Odontogenic sinusitis: a comprehensive review.

Odontogenic sinusitis (OS) is a highly prevalent, underappreciated and underdiagnosed disease that has been known for over 100 years. Apical periodontitis, periodontal disease and iatrogenic extrusion of foreign bodies into the sinus are the main causes of OS. Although the prevalence of sinus pathosis of dental origin is still controversial, otolaryngologists recognize that in the presence of recalcitrant sinusitis, a dental origin should be considered and properly treated. Currently, cone-beam computed tomography is the gold-standard imaging technique to assess the relationship between dental conditions, especially apical periodontitis and sinus diseases, and whenever this association is detected, patients should be seen by both a dentist and an otolaryngologist in order to achieve complete recovery. This article reviews the current concepts regarding the definitions, diagnosis and management of OS from a clinical point of view.

Can the Enterococcus faecalis identified in the root canals of primary teeth be a cause of failure of endodontic treatment?

OBJECTIVE: This study investigated the presence of Enterococcus faecalis in primary teeth with primary root canal infections and related to the possible failure of pulpectomy outcome after 36 months. MATERIAL AND METHODS: Root canal samples were obtained from 25 out of 244 patients using the sterile paper cone method. The identification of E. faecalis was done with culture and molecular tests using species-specific 16S rRNA gene-based polymerase chain reaction (PCR). After 36 months, the pulpectomy outcome was evaluated. RESULTS: Enterococcus faecalis was found in five (20%) samples, and dental caries were the cause of primary infection in all of them. Pulpectomy outcome was evaluated only in teeth that completed the entire clinical protocol and were followed up to 36 months (n = 8). From these, 75% (n = 6) were successful and 25% (n = 2) failed. E. faecalis was present in 50% of both successful and failed cases. CONCLUSIONS: Enterococcus faecalis was not related to the failure of endodontic treatment of primary teeth.

Staphylococcus aureus nasal isolates may have the same genetic profile in atopic dermatitis paediatric patients and their close contacts.

Atopic dermatitis (AD) is a chronic skin disease that affects up to 20 % of the paediatric population worldwide. Staphylococcus aureus colonizes anterior nares and can be transmitted in the home environment, aggravating AD. This study aimed to detect S. aureus from nares of AD patients and their family contacts, as well as to evaluate the antimicrobial resistance, virulence and clonality of these isolates. Among the 48 family groups investigated, 30 groups were selected, as both the child and his/her respective contact had methicillin-sensitive S. aureus (MSSA) (24 cases; 54 MSSA isolates) or methicillin-resistant S. aureus (MRSA) isolates (6 cases; 13 MRSA isolates). All MRSA isolates carried SCCmec IV. S. aureus carrying PVL genes were detected in 60 % of patients. Pulsed-field gel electrophoresis (PFGE) analysis was performed for 31 isolates from 15 family groups: all 6 with MRSA and 9 with MSSA isolates. Similar genotypic profiles between isolates from patients and their family contacts were noted in 10 (66.6 %) family groups, 5 (83.3 %) of the MRSA family groups and 5 (55.5 %) of the MSSA family groups, indicating that the pathogen was transmitted through family contacts.

Prevalência de HPV anal em uma coorte de indivíduos infectados pelo HIV-1 / Anal HPV prevalence in a cohort of individuals infected with HIV-1

O papilomavírus humano (HPV) é o principal agente etiológico do câncer do trato anogenital. A maior prevalência e incidência de desenvolvimento de câncer e doenças associadas ao HPV têm sido observadas em indivíduos infectados pelo vírus da imunodeficiência humana tipo 1 (HIV-1). A história natural da infecção pelo HPV não foi completamente elucidada, assim como a resposta imune que ocorre na coinfecção pelo HIV/ HPV, particularmente na mucosa anal. Objetivo: Analisar a prevalência de HPV, dados clínicos, epidemiológicos e comportamentais em uma coorte de indivíduos infectados pelo HIV do Instituto Nacional de Infectologia (INI), FIOCRUZ, RJ. Métodos: Foi incluído um total de 114 indivíduos com diagnóstico histopatológico de biópsia anal. A tipagem do DNA de HPV foi realizada através da secreção anal. A análise estatística foi realizada utilizando o software SPSS 15.0. Resultados: Pacientes HIV positivos com Neoplasia intraepitelial anal de alto grau (NIA II/III) apresentaram CD4+ nadir <50 células/mm³ , comparados a pacientes sem displasia anal (p=0,01). Os tipos de HPV mais prevalentes na secreção anal (pelo Papillocheck) foram HPV 16 (29,2%), seguido do HPV 52 (23,1%), ambos de alto risco oncogênico, seguido de HPV 44 e 55 (21,5%), que são baixo risco oncogênico. Um total de 53,3% dos indivíduos infectados pelo HIV já analisados foi exposto aos 4 tipos de HPV, que são alvos da vacina quadrivalente corrente (MSD ­ HPV 6, 11, 16 e 18). Conclusão: Os dados sugerem que a vacinação contra o HPV pode ser considerada como uma medida profilática para reduzir o risco de lesões intraepiteliais anais em indivíduos infectados pelo HIV

Human Papillomavirus (HPV) is the primary etiologic agent of anogenital tract cancer. A higher prevalence and incidence of developing cancer and diseases associated with HPV have been observed in individuals infected with the human immunodeficiency virus (HIV). The natural history of HPV infection has not been completely elucidated, as well as the immune response that occurs as coinfection with HIV/HPV, particularly in the anal mucosa. Objective: To analyze the HPV prevalence and clinical, epidemiological, and behavioral data in a cohort of HIV-seropositive individuals from the National Institute of Infectious Diseases, FIOCRUZ, RJ. Methods: The study included a total of 114 individuals from the histopathological diagnosis of anal biopsy. PCR and sequencing was performed for HPV DNA identification in anal discharge. Statistical analysis was performed using SPSS 15.0 software. Results: Patients Infected with HIV with anal intraepithelial neoplasia (AIN) II/III had nadir CD4 + <50 cells/mm³ compared to normal patients (p=0.01). The most prevalent HPV types in the anal secretion (by Papillocheck) were HPV 16 (29.2%), followed by HPV 52 (23.1%), both high-risk oncogenic, followed by HPV 44 and 55 (21.5%) that are low-risk type. A total of 53.3% HIV-infected individuals analyzed have already been exposed to the four HPV types targeted by the current quadrivalent vaccine (MSDm ­ HPV types 6, 11, 16, and 18). Conclusion: The data suggest that vaccination against HPV could be regarded as a prophylactic measure to reduce the risk of anal intraepithelial lesions in HIV-infected individuals