Phagocytosis and killing of Candida albicans of polymorphonuclear cells in patients with organ transplant of periodontal disease.

BACKGROUND: The easiest defence system carried out by the organism, the inflammatory response, happens with the support of phagocyting cells: the polymorphonuclear leukocytes (PMNL) or neutrophils are the most important cell line acting as the first defence of the organism against bacterial agents. Previous studies have shown a correlation between a reduction of the immune function and development of periodontal disease. Furthermore, it is well known that transplant patients show a variety of oral lesions as a consequence of their therapy, in particular to immunosuppressive drugs. The aim of this study is to evaluate the phagocytosis and killing functions of PMNL in transplant patients and in patients with periodontal disease in comparison with a group of healthy subjects. METHODS: PMNL, were isolated by spontaneous sedimentation from heparinized blood and centrifugation of plasma on density medium. Phagocytosis rate was expressed as the percentage of Candida albicans phagocyted after 20' incubation and phagocyting PMNLs. Intracellular killing was expressed as the percentage of yeast cells killed. RESULTS: We did not find a significant decrease of phagocytosis in transplant patients and patients with periodontal disease while these two groups of patients showed a decrease of PMNL killing activity in respect to healthy controls, an effect which was unrelated to the severity of periodontal disease. CONCLUSIONS: These results suggest that a reduction of killing activity, either spontaneous or drug-induced, would contribute to the development of periodontal disease.

HCV-RNA occurrence in saliva of odontoiatric HCV seropositive patients.

BACKGROUND: HCV-RNA occurrence in saliva of patients suffering from C hepatitis induced to consider saliva as a possible diffusion mean of this disease. METHODS: Saliva and blood samples from 32 C hepatitis seropositive patients, followed for odontostomatologic problems in Odontoiatric Clinic of Brescia University were obtained. In every blood and saliva sample HCV-RNA concentration was evaluated following HCV-RNA 2.0 Assay (bDNA) Quantiplex test (Chiron), in Microbiology Institute of Brescia University. RESULTS: All patients showing HCV-RNA in serum presented virus in saliva also; two patients with negative HCV-RNA serum presented virus in saliva. In latter cases, we supposed that viral concentration in serum was under sensibility threshold of employed method. CONCLUSIONS: Saliva appears an easily and not invasively obtainable medium for epidemiological studies on HCV diffusion in humans. Its role in C hepatitis transmission, on the contrary, has not been cleared till now.

Chlorhexidine and taste. Influence of mouthwashes concentration and of rinsing time.

BACKGROUND: This study aims to define the influence of chlorhexidine on taste, considering either its concentration in mouthwashes or time of rinsing. METHODS: Suprathreshold taste acuity of 40 healthy subjects tasting variously concentrated solutions of sucrose, sodium chloride, citric acid and quinine hydrochloride was determined. Subjects were divided into four groups. Three groups rinsed their mouths during one minute, twice a day, for seven days, with a selected mouthwash (respectively 0.12%, 0.20%, and 0.30% chlorhexidine solutions). The fourth group rinsed in the same manner with a 0.30% chlorhexidine mouthwash, and time of rinsing was 15". RESULTS: All the mouthwashes reduced taste acuity for salt and bitter; the perception of sweet and sour was not significantly modified. Chlorhexidine acted on taste in different ways: salt perception reached the lowest value on the second day of treatment and the degree of hypogeusia changed no more till mouthrinses were interrupted. Bitter perception was progressively reduced and reached the lowest value on the seventh day. In both cases taste reduction lasted some days after the interruption of mouthrinses. Quality of all tastes was altered by mouthwashes, but incidence of dysgeusia was not related to chlorhexidine concentration. CONCLUSIONS: Hypogeusia induced by chlorhexidine concerns specifically salt and bitter. Chlorhexidine concentration in mouthwashes till 0.12% and mucosa exposure not exceeding 60" twice a day, seem the best procedure to protect tastes in clinical practice.

Leukocyte adhesion deficiency in a child with severe oral involvement.

Leukocyte adhesion deficiency is a rare inherited defect of phagocytic function resulting from a lack of leukocyte cell surface expression of beta2 integrin molecules (CD11 and CD18) that are essential for leukocyte adhesion to endothelial cells and chemotaxis. A small number of patients with leukocyte adhesion deficiency-1 have a milder defect, with residual expression of CD18. These patients tend to survive beyond infancy; they manifest progressive severe periodontitis, alveolar bone loss, periodontal pocket formation, and partial or total premature loss of the primary and permanent dentitions. We report on a 13-year-old boy with moderate leukocyte adhesion deficiency-1 and severe prepubertal periodontitis. This case illustrates the need for the dentist to work closely with the pediatrician in the prevention of premature tooth loss and control of oral infection in these patients.

Absence of Helicobacter pylori in dental plaque determined by immunoperoxidase.

BACKGROUND: Attempts to detect Helicobacter pylori in dental plaque have given contrasting results, and the possibility of an oral-oral transmission of the infection remains unclear. In this study, a sensitive and specific immunoperoxidase method has been employed to assess the presence of H. pylori in dental plaque. METHODS: Dental plaque smears from 80 patients undergoing gastroscopy were analyzed by an indirect immunoperoxidase test, employing a mixture of two monoclonal antibodies against H. pylori. RESULTS: No immunostained bacteria were shown in any of the examined dental plaque samples. CONCLUSIONS: H. pylori is not usually present in dental plaque, indicating that oral-oral transmission of the infection could be due to intermittent esophageal reflux only.

[Dental and oral aspects in pediatric liver transplant patients. A comparison between the effects of cyclosporine A and FK 506]. / Aspetti odontostomatologici in pazienti trapiantati di fegato in età pediatrica. Comparazione tra effetti della Ciclosporina-A e dell'FK 506.

The evolution and the improvement of the surgical techniques and pharmacological therapies brought to new patients categories, also in odontoiatric field for example patients who underwent organ transplantation. Among the patients, we wanted to dwell our attention on pediatric patients after liver transplantation, by light of the new therapeutic outlines modifications. In fact in these young patients it is possible to observe, besides the severe systemic consequences, also the involvement of the oral cavity. After the transplantation, the immunosuppressive therapy is set up and it is based on the use of cyclosporine with the possible azotiopine or steroid association. The cyclosporine side-effects are well known and, among these, the gingival hyperplasia. FK506 is a drug recently introduced, it is a strong immunosuppressor. Therefore we began to estimate patients who assumed FK 506, in order to compare the effect at the gingival level among patients who follow a cyclosporine therapy.

[Pathology of taste: knowledge and prospectives]. / La patologia del gusto: conoscenze e prospettive.

Taste anomalies have not been systematically investigated till recently in Italy. The influence of the taste on the choice of the foods, on the nutrition and on the same psycho-physic human mindedness has largely been demonstrated. In this study, taste anomalies associated with various pathologic conditions (nervous, endocrine, metabolic, infectious, immunological, carential or neoplastic disorders) are reported, as well as those produced by drugs, or surgical interventions. The type and the degree of taste anomalies associated to immunological diseases, allogeneic bone marrow transplantation and AL amyloidosis are particularly described.

[Computed tomography in the study of periodontal disease]. / La Tomografia Computerizzata nello studio della malattia parodontale.

Periodontal disease, an affection of bacterial etiology, causes the destruction of the periodontal tissue. From both the diagnostic and the prognostic points of view, it is extremely important to evaluate the changes occurring in the alveolar bone in patients affected with periodontal disease. The information obtained by conventional radiographic techniques is usually poor due to the overlapping of anatomical structures and to the lack of an axial view of the structures. CT, thanks to millimetrical sections of the dental structures along the planes which parallel the hard palate, allows the evaluation of: 1) the size and the relationship between teeth roots, with no overlapping of anatomical structures; 2) bone thickness; 3) very early bone lesions around the teeth roots. The authors suggest CT as a valuable tool in the study of periodontal disease in its early stage and in the evaluation of advanced lesions, both before treatment and during follow-up, when it is important to check the results of conservative treatment.

[Pigmentation of the oral mucosa from endodontic materials]. / Pigmentazione della mucosa orale da materiale endodontico.

The Authors describe the clinical case in which a 30 years old male patient presents anomalous pigmentation of the oral mucosa after the endodontic treatment of the upper right central incisive. The mucosa's anomaly appeared at the height of the lower third of the root near the branch of an accessory endodontic canal previously filled and it was caused by the outlet of filling material. After the examination of this case, the Authors affirme the importance of an accurate anamnesis in order to obtain a correct diagnosis of the various kinds of pigmented lesions, distinguishing the etiology, the pathogenesis and the histologic patterns.

HTLV-1 seroprevalence in AIDS patients and in HIV-1 seropositive and seronegative subjects at risk for AIDS in northern Italy.

Sera of 1023 subjects belonging to categories at risk for AIDS, positive for HIV-1, were tested for antibodies to human T-cell leukemia virus (HTLV-1) by ELISA, Western blotting, and radioimmunoprecipitation (RIP) assay. Sera of these subjects were positive for antibodies to HTLV-1 in a percentage of 18.54%. Nine out of 18 sera from patients with AIDS had antibodies to HTLV-1 (50%). Sera of 207 intravenous drug abusers and 64 homosexual males, seronegative for HIV-1, were tested for antibodies to HTLV-1 and 6.7% of intravenous drug abusers and 7.8% of homosexual males were found to be HTLV-1 antibody positive, showing that HTLV-1 infection occurred independently of HIV-1 and HIV-2 infections. In fact the same HIV-1 seronegative patients were also tested for the presence of antibodies to HIV-2 and none of them was found to be positive.

Evaluation of BACTEC system for urine culture screening.

We compared urine culturing performed by the calibrated loop method with a screening system (BACTEC). A total of 852 urine specimens were examined by both the conventional loop method and the BACTEC system. With the loop method, 193 (22.6%) urine samples were positive, whereas with the BACTEC system, 185 (21.7%) were positive (sensitivity, 96.01%). At a breakpoint of 10(4) CFU/ml, eight false-negatives were detected (sensitivity, 87.09%), and at a breakpoint of 10(5) CFU/ml, four false-negatives were observed (sensitivity, 97.6%). The specificity of the BACTEC system was 100%. We propose the BACTEC method as an effective alternative to the other growth-dependent screening tests for bacteriuria.

In vitro studies of growth and competition between S. salivarius TOVE-R and mutans streptococci.

Streptococcus salivarius TOVE-R has previously been reported as a successful competitor with Streptococcus mutans 10449S and Streptococcus sobrinus 6715-13 WT on the teeth of rats. We studied, in vitro, some possible bases for this competition, including hydrogen peroxide or catalase production, bacteriocin or enocin production, and growth rates. Growth rates were measured spectrophotometrically in both complex and defined media. We studied conditions of aerobic and anaerobic incubation; glucose and sucrose medium supplementation at three concentrations each; various initial pH's; singly- or doubly-inoculated cultures; and half-strength, normal, or double-strength broth used both fresh and as culture filtrates. TOVE-R grew as well as did mutans streptococci at acid pH, decidedly better at alkaline pH, and nearly twice as fast near neutral pH. The average doubling time for TOVE-R was about 0.5 hr, while that for the mutans streptococci was about 1.0 hr. When TOVE-R was grown together with a mutans streptococcus, the growth rate observed for the doubly-inoculated culture was equal to or less than that of TOVE-R alone, never greater. The presence and proportions of both organisms in mixed cultures were confirmed by plate counts, direct specific immunofluorescence, and Nomarski interference microscopy. There was no evidence, by any of the methods employed, to indicate the production of an inhibitory substance against mutans streptococci by TOVE-R, or vice versa. Also, there was no evidence that the faster growth rate of TOVE-R could be attributed to nutrient limitation of the mutans streptococci.(ABSTRACT TRUNCATED AT 250 WORDS)

Ultrasonography in the early diagnosis of congenital dysplasia of the hip.

The authors discuss the feasibility of using ultrasonography in the early diagnosis of congenital dysplasia of the hip. Having used the methods of Graf and Harcke, they devised a new scan which always reveals the state of the limbus in neonatal congenital dysplasia. This has been used for two years as an additional technique in neonates with a positive Ortolani click to demonstrate the presence of an inverted limbus, which is not revealed in the Graf and Harcke scans although they give a very good overall picture of the femoral head and acetabulum. The disclosure of an inverted limbus at this early stage is of crucial importance in determining the correct treatment to be adopted.

Radiometric method for the rapid detection of Leptospira organisms.

A rapid and sensitive radiometric method for detection of Leptospira interrogans serovar pomona and Leptospira interrogans serovar copenhageni is described. Stuart's medium and Middlebrook TB (12A) medium supplemented with bovine serum albumin, catalase, and casein hydrolysate and labeled with 14C-fatty acids were used. The radioactivity was measured in a BACTEC 460 (Johnston Laboratories). With this system, Leptospira organisms were detected in human blood in 2 to 5 days, a notably shorter time period than that required for the majority of detection techniques.

Ceftriaxone against gram-negative and gram-positive bacteria: bactericidal and post-antibiotic effect.

The effect of ceftriaxone against Gram-negative and Gram-positive strains of different clinical isolates has been compared to that of other cephalosporins such as cefuroxime, cefoxitin and cefotaxime. Cefotaxime and ceftriaxone have a notably higher activity against Enterobacteriaceae than cefuroxime and cefoxitin. If ceftriaxone activity is compared to cefotaxime activity, it may be seen that the former shows a stronger action against Pseudomonas, Proteus rettgeri, Enterobacter and Serratia. Against Staphylococcus aureus and enterococci the four antibiotics show a low level of activity. The effect of a microorganism's temporary contact with ceftriaxone was tested by a method whereby the antibiotic was removed with an ion-exchanging resin. Ceftriaxone shows rapid bactericidal activity against sensitive bacteria and if it is used at concentrations slightly higher than MIC, as in vivo against bacteria of average sensibility, we notice a 10-18 h bacteriostatic effect during which a prevalence of filamentous shapes of gram-negative bacteria is observed.