Vertical gaze palsy and intraoral numbness in a patient with neuro-psychiatric systemic lupus erythematosus: A case report and literature review

We report, to the best of our knowledge, the first case of neuropsychiatric systemic lupus erythematosus with clinical presentation of bilateral upward gaze palsy and intraoral numbness. Magnetic resonance imaging of the brain was able to identify the pathogenic lesion at the left side of midbrain, involving the vertical gaze center and sensory pathways for innervating the buccal and hard palate mucosa. A course of aggressive immunosuppressive treatment resulted in prompt resolution of gaze palsy and the midbrain lesion.

MORPHOLOGY OF GLANDULAR AREA OF HARD PALATE MUCOSA IN INTACT ALBINO RATS

Some reports state that the morphology, histochemistry and innervation of mucous membrane in rats are quite similar to that in humans. Most experimental studies on the impact of certain factors on the human body involve laboratory animals, rats in particular. In our previous experimental studies we used rats to study the effect of acrylic monomer on salivary glands in order to further extrapolate data to the morphological features of minor salivary glands of rats and humans. This study was aimed at investigating morphology of glandular area of the hard palate mucosa of intact albino rats with subsequent extrapolation of the results obtained to human body. The experimental studies were conducted on adult Wistar rats aged 1 to 1.5 years. The light microscopy (slight magnification) of transverse sections of the hard palate mucosa samples of albino rats revealed the mucous membrane and well-developed submucous layer with numerous minor salivary glands within its structure. The findings confirm the similarity between the structure of minor salivary glands of rats and humans that supports the rational choice of experimental animals for subsequent extrapolation of the resulting data.

CLINICAL MANIFESTATIONS OF MEASLES IN GENERAL DENTAL PRACTICE

Despite of general tendency towards the decrease in the incidence of measles and rubella in recent years, there have been registered several outbreaks of these infections among young adults and adolescents at present. This case report describes a clinical case of measles suspected at the dental examination. The aim of this study is to make a clinical diagnosis of the patient and to draw attention of the dental professional and general physicians to the relevance of this problem. The prodromal phase of measles can be quite variable and mimic the clinical picture of other diseases, as it happened in our case, when the patient went to the dental office for symptoms of acute serous periodontitis. Belsky — Filatov — Koplik’s spots are reported to usually appear in 37.7-64.3% of cases (at the beginning of the measles rash period). In 57.5% of cases there is spot enanthema on the soft palate mucosa. Our patient presented only signs of acute catarrhal stomatitis. We would like to emphasize that 100% of patients with measles have catarrhal syndrome manifested with moderate signs of nasopharyngitis (nasal congestion, sore throat, dry cough), and only 42.8% suffer from conjunctivitis. This makes it difficult to diagnose this disease in its early period or to make differential diagnosis in the prodromal phase. An infected person can transmit the virus within 4 days before and after the rash appears that is very dangerous for surrounding people and for healthcare workers in particular. When making a diagnosis, it is important to remember that measles is a clinical diagnosis, and there is no opportunity to carry out an indicative rapid diagnosis (as with the flu), therefore every doctor should consider the issue of timely vaccination, and promotes preventive and educational work among the population.

Presence of Different Candida Species at Denture Wearers With Type 2 Diabetes and Clinically Healthy Oral Mucosa-Pilot Study

Summary Background/Aim: The aim of this study was to examine prevalence of different Candida spp. at diabetics and nondiabetics wearing dentures without clinical signs of Denture Stomatitis (DS) and to study if some local and systematic factors are confounders for harboring Candida at these subjects. Material and Methods: Total of 60 subjects wearing partial or complete upper acrylic denture having at least half of palatal mucosa covered by denture were selected and stratified into three experimental groups: systematically health subjects; patients with diagnosed Type 2 Diabetes (T2D) and good glycoregulation; and T2D subjects with poorly regulated blood sugar level. Cotton swab samples were obtained from each patient from hard palate mucosa and denture surface. Swab cultures were made on Sabouraud dextrose agar and ChromAgar Media for distinciton of various Candida spp. Density growth was also measured. Results: Frequency of Candida spp. findings were similar between groups. At healthy subjects, only C.albicans was detected. At diabetics, C.albicans was the most common isolated species, followed by C.glabrata and C.tropicalis. Negative finding of yeasts on palatal mucosa, but positive on denture surface were detected at all groups, with the highest frequency (33.4%) at diabetics with poor glycoregulation. Denture surface was heavier colonized than hard palate mucosa. Duration of diabetes in years were only independent predictors for harboring Candida spp. at denture surface (Exp B=1.186, CI=1.047-1.344, p=0.007). Conclusions: Prosthesis of denture wearers without DS may serve as reservoir of Candida spp. Presence of more pathogenic and resistant non-albicans species are related to diabetics, even without clinical signs of DS.