Is Periodontal and Peri- Implant Disease Associated with Fixed Partial Denture Use? A 25-year Prospective Case Series.

INTRODUCTION: The association of the periodontium with the fixed prosthesis is the basis of prosthetic rehabilitation. This prospective case series aimed to evaluate periodontal health through the relation between periodontal/peri-implant disease progression and the use of fixed partial dentures (FPDs). METHODS: Probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI) on either teeth or implants were evaluated at up to 25-year follow-up and compared with the baseline. Statistical analysis was performed using the Kaplan-Meier test (p⟨0.05). RESULTS: The prospective evaluation showed that the patients maintained adequate periodontal health. Failure (severe periodontal stages) occurred in 12.5% of patients. The survival rate for 107 teeth/implants was 80.48%. The comparisons for clinical parameters revealed no statistically significant difference (p⟩ 0.05). At T1, the measurements for anterior and posterior regions, respectively, were PD =2.7mm and 3.1mm; CAL= 3.3mm and 3.6mm; GI=0.5 (both regions); and PI=0.79 and 0.62. Periodontal/peri-implant disease progression did not relate to the use of prostheses. CONCLUSIONS: Patients with more frequent follow-up appointments and lower GI and PI showed periodontal health for longer periods. Patients with different oral hygiene levels present different periodontal disease progression. Periodic hygiene control and motivation are vital factors for extensive oral rehabilitation success.

Genotoxic and mutagenic effects of methyl ether dillapiole on the development of Aedes aegypti (Diptera: Culicidae).

Dillapiole, extracted from Piper aduncum essential oil and its derivatives, has been shown to be a potential alternative to the control of Aedes aegypti, which has become resistant to synthetic insecticides. Methyl ether dillapiole (MED) and temephos (TM) were compared to complement the data on the genotoxicity and developmental changes of Ae. aegypti. Over four generations (G1 -G4 ), third stage larvae were treated with MED at 60, 80 and 100 µg/mL and TM at 0.002, 0.005 and 0.007 µg/mL for 4 h. Adult females were separated to estimate oviposition and hatching rates, and total egg length. Over the four generations, a significant reduction was recorded in oviposition and hatching rates, and in mean egg length (Tukey, P < 0.05), compared with the negative control (NC). Cytological slide preparations were done from adult oocytes and larval neuroblasts. The cumulative effects of genotoxic (bridges, budding and nuclear fragmentation) and mutagenic (micronucleus and chromosomal breakage) damage was observed in the neuroblasts and oocytes of exposed mosquitoes. Developmental changes and damage to the genome of MED-treated Ae. aegypti were greater than those caused by TM. Further studies should focus on understanding the effects of the MED molecule on Ae. aegypti.

Strategy for selection of soybean genotypes tolerant to drought during germination.

Water deficit is the main reason for instability in the context of soybean culture. The development of strategies for the selection of more tolerant genotypes is necessary. These strategies include the use of polyethylene glycol 6000 solutions (PEG-6000) for conducting the germination test under conditions of water restriction. Thus, the objective of this study was to determine the osmotic potential and the main characteristics that promote the discrimination of soybean genotypes with regard to water stress tolerance during germination and the vigor test. Thirteen soybean cultivars were used. The seeds were allowed to germinate on sheets of germitest paper moistened in solution with PEG-6000, simulating different levels of water availability, which is expressed as osmotic potential (0.0, -0.2, -0.4, and -0.6 MPa). We assessed germination, length, and dry mass for seedlings and seeds, as well as reserve dynamics. Germination and variables related to the dynamics of reservation have great influence on the expression of variability in environments under stress. Among the different osmotic potentials, the -0.2 MPa was the most efficient for the expression of genetic variability among the cultivars. Conducting the germination test with PEG-6000 solution to -0.2 MPa was efficient for selecting soybean cultivars tolerant to water stress. This was accomplished by evaluating the percentage of germination, along with variables related to the dynamics of reservation.

Micro-CT evaluation of calcium hydroxide removal through passive ultrasonic irrigation associated with or without an additional instrument.

AIM: To use computerized microtomography (micro-CT) to evaluate the efficacy of passive ultrasonic irrigation (PUI), with or without an additional file (F5), in removing calcium hydroxide medication. METHODOLOGY: The root canals of single-rooted human teeth were prepared with a ProTaper(®) F4 file (Dentsply Maillefer) and filled with calcium hydroxide/propylene glycol 400 paste. After 30 days of storage under 100% humidity, the teeth were divided into four groups (n = 8) according to the removal technique: passive ultrasonic irrigation (PUI) only, additional file only (file F5), PUI + additional file and master apical file only (F4, control). The specimens were scanned (SkyScan 1174, resolution: 14.36 µm) after chemomechanical preparation, 30 days after the application of Ca(OH)2 paste and following its removal. The percentage of medicament remaining was calculated in terms of total canal volume and medicament volume after storage, based on microtomographic images. Data were analysed using three-way anova/Tukey's test or Kruskal-Wallis/Student-Newman-Keuls test (alpha: 5%). RESULTS: The use of PUI resulted in lower Ca(OH)2 residue volumes (3.7%) compared to when PUI was not used (6.4%; P < 0.001). The use of the additional file did not significantly influence the percentage of remaining Ca(OH)2 . The percentage of Ca(OH)2 residue was greater in the apical region (6.4%) than in the cervical region (3.8%; P < 0.01). CONCLUSIONS: The use of PUI resulted in more effective Ca(OH)2 paste removal relative to the control regardless of the use of the additional file. The apical region had the highest residue volumes in all techniques.

The combined effects of binder addition and different sintering methods on the mechanical properties of bovine hydroxyapatite.

Hydroxyapatite (HA) from bovine bones has been used as a biomaterial in dentistry due to its biocompatibility and bioactivity. However, dense HA bioceramics still present inadequate properties for applications that require high mechanical performance, such as infrastructure. Microstructural reinforcements and control of ceramic processing steps are methods to improve these shortcomings. The present study assessed the effects of polyvinyl butyral (PVB) addition in combination with two sintering methodologies (2-step and conventional), on the mechanical properties of polycrystalline bovine HA bioceramics. The samples were divided into four groups (with 15 samples per group): conventional sintering with binder (HBC) and without binder (HWC) and 2-step sintering with (HB2) and without binder (HW2). HA was extracted from bovine bones, turned into nanoparticles in a ball mill, and subjected to uniaxial and isostatic pressing into discs, according to ISO 6872 standards. All groups were characterized by x-ray diffractometry (XRD), differential thermal analysis (DTA) and Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and relative density. Besides, mechanical analyses (biaxial flexural strength (BFS) and modulus of elasticity) were also performed. The characterization results demonstrated that adding agglutinants or the sintering method did not affect HA's chemical and structural characteristics. Even so, the HWC group showed the highest mechanical values for BFS and modulus of elasticity being 109.0 (98.0; 117.0) MPa and 105.17 ± 14.65 GPa, respectively. The HA ceramics submitted to conventional sintering and without the addition of binders achieved better mechanical properties than the other groups. The impacts of each variable were discussed and correlated to the final microstructures and mechanical properties.

Dynamics of microbial stress responses driven by abiotic changes along a temporal gradient in Deception Island, Maritime Antarctica.

Whalers Bay (WB), Deception Island, is an environment that can drastically change its temperature within a few meters. The main forms of life inhabiting this environment are microorganisms, which, due to the high diversity and their adaptive potential, can survive and thrive under harsh stress conditions. However, the genetic potential and mechanisms to cope with fluctuating adverse conditions as well as what extent environmental variations shape the microbial community over the years it is still unknown in Antarctic environments. In this work, sediments collected in a transect in Whalers Bay, Deception Island, during the Austral Summers of 2014, 2015 and 2017 were analyzed using shotgun metagenomics. Sequence data were further processed with the SqueezeMeta tool for assembly, gene prediction, mapping, taxonomic and functional annotations. Results showed that stress-related functions had the influence of temperatures and solar radiation observed in the years of 2015 and 2017. The most differentiated functions were the ones related to oxidative stress, comparing 2014 vs 2015 and 2014 vs 2017. The genes coding for HSP20 and oxidoreductases (nrdH, grxA, korC and korD), as well as the genes clpE, cspL, and operons mtrAB and vicKR, were differentially enriched between the years, most of them found in gram-positive bacteria. The selective pressures of temperature and radiation may have favored the growth of gram-positive bacteria in 2017, with emphasis on Arthrobacter genus. Data gathered in this work showed that temperature and solar radiation could potentially be the primary driving forces shaping the repertoire of stress-response genes for the maintenance of microbial diversity in WB Antarctic sediments.

Determination of fluoroquinolone residues in poultry muscle in Portugal.

A total of 98 poultry samples, including chicken and turkey muscle, were analysed, using a sensitive and reliable analytical method based on liquid chromatography (LC) with spectrofluorimetric detection, for simultaneous determination of four fluoroquinolone (FQ) antibiotics, namely enrofloxacin (ENRO), ciprofloxacin (CIPRO), norfloxacin (NOR), and sarafloxacin (SARA). The method involved extraction with 0.15 mol L(-1) HCl and clean-up by solid-phase extraction using Oasis HLB cartridges. Chromatographic separation was carried out on a C(18) TSK gel column, in isocratic mode, with 0.025 mol L(-1) H(3)PO(4) solution, adjusted to pH 3.0 with tetrabutylammonium hydroxide-methanol (78:22) as mobile phase. Good linearity over the investigated concentration range was observed, with mean values of correlation coefficients higher than 0.9989 for all the analytes studied. The limits of quantification (LOQ), expressed as the lowest fortification level with acceptable precision were 15 microg kg(-1) for ENRO, CIPRO, and NOR, and 30 microg kg(-1) for SARA; these values are in compliance with requirements for monitoring of maximum residues levels (MRLs). Overall recoveries from spiked samples ranged from 80% to 92% with relative standard deviations (RSD) lower than 6.1%. Of the chicken and turkey samples analysed, 44.2% and 37.8%, respectively, were contaminated. The levels found in the analysed poultry samples, collected from markets of Oporto and Coimbra, located in the north and central zones of Portugal, respectively, were lower than 114.2 and 87.6 microg kg(-1) in chicken and turkey muscle samples, respectively. One positive chicken sample was contaminated with ENRO at levels higher than the MRL.

Tetracycline antibiotics in hospital and municipal wastewaters: a pilot study in Portugal.

This study investigated the occurrence of tetracyclines (TCs), namely minocycline (MIN), TC, and its epimer epitetracycline (ETC), and doxycycline (DC), in four hospital wastewater effluents and its fate in municipal wastewater treatment plants (WWTPs), in Coimbra, Portugal. Analytical determination was carried out by solid-phase extraction followed by liquid chromatography with fluorescence detection. A gradient system with a mobile phase containing oxalic acid 0.02 M and acetonitrile was used. After postcolumn derivatization with magnesium reagent, TCs were detected at lambda(exc) 386 nm and lambda(em) 500 nm. The proposed method allowed good sensitivity, accuracy, and precision. LOQs were 0.5 microg l(-1) for ETC and TC and 15 and 5 microg l(-1) for MIN and DC, respectively. The recovery values ranged between 66.4% and 117.1%, and intraday and interday repeatability was lower than 6.8%. The method was successfully used to determine the presence of the above-mentioned TCs in 24 wastewater composite samples obtained from hospital effluents and from influent and effluent of the WWTP located in Coimbra, Portugal. MIN and TC were found in 41.7% of the samples; ETC and DC were found in 25% and 8.3% of the samples, respectively. The levels found ranged from 6 to 531.7 microg l(-1) in hospital effluents, while its concentrations in WWTP ranged from 95.8 to 915.3 microg l(-1). A seasonal influence in the concentrations found has also been observed, the levels found in samples collected during spring being higher than those observed in samples collected during autumn; however, these are only preliminary results. The WWTP removal rate ranged between 89.5% and 100%.

Regional and age-specific patterns of pandemic H1N1 influenza virus seroprevalence inferred from vaccine clinical trials, August-October 2009.

The extent of the H1N1 pandemic has been estimated from case counts and deaths but the proportion of exposed populations with inapparent infections has not been described in detail. We analysed haemagglutination-inhibition (HI) antibody titres of pre-vaccination sera from pandemic vaccine trials conducted in six countries on four continents to provide an indication of A/CA/07/2009(H1N1)-like influenza seroprevalence in those populations. Among 7,962 subjects, ranging in age from 12 months to over 60 years, the proportions with HI antibody titres > or =40 to the H1N1pnd virus in the period from August to October 2009 were, by country: Costa Rica 26.4%, United States (US) 22.5%, Switzerland 16.9%, Germany 12.6%, Belgium 10.1%, and Japan 5.9%. Age-specific seropositivity rates in the samples were higher in children and adolescents in Costa Rica and in the US than in Europe and in Japan. The low proportion of seropositive children in Europe and Japan suggests that little local viral transmission had occurred in those regions even as late as September and October 2009, while in the US and Costa Rica, the greater proportion of previously infected children and young adults suggested that a significant number of asymptomatic infections had occurred during the first pandemic wave. Nevertheless, in all locations, the majority of the population remained susceptible to the pandemic virus at the beginning of the influenza season in the northern hemisphere, justifying the implementation of public health interventions.

Fluoroquinolone antibiotics determination in piggeries environmental waters.

To trace the contamination and evaluate the environmental impact of piggeries, the occurrence of norfloxacin (NOR), ciprofloxacin (CIPRO), enrofloxacin (ENRO) and sarafloxacin (SARA) residues were evaluated in water for swine consumption, piggeries' wastewaters, drainage waters and a river receiving piggery effluents. Water samples were acidified before being percolated through Oasis HLB cartridges or through a tandem system consisting of strong anion-exchange and Oasis HLB cartridges. A liquid chromatography with fluorescence detection (LC-FD) method developed in previous studies, based on the use of a monolithic column, was successfully applied. NOR, CIPRO, ENRO and SARA had good linear responses, with mean regression coefficients higher than 0.9989. The limits of quantification (LOQ) for waters for swine consumption, and a river receiving piggery effluents, were 0.025 ug L(-1) for NOR, CIPRO and ENRO and 0.05 ug L(-1) for SARA. For wastewaters and drainage waters, the LOQs were 0.05 ug L(-1) for CIPRO and ENRO and 0.1 ug L(-1) for SARA. Recoveries obtained for spiked samples ranged from 70.8 to 89.1%, and precision data were under 12.7%. The method was successfully applied to 18 environmental water samples, collected from piggeries in Alentejo, Portugal, and the first Portuguese data are presented. ENRO was detected in a total of 8 samples, at concentrations ranging between 0.31 microg L(-1) and 63 microg L(-1). CIPRO, its degradation product, and SARA were present in 2 samples, in the ranges 0.48-0.83 microg L(-1) and 1.8-14 microg L(-1), respectively. No fluoroquinolones were detected in the waters for swine consumption or in the river water samples.

Unveiling resistome profiles in the sediments of an Antarctic volcanic island.

The Deception Island, located in Maritime Antarctica, is a volcanic island with geothermal activity and one of the most visited by tourists. However, the extent of the anthropogenic impact remains largely unknown and the factors shaping the resistance/tolerance mechanisms in the microbiomes from Whalers Bay ecosystems have never been investigated. In this context, this study aimed to reveal the resistome profiles of Whalers Bay sediments and correlate them with environmental factors. Samples were collected at four sites during the summer 2014/2015 along a transect of 27.5 m in the Whalers Bay sediments. DNA isolated from sediment samples was sequenced using the Illumina HiSeq platform. Bioinformatic analyses allowed the assembly of contigs and scaffolds, prediction of ORFs, and taxonomic and functional annotation using NCBI RefSeq database and KEGG orthology, respectively. Microorganisms belonging to the genera Psychrobacter, Flavobacterium and Polaromonas were shown to dominate all sites, representing 60% of taxonomic annotation. Arsenic (As), copper (Cu) and iron (Fe) were the most abundant metal resistance/tolerance types found in the microbiomes. Beta-lactam was the most common class related to antibiotics resistance/tolerance, corroborating with previous environmental resistome studies. The acridine class was the most abundant amongst the biocide resistance/tolerances, related to antiseptic compounds. Results gathered in this study reveal a repertoire of resistance/tolerance classes to antibiotics and biocides unusually found in Antarctica. However, given the volcanic nature (heavy metals-rich region) of Deception Island soils, this putative impact must be viewed with caution.

Physical properties of films based on pectin and babassu coconut mesocarp.

The objective of this research was to study the physical properties, water sorption, thermal and structure of films made from citrus pectin (CP), babassu coconut mesocarp (BCM) and glycerol (G). Seventeen formulations were prepared according to a central compound rotational design combining different proportions of the materials and evaluating the films produced according to their moisture contents, solubility, thicknesses and water vapor permeability. The results showed a direct relationship between the composition of the film and each physical property, providing films with unique mechanical characteristics and barrier properties. In the second phase, the films were reformulated, maintaining the proportions of CP and BCM constant and altering the G content. The results showed films with permeable structures, thus favoring the use of high drying temperatures (up to 70 °C) for the confection of films, without altering their physical and structural properties.

Intradermal hepatitis B vaccination in patients with advanced chronic renal failure: immunogenicity and follow-up.

BACKGROUND: Patients undergoing dialysis usually have a poor response to conventional hepatitis B vaccination. AIM: To observe the effects of intradermal hepatitis B (HB) vaccination in a 13-month prospective study of adult patients with end-stage renal failure. The patients were with or without previous hepatitis B vaccination, but all had antibody titres <10 mUI/mL. METHODS: Patients were allotted to two groups: previous hepatitis B virus vaccination and no previous hepatitis B virus vaccination or anti-HBs titres <10 mUI/mL. Patients in both groups received 16 i.d. injections of 0.1 mL of hepatitis B virus vaccine over an eight-week period. Patients had antibody titres assessed before vaccination, 1 month after and every 3 months for a year. Antibody titres >/=10 mUI/mL were considered protective. RESULTS: Seventy patients completed the protocol. Protective titres were elicited in 82% of each group. Age, time under dialysis, diabetes, smoking and body-mass index were not associated with seroconversion. Persistent protective titres >12 months occurred in 27 (58.7%). Adverse events were trivial. CONCLUSION: Intradermal hepatitis B virus vaccination is an alternative in end-stage renal failure.

Occurrence of fumonisins B1 and B2 in broa, typical Portuguese maize bread.

Fumonisin B(1) (FB(1)) and fumonisin B(2) (FB(2)) are mycotoxins mainly produced by Fusarium verticillioides, and Fusarium proliferatum, fungi species most commonly isolated from maize. The natural occurrence of FB(1) and FB(2) in broa, typical Portuguese maize bread, was evaluated in 30 samples. Twenty five were found positive with levels ranging from 142 to 550 microg kg(-1). The limit established by the European regulations was exceeded by 27% of the samples. The tolerable daily intake for fumonisin B(1), and B(2), alone or in combination, for all of the analysed samples, was lower than 2 microg kg(-1) body weight per day established by the European Commission.

Clinical evaluation of an ointment with 10% metronidazole and 2% lidocaine in the treatment of alveolitis.

AIM: In this study, the authors evaluate the use of a 10% metronidazole and 2% lidocaine ointment, using a lanolin base and mint as flavoring, to treat alveolitis in humans. METHODS: Twenty-five patients, with a diagnosis of alveolitis, were treated in the following way: locoregional anesthesia; surgical cleaning of the socket with alveolar curettes; saline solution irrigation with a 20 ml disposable syringe; and complete filling of the socket with the ointment. RESULTS: The analysis of the results showed that the painful symptoms were severe before and on the day of the treatment in 17 (68%) of the 25 patients treated. Post-treatment analysis presented 2 patients (18%) with severe painful symptoms after 24 h of the treatment and complete remission of painful symptoms after 48 h of the treatment with the ointment. CONCLUSIONS: Based on the results, it is possible to conclude that the 10% metronidazole and 2% lidocaine ointment, with mint flavoring and lanolin as a base, can be used to treat alveolitis.

Vianna and the discovery of Leishmania braziliensis: the role of Brazilian parasitologists in the identification of Bauru's ulcer as American leishmaniasis.

The description of a new species of Leishmania spp. and the comprehensive study of a yet incompletely understood disease, mucocutaneous leishmaniasis, was a significant accomplishment of the then emerging Brazilian medical and public health science in the early decades of the 20th century. Gaspar Vianna and a group of academic-minded physicians in São Paulo brought forth a task still largely ignored, the complete description of a new nosological entity, in the process forming the core of a parasitological school that would bridge the 20th century with important contributions to medical science and public health. This article analyses the conditions surrounding this group in São Paulo and the major landmarks of their contributions.

Total serum IgE and parasite-specific IgG and IgA antibodies in human strongyloidiasis.

Total serum IgE, and Strongyloides-specific IgG and IgA antibodies were studied in 27 patients with parasitologically proven strongyloidiasis. Clinical manifestations in this case series were investigated by a retrospective study of the patient's records. Total serum IgE levels were elevated (greater than 250 IU/ml) in 59% of the patients (mean concentration = 1364 IU/ml). Parasite-specific IgG and IgA antibodies were detected by ELISA in the serum of 23 (85.2%) and 21 (77.8%) patients, respectively. Elevated serum IgE and clinical manifestations were not useful indexes of the presence of strongyloidiasis. On the other hand, our results support the view that serologic tests, particularly ELISA for detecting Strongyloides-specific IgG antibodies, can be usefully exploited for diagnostic purposes in strongyloidiasis.

[Post-transfusional hepatitis in the city of Campinas, SP, Brazil. I. Incidence, etiological agents and clinico-epidemiological aspects of hepatitis C]. / Hepatites pós-transfusionais na cidade de Campinas, SP, Brasil. I. Incidência, agentes etiológicos e aspectos clinico-epidemiológicos da hepatite por vírus C.

We have followed up 111 transfusion receptors in the ambulatory, for at least 180 days, in order to evaluate the occurrence of post-transfusional hepatitis and the etiological agents involved in the disease in the city of Campinas, state of São Paulo, Brazil. At the end of the study we have diagnosed this hepatitis in 18 (16.2%) subjects. Out of these 18 subjects, 16 (89%) were caused by hepatitis C virus, 1 (5.5%) caused by hepatitis B virus and 1 (5.5%) with undetermined etiology, 15 months after transfusion. The average incubation period of HCV was 71 days and 23% of the HCV positive receptors remained with increased AST/ALT for more than 6 months. Late serum conversion was observed for anti-HCV in 71.4% of the subjects, averaging 135 days after the transfusion. An ALT dosage and anti-HCV determination, 3 and 6 months after transfusion would diagnose, respectively, 71 and 93% of the cases which developed post-transfusional HCV.

[Post-transfusional hepatitis in the city of Campinas, SP, Brazil. II. Presence of anti-HBc and anti-HCV antibodies in blood donor candidates and occurrence of post-transfusional hepatitis C in recipients of blood or derivates]. / Hepatites pós-transfusionais na cidade de Campinas, SP, Brasil. II. Presença dos anticorpos anti-HBc e anti-HCV em candidatos a doadores de sangue e ocorrência de hepatites pós-transfusionais pelo vírus C nos receptores de sangue ou derivados.

We have analysed anti-HBc and anti-HCV antibodies in serum samples from 799 donors which had their blood or derivates transfused to 111 recipients. Anti-HBc and anti-HCV were reactive in respectively 9 and 2.1% of the donors tested. We have observed that among the 111 recipients, 44 had received at least one positive anti-HBc unit and 67 had been transfused only with negative anti-HBc, units. The risk of developing hepatitis C virus was 4.5 times higher for the recipients who received at least one positive anti-HBc unit. If the test for anti-HBc had been made for the blood donors in the serological screening, about 56% of the HCV cases in the recipients could have been avoided. The population of recipients who received at least one reacting unit of anti-HCV, presented a risk 29 times higher of developing this hepatitis, as compared to the transfused recipients with all anti-HCV negative units. Testing blood from donors for anti-HCV would avoid 79% of the post-transfusional HCV cases. Brazilian candidates to blood donors seem to be carriers either simultaneously or sequentially to hepatitis virus B and C, since 44.4% of the positive anti-HCV were also positive for anti-HBc. Testing for anti-HBc and anti-HCV in blood screening must be indicated in order to prevent post-transfusional hepatitis transmission in our community.

Listeriosis and AIDS: case report and literature review.

Listeriosis is a not uncommon infection in humans, usually associated with immunodeficient states and with newborns. However, relatively few cases have been reported in HIV-infected patients. This scarcity of reported cases has aroused interest in the association of listeriosis and AIDS. In this paper we present a case of meningitis and septicemia caused by Listeria monocytogenes in a female patient with AIDS. A review of recent medical literature indicates that association of listeriosis and AIDS may be more common than it seems. Recent research in host-parasite interaction in listerial infection suggests an important role for tumor necrosis factor (TNF) and for integralin, a bacterial protein, in modulating listerial disease in AIDS patients. Inadequate diagnosis may be in part responsible for the scarcity of reports.