiculo-bullous diseases, oral dermatoses, oral ulcerative conditions, dysplastic lesions, and mucosal diseases as manifestations of systemic disease or oral lesions as a part of systemic diseases. Each chapter discusses epidemiology, etiopathogenesis, clinical features, diagnosis, and management. Controversies and many significant gaps in knowledge are exposed, with suggestions for research to address limitations in current understandings. We take a look at the 2017 classification of the periodontal diseases and discuss the importance of close liaison between the specialties of oral medicine and of periodontology in the management of the many oral diseases, apart from the common forms primarily related to oral biofilm, affecting the gingivae and other parts of the periodontium., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- 2019
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5. Impact of oral potentially malignant disorders on quality of life.
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Tadakamadla J, Kumar S, Lalloo R, Gandhi Babu DB, and Johnson NW
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- Activities of Daily Living, Adult, Dental Health Surveys, Female, Humans, India, Leukoplakia, Oral physiopathology, Leukoplakia, Oral psychology, Lichen Planus, Oral physiopathology, Lichen Planus, Oral psychology, Male, Mouth Diseases therapy, Mouth Neoplasms therapy, Oral Health, Oral Submucous Fibrosis physiopathology, Oral Submucous Fibrosis psychology, Surveys and Questionnaires, Cell Transformation, Neoplastic, Mouth Diseases physiopathology, Mouth Diseases psychology, Mouth Neoplasms physiopathology, Mouth Neoplasms psychology, Quality of Life
- Abstract
Background: Oral potentially malignant disorders (OPMDs) could have a significant psychological impact on patients, principally because of the unknown risk of malignant transformation, while the physical and functional impairments could differ. This study aimed to assess the impact of three different OPMDs and their disease stages on the quality of life (QoL) of affected patients., Methods: Oral leukoplakia (OL), oral lichen planus (OLP) and oral submucous fibrosis (OSF) patients who were undergoing treatment at an oral medicine clinic of a dental teaching hospital in India were the study population. All subjects completed the recently developed OPMDQoL questionnaire and a short form 12 item (version 2) health survey questionnaire (SF-12v2). OPMDQoL questionnaire consists of 20 items over four dimensions. A higher score denotes poor OHRQoL. SF-12v2 has two components, a Physical Component Summary (PCS) and Mental Component Summary (MCS)., Results: A total of 150 subjects (50 each of OL, OLP and OSF) participated. OL patients (37.7 ± 7.9) reported significantly better OPMDQoL scores than OLP (47.3 ± 5.8) and OSF (45.4 ± 9.2) patients. OLP patients reported significant problems in obtaining a clear diagnosis for their condition, more so than the other OPMDs. OL patients reported fewer problems for the dimension, "physical impairment and functional limitations" than the OLP and OSF patients. A significant trend was observed with the overall OPMDQoL and MCS, deteriorating as the disease stage increased., Conclusions: OLP and OSF have a significant impact on the QoL of affected individuals: OL less so. Increasing stage of the disease is associated with worsening QoL., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- 2018
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6. Hyderabad declaration 2014.
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Challacombe SJ, Tappuni AR, Ranganathan K, Robinson PG, Williams DM, and Johnson NW
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- Humans, India, Acquired Immunodeficiency Syndrome complications, Health Services Accessibility, Mouth Diseases virology, Oral Health, Professional Role
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- 2016
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7. Comorbidities associated with HIV and antiretroviral therapy (clinical sciences): a workshop report.
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Vernon LT, Jayashantha P, Chidzonga MM, Komesu MC, Nair RG, and Johnson NW
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- Anti-Retroviral Agents adverse effects, CD4 Lymphocyte Count, Comorbidity, HIV physiology, HIV Infections immunology, Healthcare Disparities, Humans, Virus Shedding, Anti-Retroviral Agents therapeutic use, HIV Infections drug therapy, HIV Infections epidemiology, Mouth Diseases chemically induced, Mouth Neoplasms epidemiology, Oropharyngeal Neoplasms epidemiology
- Abstract
In the era of combination antiretroviral therapy (ART), parsing out the effects of HIV vs ART on health outcomes is challenging. Nadir CD4 count, a marker of the extent of immunosuppression, has significant long-term impact on an array of disease states in HIV+ persons; however, in the dental literature, reporting of pre-ART exposure to immunosuppression has largely been ignored and this limits the validity of previous studies. In Workshop A1, we explain fully the importance of nadir CD4, pre-ART immunosuppression, and identify a need to include specific variables in future research. The questions posed herein are challenging, typically not neatly addressed by any one study and require integration of the latest evidence from the wider medical literature. We consider topics beyond the confines of the oral cavity and examine oral health in the complex context of ART era HIV immunopathophysiology. We depict how variability in geographic setting and time period (pre- and post-ART era) can impact oral conditions - influencing when HIV infection was detected (at what CD4 count), the type and timing of ART as well as social determinants such as strong stigma and limited access to care. We hope our Workshop will stir debate and energize a rigorous focus on relevant areas of future research in HIV/AIDS., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- 2016
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8. Psychometric Properties of Translation of the Child Perception Questionnaire (CPQ11-14) in Telugu Speaking Indian Children.
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Kumar S, Kroon J, Lalloo R, and Johnson NW
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- Adolescent, Child, Dental Health Surveys, Female, Humans, India, Male, Mouth Diseases prevention & control, Oral Health, Oral Hygiene, Patient Education as Topic, Perception, Psychometrics, Quality of Life, Translations, Mouth Diseases diagnosis, Surveys and Questionnaires
- Abstract
Oral health related quality of life research among children in India is still nascent and no measures have been validated to date. Although CPQ11-14 has been previously used in studies from the Indian sub-continent, the instrument has never been tested for cross-cultural adaptability. This study aimed to assess the validity and reliability of CPQ11-14 in Telugu speaking Indian school children. Primary school children of Medak district, Telangana State, India, were recruited by a multi-stage probability sampling method. The translated questionnaire was initially pilot tested on a small subset of children (n = 40). Children with informed consent from parents (N = 1342) were then provided with questionnaires containing the Telugu translation of CPQ11-14, followed by a clinical examination conducted by a single examiner, using Basic WHO survey methods for dental caries, malocclusion, and Dean's Fluorosis index. Children (n = 161) in randomly chosen schools were re-administered the same questionnaire after a two week interval to test reliability of CPQ11-14 on repeated administrations. Internal consistency and test-retest reliability as determined by Cronbach's alpha and Intra-class correlation coefficient for overall CPQ11-14 scale were 0.925 and 0.923, respectively. CPQ11-14 discriminated between the categories of fluorosis and malocclusion while its discriminant validity with respect to dental caries was limited. CPQ11-14 also demonstrated good construct validity with both overall CPQ11-14 and its subscales having significant positive correlation with global ratings of oral health and overall wellbeing, even after adjusting for confounding variables. CPQ11-14 had a correlation of 0.405 with self-evaluated oral health and 0.407 with self-evaluated impact of oral health on overall wellbeing. In conclusion, Telugu translation of CPQ11-14 demonstrated good internal consistency and excellent reliability on repeated administrations after two weeks. It also exhibited good discriminant and construct validity.
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- 2016
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9. Quality of life in patients with oral potentially malignant disorders: a systematic review.
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Tadakamadla J, Kumar S, and Johnson NW
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- Humans, Cell Transformation, Neoplastic pathology, Mouth Diseases pathology, Precancerous Conditions pathology, Quality of Life
- Abstract
There is a paucity of literature on quality of life (QoL) in patients with oral potentially malignant disorders (OPMDs) despite these conditions being relatively common, chronic, and potentially debilitating. The aim of this paper is to systematically review the literature on QoL in patients with OPMDs. A search from electronic databases PUBMED, MEDLINE, and CINAHL Plus retrieved 180 titles after removing duplicates, and a further 4 papers were identified by hand searching. Study of the abstracts identified 25 truly relevant articles, which were studied in full. Of these, 14 met our strict inclusion criteria. Most studies were cross-sectional; most were from Europe and have evaluated QoL in patients with oral lichen planus (OLP). The findings differ but, overall, do not provide evidence that patients with OPMDs have a poorer QoL compared with healthy patients. Several things may explain this apparently surprising conclusion. First, the quality of most articles was moderate or weak; second, most studies assessed QoL only in patients with OLP and cannot be generalized to all patients with OPMDs; last, direct comparisons between patients with OPMD and healthy controls were rarely included. The validity of the QoL instrument used for patients with OLP was frequently inadequate., (Copyright © 2015 Elsevier Inc. All rights reserved.)
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- 2015
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10. Re: national prevalence of oral HPV infection and related risk factors in the U.S. adult population.
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Prabhu SR, Wilson D, and Johnson NW
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- Adult, Alphapapillomavirus classification, Humans, Mouth Diseases epidemiology, Papillomavirus Infections transmission, Prevalence, Risk Factors, Saliva virology, United States epidemiology, Alphapapillomavirus physiology, Mouth Diseases virology, Papillomavirus Infections epidemiology
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- 2013
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11. Mucosal fluids and biomarkers of clinical disease: workshop 3B.
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Johnson NW, Malamud D, Reznik D, Speicher DJ, and Phelan J
- Subjects
- Biomarkers analysis, Focus Groups, HIV Infections complications, HIV-1 isolation & purification, Herpesvirus 8, Human isolation & purification, Humans, Immunologic Tests, Lab-On-A-Chip Devices, Mass Screening methods, Mouth Diseases complications, Mouth Diseases virology, Mouth Neoplasms complications, Mouth Neoplasms diagnosis, Mouth Neoplasms virology, Saliva chemistry, Sarcoma, Kaposi complications, Sarcoma, Kaposi virology, Sensitivity and Specificity, HIV Infections diagnosis, Mouth Diseases diagnosis, RNA, Viral analysis, Saliva virology, Sarcoma, Kaposi diagnosis
- Abstract
Diagnostic tests for a range of oral and systemic diseases using fluids sampled from the mouth are under intense investigation and are increasingly being used. Methods exist for identification of HIV antibody and nucleic acid and for other viral infections of the mouth, such as Kaposi sarcoma herpes virus or human herpesvirus-8, which may coexist with HIV. A number of commercial test kits are available, with variable evidence of sensitivity, specificity, and utility. There is intense research on sophisticated but potentially facile handheld in-office devices for many disease markers. Challenges to their uptake require well-designed studies on their practical reliability and utility, with appropriate controls. A range of ethical, social, and political issues need to be addressed in such studies.
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- 2011
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12. The mouth in HIV/AIDS: markers of disease status and management challenges for the dental profession.
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Johnson NW
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- AIDS-Related Opportunistic Infections diagnosis, Acquired Immunodeficiency Syndrome transmission, Adult, Alphapapillomavirus classification, Candidiasis, Oral diagnosis, Dental Caries diagnosis, HIV Infections transmission, Herpesviridae Infections diagnosis, Humans, Infection Control, Dental, Papillomavirus Infections diagnosis, Periodontal Diseases diagnosis, Tuberculosis diagnosis, Acquired Immunodeficiency Syndrome complications, HIV Infections complications, Mouth Diseases complications
- Abstract
There are over 30 million people in the world with HIV infection and, whilst the rate of new infections is slowing, this number continues to grow. Although in Australia the overall prevalence of HIV infection in adults aged 15-49 is officially estimated at only 0.2%, representing less than 20,000 people living with HIV and AIDS, our geographical area contains populations with prevalences exceeding 10 times this. Oral health professionals must therefore practise safe, standard infection control at all times and be aware of the oral manifestations of HIV disease. These are predominantly opportunistic infections with fungi such as Candida albicans or with viruses of the herpes family, particularly herpes simplex, herpes zoster and Epstein-Barr virus infections. Warts or papillomas may arise due to human papilloma viruses--even in individuals on effective antiretroviral therapy. Rare types of fungal infection can occur, and severe bacterial infections, notably tuberculosis, are an ever-present risk. Susceptibility to periodontal breakdown is somewhat enhanced by the effects of HIV disease itself, and caries activity may increase because the patient neglects attention to diet and oral hygiene. Restorative and periodontal care need, therefore, to be maintained at a high level. Oral opportunistic infections cause much distress and the diagnosis and management of these is the responsibility of our profession.
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- 2010
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13. (A2) Oral health and general health.
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Johnson NW, Glick M, and Mbuguye TN
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- Dental Caries complications, HIV Infections psychology, Hepatitis, Viral, Human complications, Humans, Mouth Diseases psychology, Social Behavior, Tuberculosis, Oral complications, Xerostomia complications, HIV Infections complications, Health Status, Mouth Diseases complications, Oral Health, Quality of Life
- Abstract
The interactions between oral and systemic health are bi-directional and complex, involving many pathways. Regarding health as not merely the absence of disease, but as a state of total well-being, these interactions profoundly influence the progress of many diseases, and the quality of life and economic performance of HIV-infected individuals and populations. The evidence base for specific interactions is currently weak, partly because few good-quality studies have been published, partly because of the naïveté of the instruments currently available for recording these interactions and their inherent complexity. Recording quality of life should be a fundamental aspect of all future studies. The most significant conclusion of this Workshop is the need for all involved in oral health research and oral health care to be seen as, and to act as, essential partners in comprehensive care for whole patients and communities.
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- 2006
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14. Oral manifestations of an HIV positive cohort in the era of highly active anti-retroviral therapy (HAART) in South London.
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Eyeson JD, Tenant-Flowers M, Cooper DJ, Johnson NW, and Warnakulasuriya KA
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- Adult, Aged, CD4 Lymphocyte Count, Female, HIV Infections complications, HIV-1 isolation & purification, Humans, Logistic Models, Male, Middle Aged, Prevalence, Protease Inhibitors therapeutic use, Reverse Transcriptase Inhibitors therapeutic use, Risk Factors, Viral Load, Antiretroviral Therapy, Highly Active, HIV Infections drug therapy, HIV Infections epidemiology, Mouth Diseases complications, Mouth Diseases epidemiology
- Abstract
Background: Human Immunodeficiency Virus (HIV) infection is associated with oral manifestations of diagnostic and prognostic importance. With the advent of Highly Active Anti-retroviral Therapy (HAART) there is anecdotal evidence to suggest that the prevalence of oral lesions has declined. The number of prevalence studies, carried out in the era of HAART is, however, meagre. Our aim was to study the prevalence of the oral manifestations of HIV in a population, predominantly on HAART, attending a Genito-Urinary Medicine Centre in South London., Methods: This cross sectional study included 203 adult volunteers, comprising 76% males and 24% females. One third of the subjects were from the predominantly African or Afro- Caribbean ethnic minority groups resident in London. The relationship between the prevalence of oral lesions and demographic variables, therapeutic regimes, viral load and CD4 counts were evaluated., Results: One hundred (49%) of the patients had no detectable oral lesions. Oral lesions detected most frequently included oral hairy leukoplakia (9.9%), HIV associated periodontal diseases (9.9%) and oral candidiasis (4.9%). Three subjects had multiple papillomatous growths. Most cases (n = 17/20) of oral hairy leukoplakia were in individuals with a detectable (> 400 copies/ml) plasma RNA viral load. The majority (n = 8/10) of our patients with oral candidiasis had a plasma RNA viral load > 10,000 copies/ml and half (n = 5/10) had a CD4 count < 200 cells/mm3. Logistic regression analysis suggested that the presence of an oral lesion was not associated with any demographic features except for periodontal diseases which were associated with tobacco smoking (P = 0.023)., Conclusions: The prevalence of so called 'strongly associated' oral lesions of HIV is low in this South London HIV-infected population on HAART, and the relative frequency is different from that cited in the literature from the pre-HAART era. The oral lesions detected were found mostly in people with low CD4 counts and high HIV-1 RNA viral loads, suggesting they were very immunocompromised, not on, or declining therapy, or that their therapy was failing.
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- 2002
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15. Oropharyngeal pemphigus in a patient with chronic hepatitis C during interferon alpha-2a therapy.
- Author
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Marinho RT, Johnson NW, Fatela NM, Serejo FS, Glória H, Raimundo MO, Velosa JF, Ramalho FJ, and Moura MC
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- Adult, Antiviral Agents therapeutic use, Female, Humans, Interferon alpha-2, Interferon-alpha therapeutic use, Recombinant Proteins, Antiviral Agents adverse effects, Hepatitis C, Chronic drug therapy, Interferon-alpha adverse effects, Mouth Diseases chemically induced, Pemphigus chemically induced, Pharyngeal Diseases chemically induced
- Abstract
There are a few reports in the literature concerning pemphigus induced by interferon given for hepatitis C. We present the case of a 28-year-old woman with post-transfusional chronic hepatitis C who developed ulcers and vesicles on her tongue, cheeks, posterior oropharynx and vocal cords 5 months after beginning treatment with recombinant interferon alpha-2a. The direct and indirect immunofluorescence was diagnostic of pemphigus vulgaris. The drug was promptly withdrawn; the patient was medicated with prednisolone and azathioprine and recovered only 3 months later. Although there are several publications describing the occurrence of other autoimmune diseases in patients receiving interferon alpha therapy, this is the first report of a pemphigus induced by interferon in hepatitis C patients involving oropharyngeal and laryngeal mucosae without cutaneous involvement.
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- 2001
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16. Prevalence and incidence of oral lesions--the changing scene.
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Eyeson JD, Warnakulasuriya KA, and Johnson NW
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- AIDS-Related Opportunistic Infections epidemiology, HIV Infections drug therapy, HIV Infections immunology, Humans, Immune Tolerance, Incidence, Prevalence, Antiretroviral Therapy, Highly Active, HIV Infections epidemiology, Mouth Diseases epidemiology
- Abstract
A range of oral mucosal and periodontal lesions is associated with HIV infection and HIV disease progression. These are often symptomatic and require treatment in themselves, and also have a diagnostic and prognostic role in the management of the underlying HIV disease. These lesions have been broadly divided into: (a) those strongly associated with HIV such as oral candidoses, oral hairy leukoplakia and Kaposi's sarcoma; (b) those less strongly associated such as swellings of the major salivary glands; and (c) those least commonly associated such as recurrent aphthous ulcers. Overall the prevalence and severity of these lesions inversely correlate with the level of immunosuppression. With the passage of time, there has been improved understanding of the disease pathogenesis resulting in the development of new drugs to combat this infection. Medication has changed from monotherapy to current triple combination therapy (Highly Active Anti-Retroviral Therapy). This review looks at the impact of changing therapy on the prevalence of the various oral lesions associated with HIV. It finds a decrease in the prevalence of the oral lesions in the era of combination therapy as compared to earlier periods. It also shows a change in the types of lesions which predominate with those previously placed amongst the strongly associated lesions no longer being predominant in the era of combination therapy where such treatment is available.
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- 2000
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17. Tobacco and oral disease. EU-Working Group on Tobacco and Oral Health.
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Johnson NW and Bain CA
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- Cardiovascular Diseases etiology, Dentists, Focus Groups, Humans, Lung Diseases, Obstructive etiology, Smoking Cessation, European Union, Mouth Diseases etiology, Mouth Neoplasms etiology, Plants, Toxic, Smoking adverse effects, Nicotiana adverse effects
- Published
- 2000
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18. Oral lesions and conditions associated with human immunodeficiency virus infection in 300 south Indian patients.
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Ranganathan K, Reddy BV, Kumarasamy N, Solomon S, Viswanathan R, and Johnson NW
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- Acquired Immunodeficiency Syndrome complications, Adolescent, Adult, Age Factors, Aged, CD4 Lymphocyte Count, Candidiasis, Oral diagnosis, Cheilitis diagnosis, Child, Child, Preschool, Disease Progression, Female, Gingivitis diagnosis, HIV Seropositivity, Humans, India, Infant, Leukoplakia, Hairy diagnosis, Male, Mass Screening, Middle Aged, Oral Submucous Fibrosis diagnosis, Oral Ulcer diagnosis, Periodontitis diagnosis, Pigmentation Disorders diagnosis, Prevalence, AIDS-Related Opportunistic Infections diagnosis, HIV Infections complications, Mouth Diseases diagnosis
- Abstract
Background: Human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) is a major health problem in India. The National AIDS Control Organisation (NACO) of India reports a seropositivity of 25.03 per thousand for the whole country, as of October 1999. In spite of this high prevalence there are very few reports of oral lesions and conditions in Indian HIV/AIDS patients, which are important in early diagnosis and management of these patients., Objective and Setting: The present report describes the oral lesions in 300 HIV positive symptomatic patients presenting to us at RAGAS-YRG CARE, a non-governmental organisation in Chennai, South India, over a period of 9 months in 1998., Method: Lesions were diagnosed on clinical appearance using international criteria., Results: Of the 300 patients 89% had acquired the infection through heterosexual contact. There were 205 males and 95 females, aged from 7 months to 72 years. Forty-seven percent of the patients were in the age group 21-30 years. CD4 counts were ascertained for 105 patients, 64 (62%) had CD4 counts < or = 200. A total of 217 (72%) of the 300 patients had some oral lesion when examined. Gingivitis (47%) and pseudomembranous candidiasis (33%) were the most common oral lesions. The other oral lesions seen were oral mucosal pigmentation (23%), erythematous candidiasis (14%), periodontitis (9%), angular cheilitis (8%), oral ulcers (3%), oral hairy leukoplakia (3%), hyperplastic candidiasis (1%), oral submucous fibrosis (2%) and one case of leukoplakia., Conclusions: Oral lesions occur commonly in HIV infection. A comprehensive oral examination may not only suggest HIV disease but may also be useful in monitoring the disease progression. This is a cost-effective procedure, which may be useful in screening large populations in developing countries like India.
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- 2000
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19. Characterization of an amorphous deposit in the lamina propria in oral snuff users in the Sudan as collagen.
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Idris AM, Warnakulasuriya KA, Ibrahim YE, Hartley R, Paterson K, Patel B, Nilsen R, and Johnson NW
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- Adult, Amylases, Amyloid analysis, Antibodies, Basement Membrane pathology, Basement Membrane ultrastructure, Biopsy, Carbohydrates analysis, Coloring Agents, Congo Red, Elastin analysis, Epithelium pathology, Epithelium ultrastructure, Fibrin analysis, Fibroblasts metabolism, Fibroblasts pathology, Glycogen analysis, Humans, Hyalin ultrastructure, Middle Aged, Mucins analysis, Periodic Acid-Schiff Reaction, Salivary Ducts pathology, Salivary Glands pathology, Sudan, Collagen ultrastructure, Mouth Diseases pathology, Plants, Toxic, Tobacco, Smokeless adverse effects
- Abstract
Histological and ultrastructural features of 25 oral snuff dipper's lesions with distinctive subepithelial hyaline deposits were investigated. Periodic acid-Schiff reaction with and without diastase digestion demonstrated the presence of glycogen and other carbohydrates, but histochemical stains for normal collagen, elastin and fibrin showed a weak variable reactivity of the deposit. Although in 7/25 cases the deposit was in close proximity to labial salivary glands and on occasions ducts were found within the deposit, the presence of mucin was not a consistent feature. Congo red staining and immunohistochemical investigation with an anti-amyloid antibody did not support the previous contention that such deposits were amyloid in nature. Immunohistochemically, collagen antibodies also provided negative results, but ultrastructural features of three biopsies studied suggest that the bulk of this deposit is made up of collagen, as typical cross-striated fibrils were found. The pathogenesis of this deposit could therefore be interpreted as over-production and/or reduced turnover of collagen by resident fibroblasts, which is further altered by the ingredients of toombak. The deposit does not appear to be a secretory product.
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- 1998
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20. Oral health in alcohol misusers.
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Harris CK, Warnakulasuriya KA, Johnson NW, Gelbier S, and Peters TJ
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- Adult, Aged, Body Mass Index, Carcinoma etiology, DMF Index, Dental Plaque Index, Ethanol administration & dosage, Female, Humans, London epidemiology, Male, Middle Aged, Mouth Mucosa injuries, Mouth Neoplasms etiology, Nutrition Disorders epidemiology, Nutritional Status, Periodontal Index, Periodontal Pocket epidemiology, Prevalence, Smoking epidemiology, Tooth Attrition epidemiology, Tooth Injuries epidemiology, Tooth Loss epidemiology, United Kingdom epidemiology, Alcoholism epidemiology, Mouth Diseases epidemiology, Tooth Diseases epidemiology
- Abstract
One hundred and seven chronic alcohol misusers (mean age 42.9 years; range 21-65 years; 80 males) attending four centres in South East London were interviewed on their current and past alcohol consumption. Their nutritional status (body mass index (BMI) and mid arm muscle circumference) was also recorded. Each subject completed a dental and oral mucosal examination. Ninety four per cent of the sample consumed greater than 50 units of alcohol per week and 80 per cent greater than 100 units of alcohol per week. Smoking and alcohol misuse were found to be related, 81 per cent reporting both habits. Neither plaque index scores or mean subject pocket depths were correlated with alcohol consumption but both were positively correlated with the frequency and duration of smoking. Overall mean DMFT was 15.4; age specific mean DMFT and tooth loss of the sample were closely similar to the 1988 United Kingdom adult dental health survey data. The prevalence and severity of tooth wear and attrition were greater in the sample than levels described in the literature and these dental features may prove useful markers to the practitioner. Trauma to teeth and oral mucosae was noted in 25 per cent of the sample. Seven oral mucosal lesions (including one treated carcinoma) were detected; mucosal trauma could have acted as a co-factor. Furthermore, 21 per cent of the alcoholics were malnourished (BMI < 20). It is concluded that, unlike several reports from the United States, dental health in this sample of alcoholics is not compromised; however mucosal health is a cause for concern.
- Published
- 1996
21. Epstein-Barr virus (EBV) associated lesions of the head and neck.
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Boulter A, Johnson NW, Birnbaum W, and Teo CG
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- Burkitt Lymphoma virology, Carcinoma virology, Herpesvirus 4, Human genetics, Herpesvirus 4, Human immunology, Herpesvirus 4, Human physiology, Humans, Leukoplakia, Hairy virology, Lymphoma virology, Lymphoproliferative Disorders virology, Nasopharyngeal Neoplasms virology, Opportunistic Infections virology, Sjogren's Syndrome virology, Virus Latency, Head and Neck Neoplasms virology, Herpesvirus 4, Human pathogenicity, Mouth Diseases virology
- Published
- 1996
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22. Toombak-associated oral mucosal lesions in Sudanese show a low prevalence of epithelial dysplasia.
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Idris AM, Warnakulasuriya KA, Ibrahim YE, Nielsen R, Cooper D, and Johnson NW
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- Adolescent, Adult, Aged, Aged, 80 and over, Alkalies adverse effects, Burns, Chemical pathology, Carcinogens adverse effects, Cell Transformation, Neoplastic pathology, Epithelium pathology, Female, Humans, Leukoplakia, Oral pathology, Lip pathology, Male, Middle Aged, Mouth Diseases classification, Mouth Diseases etiology, Mouth Neoplasms pathology, Nitrosamines adverse effects, Prevalence, Risk Factors, Sodium Bicarbonate adverse effects, Sudan, Sweden, Time Factors, Mouth Diseases pathology, Mouth Mucosa pathology, Plants, Toxic, Tobacco, Smokeless adverse effects
- Abstract
Clinical (n = 281) and histopathological (n = 141) characteristics of toombak-associated oral mucosal lesions detected in an epidemiological study in northern Sudan in 1992/93 are described. The lesional site in the majority of toombak users was the anterior lower labial groove and the lower labial mucosa. 4 degrees (1-4) of clinical severity of lesions, similar to those used to characterise Swedish snuff-dipper's lesion, were applied. An association between the severity of mucosal lesions and a longer lifetime duration (> 10 years) of toombak use was found, but the severity was not related to the daily frequency of the habit. Parakeratosis, pale surface staining of the epithelium and basal cell hyperplasia were commonly observed, but epithelial dysplasia was infrequent (10/141). The most significant observation was a PAS-positive amorphous deposit between the lamina propria and the submucosa, found in 25/141 biopsies. The clinical and histopathological features of toombak lesions are closely similar to Swedish moist snuff-dipper's lesions and this may reflect the high alkalinity of these products, resulting in an alkaline burn on the oral mucosa following chronic exposure. The low prevalence of epithelial dysplasia implies a low risk of malignant transformation. Nevertheless, the high concentrations of tobacco-specific nitrosamines present in toombak, and the high prevalence of oral cancer in Sudan, mandate biopsy and careful histopathological analysis of any such lesions detected in habitues.
- Published
- 1996
- Full Text
- View/download PDF
23. Orofacial involvement by systemic mycoses in HIV infection.
- Author
-
Scully C, Almeida OP, Warnakulasuriya KA, and Johnson NW
- Subjects
- Humans, Mycoses etiology, AIDS-Related Opportunistic Infections microbiology, Cryptococcosis etiology, Mouth Diseases etiology
- Published
- 1995
- Full Text
- View/download PDF
24. Epithelial cells kinetics. A review of methods of study and their application to oral mucosa in health and disease. Part B. Comparison of cell kinetics in normal and abnormal epithelia.
- Author
-
Scragg MA and Johnson NW
- Subjects
- Animals, Carcinoma, Squamous Cell pathology, Cell Division, Cricetinae, Epithelial Cells, Female, Gastrointestinal Neoplasms pathology, Humans, Kinetics, Leukoplakia, Oral pathology, Lichen Planus pathology, Mice, Neoplasms therapy, Neoplasms, Experimental pathology, Pathology, Prognosis, Rats, Skin Neoplasms pathology, Uterine Cervical Neoplasms pathology, Mouth Diseases pathology, Mouth Mucosa cytology, Mouth Neoplasms pathology
- Abstract
In Part A, the techniques most commonly used to study epithelial cell kinetics and their suitability for use in man are reviewed. In Part B, the application of such methods to comparative studies of normal and abnormal oral epithelial of both man and experimental animals is examined. Claims regarding the possible prognostic value of LI's or MI's of biopsies of potentially or overtly malignant human oral lesions are also considered. Normal and abnormal kinetic data for other lining epithelia, e.g., skin, uterine cervix and gastrointestinal mucosa are assessed where they provide a better illustration of some of the problems arising in such comparative investigations. Finally, the present and likely future areas in which cell kinetic studies may provide a guide to expected tumour prognosis and optimum treatment are summarized.
- Published
- 1982
- Full Text
- View/download PDF
25. Oral pyogenic granuloma as a complication of pregnancy and the use of hormonal contraceptives.
- Author
-
Mussalli NG, Hopps RM, and Johnson NW
- Subjects
- Female, Granuloma chemically induced, Humans, Mouth Diseases chemically induced, Pregnancy, Contraceptives, Oral adverse effects, Contraceptives, Oral, Hormonal adverse effects, Granuloma etiology, Mouth Diseases etiology, Pregnancy Complications
- Published
- 1976
- Full Text
- View/download PDF
26. Potential applications of anti-keratin antibodies in oral diagnosis.
- Author
-
Morgan PR, Shirlaw PJ, Johnson NW, Leigh IM, and Lane EB
- Subjects
- Antigens, Surface genetics, Gene Expression Regulation, Humans, Mouth Diseases genetics, Antibodies, Monoclonal, Keratins genetics, Mouth Diseases diagnosis
- Abstract
Recent progress in understanding the biology of keratins together with the development of monoclonal antibodies to individual keratin proteins provide the foundation for studying keratin expression in normal and pathological oral epithelia. Areas of oral pathology in which the examination of epithelial keratin profiles may yield information of potential diagnostic value are discussed. Examples of altered keratin expression in epithelial dysplasia, oral cancer and odontogenic cysts and tumours are presented. Immunocytochemical demonstration of individual keratins can clarify the composition of complex epithelia and may help to establish epithelial lineage or indicate progression changes in tumours. Some problems in the application and interpretation of keratin immunocytochemistry are also considered.
- Published
- 1987
- Full Text
- View/download PDF
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