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1.
Int J Immunopathol Pharmacol ; 27(2): 267-72, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25004839

RESUMO

A 23-year-old man was admitted to hospital with a 12-day history of daily fever. A clinical history revealed that 10 months previously, the patient had been splenectomized and polytransfused for a severe blunt trauma. On admission, laboratory data revealed significant leukocytosis (33,230/ul). The patient's general clinical conditions rapidly worsened into a severe systemic inflammatory response syndrome in four days. After 10 days of broad-spectrum antibiotic treatment, the temperature curve was unmodified and severe leukocytosis persisted (44,300 ul) with absolute lymphocytosis. Laboratory tests ruled out hematological diseases, pneumonia, abscesses and endocarditis. In the light of IgM positivity for CMV (unconfirmed by PCR) and with the support of a PubMed search, we commenced a salvage treatment with intravenous ganciclovir, suspecting a viral infection or reactivation. After two days of therapy, an immediate defervescence was observed with a remarkable clinical improvement. After 10 days, the clinical syndrome had been completely resolved and the patient was discharged in good, general clinical health.


Assuntos
Antivirais/uso terapêutico , Transfusão de Sangue , Infecções por Citomegalovirus/tratamento farmacológico , Ganciclovir/uso terapêutico , Terapia de Salvação , Esplenectomia , Síndrome de Resposta Inflamatória Sistêmica/tratamento farmacológico , Ferimentos não Penetrantes/terapia , Administração Intravenosa , Antivirais/administração & dosagem , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/virologia , Medicina Baseada em Evidências , Ganciclovir/administração & dosagem , Humanos , Masculino , PubMed , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/virologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
2.
Front Oral Health ; 5: 1495012, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39483115

RESUMO

Introduction: In the last decades, dermal fillers have gained widespread acceptance for cosmetic purposes since their approval for different health conditions, including lip augmentation and aesthetic intervention of the face. Unfortunately, while filler lip procedures are performed using biomaterials with improved physical characteristics, they are not devoid of adverse drug reactions (ADRs), including those with late-onset. Methods: This systematic aims to investigate the ADRs associated with lip augmentation procedures using dermal fillers. A systematic review search was conducted in Medline/PubMed, Scopus, Web of Science to answer the PEO question: What are the ADRs in patients undergoing lip augmentation procedures with dermal fillers, and how frequent are they? Results: The risk of bias was assessed, and a systematic review was conducted. Nineteen studies were included. In total, 30 patients affected by filler lip ADRs were analyzed, of which 29 were females and only 1 was male with a mean age of 50.9 ± 12.8 years. Hyaluronic acid was the most commonly dermal filler used and granulomatous foreign body reaction was the most common filler lip reaction reported. The mean time between filler lip injection and granulomatous foreign body reaction onset was 57.9 ± 54 months (median 24 months). Discussion: No study reported ADRs to regulatory authorities. Our results indicate that adverse reactions can occur even long-term after the aesthetic procedure. Therefore, ongoing short-term and long-term follow-up visits are essential, as biocompatible materials are not free from ADRs. Additionally, a lack of reporting ADRs to regulatory authorities has emerged, which is crucial for patient safety. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=534656, identifier: CRD42024534656.

3.
Oral Dis ; 18(4): 396-401, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22221322

RESUMO

OBJECTIVE: The aim of this study is to assess the main oral mucosal lesions (OMLs) within a hospital base and to provide an anamnestic, diagnostic model based on homogeneity analysis of some variables. METHODS: The demographic and behavioural data (i.e. gender, age, smoking status, alcohol consumption and therapeutic drug usage) of 1753 patients with at least one OML were considered. Multiple correspondence analysis (MCA) and multivariate tests of the simultaneous marginal homogeneity hypothesis (SMH) were used to analyse the evidence of any differences between the demographic and behavioural profiles relating to OMLs diagnoses. Statistical significance of P < 0.05 was chosen. RESULTS: With respect to the model used, patients affected by oral squamous cell carcinoma (n = 65; 3.5%) and oral leukoplakia (n = 73; 4.0%) differed significantly for demographic and behavioural characteristics analyzed, in particular with respect to gender (63.9%vs 50.1% males) and alcohol consumption (29.1%vs 12.1%). Patients affected by burning mouth syndrome (n = 134; 7.3%) and bisphosphonate-related osteonecrosis of the jaw (n = 40; 2.2%) differed significantly for chronic use of drugs (45.7%vs 71.6%). Finally, patients with halitosis (n = 60; 3.3%) and recurrent aphthous stomatitis (n = 103; 5.6%) showed similar profile, mainly in terms of men (47.6%), drinker (4.8%), drug user (34.9%), ≥60 years old (20.8%) and smoker (6.4%). CONCLUSION: Knowledge of some similarities in patients' profile could help in positing the likely presence of OML when making diagnosis process by either general physicians or dentists, especially those without extensive experience in the field of oral medicine.


Assuntos
Comportamentos Relacionados com a Saúde , Doenças da Boca/epidemiologia , Neoplasias Bucais/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/epidemiologia , Síndrome da Ardência Bucal/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Criança , Pré-Escolar , Demografia , Tratamento Farmacológico/estatística & dados numéricos , Feminino , Halitose/epidemiologia , Humanos , Itália/epidemiologia , Leucoplasia Oral/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fumar/epidemiologia , Estomatite Aftosa/epidemiologia , Adulto Jovem
4.
Oral Dis ; 16(1): 102-7, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19735453

RESUMO

OBJECTIVE: Desquamative gingivitis (DG) represents the gingival manifestation associated with several mucocutaneous disorders and systemic conditions. Little is known of whether or not DG could influence the onset or progression of plaque-related periodontitis. In this study, the potential impact of DG on plaque-related attachment loss and pocket formation has been evaluated. METHODS: A cross-sectional evaluation of 12 patients with DG [eight oral lichen planus (OLP), four mucous membrane pemphigoid (MMP)], never treated for DG lesions or plaque-related periodontitis, was carried out. Probing depth (PD), clinical attachment loss (CAL), full-mouth plaque (FMPS), and bleeding (FMBS) scores were evaluated at six sites per tooth. Clinical parameters of sites with DG lesions were compared with that of DG unaffected sites. RESULTS: Median PD and CAL, as well as FMPS and FMBS, were not significantly different (P > 0.05 Mann-Whitney test) for both OLP and MMP patients. However, a negative association between DG lesions and PD < 4 mm (OLP: OR = 0.26; MMP: OR = 0.47), and a positive association with PD 4-6 mm (OLP: OR = 3.76; MMP: OR = 2.68) and with PD > 6 mm (only for OLP: OR = 3.83) were found to be significant. CONCLUSIONS: The potential interference between DG lesions and periodontitis needs further prospective investigation; nonetheless, a higher level of attention might be prudent.


Assuntos
Gengivite/complicações , Gengivite/patologia , Perda da Inserção Periodontal/etiologia , Bolsa Periodontal/etiologia , Adulto , Idoso , Distribuição de Qui-Quadrado , Estudos Transversais , Placa Dentária/complicações , Feminino , Humanos , Líquen Plano Bucal/complicações , Masculino , Pessoa de Meia-Idade , Razão de Chances , Higiene Bucal/estatística & dados numéricos , Penfigoide Mucomembranoso Benigno/complicações , Projetos Piloto , Estatísticas não Paramétricas
5.
Eur J Dent Educ ; 14(1): 17-25, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20070795

RESUMO

OBJECTIVE: The aim of this study was to investigate the smoking habits of Italian dental and dental hygiene students and to assess their knowledge on the health effects of cigarette smoking and their attitudes toward tobacco-use cessation (TUC) in dental practice. MATERIALS AND METHODS: Data was collected from 220 students attending the Dental and Dental Hygiene Schools (DS and DHS, respectively) at the University of Palermo (Italy). RESULTS: The percentage of smokers amongst DS and DHS students was similar (32.78% vs. 32.5%) with 67.77% of DS students and 77.5% of DHS agreeing that the damages to health caused by smoking were covered in their didactic course work. A high percentage of DS (63.33%) and DHS (67.5%) students reported the relationship between smoking and a number of associated health conditions. Both DS and DHS students showed poor knowledge of TUC interventions. Both DS and DHS students reported to be conscious of their own role as a counsellor, with DHS students feeling more comfortable in approaching counselling in clinical practice. Although DS and DHS students reported a positive attitude toward TUC interventions, almost half of the students had some concerns about the effectiveness of smoking cessation activities. DISCUSSION: The introduction of a comprehensive tobacco education curriculum in DS and DHS programs could further improve students' perceptions and attitudes and provide knowledge and clinical experience which would lead to the incorporation of TUC into subsequent professional practice.


Assuntos
Atitude do Pessoal de Saúde , Higienistas Dentários/educação , Abandono do Hábito de Fumar/psicologia , Estudantes de Odontologia/psicologia , Doença das Coronárias/etiologia , Aconselhamento , Higienistas Dentários/psicologia , Educação em Odontologia , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Itália , Leucoplasia Oral/etiologia , Neoplasias Pulmonares/etiologia , Masculino , Neoplasias Bucais/etiologia , Saúde Bucal , Doenças Periodontais/etiologia , Fumar/efeitos adversos , Fumar/psicologia
6.
Ann Ig ; 22(1): 69-81, 2010.
Artigo em Italiano | MEDLINE | ID: mdl-20476665

RESUMO

The aim of this study was to evaluate the level of edentulousness and the prosthetic treatment need in a sample of the over 18-year-old inhabitants of Palermo (Italy). A stratified sample of 385 subjects (183 female and 202 male) was taken to represent the population of the city. Each subject included in the study was examined to record the level of edentulousness (complete edentulousness, partial edentulousness, intact dentition) and the level of denture wearing. Requirement for repair of dentures was recorded according to the marginal fitting for fixed dentures, and to the extension, stability and retention for removable dentures. Complete edentulousness of one or both arches was present in 4,6% of the studied population, whereas 184 (34.8%) of the sample population had intact dentition. Partial edentulousness was present in 60.6% of the subjects surveyed, but only the 45.9% of these was wearing dentures. Loss of structural integrity or incongruous marginal fitting was found in the 37.9% of fixed dentures. The majority of partial and complete removable dentures (74.5%) did not ever undergo relining, and the 51.7% of them needed relining or replacement. Statistical analysis (chi-square test) showed that the level of edentulousness was correlated with age; similarly, the frequency of dental visits significantly impacted on the number of missing tooth (P < 0.01). The results of the present study show that the adult inhabitants of Palermo had high level of partial edentulousness and low level of denture wearing. The majority of existing removable dentures required relining or replacement.


Assuntos
Prótese Dentária , Boca Edêntula/terapia , Adolescente , Adulto , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Saúde da População Urbana , Adulto Jovem
7.
Panminerva Med ; 51(2): 125-31, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19776713

RESUMO

Dysphagia, defined as a difficulty in swallowing of fluids and/or solid foods, is one of the most frequent symptoms of esophageal, gastrointestinal, ear, nose and throat diseases. As such, it poses a diagnostic challenge and an interdisciplinary clinical problem. Of particular importance in diagnosis is to distinguish between esophageal and oropharyngeal dysphagia. Oropharyngeal dysphagia is often associated with neuromuscular disorders and is treated with rehabilitative protocols, while esophageal dysphagia may be due to anatomical alterations and esophageal motility difficulties. While the former can be adequately treated with endoscopic or surgical therapy, the latter are currently treated only pharmacologically. Interestingly, dysphagia may present as the initial symptom of a wide spectrum of oral conditions, including traumatic ulcerations, neuromuscular diseases, systemic and local immuno-mediated or infectious lesions, malignant neoplastic diseases or mucositis following chemo-radiotherapy for head and neck cancers: in these cases it is called oral dysphagia. Dysphagia, with or without evident oral lesions, suggests the presence of an oropharyngeal disease and requires adequate diagnostic-therapeutic management. This paper describes the major oral and systemic diseases that may manifest themselves with oral manifestations inducing dysphagia. Clinical management guidelines in dysphagia triggered by neuromyogenic pathogenesis are discussed.


Assuntos
Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/etiologia , Deglutição , Transtornos de Deglutição/fisiopatologia , Transtornos de Deglutição/terapia , Diagnóstico Diferencial , Humanos , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Fatores de Risco
8.
J Endocrinol Invest ; 32(6): 538-41, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19474528

RESUMO

BACKGROUND AND AIMS: Metabolic syndrome (MS) may be associated with the presence of an energy-sparing metabolism that predisposes to the excess accumulation of body fat. This study examined the relationship between reported energy intake and obesity in individuals with and without MS. METHODS AND RESULTS: Ninety consecutive non-diabetic obese subjects were divided into 2 groups based on the presence (MS+: no.=50) or absence (MS-: no.=40) of MS. The study design was cross-sectional. The 3-day food record method was used to assess the subjects' usual energy intake and the Diet Readiness Test (DRT) was also administered. Compared to the MS- group, the MS+ group had a significantly higher body weight, body mass index (mean+/-SEM: 39.1+/-1.3 vs 31.5+/-0.9, p<0.001) and fat mass. The absolute energy intake of the MS+ group (8629+/-331 kJ/24h) did not differ from that of the MS- group (8571+/-515 kJ/24h; p=ns). The daily energy intake normalized for the fat-free mass (FFM) size was higher in the MS- group (163+/-8 kJ/kg-FFM x 24h) than in the MS+ group (138+/-4 kJ/kg-FFM x 24h; p<0.03). The DRT test results were similar in both groups except that section 6 (exercise patterns and attitudes) score was lower in the MS+ group (10.0+/-0.5) than in the MS- group (11.9+/-0.5; p<0.01). CONCLUSION: The results of this study support the hypothesis that subjects with MS have an energy-sparing metabolism.


Assuntos
Ingestão de Energia/fisiologia , Síndrome Metabólica/metabolismo , Adulto , Metabolismo Basal/fisiologia , Glicemia/metabolismo , Pressão Sanguínea/fisiologia , Composição Corporal , Índice de Massa Corporal , Peso Corporal/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Insulina/sangue , Modelos Lineares , Masculino , Síndrome Metabólica/sangue , Obesidade/sangue , Obesidade/metabolismo
9.
Arch Oral Biol ; 53(4): 388-97, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18191810

RESUMO

OBJECTIVE: To assess a panel of risk factors associated to oral candidosis (OC) onset and its chronic maintenance by means of fuzzy logic (FL) approach and statistical traditional methodology (STM); to investigate their casual relationship within a multifactorial framework. DESIGN: Case-control study. SETTING: One hospital-based clinic. PATIENTS: Eighty-nine patients with OC infection microbiologically diagnosed and 98 healthy subjects were consecutively recruited. OUTCOME MEASUREMENTS: Anamnestic and clinical evaluations for OC, microbiological assessment (i.e. culture, CFU/mL counting and identification) were performed. The commonest predisposing factors for OC onset and its chronic status were analysed by FL and STM. RESULTS: By means of a twofold analysis (FL and STM) significant associations between OC onset and its chronic maintenance were found with respect to denture wearing and hyposalivation/xerostomia, as local risk factors, and to age and female gender, as socio-demographical variables. Tobacco smoking was found not to be a risk factor. CONCLUSIONS: The twofold (FL and STM) statistical approach for the identification of OC risk factors has been found useful and accurate in individuating a more selected target population for OC onset and chronic maintenance. The target patient appears to be an elderly person with multiple disease inducing, directly or by medications, hyposalivation/xerostomia. This data could provide to general and dental practitioners a decision-making model finalised to their preventative strategies for the geriatric population.


Assuntos
Candidíase Bucal/etiologia , Infecções Oportunistas/etiologia , Doença Aguda , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Doença Crônica , Dentaduras/efeitos adversos , Feminino , Lógica Fuzzy , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Xerostomia/complicações
10.
Eur J Paediatr Dent ; 9(4 Suppl): 19-22, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19886368

RESUMO

BACKGROUND: The Smith-Lemli-Opitz Syndrome (SLOS) is an autosomal recessive genetic disorder, characterised by multiple congenital malformations, dysmorphic facial features and mental retardation. SLOS is caused by a genetically inherited deficiency of the enzyme 7-dehydrocholesterol delta7 reductase (7-DHC reductase), the catalyst involved in the final step of cholesterol biosynthesis, with the consequence of an increased serum levels of 7-DHC and generalised cholesterol deficiency. CASE REPORT: A 5-year-old female child was referred to the Department of Paediatric Dentistry of the University of Palermo for caries, gingivitis and malocclusion. The medical history revealed the diagnosis of SLOS, confirmed by a biochemical analysis 5 weeks after birth. The child exhibited several dysmorphic craniofacial features, typical of SLOS. Dental treatment, including oral prophylaxis, was performed without sedation. Instructions on proper oral self-care and dental disease prevention were provided to the mother of the patient. CONCLUSION: Suggestions regarding comprehensive dental care may be important to properly treat children with SLOS in the dental office.


Assuntos
Cárie Dentária/terapia , Gengivite/terapia , Mordida Aberta/terapia , Síndrome de Smith-Lemli-Opitz/patologia , Pré-Escolar , Profilaxia Dentária , Feminino , Seguimentos , Humanos , Higiene Bucal
11.
Minerva Stomatol ; 56(1-2): 31-44, 2007.
Artigo em Inglês, Italiano | MEDLINE | ID: mdl-17287705

RESUMO

The aim of this paper was to provide a systematic review of the literature on the root resorption caused by orthodontic treatment. Original papers on this subject, published in English from January 2000 until December 2005, were located in the MEDLINE/PubMed database. Other sources were taken from the references of the selected papers. Root resorption is the most common sequela of the orthodontic treatment. It is an inflammatory process that leads to an ischemic necrosis localized in the periodontal ligament when the orthodontic force is applied. The onset and progression of root resorption are associated with risk factors related to the orthodontic treatment such as the duration of treatment, the magnitude of the force applied, the direction of the tooth movement, the method of force application (continuous versus intermittent), the orthodontic movement. Patient-related risk factors are the individual susceptibility on a genetic basis, some systemic diseases, anomalies in root morphology, dental trauma, and previous endodontic treatment. The prevention of root resorption during the orthodontic treatment may be performed controlling the risk factors. The periodic radiographic control during the treatment is necessary in order to detect the occurrence of root damages and quickly reassess the treatment goals.


Assuntos
Ortodontia Corretiva/efeitos adversos , Reabsorção da Raiz/etiologia , Suscetibilidade a Doenças , Etnicidade/estatística & dados numéricos , Humanos , Inflamação/complicações , Má Oclusão/complicações , Má Oclusão/terapia , Fatores de Risco , Tratamento do Canal Radicular , Reabsorção da Raiz/epidemiologia , Reabsorção da Raiz/patologia , Traumatismos Dentários/complicações , Técnicas de Movimentação Dentária/efeitos adversos , Raiz Dentária/anormalidades
12.
Ann Ig ; 18(2): 155-70, 2006.
Artigo em Italiano | MEDLINE | ID: mdl-16649513

RESUMO

The aim of this paper was to present specific strategies to guide dental professionals providing smoking cessation interventions. Original papers, reviews and current guidelines on this subject, published in English from 2001 to the first semester of 2005, were located in the MEDLINE/Pubmed database. Additional publications were obtained by searching the reference lists of retrieved studies. The "Five A's" strategic approach represents a brief and effective protocol for smoking cessation that members of dental team can use with all patients in their office practice. Intensive interventions, more effective than brief ones, can be further adopted with any smokers willing to make a quit attempt. All patients attempting to quit should also be encouraged to use the approved pharmacotherapy agents, including nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, and bupropion sustained released. These medications significantly increase success rates and offer valuable assistance in the reduction of nicotine withdrawal symptoms. The evidence presented supports the efficacy of smoking cessation counselling by oral health professionals. Dentists and dental hygienists, therefore, should be trained on smoking cessation counselling and dental offices should incorporate this service into routine patient care.


Assuntos
Aconselhamento , Recursos Humanos em Odontologia , Abandono do Hábito de Fumar/métodos , Prevenção do Hábito de Fumar , Administração Cutânea , Adolescente , Adulto , Idoso , Antidepressivos de Segunda Geração/administração & dosagem , Bupropiona/administração & dosagem , Goma de Mascar , Higienistas Dentários , Odontólogos , Inibidores da Captação de Dopamina/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nicotina/administração & dosagem , Agonistas Nicotínicos/administração & dosagem , Terapia Respiratória , Fumar/efeitos adversos , Fumar/tratamento farmacológico , Abandono do Hábito de Fumar/psicologia , Fatores de Tempo
13.
Minerva Stomatol ; 54(1-2): 1-14, 2005.
Artigo em Inglês, Italiano | MEDLINE | ID: mdl-15902058

RESUMO

The aim of this paper was to review the relationship between periodontitis and preterm delivery (PTD). Original papers on this subject, published in English until the first quarter of 2004, were located in the MEDLINE/PubMed database. Additional papers were obtained by searching reference lists of previously published review papers. Case control studies pointed to an association between periodontitis and increased rates of PTD of low birth-weight (LBW) infants. Longitudinal studies showed that the incidence or progression of periodontitis during pregnancy may be an independent risk factor for PTD and LBW. Microbiological, immunological and animal model studies suggested that periodontal pathogens and their products may translocate to the fetal-placental unit resulting in PTD or fetal growth restriction. Maternal periodontal infection may also provide a chronic reservoir of inflammatory mediators and cytokines (TNF-alpha, IL-1, IL-6, PGE2) that could adversely affect pregnancy outcome. Randomized controlled studies published indicated that periodontal treatment significantly reduces the risk of PTD and LBW infants. If these results are confirmed in further intervention studies, then prevention and treatment of periodontitis should be considered as a necessary part of prenatal care.


Assuntos
Trabalho de Parto Prematuro/etiologia , Periodontite/complicações , Animais , Doença Crônica , Feminino , Humanos , Gravidez
14.
J Periodontol ; 68(8): 729-33, 1997 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-9287062

RESUMO

The purpose of this study was to investigate the in vitro antifungal properties of seven commercial mouthrinses containing antimicrobial agents. These included cetylpyridinium chloride (CPC), chlorhexidine digluconate (CHX), hexetidine (HEX), sanguinarine (SNG), and triclosan (TRN). The minimum fungicidal concentration (MFC) against six species of yeasts was determined by a broth macrodilution method. The kill-time of mouthrinses at half the concentration of the commercial formulations was also determined. MFCs were achieved with each mouthrinse, except the SNG-containing mouthrinse, against all the organisms being tested. However, the CPC-containing mouthrinse appeared more active than the other products (P < 0.001). There were no significant differences in MFC values among CHX mouthrinse products, once adjusted for initial concentration differences (P = 0.1). Kill-times of mouthrinses containing either CHX or CPC were less than or equal to 180 seconds with all the species of yeasts, and no significant differences were found among these products (P = 0.18). On the other hand, mouthrinses containing either TRN or HEX did not show a lethal effect on Candida albicans, Candida parapsilosis, or Candida guilliermondii. No kill-times were achieved with the SNG-containing mouthrinse. These results suggest that mouthrinses containing antimicrobial agents might represent an appropriate alternative to conventional antifungal drugs in the management of oral candidiasis. However, the effectiveness of antimicrobial mouthrinses as antifungal agents needs to be evaluated in further clinical trials.


Assuntos
Anti-Infecciosos Locais/farmacologia , Antifúngicos/farmacologia , Fungos/efeitos dos fármacos , Antissépticos Bucais/farmacologia , Alcaloides/administração & dosagem , Alcaloides/farmacologia , Anti-Infecciosos Locais/administração & dosagem , Antifúngicos/administração & dosagem , Benzofenantridinas , Candida/efeitos dos fármacos , Candida albicans/efeitos dos fármacos , Candidíase Bucal/tratamento farmacológico , Cetilpiridínio/administração & dosagem , Cetilpiridínio/farmacologia , Clorexidina/administração & dosagem , Clorexidina/análogos & derivados , Clorexidina/farmacologia , Ensaios Clínicos como Assunto , Contagem de Colônia Microbiana , Estudos de Avaliação como Assunto , Hexitidina/administração & dosagem , Hexitidina/farmacologia , Humanos , Isoquinolinas , Antissépticos Bucais/administração & dosagem , Saccharomyces cerevisiae/efeitos dos fármacos , Fatores de Tempo , Triclosan/administração & dosagem , Triclosan/farmacologia
15.
Artigo em Inglês | MEDLINE | ID: mdl-11346733

RESUMO

OBJECTIVE: The purpose of this study was to investigate the relationship between oral lesions and gender, age, CD4(+) cell count, human immunodeficiency virus-1 (HIV-1) viral load, antiretroviral therapy, and route of transmission in a group of HIV-infected (HIV+) persons from the Mediterranean region. STUDY DESIGN: The participants in this study were HIV+ adults who sought dental care between January 1999 and June 1999 in the Department of Oral Medicine (University of Palermo, Italy). RESULTS: One hundred thirty-six HIV+ adults came in for an initial oral examination. Their mean age was 35.2 years (SD +/- 7.97), and 33% were women. Their mean CD4(+) cell count was 325.3 x 10(6) /L (SD +/- 225.8), and their HIV-1 viral load was 39,168.3 copies/mL (SD +/- 144,256.1). Oral lesions were found in 47% of the study group, as well as in 56.5% of women (n = 46) versus 45.5% of men (n = 90; P =.05). Oral candidiasis was the most common disease; it is significantly associated with women (P =.004), CD4(+) cell count (P =.005), and HIV-1 viral load (P =.0003). No significant relationships were found between any types of oral lesions and age, antiretroviral therapy, or route of transmission (P >.2). CONCLUSION: The prevalence of HIV-related oral lesions was significantly higher in women than in men, especially for oral candidiasis, the most common lesion observed related to immune status and HIV-1 viral load.


Assuntos
Infecções Oportunistas Relacionadas com a AIDS/fisiopatologia , Doenças da Boca/fisiopatologia , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Adulto , Fatores Etários , Análise de Variância , Antivirais/uso terapêutico , Contagem de Linfócito CD4 , Candidíase Bucal/imunologia , Candidíase Bucal/fisiopatologia , Distribuição de Qui-Quadrado , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/transmissão , HIV-1 , Humanos , Itália , Masculino , Doenças da Boca/imunologia , Prevalência , Fatores Sexuais , Sicília , Estatística como Assunto , Estatísticas não Paramétricas , Carga Viral
16.
Artigo em Inglês | MEDLINE | ID: mdl-9927079

RESUMO

OBJECTIVE: Antimicrobial mouthrinses may represent a valid alternative to topical antifungal agents. However, the action of antimicrobials could be affected by the different ingredients incorporated into mouthrinse products. The purpose of the present study was to investigate the in vitro antifungal and fungicidal activities of antimicrobials alone. STUDY DESIGN: A broth macrodilution method was used to determine the minimum inhibitory concentration of 4 antimicrobial agents against Candida species. Minimum fungicidal concentration was also determined. RESULTS: All antimicrobials showed antifungal activity against all tested organisms, but cetylpyridinium chloride received significantly lower minimum inhibitory concentrations (P < .005). Cetylpyridinium chloride also showed a greater fungicidal activity than chlorhexidine digluconate and hexetidine (P< .005), whereas sanguinarine chloride appeared to be less fungicidal against most of the isolates tested. CONCLUSIONS: These findings suggest that cetylpyridinium chloride may be used as a topical antifungal agent. Clinical trials are now required to assess its value in the management of oral candidosis.


Assuntos
Anti-Infecciosos Locais/farmacologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Antissépticos Bucais/farmacologia , Alcaloides/farmacologia , Análise de Variância , Benzofenantridinas , Cetilpiridínio/farmacologia , Clorexidina/análogos & derivados , Clorexidina/farmacologia , Contagem de Colônia Microbiana , Relação Dose-Resposta a Droga , Hexitidina/farmacologia , Isoquinolinas , Testes de Sensibilidade Microbiana , Estatísticas não Paramétricas
17.
New Microbiol ; 23(1): 63-71, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10946407

RESUMO

Adhesion to epithelial surfaces is considered as a critical step in the pathogenesis of oral candidosis. Therefore, the effects of the most commonly consumed dietary carbohydrates on the adhesion of Candida albicans, Candida tropicalis, and Candida krusei to monolayered HeLa cells were investigated. Adherence of C. albicans and C. tropicalis appeared significantly promoted by incubation in defined medium containing a high concentration (500 mM) of fructose, glucose, maltose, and sucrose (p < 0.001). C. albicans organisms grown in sucrose elicited maximal increase in adhesion, whereas adhesion of C. tropicalis and C. krusei was enhanced to the greatest extent when cultured in glucose. Maltose and fructose also promoted adherence of C. albicans and C. tropicalis (p < 0.001), but to a lesser extent than sucrose and glucose. On the other hand, sorbitol-grown yeasts demonstrated a marginal increase in adhesion (p > 0.01). Xylitol only significantly reduced adherence of C. albicans (p < 0.001). These results suggest that the frequent consumption of carbohydrates, such as sucrose, glucose, maltose, or fructose, might represent a risk factor for oral candidosis. The limitation of their consumption by substituting xylitol or sorbitol could be of value in the control of oral Candida colonization and infection.


Assuntos
Candida albicans/fisiologia , Candida/fisiologia , Carboidratos da Dieta/farmacologia , Candidíase Bucal/microbiologia , Adesão Celular , Meios de Cultura , Células HeLa , Humanos , Fatores de Risco
18.
New Microbiol ; 24(4): 397-404, 2001 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11718378

RESUMO

Candida dubliniensis ia an opportunistic pathogen mainly associated with oral candidiasis in human immunodeficiency virus (HIV)-infected individuals. We recently recovered the first Italian clinical isolates of C. dubliniensis from the oral cavities of seven HIV-seropositive subjects. The in vitro susceptibility to fluconazole (FLCZ) of these isolates was determined according to the National Committee for Clinical Laboratory Standards (NCCLS) M27-A broth microdilution method for yeasts. All seven isolates of C. dubliniensis were susceptible to FLCZ (MICs < or =0.5 microg/ml). Results of this reference method were compared to those obtained with simplified tests, more adapted to routine evaluation in hospital laboratories. Fungitest and Sensititre YeastOne colorimetric microplate-based methods have been evaluated. The agar disk diffusion method has also been tested on two different media: RPMI 1640-2% glucose and High Resolution-2% glucose-0.5 microg/ml methylene blue. All of the simplified methods tested were able to correctly identify FLCZ-susceptibility of this group of Italian C. dubliniensis isolates.


Assuntos
Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidíase Bucal/tratamento farmacológico , Fluconazol/farmacologia , Candida/isolamento & purificação , Candidíase Bucal/diagnóstico , Candidíase Bucal/microbiologia , Colorimetria/normas , Farmacorresistência Fúngica , Humanos , Itália , Testes de Sensibilidade Microbiana/normas , Técnicas Microbiológicas/normas , Padrões de Referência
19.
Minerva Stomatol ; 47(12): 665-71, 1998 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-10207302

RESUMO

BACKGROUND: Oral candidosis has emerged as an increasing problem in immunocompromised patients because oral cavity represents an important port of entry for systemic fungal infections. METHODS: The aim of the present study was to investigate the in vitro antifungal activity of 5 commercial mouthrinses containing chlorhexidine (CHX). The Minimum Fungicidal Concentration (MFC) against six species of yeasts was determined by a broth macrodilution method. The kill-time of mouthrinses at half the concentration of the commercial formulations was also determined. RESULTS: MFCs were achieved with each mouthrinses against all the organisms under test. However, significant differences in MFC values were found for Ebur Os in comparison with Dentosan, Corsodyl and Plak out (p < 0.001). Kill-times of Corsodyl and Dentosan were less than or equal to 120 sec with all the species of yeasts, except Torulopsis glabrata. Significant differences were found in kill-time values between Dentosan and Broxo Din only (p < 0.001). CONCLUSIONS: These results suggest that CHX-containing mouthrinses may represent an appropriate alternative to conventional antifungal drugs in the management of oral candidosis. Effectiveness in preventing systemic fungal infections in immunocompromised patients requires further in vivo studies.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Candidíase Bucal/microbiologia , Clorexidina/uso terapêutico , Doenças da Boca/microbiologia , Micoses/microbiologia , Candidíase Bucal/tratamento farmacológico , Humanos , Técnicas In Vitro , Doenças da Boca/tratamento farmacológico , Antissépticos Bucais , Micoses/tratamento farmacológico
20.
Minerva Stomatol ; 52(5): 201-10, 2003 May.
Artigo em Italiano | MEDLINE | ID: mdl-12874539

RESUMO

Hybrid prosthesis supported by natural teeth (overdenture) is widely used in clinical practice and should be executed whenever the clinical conditions suggest it. Through a critical review of the literature, the anatomical, functional, psychological and clinical advantages are emphasized. Among the first ones, the prophylaxis of residual anatomical components, due to the limitation of bone resorption, and the preservation of sensorial proprioception are relevant. Important advantages are also represented by a better crown-root ratio of residual teeth supporting overdenture, with the consequent improvement of the longitudinal prognosis of such teeth. The greater retention and stability of overdenture in comparison with complete denture greatly improve the masticatory efficacy. The psychological advantages resulting from the dental anchorage, which allows the patient to be more confident in social life, are also relevant. Finally, when the dental support is lost, converting overdenture into complete denture is simple and quick, and makes easier the longitudinal clinical maintenance of the denture.


Assuntos
Revestimento de Dentadura , Reabsorção Óssea/prevenção & controle , Dentaduras , Humanos , Estudos Longitudinais , Mastigação , Autoimagem , Perda de Dente/psicologia , Perda de Dente/terapia
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