Descriptive observational study on early functional recovery and postoperative pain in knee joint replacement surgery. / Estudio observacional descriptivo sobre recuperación funcional temprana y dolor postoperatorio en cirugía de reemplazo articular de rodilla.

INTRODUCTION: The management of postoperative pain in joint replacement surgery represents a challenge. Therefore, the advent of new strategies in the management of pain such as local infiltration analgesia (LIA) and the adductor canal block, allowed an adequate postoperative pain control and early rehabilitation of the patient in total knee arthroplasty. MATERIALS AND METHODS: A descriptive, observational and longitudinal study of a prospective cohort of patients operated by the group of joint replacements between September 29, 2017 and November 30, 2017 was conducted. They were evaluated with the analog pain scale for postoperative pain at 5 different times (1:Upon leaving recovery; 2:On the first postoperative day; 3:Before initiating in-hospital physical therapy; 4:At the end of physical therapy, and 5:Upon departure from the clinic). RESULTS: Of the 141 patients operated on, 70.9% of the patients were managed with LIA and 29.1% with adductor canal block. There were no differences between groups in postoperative pain assessment during the 5 different times (P≥.45). DISCUSSION: Our results indicate that LIA and the adductor canal blockade demonstrated the same efficacy for the control of postoperative pain and rehabilitation.

The United Kingdom Primary Immune Deficiency (UKPID) registry 2012 to 2017.

This is the second report of the United Kingdom Primary Immunodeficiency (UKPID) registry. The registry will be a decade old in 2018 and, as of August 2017, had recruited 4758 patients encompassing 97% of immunology centres within the United Kingdom. This represents a doubling of recruitment into the registry since we reported on 2229 patients included in our first report of 2013. Minimum PID prevalence in the United Kingdom is currently 5·90/100 000 and an average incidence of PID between 1980 and 2000 of 7·6 cases per 100 000 UK live births. Data are presented on the frequency of diseases recorded, disease prevalence, diagnostic delay and treatment modality, including haematopoietic stem cell transplantation (HSCT) and gene therapy. The registry provides valuable information to clinicians, researchers, service commissioners and industry alike on PID within the United Kingdom, which may not otherwise be available without the existence of a well-established registry.

Metal-free, direct conversion of α-amino acids into α-keto γ-amino esters for the synthesis of α,γ-peptides.

An efficient, metal-free synthesis of unusual α-keto γ-amino esters from α-amino acids is achieved by a radical scission-oxidation-addition of silyloxy acrylates procedure, where no purification of the reaction intermediates is needed. This protocol can be applied to the selective modification of the C-terminal position in peptides to give α,γ-hybrids.

Rehabilitación de miembro superior con ambientes virtuales: revisión / Upper limb rehabilitation with virtual environments: a review

Resumen En este artículo se presentan los resultados de un proceso de revisión bibliográfica sobre rehabilitación de miembro superior basada en ambientes virtuales. El estudio parte de los siguientes interrogantes sobre el estado actual del conocimiento en el área mencionada: ¿cómo inciden los entornos virtuales frente a la rehabilitación tradicional?, ¿qué métricas de desempeño se han aplicado en la rehabilitación virtual de miembro superior? y ¿qué dispositivos hardware se utilizan en rehabilitación virtual?. Para responder las anteriores preguntas se realizó una búsqueda de artículos científicos en el motor de búsqueda Google Scholar y en las bases de datos PubMed, HINARI, ProQuest y Science Direct. De la revisión realizada se concluyó que pese a la existencia de decenas de índices de desempeño para cuantificar la habilidad motriz, no existen criterios para seleccionar el indice que mejor se adapta a los objetivos de un determinado proceso de rehabilitación.

Abstract This article gives the results of a literature review process about upper limb rehabilitation based on virtual environments. The study borns of the following questions about the current state of knowledge in this subject: how virtual environments influence traditional rehabilitation?, Which performance metrics have been aplied in upper limb virtual rehabilitation? and which hardware devices are used in virtual rehabilitation? To answer the above questions a search for scientific articles was made in the search engine Google Scholar and databases PubMed, HINARI, ProQuest and Science Direct. The conducted review concluded that despite the existence of dozens of performance indicators to quantify the driving ability, there are no criteria to select a better index that best suits the objectives of a rehabilitation process.

Clinical and laboratory correlates of lung disease and cancer in adults with idiopathic hypogammaglobulinaemia.

Idiopathic hypogammaglobulinaemia, including common variable immune deficiency (CVID), has a heterogeneous clinical phenotype. This study used data from the national UK Primary Immune Deficiency (UKPID) registry to examine factors associated with adverse outcomes, particularly lung damage and malignancy. A total of 801 adults labelled with idiopathic hypogammaglobulinaemia and CVID aged 18-96 years from 10 UK cities were recruited using the UKPID registry database. Clinical and laboratory data (leucocyte numbers and serum immunoglobulin concentrations) were collated and analysed using uni- and multivariate statistics. Low serum immunoglobulin (Ig)G pre-immunoglobulin replacement therapy was the key factor associated with lower respiratory tract infections (LRTI) and history of LRTI was the main factor associated with bronchiectasis. History of overt LRTI was also associated with a significantly shorter delay in diagnosis and commencing immunoglobulin replacement therapy [5 (range 1-13 years) versus 9 (range 2-24) years]. Patients with bronchiectasis started immunoglobulin replacement therapy significantly later than those without this complication [7 (range 2-22) years versus 5 (range 1-13) years]. Patients with a history of LRTI had higher serum IgG concentrations on therapy and were twice as likely to be on prophylactic antibiotics. Ensuring prompt commencement of immunoglobulin therapy in patients with idiopathic hypogammaglobulinaemia is likely to help prevent LRTI and subsequent bronchiectasis. Cancer was the only factor associated with mortality. Overt cancer, both haematological and non-haematological, was associated with significantly lower absolute CD8(+) T cell but not natural killer (NK) cell numbers, raising the question as to what extent immune senescence, particularly of CD8(+) T cells, might contribute to the increased risk of cancers as individuals age.

Evaluation of an extended-release formulation of ceftiofur crystalline-free acid in koi (Cyprinus carpio).

The use of an extended release ceftiofur crystalline-free acid formulation (CCFA, Excede For Swine(®) , Pfizer Animal Health) in koi was evaluated after administration of single intramuscular (i.m.) or intracoelomic (i.c.) doses. Twenty koi were divided randomly into a control group and four treatment groups (20 mg/kg i.m., 60 mg/kg i.m., 30 mg/kg i.c., and 60 mg/kg i.c.). Serum ceftiofur-free acid equivalents (CFAE) concentrations were quantified. The pharmacokinetic data were analyzed using a nonlinear mixed-effects approach. Following a CCFA injection of 60 mg/kg i.m., time durations that serum CFAE concentrations were above the target concentration of 4 µg/mL ranged from 0.4 to 2.5 weeks in 3 of 4 fish, while serum CFAE concentrations remained below 4 µg/mL for lower doses evaluated. Substantial inter-individual variations and intra-individual fluctuations of CFAE concentrations were observed for all treatment groups. Histological findings following euthanasia included aseptic granulomatous reactions, but no systemic adverse effects were detected. Given the unpredictable time vs. CFAE concentration profiles for treated koi, the authors would not recommend this product for therapeutic use in koi at this time. Further research would be necessary to correlate serum and tissue concentrations and to better establish MIC data for Aeromonas spp. isolated from naturally infected koi.

Low ficolin-2 levels in common variable immunodeficiency patients with bronchiectasis.

Common variable immunodeficiency (CVID) encompasses a heterogeneous group of antibody deficiencies characterized by susceptibility to recurrent infections and sequelae, including bronchiectasis. We investigated the relevance of the lectin complement pathway in CVID patients by analysing ficolin-2 and ficolin-3 serum levels and genotyping single nucleotide polymorphisms (SNPs) in the FCN2 and FCN3 genes. Our results show that ficolin-2 levels in CVID patients are significantly lower (P < 0.0001) than in controls. The lowest ficolin-2 levels are found in CVID patients with bronchiectasis (P = 0.0004) and autoimmunity (P = 0.04). Although serum levels of ficolin-3 were similar in CVID patients and controls, CVID patients with bronchiectasis again showed lower levels when compared to controls (P = 0.0001). Analysis of single nucleotide polymorphisms in the FCN2 gene confirmed known influences on ficolin-2 serum levels, but did not support a genetic basis for the observed ficolin-2 deficiency in CVID. We found that CVID patients with bronchiectasis have very low levels of ficolin-2. The reason for the deficiency of ficolin-2 in CVID and any possible causal relationship is currently unknown. However, as bronchiectasis is a very important factor for morbidity and mortality in CVID, ficolin-2 could also serve as biomarker for monitoring disease complications such as bronchiectasis.

Mejora de la Señal de Flujo Sanguíneo en Implantes Coronarios Mediante la Detección de Distorsiones Eventuales / Improving the Blood Flow Signal in Coronary Bypass by Detection of Eventual Distortions

Se presenta un método para el procesamiento de señales en aplicaciones médicas que utilizan técnicas de diagnóstico basadas en ultrasonido Doppler. El método está orientado a obtener una mejor representación de la señal de flujo sanguíneo, a partir de la identificación y exclusión de los ciclos, de dicha señal, que se encuentran afectados por distorsiones eventuales. Esto permite, de manera robusta y confiable, estimar parámetros y extraer información clínicamente útil con el objetivo de formular diagnósticos precisos sobre la funcionalidad del objeto examinado. Se muestran los resultados de la aplicación del método sobre señales reales de flujo sanguíneo obtenidas durante procedimientos de revascularización coronaria y se demuestra que la estimación de los índices clínicos de interés mejora considerablemente cuando los ciclos detectados como afectados por ruido eventual son excluidos del análisis.

This paper aims to implement a method for signals processing in biomedical applications based on Doppler ultrasound techniques. The method is aimed to obtain a better representation of the blood flow signal, and it is based on the detection and exclusion of signal cycles detected as affected by eventual noise. This allows, in robust and reliable way, to estimate parameters and extract useful clinical information, in order to make accurate diagnoses on the functionality of the scanned object. The results of applying the method to two blood flow signals in coronary implants are presented, and it is observed that the estimation of the clinical indices improve when affected cycles are excluded of the signal analysis.

Effect of nicotine on ATPase, catalase and calcium levels in the presence of oligoelements in brain regions of young rats.

UNLABELLED: The effect of nicotine on membrane alterations and fluidity changes in very young models remains unclear. The aim of this study was to evaluate the effect of nicotine on total ATPase, H(2)O(2) and calcium in brain of young rats in the presence of oligoelements. Male Wistar rats (weight 80 g) received intraperitoneally either a single dose or repeated doses for 4 days as follows: Group 1 (control) NaCl 0.9%; group 2 nicotine (1mg/kg); group 3 oligoelements (50 µl); and group 4 nicotine (1mg/kg) + oligoelements (50 µl). The brain regions (cortex, hemispheres and cerebellum + medulla oblongata) of each rat were then obtained to measure the concentrations of total ATPase, H(2)O(2) and calcium using spectrophotometric methods. RESULTS: Total ATPase increased significantly (p < 0.05) in groups treated with oligoelements in repeated doses in hemisphere region, and in groups that received oligoelements + nicotine in single or repeated doses in medulla oblongata. Catalase showed significant decreased in cerebellum/medulla oblongata. Results suggest that nicotine induces changes in membrane fluidity in brain of young rats, and that ATPase could be a biomarker of nicotine consumption in young subjects.

Effect of flutamide and two novel synthetic steroids on GABA, glutamine and some oxidative stress markers in rat brain and prostate.

Flutamide is a steroid used to treat androgen-dependent disorders and as antiepileptic, but it induces a number of non-desirable side effects. This work was aimed at assaying the effect of flutamide and two novel synthetic steroids on the levels of GABA, glutamine and oxidative stress markers. Male Wistar rats (weight 180 g) received a single diazepam dose (5 mg/kg) 30 min prior to sacrifice (group A). Group B, flutamide; group C, 16ß-methyl-17α-benzoyloxypregnen-4-en-3,20-dione; group D, estrone-3-hemisuccinate; group E, testosterone; group F, progesterone; all administered intraperitoneally at 10 mg/kg, daily for 3 days. Brain and prostate were obtained to assess lipid peroxidation (TBARS), Na(+) , K(+) ATPase activity, reduced glutathione (GSH), γ-amino butiric acid (GABA), glutamine and serotonin (5-HT) concentrations through spectrophotometry, fluorescence and HPLC. GABA levels increased and glutamine decreased in group A (P < 0.05). Total ATPase activity increased in group F and TBARS decreased in group B (P < 0.05). GSH decreased in A, B and C groups. 5-HT increased in group A and the prostate weight was increased in group E. The conclusion is that 16ß-methyl-17α-benzoyloxypregnen-4-en-3,20-dione may be considered novel and promising to treat androgen-dependent diseases and epilepsy, since it showed an antioxidant effect and seemed to impair the GABAergic and serotonergic metabolism.

Effect of prostaglandin E1 (PGE1) and sildenafil on serotonin metabolism and some oxidative damage markers in rat prostate gland and brain.

The aim of this study was to evaluate the effect of sildenafil and prostaglandin E1 (PGE1) (drugs used in erectile dysfunction) on production of free radicals in prostate and brain of rat. A single dose of sildenafil (10 mg kg(-1) ) and PGE1 (20 µg kg(-1) ) was given to Sprague-Dawley rats (300 g weight) intraperitoneally. The levels of testosterone were measured in blood. Their brains and prostate glands were separated to measure lipid peroxidation, Na(+) and K(+) ATPase activity, reduced glutathione (GSH) and serotonin levels, by means of validated methods. The levels of testosterone increased slightly in animals treated with sildenafil and PGE1. The activity of total ATPase was increased in the prostate of animals treated with sildenafil + PGE1 but decreased in those that received sildenafil alone. PGE1 caused significant diminution of GSH levels in both organs. Sildenafil increased the levels of serotonine in brain, whereas in prostate they decreased instead. Our results suggest that sildenafil induced changes in GSH levels as well as in the serotonergic metabolism, alone or with PGE1 in prostate and brain, respectively. Thus, the combination therapy may be ideal to sustain the biochemical balance due to biphasic stimulation on brain and prostate.

Perfil epidemiológico de la candidiasis invasora en unidades de pacientes críticos en un hospital universitario / Epidemiologial profile of invasive candidiasis in intensive care units at a university hospital

Invasive candidiasis (IC) epidemiology has changed in critically ill patients and limited data are available in Chile. Objective: To describe the epidemiological and microbiological profile of IC in critically ill patients. Methods: Observational prospective study conducted from October 2001 to August 2003 in critically ill adults with suspected or confirmed IC. Results: 53 patients met criteria for IC, finding 18 (33.9 percent) candidemias, 22 (41.5 percent) disseminated IC, and 13 (24.5 percent) local IC. We identified 8 (44.4 percent) C. albicans and 10 (55.6 percent) non-albicans Candida in candidemias. C. tropicalis was the predominant non-albicans species (27.7 percent). An 88.8 percent of Candidas sp recovered in candidemias were fluconazole susceptible. Overall hospital mortality was 24.5 percent. Mortality in candidemia was significantly lower than in disseminated IC (16.6 vs 31.8 percent, p = 0.02). Conclusions: A higher proportion of non-albicans Candida was observed in candidemias from critically ill patients. However, most of these strains were fluconazole susceptible. A lower overall mortality was observed in candidemias.

La epidemiología de candidiasis invasora (CI) ha cambiado, lo cual no ha sido suficientemente estudiado en Chile. Objetivo: Describir el perfil epidemiológico y microbiológico de CI en pacientes críticos. Métodos: Estudio observacional prospectivo entre octubre 2001 y agosto 2003, en pacientes críticos adultos con sospecha o confimnación de CI. Resultados: 53 pacientes cumplieron criterios de CI. De ellos, 18 (33,9 por ciento) tuvieron candidemia, 22(41,5 por ciento) CI diseminada y 13(24,5 por ciento) CI local. Entre las candidemias, hubo 8 C. albicans (44,4 por ciento) y 10 Candida no albicans (55,6 por ciento), predominando C. tropicalis (27,7 por ciento). Un 88,8 por ciento de las candidemias fueron susceptibles a fluconazol. La mortalidad hospitalaria global fue 24,5 por ciento, significativamente menor en pacientes con candidemias vs CI diseminada (16,6 vs 31,8 por ciento, p = 0,02). Conclusiones: Se observó una mayor proporción de Candida no albicans en candidemias de pacientes críticos. Sin embargo, la mayoría de estas cepas fue susceptible a fluconazol. La mortalidad global fue menor en candidemias.

Implementación de 9 indicadores de calidad en un laboratorio hospitalario / Implementation of nine quality indicators in a hospital emergency clinical laboratory

Background: Quality indicators are tools used to monitor specific activities within a process and improve it. In the area of clinical laboratories, the National Accreditation Standards for Providers of Health and the ISO 15189 standard recommend the implementation of indicators that monitor the test cycle with emphasis on those that contribute to a safer health care. Aim: To describe the implementation of nine indicators in a hospital clinical laboratory and their measurement during one year. Material and Methods: The indicators implemented and measured were four of the pre-analytical phase (number of rejected samples, times of transport, blood culture contamination and blood cultures inoculated with adequate blood volumes), two of the analytical phase (coherence of Gram stains of blood culture with microorganism cultured and correct results in external quality control surveys) and three of the post-analytical phase (compliance with order to report lapse goals, corrected reports and alert values report). Results: Two indicators of pre-analytical phase did not meet the per determined targets: number of rejected samples and blood cultures inoculated with adequate blood volume. All indicators of the analytical and post analytical phases were within thepre-determined targets. Conclusions: Coordinated work should be initiated especially with the nursing service to correct the two indicators that did not meet the target. The incorporation of quality indicators to monitor critical processes within the laboratory was undoubtedly an opportunity to identify areas for improvement.

Reversibility of hepatic histological damage after surgical temporary obstruction of the common bile duct in a murine model.

The reversibility of hepatic histological damage after restoring bile flow in a murine model was assessed. 25 male Balb C mice (25-35 g, age 6 weeks) were divided into 5 groups and their common bile duct (CBD) fastened to obstruct the release of gall bladder and liver contents. Group I, CBD untied at day 10, group II at day 15, and groups III and IV at days 20 and 30, respectively. Hematoxilin-eosin stained liver slices were analysed 0, 5, 10 and 20 days after restoring bile flow. Group I showed slight histological lesions (second stage), as cholangiolar bile pigment concretion, pericholangiolar and portal collagen accumulation; group II, mild lesions (third stage), as cholangiolar hamartomatous proliferation and bile duct portal fibrosis; group III showed severe lesions (fourth stage), as loss of functional parenchyma, and also the second and first stage lesions. Group IV died before 30 days. First stage corresponds to absent lesions (control group). Group I recovered totally, group II recovered only from slight lesions and group III had irreversible damage. Severity of lesions increased gradually and accumulatively, irreversible hepatic damage was achieved at 20 days and is deadly at 30 days. Our model of temporary CBD obstruction was suitable to assess reversibility of hepatic histological damage.

Effect of orlistat on lipid peroxidation, Na+, K+ ATPase, glutathione and serotonin in rat brain.

The aim of this study was to evaluate the effect of orlistat, a drug used in weight loss, on 5-HT and indicators of oxidative stress in rat brain. Orlistat, 12 mg/kg was administered to Wistar rats as single dose or successive doses on 3 consecutive days. Blood glucose and oxidative stress indicators were detected by measurement of lipid peroxidation, Na+, K+ ATPase, glutathione and serotonin levels using previous validated methods. The levels of glucose decreased in rats receiving successive doses. The activity of Na+, K+ ATPase and total ATPase was reduced in rats receiving successive doses, while the level of lipid peroxidation increased slightly in both groups. Glutathione underwent significant reduction in the successive doses group (p < 0.05). 5-HT increased significantly after single dose treatment (p < 0.05). Orlistat can induce pro-oxidant effects in the brain due to alteration of serotonergic metabolism and the reduction of glutathione.

Evaluación de un test comercial de avidez de IgG: Aporte al diagnóstico de primoinfección por Toxoplasma gondii / Evaluation of an IgG avidity commercial test: Contribution to diagnosis of primary infection caused by Toxoplasma gondii

Introduction: Toxoplasmosis (T) is a major chronic parasitic infection in immunocompromised patients and pregnant women. It is important to discriminate between acute phase (AT) and chronic phase (CT). Diagnosis is serological in immunocompetent patients (concentration of IgG and IgM). Objective: To evaluate the utility of an IgG avidity test (A-IgG) to identify the acute and chronic stage. Avidity is the strength of affinity between a specific immunoglobulin and the protein antigenic epitope of the infecting agent, an affinity that increases over time. Patients and Methods: We used a qualitative kit that measures the avidity of IgG, discriminating the two phases. In 35 patients with clinical diagnosis of AT and/or CT, IgG, IgM and IgG A (VIDAS®) were performed. Results: Patients with AT were positive for IgM and IgG, but presented weak avidity. In the 21 cases with CT, 52 percent (n: 11) were IgM positive and 100 percent (n: 21) had positive IgG with strong avidity. Discussion: The results confirm that the test of A-IgG may be useful in the diagnosis of AT, and has 100 percent concordance with reference test (qualitative IgM + quantitative IgG). The result is available within 24 hrs, and may be useful in diagnosis of AT in pregnant women.

Introducción: Toxoplasmosis (T) es una infección parasitaria crónica importante en pacientes inmunocompro-metidos y mujeres embarazadas. Es relevante discriminar entre fase aguda (TA) y fase crónica (TC). Su diagnóstico es serológico en inmunocompetentes (detección de IgG e IgM). Objetivo: Evaluar la utilidad del test de avidez IgG (A-IgG) para identificar la fase aguda y o crónica. Avidez es la fuerza de afinidad entre una inmunoglobulina específica y el epítope de la proteína antigénica del agente infectante, afinidad que aumenta con el tiempo. Pacientes y Métodos: Se usó un test cualitativo que mide la avidez de IgG, discriminando las dos fases. A 35 pacientes con diagnóstico clínico de TA y o TC, se les realizó IgG, IgM e A-IgG en Equipo VIDAS®. Resultados: Los pacientes con TA fueron positivos para IgM e IgG y presentaron avidez débil. Los 21 casos con TC 52 por ciento (n: 11) tuvieron IgM positivo y 100 por ciento (n: 21) tuvo IgG positiva con avidez fuerte. Discusión: Los resultados confirman que el test de A-IgG puede ser de gran utilidad en el diagnóstico de TA, concordancia: 100 por ciento con test de referencia (IgM cualitativa + IgG cuantitativa). El resultado está disponible en menos de 24 hrs, pudiendo ser útil en el diagnóstico de TA en mujeres embarazadas.

¿Cuándo dos exámenes seriados de laboratorio representan un cambio en el estado de salud de un paciente? / When two consecutive laboratory results indicate a change in health status in a patient?

Sources of variation between two serial tests must be considered in interpreting if there was a clinically significant change. The main causes of variation are the biological variation coefficient (CVB) of the test in question, which must be obtained from the literature, and the analytical coefficient of variation (CVA) of the same test, which must be obtained from the internal quality control laboratory data. With both data we can calculate the critical difference or “reference change value” which helps us to decide whether there was a real change in the patient’s health.

Troponina en el diagnóstico de infarto al miocardio: consideraciones desde el laboratorio clínico / Troponin in the diagnosis of myocardial infarction: an approach from the clinical laboratory

Among the many biomarkers studied to evaluate myocardial damage, troponin is considered the most sensitive and specific. However, current methodologies present pre-analytical, analytical and post-analytical problems, of which the more significant are the lack of standardization and a high uncertainty in the level of decision or cut-off. It is hoped that a new generation of assays called "ultra sensitive" will improve analytical performance characteristics of the technique and achieve compliance with the internationally recommended quality specifications.

Entre los múltiples biomarcadores estudiados para evaluar daño miocárdico, la troponina se considera el más sensible y específico. Sin embargo, la mayoría de las metodologías actuales utilizadas para su determinación presentan problemas tanto pre-analíticos, analíticos como post-analíticos, de los cuales los más relevantes son la falta de estandarización y una imprecisión alta en el nivel de decisión o de corte. Se espera que una nueva generación de ensayos para la determinación de troponina, denominados ultrasensibles, mejoren las características de desempeño de la técnica y logren cumplir con las especificaciones de calidad recomendadas internacionalmente.

Confounding and interaction effect of Treponema denticola salivary carriage in chronic periodontitis.

AIM: To evaluate the salivary carriage of Treponema denticola and its association with demographic variables in the etiopathogenesis of chronic periodontitis. SUBJECTS AND METHODS: Ninety-seven chronic periodontitis (CP) patients and a control group of 51 healthy subjects (HC) were selected. Periodontal status was assessed by criteria based on probing depth, attachment loss, extent, and severity of periodontal breakdown. A polymerase chain reaction method was used to determine the occurrence of T. denticola in saliva samples. Risk indicators for CP were assessed individually and adjusted for confounding and/or interaction using a logistic regression model. RESULTS: Although univariate analysis revealed a positive association of age >or=30 years, smoking, and salivary carriage of T. denticola with CP, after logistic regression analysis, the association between age >or=30 years/smoking and CP persisted, whereas salivary carriage of T. denticola failed to achieve statistical significance. An interaction effect was significantly detected between these three variables. CONCLUSION: Although salivary carriage of T. denticola may be a risk indicator for CP, its pathogenicity should not be exclusively endorsed to its detection in saliva, but it might be associated with the synergistic biological interaction of the bacterium with some demographic characteristics of the susceptible host.