Practical use of povidone-iodine antiseptic in the maintenance of oral health and in the prevention and treatment of common oropharyngeal infections.

AIMS: To better inform medical practitioners on the role of antiseptics in oropharyngeal health and disease, this article focuses on povidone-iodine (PVP-I), an established and widely-available antiseptic agent. METHODOLOGY: Review of the anti-infective profile, efficacy and safety of PVP-I in managing common upper respiratory tract infections such as the common cold, influenza and tonsillo-pharyngitis, as well as oral complications resulting from cancer treatment (oral mucositis), and dental conditions (periodontitis, caries). RESULTS: Antiseptics with broad-spectrum anti-infective activity and low resistance potential offer an attractive option in both infection control and prevention. While there is some evidence of benefit of antiseptics in a variety of clinical settings that include dental and oral hygiene, dermatology, oncology, and pulmonology, there appears to be discordance between the evidence-base and practice. This is especially apparent in the management and prevention of oropharyngeal infections, for which the use of antiseptics varies considerably between clinical practices, and is in marked contrast to their dermal application, where they are extensively used as both a prophylaxis and a treatment of skin and wound infections, thus minimising the use of antibiotics. CONCLUSION: The link between oral and oropharyngeal health status and susceptibility to infection has long been recognised. The high rates of antibiotic misuse and subsequent development of bacterial resistance (e.g. increasing vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA)) in large parts of the world, especially across Asia Pacific, highlight the need for identifying alternative antimicrobials that would minimise the use of these medications. This, together with recent large-scale outbreaks of, for example, avian and swine influenza virus, further underline the importance of an increasing armamentarium for infection prevention and control.

Lovastatin decreases the synthesis of inflammatory mediators during epileptogenesis in the hippocampus of rats submitted to pilocarpine-induced epilepsy.

Statins may act on inflammatory responses, decreasing oxidative stress and also reducing brain inflammation in several brain disorders. Epileptogenesis is a process in which a healthy brain becomes abnormal and predisposed to generating spontaneous seizures. We previously reported that lovastatin could prevent neuroinflammation in pilocarpine-induced status epilepticus (SE). In this context, this study investigated the long-lasting effects of lovastatin on mRNA expression of proinflammatory cytokines (interleukin-1ß, tumor necrosis factor α, interleukin-6) and the antiinflammatory cytokine IL-10 in the hippocampus during epileptogenesis by immunohistochemistry and real time polymerase chain reaction (RT-PCR) during the latent and chronic phases in the epilepsy model induced by pilocarpine in rats. For these purposes, four groups of rats were employed: saline (CONTROL), lovastatin (LOVA), pilocarpine (PILO), and pilocarpine plus lovastatin (PILO+LOVA). After pilocarpine injection (350mg/kg, i.p.), the rats were treated with 20mg/kg of lovastatin via an esophagic probe 2h after SE onset. All surviving rats were continuously treated during 15days, twice/day. The pilocarpine plus lovastatin group showed a significant decrease in the levels of IL-1ß, TNF-α, and IL-6 during the latent phase and a decreased expression of IL-1ß and TNF-α in the chronic phase when compared with the PILO group. Moreover, lovastatin treatment also induced an increased expression of the antiinflammatory cytokine, IL-10, in the PILO+LOVA group when compared with the PILO group in the chronic phase. Thus, our data suggest that lovastin may reduce excitotoxicity during epileptogenesis induced by pilocarpine by increasing the synthesis of IL-10 and decreasing proinflammatory cytokines in the hippocampus.

Infection with uncommon subgroup Y Neisseria meningitidis in patients with systemic lupus erythematosus.

The association of Neisseria meningitidis infection and systemic lupus erythematosus (SLE) is uncommon. We describe here three patients with SLE who developed disseminated meningococcal disease. Each patient had long-standing SLE and was receiving treatment with prednisone. Furthermore, each patient showed serum hypocomplementemia at the time of the infection. N. meningitidis Group Y, considered to be an organism of relatively low virulence, was isolated from the blood or cerebrospinal fluid in each case. The patients presented with diverse clinical manifestations of meningococcal disease. The relationship of disseminated meningococcal infections to hypocomplementemia in patients with SLE is discussed in light of a review of the literature.

Presence of human T lymphotropic virus type I in two patients with progressive myelopathy in Puerto Rico.

Two patients from Puerto Rico with progressive paraparesis had serum positive for human T lymphotropic virus type I (HTLV-I) antibodies by ELISA and Western blot, and one patient had HTLV-I antibodies in CSF by the ELISA method. Although the Caribbean basin is considered to be an endemic area for tropical spastic paraparesis, this is the first report of the isolation of HTLV-I antibodies in the serum and CSF of patients with chronic myelopathies in Puerto Rico.

[Oral amyloidosis. Concept, histopathology, clinical manifestations and treatment. Presentation of a clinical case]. / Amiloidosis oral. Concepto, histopatología, clínica y tratamiento. Presentación de un caso clínico.

The definition and current classification of amyloidosis as well as the incidence, etiopathogenesis, pathology, clinical manifestations, specific diagnosis and prognosis and treatment of the disease are reviewed. A case of amyloidosis of the oral cavity without systemic involvement is reported. A 77 year-old woman suffered from multiple tumor masses in the mouth and presented with symptoms of impaired speech and ingestion.

Primary lateral sclerosis: a distinct clinical entity in patients with chronic spastic paraparesis.

The development of neurologic deficits confined to the corticospinal tracts has been referred as Primary Lateral Sclerosis (PLS). Through the years, this diagnosis has remained uncertain. In this study we describe seven patients with chronic involvement of the pyramidal system. Two of these patients had serologic evidence of human T-lymphotrophic virus type I infection, one patient had multiple sclerosis and in four patients the clinical diagnosis of PLS was made. The clinical characteristics and diagnostic studies of these patients are presented. A review of the literature with emphasis in the differential diagnosis and a proposed workup for patients with chronic spastic paraparesis are made. This study provides supporting evidence in favor of the clinical entity of PLS.

Primary lateral sclerosis: a distinct clinical entity in patients with chronic spastic paraparesis

La aparición de signos neurológicos confinados al tracto piramidal se conoce como esclerosis lateral primaria. A través de los años, este diagnóstico ha sido cuestionado. En este estudio se describen siete pacientes con daño crónico del sistema piramidal. Dos de estos pacientes tenían evidencia serológica de infección con el virus humano T-linfotrópico tipo I. Un paciente tenía esclerosis múltiple y en cuatro pacientes el diagnóstico de esclerosis lateral primaria fue hecho. Las características clínicas y estudios diagnósticos de estos pacientes son presentados, incluyendo una revisión de la literatura con énfasis en el diagnóstico diferencial de paraparesis espática crónica. Este estudio provee evidencia a favor del diagnóstico de esclerosis lateral primaria como una entidad clínica