Asociación entre los niveles de linfocitos T CD4 y lesiones bucales de portadores del VIH/sida / Association between CD4 T lymphocyte levels and oral lesions in HIV/AIDS patients

Introducción: Las enfermedades de la cavidad bucal en los pacientes con VIH/sida pueden verse agravadas dependiendo de la respuesta inmunitaria del paciente y los niveles de linfocitos. Objetivo: Relacionar los niveles de linfocitos T CD4 y las principales lesiones bucales en pacientes con el VIH/sida del Hospital Nacional Hipólito Unanue (Lima, Perú), durante el 2018. Métodos: Se realizó un estudio analítico y de corte transversal, entre julio y octubre del 2018, en 65 pacientes hospitalizados, a los cuales se realizó un examen clínico de la cavidad bucal. Se evaluó la presencia de manifestaciones bucales asociadas al VIH/sida; también se clasificó el nivel de linfocitos T CD4 en tres categorías (> 500 cel/mm3, entre 200-500 cel/mm3 y < 200 cel/mm3). Resultados: Un 70,8 por ciento de los pacientes no se encontraba con tratamiento antirretroviral al momento del examen. El nivel promedio de linfocitos T CD4 fue 237,65 cel/mm3, con mayor prevalencia en mujeres. El 56,9 por ciento de los pacientes presentaron lesiones bucales, el sexo masculino fue el más afectado (91 por ciento). La lesión más frecuente fue la candidiasis bucal (44,6 por ciento) y la categoría que presentó mayor frecuencia de lesiones bucales fue la < 200 cel/mm3 (38,5 por ciento; p < 0,05). Conclusiones: El sexo masculino presentó la mayor cantidad de lesiones bucales asociadas a bajos niveles de linfocitos T CD4. La mayor parte de lesiones bucales se presentaron en un nivel de linfocitos T CD4 < 200 cel/mm3. La candidiasis bucal fue la lesión que más se evidenció al momento de realizar el examen clínico(AU)

Introduction: Oral diseases may be aggravated in HIV/AIDS patients depending on their immune response and lymphocyte levels. Objective: Describe the relationship between CD4 T lymphocyte levels and the main oral lesions in HIV/AIDS patients from Hipólito Unanue National Hospital in Lima, Peru, during the year 2018. Methods: An analytical cross-sectional study was conducted of 65 hospitalized patients from July to October 2018. The patients underwent oral clinical examination. Evaluation was performed of the presence of HIV/AIDS-related oral manifestations, and CD4 T lymphocyte levels were classified into three categories: > 500 cell/mm3, 200-500 cell/mm3 and < 200 cell/lmm3. Results: Of the total patients studied, 70.8 percent were not under antiretroviral treatment at the moment of the examination. Average CD4 T lymphocyte level was 237.65 cell/mm3, with higher results among women. 56.9 percent of the patients had oral lesions. Males were more commonly affected (91 percent). The most frequent lesion type was oral candidiasis (44.6 percent), whereas the category presenting the highest frequency of oral lesions was < 200 cell/mm3 (38.5 percent; p < 0.05). Conclusions: Male patients presented the largest number of oral lesions associated to low CD4 T lymphocyte levels. Most of the oral lesions were found at a CD4 T lymphocyte level < 200 cell/mm3. Oral candidiasis was the lesion most commonly found by the clinical examination(AU)

Pseudomembranous candidiasis by candida tropicalis in an immunocompromised patient: case report

Pseudomembranous candidiasis is the most frequent type of infection by candida spp., and candida albicans is the most common species to cause it. candidiasis can be due to other candida species less frequently, as is the case of candida tropicalis a pathogenic species that can cause infection in immunocompromised patients. the aim of this case report is to describe a pathological condition produce by candida tropicalis.

Differences by Resistotyping Between C. albicans Strains Isolated from the Oral Cavity of HIV+ and Seronegative Patients / Diferencias por resistotipificación entre cepas de C. albicans aisladas de la cavidad oral de pacientes VIH+ y seronegativos

Abstract Candida albicans is the etiological agent most frequently associated with oral candidiasis in human immunodeficiency virus (HIV) carriers. Strain typification is important to disease epidemiology, particularly with simple, low-cost methodologies such as resistotyping. The present study was designed to use resistotyping to identify possible phenotypic differences between C. albicans strains isolated from the oral cavity of HIV+ and HIV-seronegative patients. Analyses were run using resistotyping (boric acid, cetrimide, sodium periodate, sodium selenite and silver nitrate) to identify phenotypical differences between C. albicans. Descriptive statistics was performed. Of the 149 clones isolated from HIV+ patients the most frequent (47.0%) resistotype was ABCDE. The most frequent resistotype (64.8%) in the 74 clones from HIV-seronegative patients was --CDE. Phenotypic differences were identified between the strains isolated from each group. HIV+ patients exhibited greater strain diversity. Although it has limitations, resistotyping effectively identified differences between C. albicans strains.

Resumen Candida albicans es el agente etiológico más frecuentemente asociado con la candidiasis oral en portadores del virus de la inmunodeficiencia humana (VIH). La tipificación de la cepas es importante para conocer la epidemiología de la enfermedad, particularmente con metodologías simples y de bajo costo, como la resistotipificación. El presente estudio fue diseñado para identificar posibles diferencias fenotípicas por el método de resistotipificación entre cepas de C. albicans aisladas de la cavidad oral de pacientes VIH+ y seronegativos. Se realizó estadística descriptiva. Los análisis se realizaron utilizando resistotipificación (ácido bórico, cetrimida, peryodato de sodio, selenito de sodio y nitrato de plata) para identificar diferencias fenotípicas entre C. albicans. De las 149 clonas aisladas de pacientes VIH+, el resistotipo más frecuente (47.0%) fue ABCDE. El resistotipo más frecuente (64.8%) en las 74 clonas de pacientes seronegativos al VIH fue --CDE. Se identificaron diferencias fenotípicas entre las cepas aisladas de cada grupo. Los pacientes VIH + exhibieron una mayor diversidad de cepas. Aunque tiene limitaciones, la resistotipificación identificó de manera efectiva las diferencias entre las cepas de C. albicans.

Principais manifestações bucais em pacientes pediátricos HIV positivos e o efeito da terapia antirretroviral altamente ativa / Most common oral manifestations in pediatric patients HIV positive and the effect of highly active antiretroviral therapy

Resumo Esta revisão integrativa da literatura tem por objetivo identificar as principais lesões bucais que afetam pacientes pediátricos com HIV, bem como descrever o efeito da terapia antirretroviral altamente ativa (HAART) sobre essas lesões, comparando-a com a terapia antirretroviral (ART). Foi feita uma busca nas bases de dados PubMed e Scielo, seguindo critérios de inclusão e exclusão pré-determinados. Foram selecionados dezenove artigos científicos e extraídas as informações principais sobre prevalência e a frequência das manifestações bucais em pacientes pediátricos HIV positivos e o efeito da terapêutica aplicada. As lesões mais frequentes foram candidíase oral, gengivite, aumento das parótidas e eritema gengival linear. O uso da HAART mostrou diminuir a prevalência das manifestações bucais nos pacientes pediátricos com HIV e ser mais eficaz que a ART. Os achados deste estudo sugerem que a manifestação bucal mais frequente em pacientes pediátricos com HIV é a candidíase oral, seguida de alterações como gengivite e aumento das glândulas parótidas. O uso de HAART parece reduzir a prevalência dessas lesões orais, apresentando resultados mais eficazes que os da ART.

Abstract This integrative literature review aims to identify the main oral lesions affecting pediatric patients with HIV, and describe the effect of highly active antiretroviral therapy (HAART) on these injuries, comparing it to antiretroviral therapy (ART). A search was conducted in PubMed and Scielo databases, following predetermined inclusion and exclusion criteria. 19 papers were selected and the main information on the prevalence and frequency of oral manifestations in HIV-positive pediatric patients and effect of therapy applied were extracted. The most frequent injuries were oral candidiasis, gingivitis, parotid gland enlargement and linear gingival erythema. The use of HAART shown to reduce the prevalence of oral manifestations in pediatric patients with HIV and be more effective than ART. The findings of this study suggest that the most frequent oral manifestation in HIV-infected children is oral candidiasis, followed by changes such as gingivitis and enlargement parotid glands. The use of HAART appears to reduce the prevalence of these oral lesions, showing more effective results than ART.

A single-center 18-year experience with oral candidiasis in Brazil: a retrospective study of 1, 534 cases

Abstract Despite the large number of published studies about oral candidiasis and associated risk factors, reports of large single-center retrospective studies on the prevalence of oral candidiasis, risk factors, and the oral candidiasis types diagnosed more frequently in oral diagnostic reference centers are scarce. The objective of the present study was to retrospectively survey the demographic and clinical profiles of 1,534 patients diagnosed with candidiasis and treated at the Center for Diagnosis of Oral Diseases (CDOD), Pelotas Dental School, Federal University of Pelotas between 1997 and 2014. Using a retrospective, cross-sectional, epidemiological design, data on race, gender, age, systemic diseases, oral candidiasis type and location, symptoms, and harmful habits such as smoking and alcohol consumption were collected. The statistical analysis was performed using STATA version 13.1. Risk factors for chronic atrophic candidiasis (CAC) were evaluated using Poisson regression with robust variance (p ≤ 0.05). The majority of patients with oral candidiasis seen at the CDOD over the 18-year period of analysis were Caucasian women, aged 51-60 years, nonsmokers, and nondrinkers, with no systemic disease, and who wore some form of dental prostheses. CAC was the single most common clinical type of candidiasis detected, and the most frequently affected oral site was the palate. These data from a large single-center in Brazil agree with previous evidence about the clinical and demographic profiles of patients with oral candidiasis.

Frecuencia de candidiasis oral asociada al uso de prótesis dentales en pacientes de la clínica odontológica de la Universidad Anáhuac Norte / The frequency of oral candidiasis associated with the use of dental prostheses in patients of the dental clinic at the Anahuac University

La candidiasis es la infección micótica más común de la cavidad bucaly es causada por el hongo Candida. Dentro de la población geriátricala candidiasis oral es uno de los tres principales motivos de consulta. El crecimiento en superfi cies es parte natural del modo de vivir del hongo Candida y es común que colonice las prótesis dentales, dando como resultado estomatitis por uso de dentadura o estomatitis subplaca.El diagnóstico de estomatitis por dentadura es relevante, ya quealrededor de 50 por ciento de las personas de edad promedio de 65 a 74 años, y 70 por ciento de 75 a 84 años utilizan prótesis dentales removibles. El objetivo del presente estudio fue determinar la frecuencia de candidiasis oral asociada a prótesis dentales removibles en los pacientes de la ClínicaOdontológica de la Universidad Anáhuac México Norte durante el periodo enero-mayo de 2016. Material y métodos: Se realizó un estudiodescriptivo, transversal y observacional. La muestra estuvo conformada por pacientes portadores de prótesis dentales removibles que acudieron a la Clínica Odontológica de la Universidad Anáhuac México Norte.Se interrogó al paciente respecto al uso de la prótesis y su condición de salud, posterior a la exploración clínica se tomó la citología exfoliativa de la mucosa debajo de la prótesis removible. Resultados: La muestraestuvo constituida por 22 pacientes de la clínica de prótesis removible,seis eran portadores de prótesis, de éstos 83 por ciento fueron positivos a candidiasis. Conclusiones: La falta de indicaciones sobre el cuidado, uso ehigiene de las prótesis dentales o la falta de apego a estas indicacionespor parte del paciente ocasionan el desarrollo de estomatitis subplaca.

Candidiasis is the most common mycotic infection in oral cavity andcaused by fungi candid. Oral candidiasis is one of three principalreasons for consultation in a geriatric population. A natural part of theway of living of the fungi Candida is the growth on surfaces. It growthmakes common that the fungi Candida colonize the dental prostheses,so the denture stomatitis or dental-related stomatitis is development.Denture stomatitis diagnosis is quite important because from the totalpopulation using dental removable prostheses around of 50% is between65-74 years old and 70% is between 75-84 years old. The ofthis study was identifying oral candidiasis frequency related to dentalremovable prostheses in patients from Universidad Anahuac, DentalSchool (México Norte), from January 2016 to May 2016. Material andmethods: Was made a descriptive, cross and observational study. Thesample was integrated by patients using dental removable prostheses,who went to Universidad Anahuac’s dental school (México Norte). Thepatients were interrogated about dental removable prostheses use andtheir health condition, after clinic exploration and exfoliative cytologywas taken from mucosa below dental removable prostheses. Results: 22patients from dental service using removable prosthesis constituted thesample, from this 22 patients only 6 were using a removable prosthesisand from this 6 patients only 83% were positive to oral candidiasis.Conclusions: Instructions scare about care, use, and hygiene of dentalprosthesis as well as not follow these instructions for patient’s partmake possible denture stomatitis development.

Influencia de la aparatología ortodóntica sobre la ocurrencia de Candida spp. en la cavidad oral / Influence of orthodontic appliances on the occurrence of Candida spp. in the oral cavity

Introducción: El uso de aparatología ortodóntica crea condiciones favorables para el incremento de la placa bacteriana. Objetivo: Evaluar si el uso de aparatología ortodóntica influye en la presencia de especies de Candida en la cavidad oral, en un grupo de pacientes pediátricos. Material y Métodos: Se estudiaron 60 pacientes entre 4 y 10 años de edad, que requirieron tratamiento con aparatología ortodóntica. Se tomaron muestras de la cavidad oral al inicio del tratamiento ortodóntico y a los seis meses de uso. Las muestras fueron sembradas en Agar Dextrosa Sabouraud y CHROMagar® Candida. Las especies de Candida se confirmaron por RPC múltiple. Los resultados se analizaron con la prueba estadística de chi cuadrada. Resultados: La presencia de Candida fue mayor en las muestras tomadas a los seis meses de iniciado el tratamiento (p < 0,001). La especie más frecuente antes del tratamiento fue C. albicans (8,3%) y después del tratamiento fue C. tropicalis (20,0%). Conclusiones: El uso de aparatología ortodóntica influye en la presencia de especies de Candida, por lo que deben tomarse medidas preventivas para evitar su conversión en candidiasis oral, en especial, en pacientes inmunodeprimidos.

Introduction: Use of orthodontic appliances creates favorable conditions for growth of dental bacterial plaque. Aim: To establish if use of orthodontic appliance affects the presence of Candida species in the oral cavity in a group of pediatric patients. Materials and Methods: We studied 60 patients between 4 and 10 years old, requiring treatment with orthodontic appliances. Samples were taken of the oral cavity before orthodontic treatment and six months after use began. Samples were inoculated in Sabouraud Dextrose Agar and Candida CHROMagar®. Candida species confirmation and identification was done by multiple PCR, and results analyzed with a chi-squared test. Results: Candida presence was greater (p < 0,001) in the samples taken six months after use began than in the initial samples. Before treatment, the most frequently found species (percentage of studied patients) was C. albicans (8.3%), while after treatment it was C. tropicalis (20.0%). Conclusions: Use of orthodontic appliances in children increases Candida species presence in the oral cavity. Preventative measures should be taken to avoid oral candidiasis, particularly in immunosuppressed patients.

Manifestações dermatológicas em pacientes infectados pelo HIV: um estudo de prevalência / Dermatological manifestations in HIV-infected patients: a prevalence study

Na infecção pelo HIV, a pele pode ser tanto um indicador precoce de doença quanto de gravidade. Este estudo analisou a frequência e a apresentação clínica de manifestações dermatológicas em pacientes portadores de HIV, destacando as lesões mais encontradas, e correlacionou suas características com o estado imunológico. Foram encontradas 129 lesões mucocutâneas dentre os 57 pacientes portadores de HIV examinados, havendo em média 2,25 lesões por paciente. As dermatoses mais comuns, em ordem decrescente de frequência, foram candidíase oral, onicomicose e dermatite seborreica. As lesões oportunistas mostraram relação significativa com deficiência imunológica, e as afecções de pele mais encontradas mostraram-se bons indicadores do estado imunológico do paciente e da progressão da doença.

In the HIV infection the skin can be either an early indicator of disease and severity. This study examined the frequency and clinical presentation of skin manifestations in patients with HIV, highlighting the most frequent injuries, and correlated their characteristics with the immune status. We found 129 mucocutaneous lesions among 57 patients with HIV, with an average of 2.25 lesions per patient. The most common skin diseases in descending order of frequency were oral candidiasis, onychomycosis and seborrheic dermatitis. Opportunistic lesions showed significant relationship with immune deficiency and the most frequent skin diseases proved to be good indicators of the immune status of the patient and disease progression.

Risk factors of HIV-related oral lesions in adults / Fatores de risco de lesões bucais associadas ao HIV em adultos / Factores de riesgo de lesiones bucales asociadas al VIH en adultos

OBJECTIVE: To assess the risk factors in the occurrence of oral lesions in HIV-positive adults. METHODS: A retrospective analytical-descriptive survey was conducted using the medical/dental records of 534 patients with oral lesions associated with HIV. The data were collected from five referral centers for managing HIV and associated comorbidities in the city of Porto Alegre, Southern Brazil, between 1996 and 2011. Using a standardized form, socio-demographic and clinical data were recorded. Exclusively and definitively diagnosed oral pathologies were included and classified according to ECC criteria on Oral Problems Related to HIV Infection. For data analysis cross-tabulations, Chi-squared tests and logistic regression models were used where appropriate. RESULTS: CD4+ counts lower than 350 cells/mm³ (p < 0.001), alcohol consumption (p = 0.011) and female gender (p = 0.031) were predisposing factors for oral candidiasis. The occurrence of hairy leukoplakia was independently associated with CD4+ counts below 500 cells/mm³, (p = 0.029) a viral load above 5,000 copies/mm³ (p = 0.003) and smoking (p = 0.005). CONCLUSIONS: Moderate and severe degrees of immunodeficiency and detectable viral loads were risk factors for the onset of oral lesions. Smoking and alcohol consumption also increased susceptibility to the development of opportunistic infections in HIV-positive adults from Porto Alegre, irrespective of the use of antiretroviral therapy.

OBJETIVO: Analisar fatores de risco para a ocorrência de lesões bucais em adultos soropositivos para o HIV. MÉTODOS: Estudo transversal, descritivo analítico de prontuários médicos/odontológicos de 534 pacientes com lesões bucais associadas ao HIV em Porto Alegre, RS, no período de 1996 a 2011. Os dados foram coletados em cinco centros de referência em saúde para o atendimento de portadores do HIV e comorbidades associadas. Os dados sociodemográficos e clínico-laboratoriais foram coletados em formulários padronizados. Foram incluídos dados exclusivamente de lesões com diagnóstico definitivo e classificadas de acordo com os critérios da ECC on Oral Problems Related to HIV Infection. A análise dos dados foi realizada mediante a aplicação de tabulações cruzadas, teste do Qui-quadrado e modelos de regressão logística. RESULTADOS: Níveis de CD4+ < 350 células/mm³ (p < 0,001), consumo de álcool (p = 0,011) e sexo feminino (p = 0,031) foram predisponentes para candidíase bucal. A ocorrência de leucoplasia pilosa foi associada com contagens de CD4+ < 500 células/mm³ (p = 0,029), cargas virais > 5.000 cópias/mm³ (p = 0,003) e tabagismo (p = 0,005). CONCLUSÕES: Graus de imunodeficiência moderados e severos e cargas virais detectáveis foram fatores de risco para o desenvolvimento de lesões bucais. O consumo de tabaco e álcool aumentou a suscetibilidade de desenvolver infecções oportunistas em adultos HIV positivos, independentemente do uso de terapia antirretroviral.

OBJETIVO: Analizar factores de riesgo para la ocurrencia de lesiones bucales en adultos seropositivos para VIH. MÉTODOS: Estudio transversal, descriptivo analítico de prontuarios médicos/odontológicos de 534 pacientes con lesiones bucales asociadas al VIH en Porto Alegre, RS, Brasil, en el período de 1996 a 2011. Los datos se colectaron en cinco centros de referencia en salud para la atención de portadores del VIH y comorbilidades asociadas. Los datos sociodemográficos y clínico-laboratoriales se colectaron en formularios estandarizados. Se incluyeron datos exclusivamente de lesiones con diagnóstico y clasificadas de acuerdo con los criterios de la ECC on Oral Problems Related to HIV Infection. El análisis de los datos fue realizado mediante la aplicación de tabulaciones cruzadas, prueba de Chi-cuadrado y modelos de regresión logística. RESULTADOS: Niveles de CD4+ < 350 células/mm³ (p<0,001), consumo de alcohol (p=0,011) y sexo femenino (p = 0,031) predispusieron para candidiasis bucal. La ocurrencia de leucoplasia pilosa estuvo asociada con contaje de CD4+ < 500 células/mm³ (p = 0,029), cargas virales > 5.000 copias/mm³ (p = 0,003) y tabaquismo (p = 0,005). CONCLUSIONES: Grados de inmunodeficiencia moderados y severos y cargas virales detectables fueron factores de riesgo para el desarrollo de lesiones bucales. El consumo de tabaco y alcohol aumentó la susceptibilidad de desarrollar infecciones oportunistas en adultos VIH positivos, independientemente del uso de terapia anti=retroviral.

Atividade antifúngica e alterações morfológicas induzidas pelo óleo essencial de Cinnamomum cassia frente cepas de Candida albicans isoladas de pacientes HIV positivos / Antifungal activity and morphological alterations induced by Cinnamomum cassia essential oil against Candida albicans strains isolated from HIV-positive patients

Objetivo: Avaliar a atividade antifúngica, o efeito sobre a cinética de morte microbiana e as alterações morfológicas do óleo essencial de Cinnamomum cassia (canela) sobre cepas de Candida albicans isoladas de pacientes HIV positivos e cepa padrão (ATCC 76485). Método: Suspensões fúngicas (106UFC/mL) foram preparadas a partir de amostras clínicas (n=15) e padrão (n=1) de C. albicans. Emulsões do óleo essencial foram avaliadas em concentrações que variaram entre 1024µg/mL e 4µg/mL. A ação antifúngica foi determinada pela Concentração Inibitória Mínima (CIM), por meio da técnica da microdiluição. Realizou-se o ensaio de cinética sobre a morte das leveduras (tempos 0, 30, 60, 180 minutos e 24h), bem como a avaliação da interferência do óleo essencial sobre a micromorfologia das cepas. O miconazol (50 µg/mL) foi utilizado como controle e a análise estatística se deu pelos testes Kruska-Wallis e Dunn (p menor que 0,05). Resultados: A CIM variou entre 64 e 128 µg/mL, frente às cepas testadas. Para o teste de cinética, verificou-se ação antifúngica de C. cassia nas concentrações CIM, 2xCIM e 4xCIM, em todos os tempos analisados. O controle de crescimento foi estatisticamente diferente do miconazol e do óleo essencial (p menor que 0,01), não sendo observada diferença estatística entre o efeito do miconazol e do produto natural (p maior que 0,05). Alterações na micromorforlogia das cepas (ausência de pseudohifas e clamidoconídeos) foram verificadas na CIM. Conclusão: O óleo essencial de C. cassia, semelhante ao miconazol, apresentou atividade antifúngica e efeito sobre a cinética de morte microbiana. Os produtos avaliados provocaram alterações sobre a micromorfologia das cepas testadas.

Objective: To evaluate the antifungal activity, the effect on microbial death kinetics and the morphological alterations caused by Cinnamomum cassia (canela) essential oil against Candida albicans strains isolated from HIV-positive patients and a reference strain (ATCC 76485). Method: Fungal suspensions (106CFU/mL) were prepared from clinical (n=15) and reference (n=1) C. albicans samples. Essential oil emulsions were evaluated at concentrations between 1024 µg/mL and 4 µg/mL. The antifungal action was determined by the minimal inhibitory concentration (MIC) using the microdiluition technique. The kinetics assay for yeast death was performed (times: 0, 30, 60, 180 minutes and 24 h) as well as evaluation of the interference of the essential oil on the micromorphology of the strains. Miconazol (50 µg/mL) was used as a control. The statistical analysis was performed by the Kruskal-Wallis and Dunn tests (p less than 0.05). Results: The MIC varied from 64 to 128 µg/mL for the tested strains. The kinetics assay revealed antifungal action of the C. cassia at the concentrations MIC, 2xMIC and 4xMIC, at all analyzed times. Growth control was significantly different for miconazol and for the essential oil (p less than 0.01), with no statistically significant difference between the effect of miconazol and the natural product (p greater than 0.05). Alterations in the micromorphology of the strains (absence de pseudohifas and chlamydoconidias) were verified in the MIC. Conclusion: In the same way as miconazol, C. cassia essential oil presented antifungal activity and effect on microbial death kinetics. The tested products caused alterations on the micromorphology of the tested strains.

Valoración del tratamiento local de la candidosis oral: correlación etiológica / Assessment of the local therapy in candidosis: ethiological relation

La candidosis oral es una infección oportunista causada por hongos del género Candida. En los últimos años se ha observado un significativo incremento de la incidencia de las infecciones micóticas. Objetivos. Reconocer las formas clínicas que se observan en los pacientes que concurren a la Clínica de Estomatología de la Facultad de Odontología de la Universidad de la República. Evaluar la eficacia de la terapia local. Establecer la relación entre el tiempo promedio de curación y los factores predisponentes observados.Metodología. Se diagnosticó candidosis oral en 51 pacientes. Se implementó el tratamiento antimicótico tópico, corrección de los factores predisponentes y el régimen de controles clínicos.Resultados. Edad promedio: 50 años, localización prevalente paladar, forma clínica: 54% crónica erimatosa, el 73% de los pacientes curaron entre 14 y 21 días, sólo un 26% necesitó mas de 21 días.Conclusiones. Se realiza un primer estudio nacional sobre candidosis oral basado en el diagnóstico clínico, apoyado por el laboratorio microbiológico y histopatológico.Se mostró el índice de respuesta a la terapia local y se confirmó la necesidad de tratamiento más prolongado en el subgrupo de pacientes fumadores.

Comparison of oral manifestations with CD4 count in HIV-infected patients.

Aim and Objective: This study was carried out with the primary aim of correlating oral changes and general changes of HIV-infected patients with their CD4 count. Materials and Methods: 124 patients were selected, and after taking their informed consent, they were subjected to detailed history taking and thorough clinical examination. Specific oral lesions and general physical changes were recorded. Every patient was subjected to laboratory investigation for CD4 count. All these findings were tabulated. The clinical observation and laboratory findings were subjected to critical analysis and correlated. Statistical test, i.e. Student's " t" test, was applied and objective conclusions were drawn. Result: Out of 124 patients, 40 had oral candidiasis, 6 had oral hairy leukoplakia, 12 had periodontal disease, 20 had xerostomia, 30 had melanin pigmentation, while 4 had HSV2, and atypical ulceration. Out of 40 patients with oral candidiasis, 28 patients had CD4 count <200 (group A), 10 patients were in group, B (CD4 count 200-500 cell/mm 3 ) and 2 patients in group C(CD4 >500 cell/mm 3 ). Oral hairy leukoplakia occurred in equal proportions in group A and B. These periodontal diseases were more commonly in group B; xerostomia and melanin pigmentation was equally seen in group A and B. Conclusion: Oral candidiasis, oral hairy leukoplakia, linear gingival erythema, necrotizing ulcerative gingivitis, and necrotizing ulcerative periodontitis are specific oral indicators which will definitely suggest to the dental surgeon that the disease is running a rapid downhill course and due to this the oral physician is in a position to raise a suspicion and alert the general physician regarding the declining immune status of patient.

Dental consultation in patients planned for/undergoing/post radiation therapy for head and neck cancers: A questionnaire-based survey.

Background: Mouth and pharyngeal cancers account for approximately 6% of cancers worldwide. Radiotherapy is one of the means of treatment of head and neck cancer. Consultation with a dental team experienced in caring for patients undergoing treatment for head and neck cancer will improve the quality of life of such patients. Aims and Objectives: To evaluate the attitude of oncologists toward dental consultation to patients planning for/prior to/undergoing/post radiation therapy for head and neck cancers and to evaluate the number of radiation oncologists who encounter oral complaints and consider worth referring to a dentist. Materials and Methods: A questionnaire-based study was carried out following mailing of covering letter and self-administered questionnaire comprising 11 items, to 25 radiation oncology centers selected in India based on convenient sampling. Results: Out of the 25 centers, we received response from 20 centers with 60 completely filled questionnaires. Five centers did not respond for further correspondences. Conclusion: The study indicated a need for awareness and education among radiation oncologists regarding dental consultation in patients planned/undergoing /post radiation therapy for head and neck cancer.

Biochemically assessed pathological activity of oral candida in denture and non denture wearers

To assess the Candida activity through recording pH changes in Candida selective medium inoculated with standardized dilution salivary samples obtained from dentures wearers and non denture wearers. A Cross Sectional, Comparative study during March-September 2007 was conducted at Khyber College of Dentistry Peshawar and Zoology Department, University of Peshawar [Pakistan]. Using a structured proforma, data were collected from 100 subjects [50 DWs and 50 NDWs]. Stimulated salivary samples were collected from each subject. One ml of standard dilution saliva was mixed with 4 ml sterile liquid Candida-selective medium. The extent of Candida activity was then determined, biochemically, through change in pH of the medium 24 hrs after inoculation and incubation at 37°C. The influence of age, gender, socioeconomic status, smoking habits, medication-use, oral-hygiene maintenance method, denture-plaque level, and level of salivary function was also investigated. Pathological Candida activity was seen both in DWs and NDWs. However, it was significantly higher in DWs [p value = 0.00] with mean pH decrease of 1.9 as compared to 0.8 in NDWs. Except age, the effect of gender, socioeconomic status, medications, oral hygiene maintenance on the oral Candida activity was insignificant both within and between groups. Not-with-standing the varying effect of other variables, denture-wearing significantly enhanced pathogenic activity of oral Candida. The importance of meticulous oral and denture hygiene maintenance and rest to denture-supporting tissues is re-emphasized

Eficacia del enjuagatorio con té de Vimang en la estomatitis subprótesis / Efficiency of the mouthwash with Vimang tea in subprosthesis stomatitis

Se evaluó la eficacia del té de Vimang como fitofármaco antioxidante y antiinflamatorio en el tratamiento de la estomatitis subprotésica. Se aplicó el medicamento en 35 pacientes en forma de enjuagatorios 4 veces al día; se dividieron en 2 grupos: el primero incluyó a 18 portadores de prótesis total y el segundo 17 portadores de prótesis parcial acrílica. Todos dejaron de usar las prótesis en el horario nocturno. Para realizar el tratamiento se agruparon en intervalos de edades según uno y otro sexo. Se controlaron sistemáticamente a los 3 y 7 días para evaluar el estado de la enfermedad y determinar la eficacia del medicamento. En 34 casos se observaron resultados satisfactorios, y un paciente manifestó reacciones locales adversas, lo cual no constituyó un dato estadísticamente significativo, por lo que consideramos efectivo el empleo del Vimang en el tratamiento(AU)

It was evaluated the effectiveness of the tea of Vimang like fitofármaco antioxidante and antiinflamatorio in the treatment of the estomatitis subprotésica. The medication was applied in 35 patients in enjuagatorios form 4 times a day; they were divided in 2 groups: the first one included to 18 payees of total prótesis and the second 17 payees of acrylic partial prótesis. All stopped to use the prótesis in the night schedule. To carry out the treatment they grouped in intervals of ages according to one and another sex. They were controlled systematically to the 3 and 7 days to evaluate the state of the illness and to determine the effectiveness of the medication. In 34 cases satisfactory results were observed, and a patient manifested adverse local reactions, that which didn't constitute a fact statistically significant, for what we consider effective the employment of the Vimang in the treatment(AU)

O papel do cirurgião-dentista na radioterapia de cabeça e pescoço / The role of the dentist in head and neck radiotherapy

A radioterapia tem atualmente um papel fundamental no tratamento do câncer de cabeça e pescoço. Dois terços dos pacientes com câncer recebem em alguma fase de sua doença tratamento com radiações, seja como tratamento exclusivo ou associado à cirurgia e/ou quimioterapia. As principais conseqüências orais decorrentes da radioterapia de cabeça e pescoço são mucosite, xerostomia, perda do paladar, trismo, cárie de radiação, candidíase e osteorradionecrose. É de fundamental importância que o cirurgião dentista esteja familiarizado com tais complicações para que possa juntamente, com a equipe oncológica, prevenir, controlar e tratar tais conseqüências. O objetivo deste estudo é apresentar as principais complicações orais advindas da radioterapia e descrever a conduta clínica geral em pacientes antes, durante e após o tratamento radioterápico

Interação entre diabete melito e alterações estomatológicas / The interaction between diabetes mellitus and estomatologic alterations

O diabete melito produz muitas alterações complexas na vida de seus portadores. O nível elevado de glicose no sangue, que pode ocorrer na ausência de sintomas, leva a complicações posteriores devido aos danos teciduais. Nos últimos dez anos, diversos estudos vem apontando para uma relação entre o diabete melito e várias doenças e desordens tanto sistêmicas quanto orais. Além disso, infecções crônicas por si só podem contibuir para o aumento dos níveis de glicose no sangue e, por esta razão, surgem as complicações posteriores do diabete. As doenças orais mais comuns associadas ao diabete melito são a doença periodontal, cicatrização de feridas dificultada, neuropatia oral, fluxo salivar reduzido, cárie dental e candidíase oral. Achados recentes sugerem que a equipe odontológica pode contribuir muito nos cuidados aos diabéticos com a equipe de atenção ao diabético em si. O objetivo desta revisão é apontar as manifestações estomatológicas relacionadas ao diabete melito

Candidiasis bucal / Oral candidiasis

La candidiasis oral (CO) es una infección frecuente de la mucosa bucal provocada por hongos la familia de la Cándida spp. Estoshongos son integrantes de la flora bucal habitual pero, por diferentes factores locales y sistémicos, pueden transformarse en lainfección denominada CO.En este trabajo se presentan los factores locales y sistémicos que favorecen la infección por Cándida spp, se revisan las diferentesformas clínicas de presentación y los métodos de diagnóstico más empleados. Se presentan, además, las características especialesde esta infección en los pacientes VIH - SIDA.

Oral candidiasis (OC) is a frequent infection of the oral cavity due to fungus of the Candida spp. Those microorganisms aremembers of bucal flora but local and systemic factors collaborates to produce an infection called Oral candidiasis.We review those factors; the clinical forms of presentation of the OC and the laboratories diagnostic methods. Also, the presentationof this infection in HIV – AIDS patients are reviewed.

Prevalência de glossite rômbica mediana em diferentes faixas etárias / Prevalence of median rhomboid glossitis in different age groups

A Glossite Rômbica Mediana (GRM) apresenta-se como uma área despapilada, de formato oval ou rombóide, localizada na linha média, em frente ao ápice do "V" formado pelas papilas circunvalares no terço posterior e/ou médio do dorso lingual. A prevalência desta entidade na população é baixa (inferior a 1 por cento), não havendo distinção quanto ao sexo e a raça dos indivíduos. No entanto, é fundamental saber diagnosticá-la, buscando com isto realizar o diagnóstico diferencial com outras patologias de língua. Esse estudo procurou avaliar a prevalência da GRM, comparando pacientes pediátricos e adultos, de ambos os sexos, com distintas procedências na cidade de Porto Alegre, RS