RESUMO
Actinomycosis is a very rare, infectious disease, which is especially difficult to diagnose due to non-specific symptoms and the ability to emulate neoplasms or inflammatory changes. Due to those facts, it is often misdiagnosed or diagnosed too late to be successfully treated. This article presents the case of 31-year-old Caucasian female with recurrent upper respiratory tract infections and tonsillitis as the potential risk factors of actinomycosis. Upon examination of material collected through the course of tonsillectomy, the patient was diagnosed with actinomycosis of the left palatine tonsil. Despite the introduction of antibiotic therapy, initial progression was noted with the appearance of numerous, hypodense changes in the liver and the spleen, which regressed during further antibiotic treatment. According to our team's knowledge, this is the first described case of a patient with actinomycosis occurring simultaneously in the cervico-facial and abdominal area. The unusual localization and potential dissemination of actinomycosis should be considered in clinical practice.
Assuntos
Actinomicose , Tonsilite , Humanos , Feminino , Adulto , Actinomicose/diagnóstico , Actinomicose/tratamento farmacológico , Tonsilite/microbiologia , Tonsilite/tratamento farmacológico , Tonsilite/diagnóstico , Antibacterianos/uso terapêutico , Actinomicose Cervicofacial/diagnóstico , Actinomicose Cervicofacial/tratamento farmacológico , AbdomeRESUMO
Actinomycosis is one of the greatest 'chameleons' among infectious diseases. It may imitate inflammation, abscess or a neoplasmatic tumor. Moreover, correct diagnosis is even more challenging due to the fact that the disease takes on various forms like: cervicocephalic, abdominal, or affects the reproductive organs. In order to highlight the diagnostic difficulties of actinomycosis, we have decided to describe six cases of female patients (aged 31-73 years, mean age: 52 years) hospitalized due to actinomycosis in the Department of Infectious Diseases and Hepatology between 2014-2019. Additionally, a case of one patient was described in detail as the course of her disease was exceptionally non-specific. Only in 2 of 6 patients the primary diagnosis was correct. The four other patients were initially suspected with cancer or inflammation. Three of the patients were diagnosed with the abdominal form of actinomycosis, one - neck and head, and one presented both locations. Only histopathological examinations during invasive procedures allowed to state the final diagnosis. An adequate diagnosis was associated with a number of additional tests and delayed appropriate treatment. WBC and CRP were within normal range in all patients. Four patients completed treatment successfully after 60-192 days, one is still on therapy and one is lost to follow-up. In conclusion, common features of actinomycosis presented in this case series include predominance of female gender, abdominal localization and lack of typical symptoms. What is more, therapy with antibiotics, mainly doxycycline and beta-lactams resulted in complete regression of lesions in the majority of cases. Given the examples of our patients we believe that actinomycosis should be considered in the differential diagnosis of all abdominal tumors, especially in women. Abbreviations: WBC - white blood cells, CRP - C-reactive protein, CT - computed tomography, IUD - Intra-Uterine Device, i.v. - intravenous.
Assuntos
Actinomicose , Dispositivos Intrauterinos , Abscesso/tratamento farmacológico , Actinomicose/diagnóstico , Actinomicose/tratamento farmacológico , Antibacterianos/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , PolôniaRESUMO
INTRODUCTION: The oral cavity is a unique ecosystem in which the microbiome is formed by the colonization of billions of bacteria, viruses, and fungi. Aim of the study was to assess the quality and quantity of bacterial microbiota of the oral cavity in children with type 1 diabetes in comparison to healthy children. MATERIAL AND METHODS: The study group consisted of 50 randomly selected type 1 diabetic children aged 10-18 years divided into 2 groups (25 people each) according to the level of diabetes control: well-controlled group (WC) - HbA1c ≤ 7.5%) and poorly-controlled group (PC) - HbA1c > 7.5%. The control group (GC) consisted of 25 randomly selected children with no systemic diseases. The material for microbiological tests was collected as two swabs: one from the bottom of the oral cavity and the other one from the posterior part of the dorsum of the tongue). RESULTS: The statistical analysis revealed statistically significant differences in the total number of isolated microorganisms between PC and GC (post hoc test p = 0.003) and WC and GC (post hoc test p < 0.001). There were no statistically significant differences in the number of isolated microorganisms between PC and WC (p = 0.195). CONCLUSIONS: Oral microbiome in type 1 diabetic children is significantly quantitatively different in comparison to healthy children. There are also visible qualitative differences in the profile of oral microbiota in type 1 diabetic children and healthy children.
Assuntos
Diabetes Mellitus Tipo 1 , Microbiota , Criança , Humanos , BocaRESUMO
The appropriate approach to dental patients, developed during the course of dentists' training, is a prerequisite for the holistic treatment of patients. Empathy is an important component of such an approach. This study aimed to determine the levels of empathy among students of dentistry at different stages in their training.The Jefferson Scale of Empathy - Health Profession Students Version was used to conduct the research, and 100 dental students (66 female and 34 male) ranging from first to fifth year participated in the survey. The scale contained 20 questions, with a possible score interval between 20 and 140. A higher score indicates increased ability to express empathy.The level of empathy among dentistry students increased from the first and second to fourth years, where it reached its maximum. During the fifth year, a decrease in levels of empathy was observed.The increase in empathy during the dental course may be correlated with the growth of clinical practice during the subsequent years of study. A slight decrease in empathy in the fifth-year students may be due to the curricular focus on performing procedures, with students having to meet a set target in order to finish the course.
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Atitude do Pessoal de Saúde , Empatia , Estudantes de Odontologia/psicologia , Adulto , Educação em Odontologia , Feminino , Humanos , Masculino , Assistência Centrada no Paciente/métodos , Polônia , Distribuição por Sexo , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: Type 1 diabetes mellitus (T1DM) is a chronic metabolic disease that strongly affects the health of individuals. Some studies have sug-gested that it affects oral health, thus indicating a higher-than-average predisposition of patients with diabetes to caries and periodontal diseases. AIM OF THE STUDY: We aimed at investigating the association between caries, periodontal diseases, and diabetes among children using dental indices. MATERIAL AND METHODS: The study included 50 children (aged 10-18 years) who had type 1 diabetes for at least years. The participants were divided into well controlled (WC), (HBA1c < 7.5%) and poorly controlled (PC) (HBA1c ≥ 7.5%) groups (25 diabetic children each). The control group (GC) included non-diabetic children. The following clinical parameters were measured: DMFT index, plaque index (PI), approximal plaque index (API), gingival index (GI), and modified sulcus bleeding index (mSBI). RESULTS: The WC group had the lowest average value - 3.44 of the DMFT index with values of 5.80 and 3.88 in the PC and GC groups, respec-tively. A statistically significant difference was found in the DMFT value between PC and WC groups (p = 0.04). No statistically signif-icant differences in the values of other indices were found between the groups. CONCLUSIONS: Children with poorly controlled type 1 diabetes were characterised by a significantly higher intensity of caries. In contrast, no statistical-ly significant differences were observed in the periodontal status between the study groups.
Assuntos
Cárie Dentária/etiologia , Diabetes Mellitus Tipo 1/complicações , Adolescente , Placa Dentária/etiologia , Feminino , Gengivite/etiologia , Humanos , Masculino , Doenças Periodontais/etiologia , Índice PeriodontalRESUMO
INTRODUCTION AND OBJECTIVE: Dentists experience high amounts of professional stress beginning with their student years in dental school. This stress, given its early onset, may negatively impact the personal and professional lives of these individuals, as well as the quality of their clinical work. We sought to create an objective scale to evaluate the levels of stress in students at different stages of their education, as well as in practicing physicians. MATERIALS AND METHODS: Thirty dental students participated in this study, with 10 students each selected from junior, mid-senior, and senior classes. They were randomly divided into two groups in which one group was subjected to stressors while the other group was not. JINS MEME ES_R (JINS) smart glasses and Garmin Vivoactive 3 smartwatches were used to obtain data, including electrooculography (EOG), heart rate (HR), and accelerometer (ACC) and gyroscope (GYRO) feedback, while the subjects performed a dental exercise on a phantom tooth. RESULTS: The heart rates of more experienced students were lower than those of the junior students. The EOG, ACC, and GYRO signals showed multiple differences in the measurement of amplitudes and frequency of episodes. CONCLUSION: Our pilot results show that electronic tools, like smart glasses with software and sensors, are useful for monitoring the stress levels of dental students in preclinical operating conditions. We would like to further assess the stress levels in students performing dental procedures on phantom teeth and in later clinical interactions with patients.