Prevalence of Demodex spp. in patients with chronic blepharitis.

Blepharitis is a very common disease in ophthalmology, dermatology and allergy practice. It generally follows a chronic course and is frequently associated with objective and/or subjective symptoms such as epiphora, red eye, dandruff, gritty sensation, itching, burning, photophobia, and blurred vision. The purpose of this study is to analyze the prevalence of Demodex spp. in patients with symptoms of chronic blepharitis. An analytical cross-sectional study was conducted in the period between 2016 and 2020. All patients with symptoms of chronic blepharitis who underwent a parasitological test of eyelashes (Rapitest) in the Dermatology Department of the Hospital Italiano de Buenos Aires were included. Those with previously established blepharitis due to another infectious cause were excluded. We analyzed 972 patients. Sixty percent (n=585) underwent a positive Rapitest for the presence of Demodex spp. Seventy five percent (n=728) were women. There were no significant differences in the prevalence associated with sex (p=0.38). Among the patients positive for Demodex spp., 65% (n=628) were older than 60 years old. The most frequently associated symptom was itching, present in 35% (n=342). A statistically significant decrease in the number of consultations was observed during the cold months of the year (May-June-July-August). Our results show a high prevalence of Demodex spp. in patients with chronic blepharitis. As its presence reveals a direct association with age, we recommend looking for this parasite in this age group.

Aerobic Cultivation of Mucor Species Enables the Deacidification of Yogurt Acid Whey and the Production of Fungal Oil.

As the Greek-style yogurt market continues to experience prosperous growth, finding the most appropriate destination for yogurt acid whey (YAW) is still a challenge for Greek yogurt manufacturers. This study provides a direct alternative treatment of YAW by leveraging the abilities of Mucor circinelloides and Mucor genevensis to raise the pH of YAW and to produce fungal biomass with a high lipid content. Aerobic cultivations of these species were conducted in YAW, both with and without the addition of lactase, at 30 °C, and 200 rpm agitation. The density, pH, biochemical oxygen demand (BOD), biomass production, lipid content, fatty acid profile, and sugar and lactic acid concentrations were regularly measured throughout the 14-day cultivations. The data showed that M. genevensis was superior at deacidifying YAW to a pH above 6.0-the legal limit for disposing of cultured dairy waste. On the other hand, M. circinelloides generated more fungal biomass, containing up to 30% w/w of lipid with high proportions of oleic acid and γ-linolenic acid. Additionally, the treatments with lactase addition showed a significant decrease in the BOD. In conclusion, our results present a viable treatment to increase the pH of YAW and decrease its BOD, meanwhile generating fungal oils that can be further transformed into biodiesel or processed into functional foods or dietary supplements.

Reconstrucción mamaria inmediata con técnica simultánea / Inmmediate breast reconstruction with simultaneous technique

Introducción y objetivo: La reconstrucción mamaria inmediata con implantes y/o expansores es uno de los métodos más realizados en la actualidad. Esto ha llevado a la utilización de mallas dérmicas de diferentes orígenes para la cobertura del polo inferior de la mama y así evitar la extrusión de los dispositivos, donde el músculo pectoral no los puede cubrir. Presentamos nuestra experiencia con una alternativa quirúrgica de colocación de expansor o implante sencilla, rápida y que nos evita el uso de cualquier tipo de malla en pacientes a las que se les realiza reconstrucción mamaria inmediata. Material y método: Realizamos un estudio descriptivo, retrospectivo, analizando el comportamiento de las pacientes sometidas a reconstrucción mamaria inmediata a través del registro de historias clínicas, incluyendo aquellas que acudieron a nuestra unidad con diagnóstico de cáncer de mama y que deseaban reconstrucción inmediata simultánea. El procedimiento se llevó a cabo mediante mastectomía total clásica y, antes de separar todo el tejido mamario del músculo, iniciamos la construcción del bolsillo similar a como lo hacemos para la mamoplastia de aumento retromuscular, pudiendo levantar la unión muscular serrato - pectoral y el surco mamario con mayor facilidad. Resultados: Incluimos en el estudio 13 pacientes a las que se les realizó mastectomia total con reconstrucción inmediata, 3 de ellas con preservación de piel y colocación de implante y el resto sin conservación de piel y colocación de expansores. Tras 15 meses de seguimiento, ninguna paciente sufrió complicaciones mayores, considerando como tales hematoma, seroma o infección, ni se desarrolló contractura capsular en ningún caso. Conclusiones: En nuestra experiencia, el uso de esta técnica en reconstrucción mamaria inmediata representa una alternativa quirúrgica segura, accesible, rápida y de bajo coste, que no prolonga el tiempo operatorio y evita el uso de mallas. (AU)

Background and objective: Immediate breast reconstruction with implants and / or expanders is one of the most performed methods today. This has led to the use of dermal meshes of different origins to cover the lower pole of the breast and thus avoid the extrusion of the devices, where the pectoral muscle cannot cover it. We present our experience with a safe, real, simple and fast surgical alternative that avoids the use of any type of mesh, in patients who undergo immediate breast reconstruction. Methods: A descriptive and retrospective study was carried out in which patients who came to our unit with a diagnosis of breast cancer who wanted immediate reconstruction were included. We carry out an immediate simultaneous breast reconstruction technique, where the total mastectomy is started in the classic way and before separating all the breast tissue from the muscle, we begin the construction of the pocket, similar to how we do it for the retromuscular augmentation mamoplasty, being able to lift the serratus - pectoral muscle union and the mammary groove more easily. Results: Thirteen patients were included who underwent total mastectomy with immediate reconstruction, 3 of them with skin preservation and implant placement, and the rest without skin preservation and placement of expanders. After 15 months of follow-up no patient has suffered major complications, considering as such hematoma, seroma or infection, and capsular contracture did not develop in any case. Conclusions: In our experience, the use of this technique in mammary reconstruction is a safe, accessible, fast and low-cost alternative that does not prolong operative time and avoids the use of meshes. (AU)

A Quantitative Analysis of Surgical Smoke Exposure as an Occupational Hazard.

OBJECTIVE: We hypothesized that OR airborne PM was different in quantity and mutagenic potential than office air and cigarette smoke. SUMMARY OF BACKGROUND DATA: Exposure to surgical smoke has been equated to cigarette smoking and thought to be hazardous to health care workers despite limited data. METHODS: PM was measured during 15 operations in ORs with 24.8 ±â€Š2.0 air changes/h, and in controls (cigarettes, office air with 1.9-2.9 air changes/h). Mutagenic potential was assessed by gamma Histone 2A family member X staining of DNA damage in small airway epithelial cells co-cultured with PM. RESULTS: Average PM concentration during surgery was 0.002 ±â€Š0.002 mg/m3 with maximum values at 1.08 ±â€Š1.30 mg/m3. Greater PM correlated with more diathermy (ρ = 0.69, P = 0.006). Values were most often near zero, resulting in OR average values similar to office air (0.002 ±â€Š0.001 mg/m3) (P = 0.32). Cigarette smoke average PM concentration was significantly higher, 4.8 ±â€Š5.6 mg/m3 (P < 0.001). PM collected from 14 days of OR air caused DNA damage to 1.6% ±â€Š2.7% of cultured cells, significantly less than that from office air (27.7% ±â€Š11.7%, P = 0.02), and cigarette smoke (61.3% ±â€Š14.3%, P < 0.001). CONCLUSIONS: The air we breathe during surgery has negligible quantities of PM and mutagenic potential, likely due to low frequency of diathermy use coupled with high airflow. This suggests that exposure to surgical smoke is associated with minimal occupational risk.

Lactose oxidase: Enzymatic control of Pseudomonas to delay age gelation in UHT milk.

Shelf-stable milk is consumed worldwide, and this market is expected to continue growing. One quality challenge for UHT milk is age gelation during shelf life, which is in part caused by bacterial heat-stable proteases (HSP) synthesized during the raw milk storage period before heat processing. Some Pseudomonas spp. are HSP producers, and their ability to grow well at refrigeration temperature make them important spoilage organisms for UHT processors to control. Previous studies have shown that lactose oxidase (LO), a natural and commercially available enzyme that produces hydrogen peroxide and lactobionic acid from lactose, can control bacterial growth in raw milk. In this research, we investigated the ability of LO to control HSP producer outgrowth, and thus delay age gelation in UHT milk. Six strains of Pseudomonas spp. were selected based on their ability to synthesize HSP and used as a cocktail to inoculate both raw and sterile (UHT) milk at a level of 1 × 105 cfu/mL. Groups were treated with and without LO, stored for 4 d at 6°C, and monitored for cell count and pH. Additionally, a sample from each was tested for HSP activity via particle size analysis (average effective diameter at 90° angle and 658 nm wavelength) and visual inspection on each day of the storage period. The HSP activity results were contrasted using Tukey's HSD test, which showed that in UHT milk, a LO treatment (0.12 g/L) effectively prevented gelation as compared with the control. In raw milk, however, a concentration of 0.24 g/L of LO was needed to obtain a similar effect. This test was scaled up to 19-L pilot plant batches of raw milk where they were challenged with Pseudomonas cocktail, treated with LO for 3 d, and then UHT processed. Resulting UHT milk bottles were monitored for gelation. Significant differences in particle size between the LO-treated samples and the control were observed as early as 1 mo after processing, and gelation was not detected in the LO-treated samples through 6 mo of storage. These results demonstrated that LO can be used to delay age gelation in UHT milk induced by HSP-producing Pseudomonas spp., representing an opportunity to improve quality and reduce postproduction losses in the shelf-stable milk market sector.

Clinical Evaluation of the Nasopalatine Canal in Implant-Prosthetic Treatment: A Pilot Study.

Implant-prosthetic rehabilitation of missing teeth in the anterior maxilla is often challenging due to ongoing bone resorption and remodeling events and may require regeneration procedures involving the nasopalatine canal (NPC). We describe a surgical approach with a block graft in relation to the NPC and evaluate clinical performance, sensory perception, and aesthetic result of the implant-prosthetic treatment over a two- to nine-year (mean: 3.5 years) follow-up. Ten implants (six in the right central incisor and four in the left central incisor) were, respectively, placed in 10 consecutive patients with bone defects affecting the NPC and unfavorable widening of the incisive foramen. Treatment stages included: (1) Diagnosis: evaluation of clinical-aesthetic parameters using Cone Beam Computed Tomography; (2) Surgery: block graft placement by palatine and incisal with simultaneous guided bone regeneration, and late (6-10 months) implant placement; (3) Prosthetics: placement of a screw-retained crown (torque of 32 N/cm). At treatment initiation, all the NPCs evaluated in our study were free of pathologies. Treatment evaluation included bone crest thickness, neurosensory status, patients' treatment perception, and pink and white aesthetic scores (PES/WES). Pre-surgery, anterior ridge thickness at the level of the incisive foramen was (mean ± SD) 3.5 ± 2 mm, 5.4 ± 1.5 mm, and 6.1 ± 1.9 mm at heights of 4, 8, and 14 mm apical to the marginal bone crest, respectively. Post-treatment values were, respectively, 10.1 ± 2.0 mm, 10.5 ± 1.0 mm, and 13.4 ± 3.0 mm. The perception of treatment with the aesthetic pink and white indices (PES/WES) was an average of 7.5 and 7 points, respectively, out of a total of 10 each index, with a recovery of 100% of the neurosensory perception of the area. We propose that bone augmentation using block and particulate graft material can compensate for anatomical variations in the NPC, optimize implant's three-dimensional positioning and improve facial contour, providing tissue and implant stability and good aesthetic outcomes.

Injerto en bloque para la regeneración horizontal y vertical por palatino en brecha unitaria. Implicancia clínica del conducto nasopalatino / Block graft for horizontal and vertical regeneration by palatal in unit gap: clinical implications of nasopalatine canal

Objetivo: Describir un abordaje quirúrgico con injerto en bloque en relación con el conducto nasopalatino y evaluar su desempeño clínico, la percepción sensorial del paciente y el resultado estético en el tratamiento implanto-protésico. Materiales y métodos: Se realizó un estudio clínico en una serie de 10 pacientes con defecto óseo que incluía el conducto nasopalatino con ensanchamiento desfavorable del foramen incisivo. Se colocaron 10 implantes: 6 en incisivo central derecho y 4 en incisivo central izquierdo. La rehabilitación implanto-protésica se llevó a cabo en tres etapas: 1) Diagnóstica: Se evaluaron parámetros clínicoestéticos y se realizó tomografía computarizada de haz cónico; 2) Quirúrgica: Se colocó injerto en bloque por palatino e incisal con regeneración ósea guiada simultánea, y entre seis y diez meses después se colocaron implantes de 3,8 mm de diámetro y una longitud de 10,5 a 15 mm; 3) Protésica: Se atornilló la corona con un torque de 32 N. Se realizó el seguimiento de los pacientes durante 2 a 9 años, en el que se evaluó espesor de la cresta ósea, prueba neurosensorial, percepción del paciente e índices estéticos rosa y blanco. Resultados: Previamente a la cirugía, la media y la desviación estándar del ancho vestibulopalatino de la cresta anterior, a nivel del foramen incisivo, en las alturas 4 mm, 8 mm y 14 mm apicales a la cresta ósea marginal eran de 3,5±2 mm, 5,4±1,5 mm y 6,1±1,9 mm, respectivamente. Las medias totales del espesor postratamiento de la cresta vestibulopalatina en las mismas alturas fueron de 10,09±2,01 mm, 10,5±1 mm y 13,4±3 mm. La evaluación de los resultados de los índices estéticos rosa y blanco fue satisfactoria. Ningún paciente informó alteración neurosensorial. Conclusión: Las variaciones anatómicas del conducto nasopalatino pudieron ser compensadas con un aumento óseo. El injerto en bloque y particulado optimizó la posición tridimensional del implante mejorando el contorno facial del paciente. El control realizado entre 2 y 9 años mostró estabilidad de los tejidos y mantención de la estética lograda.

Aim: To describe a surgical approach with a bloc graft in relation to the nasopalatine duct, to evaluate its clinical performance, the sensory perception, as well as the aesthetic result of the implant prosthetic treatment. Materials and methods: A clinical study was conducted on a series of 10 consecutive patients with bone defects involving the nasopalatine duct with unfavourable widening of the incisive foramen, in which 10 implants were placed, 6 in the right and 4 in the left central incisor. The implant-prosthetic rehabilitation was performed in three stages: 1) Diagnosis: clinical-aesthetic parameters were evaluated and Cone Beam computed tomography scans were analysed; 2) Surgical: a block graft was placed palatal and incisal with simultaneous guided bone regeneration and between 6 and 10 month later implants were placed; 3) Prosthetic: crowns were screwed with a torque of 32 N. Patient follow-up was between 2 to 9 years. Outcomes assessed were: thickness of the bone crest, sensorineural test, pink and white aesthetics scores

Use of personal electronic devices by psychiatric inpatients: benefits, risks and attitudes of patients and staff.

OBJECTIVES: The study aimed to evaluate the attitudes of patients and staff in relation to the potential benefits and risks of allowing psychiatric inpatients controlled access to personal electronic devices (PEDs), and to document a snapshot audit of practice within the mental health inpatient units of New South Wales, Australia. METHODS: Psychiatric inpatients and staff at Royal North Shore Hospital's Mental Health inpatient units were surveyed, and an audit of the policies of the psychiatric inpatients of New South Wales was undertaken. RESULTS: Access to PEDs is denied in 85% of New South Wales psychiatric inpatient units. While patients and staff appear to concur on the risks of access to PEDs and the need for risk assessment and rules, compared to patients, staff appear to underestimate the importance of PEDs to maintaining social connection and recovery. CONCLUSIONS: This study may assist in the formulation of local policy and procedure to allow a more recovery-oriented approach to the question of whether patients should have access to their PEDs while in hospital.

Análisis tridimensional de la deformación ósea cortical en prótesis parcial fija implantosoportada con voladizo distal sobre implantes cortos en maxilar / Three-dimensional analyisis of cortical bone deformation in implant-supported fixed partial prosthesis with distal cantilever, on short maxillary implants

Objetivo: Analizar la distribución de tensiones que provoca una fuerza axial en el modelo tridimensional, con elmétodo de elementos finitos, en la prótesis parcial fija implantosoportada con voladizo distal (PPFIVD) sobre implantes dentales cortos en el sector posterior del maxilar parcialmente desdentado. Materiales y métodos: Se crearon modelos geométricos del maxilar. Se diseñaron dos grupos y cuatro subgrupos. En zona premolar, se ubicaron implantes cortos StandardPlus SLA® (Straumann) de diferentes longitudes. Grupo A: PPFIVD con dos implantes, GA1 de 8 mm y GA2 de 4 mm. Grupo B: PPFIVD con un implante, GB1 de 8 mm y GB2 de 4 mm. Se aplicó una fuerza axial de 100 N a 30°.Resultados: La distribución de las tensiones en los implantes fue menor en GA1 que en GA2, y en GB1 que enGB2. A nivel óseo, la distribución de las tensiones fue mayor en GA1 que en GA2, y en GB2 que en GB1. Se observaron microdeformaciones óseas periimplante y, posteriormente, desplazamiento del conjunto prótesis/implante. Conclusiones: La PPFIVD sobre dos implantes de 8 y4 mm ferulizados podría ser una alternativa viable al levantamiento del piso de seno maxilar. La PPFIVD sobre un implante de 4 mm no sería recomendable. Las tensiones elevadas provocaron menor rendimiento en geometría oseoimplantaria, evidenciando microdeformaciones en el tejido óseo tridimensional y desplazamientos de la PPFIVD.

Enseñanza integrada de anatomía e histología en la Facultad de Odontología de la Universidad Nacional de Córdoba, Argentina / Integrated teaching of anatomy and histology in the School of Dentistry, National University of Córdoba, Argentina

INTRODUCCIÓN: Docentes de anatomía, histología y asesoría pedagógica conformaron un equipo para diseñar e implementar una experiencia de enseñanza integrada (EI) en la Facultad de Odontología, Universidad Nacional de Córdoba, Argentina. El objetivo fue promover una mayor integración entre la anatomía e histología del sistema estomatognático y guiar la transferencia a situaciones clínicas. MATERIALES Y MÉTODOS: En 2010 se rediseñó una propuesta sobre EI para su aplicación a la totalidad de alumnos y con todos los docentes, quienes participaron en ateneos interdisciplinarios para la actualización de contenidos, unificación de criterios, etc. Los alumnos realizaron cuatro clases teórico-prácticas y un trabajo práctico elaborado sobre un caso clínico, con la participación de un docente de anatomía y otro de histología. En el trabajo práctico, los alumnos efectuaron una exploración guiada de la cavidad bucal y trabajaron grupalmente para resolver preguntas sobre el caso clínico. Evaluaron cada actividad de EI, indicando aspectos positivos y a mejorar. Los docentes se expresaron a través de una encuesta. RESULTADOS: Los alumnos destacaron que el abordaje integrado les permitió una mejor comprensión y relación de los temas de las dos asignaturas; valoraron el dinamismo, las explicaciones claras y bien ilustradas de las clases, y el trabajo sobre situaciones clínicas. Los docentes consideraron que la EI es una experiencia positiva, desafiante, enriquecedora, que mejora los nexos con sus colegas y alumnos. CONCLUSIONES: La experiencia de EI permitió lograr los objetivos de aprendizaje propuestos para los alumnos y constituyó una valiosa oportunidad formativa para los docentes

INTRODUCTION: Professors of Anatomy, Histology and from the pedagogic area formed a team with the objective of designing and carrying out an experience based on integrated teaching (IT) at the School of Dentistry, National University of Córdoba, Argentina. The main purpose was to achieve more integration between the anatomy and histology of the stomatognathic system as well to guide the transference to clinical situations. MATERIAL AND METHODS: In 2010 a new experience of IT was designed for its application to all the students and with all the professors, who participated in interdisciplinary meetings tending to content updating, criteria unification, and so on. The students attended four theoretical and practical classes and one practical activity elaborated on the basis of a clinical situation, guided by one professor of Anatomy and another of Histology. During the practical activity the students performed an oral cavity examination and worked in groups so as to answer questions referred to the clinical situation. They evaluated each IT activity, indicating positive aspects as well as those requiring adjustments. The teachers gave their opinions through an anonymous quest. RESULTS: The students remarked that the integrated approaching allowed them a better comprehension and the possibility of relating anatomical and histological contents. They also remarked the class dynamism and illustrations, clear explanations, and the activities based on clinical situations. The professors considered that the IT was a positive, defying and enriching experience that also improved the nexus with colleagues and students. CONCLUSIONS: The IT experience allowed to reach the proposed learning objectives for the students and constituted a valuable formative opportunity for the teachers

Condiciones Psico-Físicas, socio-económicas y de conocimiento de la población mayor de 20 años que requiere una prótesis implanto-soportada, en tres consultorios odontológicos privados de la ciudad de Córdoba, Argentina. 2011 / Psycho-physical, socio-economic and knowledge of the population over 20 years requiring implant-supported prostheses in three private dental offices in the city of Córdoba, Argentina Conditions. 2011

La Prostodoncia e Implantología se interrelacionan para restablecer la ausencia de piezas dentarias. La insatisfacción hacia las prótesis dentales convencionales y la desinformación de la odontología actual repercute en el bienestar personal. El objetivo de este trabajo fue describir las características psico-físicas, socio-económicas y de conocimiento, de la población que requerían una rehabilitación bucal con implantes dentales, en tres consultorios privados de Córdoba, Argentina. Se realizó una investigación observacional, descriptiva y transversal en 100 personas de ambos sexos, mayores de 20 años, en el año 2011. Fueron incluidos al azar mediante muestreo aleatorio simple sistematizado. Se aplicó una Historia Clínica con dos secciones: Exámen clínico odontológico y Encuesta. En la cavidad bucal se observó: presencia de prótesis dental (55%), fijas (36%), removibles (20%) y prótesis implanto-soportada (10%). Sólo el 19% tenían sus prótesis dentales en buen estado. El 97% de los pacientes deseaban una prótesis sobre implantes; se sentían emocional y físicamente frustrados por la ausencia de sus dientes (53%); deseaban estética (20%); masticar bien (29%); el 50% deseaba estética y masticar bien. La población estudiada desconocían el tratamiento (61%) y aún no se colocaron implantes por razones económicas (41%). Se verificó una tendencia, a mayor nivel de estudios mayor cantidad de dientes en buen estado. El porcentaje de pacientes sin obra social aumenta con la edad...

The Prosthodontic and Implantology interrelate to reset the absence of teeth. The dissatisfaction with conventional dentures and misinformation of current dentistry affects the personal welfare. The aim of this study was to describe the psycho-physical, socio-economic and knowledge of the population requiring oral rehabilitation with dental implants in three private clinics in Córdoba, Argentina. Was performed an observational, descriptive and transversal in 100 people of both sexes, aged 20 years, in 2011. Were included randomly using systematic random sampling. A medical history was applied with two sections: dental clinical examination and survey. In the oral cavity was observed: presence of dental prostheses (55%), fixed (36%), removable (20%) and implant-supported prostheses (10%). Only 19% had their dentures in good condition. 97% of patients wanted an implant prosthesis, emotionally and physically felt frustrated by the absence of teeth (53%) wanted aesthetics (20%), chew (29%), 50% wanted aesthetics and chewing okay. The study population unaware of the treatment (61%) and have not been implanted for economic reasons (41%). Was verified a trend, more educated as many teeth in good condition. The percentage of patients without social work increases with age...

Oral ketamine and midazolam for pediatric burn patients: a prospective, randomized, double-blind study.

PURPOSE: The aim of this study was to compare the efficacy of oral midazolam and ketamine with oral midazolam, acetaminophen, and codeine in providing sedation and analgesia for wound care procedures in children with burns. METHODS: This is a prospective, randomized, double-blind study that includes patients 1 to 5 years old hospitalized between 2010 and 2011, with burns covering up to 10% of total body surface area that required bedside wound care. Group 1 received oral midazolam (0.5mg/kg) and ketamine (5mg/ kg). Group 2 received oral midazolam (0.5mg/kg), acetaminophen (10mg/kg), and codeine (1mg/kg). Sedation was assessed using the University of Michigan Sedation Scale and pain using the CHEOPS scale. RESULTS: Sixty patients were enrolled and evenly distributed into the two groups. There were a higher percentage of well-sedated patients in Group 1, but this was not statistically significant. Patients in Group 2 reported lower levels of pain (p=0.0245). Adverse reactions were reported in both groups. The only parameter that had a statistical difference was nystagmus (p=0.001). CONCLUSION: The combination of oral midazolam and ketamine provides better analgesia than the combination of midazolam, acetaminophen, and codeine for painful procedures in burned children.

Onicomicosis: estudio multicéntrico clínico, epidemiológico y micológico / Onychomycosis: multicentre epidemiological, clinical and mycological study

Antecedentes. Las onicomicosis representan aproximadamente el 50% de las onicopatías, pueden ser causadas por dermatofitos, levaduras u hongos filamentosos no dermatofitos. Objetivos y metodología. Se realizó un estudio multicéntrico para conocer la prevalencia de onicomicosis, los agentes causales y las formas clínicas más frecuentes. Se evaluaron todas las muestras de uñas de manos y pies durante el período de un año en 9 centros asistenciales. Resultados. Se procesaron 5.961 muestras, el 82,3% correspondieron a uñas de pies y el 17,7% a uñas de manos. La edad promedio de los pacientes fue 49,7 años y el 66% perteneció al sexo femenino. Los exámenes directos fueron positivos en el 61% de los casos. En adultos, las uñas de los pies presentaron un 61,2% de resultados positivos en el examen directo, y los cultivos fueron positivos en un 43,7%. Los hongos predominantes fueron los dermatofitos (82,8%) y la forma clínica más frecuente fue la distal subungueal. En uñas de manos la positividad del examen directo fue del 59,8% y los cultivos fueron positivos en un 52,9%; los hongos predominantes fueron de tipo levaduriforme y la forma clínica más frecuente fue la onicolisis. Conclusiones. Se encontró un 61% de positividad en el examen directo, valor superior al de otras investigaciones. En las uñas de los pies prevalecieron los dermatofitos en ambos sexos, y en uñas de manos las levaduras, en el sexo femenino, y dermatofitos, en el masculino. El 4,8% de los aislamientos de uñas de pies y el 2,05% de los de uñas de manos fueron de hongos filamentosos no dermatofíticos(AU)

Background. Onychomycosis accounts for up to 50% of all nail disorders. They can be caused by: yeasts, dermatophytes and non-dermatophyte moulds. Objectives and methods. A multicentre study designed to determine the prevalence, mycological test results, aetiological agents, and clinical presentation of onychomycosis was carried out. All fingernail and toenail samples taken during a one year period at 9 diagnostic centres were included. Results. A total of 5,961 samples were analysed, of which 82.3% were from toenails and 17.7% from fingernails. The mean age of the patients was 49.7 years, and 66% were females. Direct microscopic examination was positive in 61% of the samples. In adults, 61.2% of toenails were positive using potassium hydroxide (KOH), and 43.7% were positive in cultures. The prevailing aetiological agents belong to the dermatophyte group (82.8%), and distal subungual was the most common clinical form. In fingernails, direct examination showed 59.8% positive samples, and cultures were positive in 52.9%. The prevailing agents were yeasts belonging to Candida species, and onycholysis was the most common lesion. Conclusions. Direct mycological examinations were positive in 61%, a higher value than that found in other series. Dermatophytes were prevalent in toenails of both sexes, and in finger nails yeast were prevalent in females, and dermatophytes in males. Non-dermatophyte moulds corresponded to 4.8% of toenail and 2.05% of fingernails isolates(AU)

[Onychomycosis: multicentre epidemiological, clinical and mycological study]. / Onicomicosis: estudio multicéntrico clínico, epidemiológico y micológico.

BACKGROUND: Onychomycosis accounts for up to 50% of all nail disorders. They can be caused by: yeasts, dermatophytes and non-dermatophyte moulds. OBJECTIVES AND METHODS: A multicentre study designed to determine the prevalence, mycological test results, aetiological agents, and clinical presentation of onychomycosis was carried out. All fingernail and toenail samples taken during a one year period at 9 diagnostic centres were included. RESULTS: A total of 5,961 samples were analysed, of which 82.3% were from toenails and 17.7% from fingernails. The mean age of the patients was 49.7 years, and 66% were females. Direct microscopic examination was positive in 61% of the samples. In adults, 61.2% of toenails were positive using potassium hydroxide (KOH), and 43.7% were positive in cultures. The prevailing aetiological agents belong to the dermatophyte group (82.8%), and distal subungual was the most common clinical form. In fingernails, direct examination showed 59.8% positive samples, and cultures were positive in 52.9%. The prevailing agents were yeasts belonging to Candida species, and onycholysis was the most common lesion. CONCLUSIONS: Direct mycological examinations were positive in 61%, a higher value than that found in other series. Dermatophytes were prevalent in toenails of both sexes, and in finger nails yeast were prevalent in females, and dermatophytes in males. Non-dermatophyte moulds corresponded to 4.8% of toenail and 2.05% of fingernails isolates.

Micosis oportunistas de senos paranasales: manifestaciones cutáneo-mucosas / Mycoses opportunist of nasal sinuses: manifestations cutaneous-mucosas

Se presentan nueve pacientes con sinusitis fúngica, en el período de 1986-1988. Se aislaron los siguientes agentes etiológicos: Aspergillus flavus (n=3), Alternaria alternata (n=3), Acremonium falciforme (n=1), Rhizopus sp. (n=1), y Cladosporium bantianum (n=1). En individuos inmunocomprometidos (n=8) se observó necrosis de cornetes, tumefacción, edema, obstrucción nasal y rinorrea. En algunos casos estas lesiones progresaron con compromiso de la pared nasal, senos paranasales y cavidad craneal. La mayoría de estos pacientes padecían leucemia mieloide aguda (LMA) y se encontraban en período de neutropenia crítica, asociada a tratamientos quimioterapéuticos. En uno de los pacientes no se detectaron alteraciones inmunológicas. La lesión fue localizada, no invasiva, con congestión nasal y rinorrea. El tratamiento fue anfotericina B en todos los casos, hasta completar 1 g de dosis total. Se comprobó la cura clínica y micológica en cinco de los pacientes, los cuatro restantes fallecieron sin recuperar valores normales de neutrófilos, o corregir su enfermedad de base.

Alternariosis de senos paranasales / Alternariosis of paranasal sinus

Paciente, de sexo femenino , de 47 años de edad, sin antecedentes clínicos de importancia, que presenta una neoformación que ocupa el seno paranasal izquierdo con obstrucción nasal, rinorrea y protrusión del globo ocular del mismo lado. No hay manifestaciones cutáneas. La TC (tomografía computada) muestra una masa ocupante del seno maxilar, etmoides y frontal izquierdo con destrucción de la pared orbitaria, apófisis pterigoides, lámina cribosa del etmoides y desviación del tabique nasal a la derecha. Se efectúa una sinusotomía frontal y del material obtenido se aísla Alternaria alternata. Se realiza tratamiento con anfotericina B, 820 mg dosis total durante un mes. Continúa en forma ambulatoria con grisepfulvina 2 g por día. Finaliza a los dos meses con involución total de las lesiones y controlada por la TC. hasta la fecha no se ha demostrado en nuestra paciente signos de inmunodeficiencia