Chronic inflammatory demyelinating polyradiculoneuropathy in patients with diabetes mellitus - treatment with intravenous immunoglobulins: A systematic review.

BACKGROUND: Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a rare disease, but it is one of the most common inflammatory neuropathies in the population. It is particularly common among patients with diabetes mellitus. This raises many problems, both with the differential diagnosis of diabetic and inflammatory neuropathy, as well as the choice of treatment. Intravenous immunoglobulin (IVIG) is one of the therapeutic options. There is evidence for the effectiveness of IVIG in treating about two-thirds of patients. However, no review has been published to date systematising studies evaluating the response to IVIG treatment in patients with CIDP and coexisting diabetes. METHODS: The present study is based on the PRISMA statement and is registered at PROSPERO (CRD42022356180). The study included searches of the databases of MEDLINE, ERIC, CINAHL Complete, Academic Search Ultimate and Health Source: Nursing/Academic Edition, finally including seven original papers evaluating a total of 534 patients in the review. The main inclusion criteria were the presence of a group of patients with CIDP and comorbid diabetes in the study. RESULTS: The systematic review showed a lower efficacy of IVIG treatment among patients with coexisting diabetes compared with idiopathic CIDP (61 % vs 71 %). In addition, the presence of conduction blocks on neurography and shorter disease duration proved to be significant factors improving response to treatment. CONCLUSIONS: Current scientific data do not allow for strong recommendations on the choice of treatment for CIDP. A randomised, multicentre study evaluating the efficacy of different therapeutic approaches to this disease entity needs to be planned.

Identification of Fungi Isolated from Oral Cavity of Patients with HIV Using MALDI-TOF MS.

BACKGROUND: A growing incidence of invasive fungal infections, especially among immunocompromised patients, has given increased significance to microbiological diagnostics of yeast-like fungi. More accurate and faster fungi identification methods that can compete with classical methods are being searched for. In this paper, classical microbiological methods are compared to MALDI-TOF MS (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry). METHODS: The diagnostic material was collected from buccal mucosa from 98 adults, including 69 with HIV. Only positive cultures were included in the study. RESULTS: Matching results were obtained in 45 samples, and there were nonmatching results in 35 samples, with the majority of these in the study group, constituting 50% of identifications within this group. A particularly common mistake resulting from the use of classical methods is the false identification of C. dubliniensis as C. albicans. Additionally, C. tropicalis proves to be difficult to identify. CONCLUSIONS: Our results and literature data suggest that MALDI-TOF MS should be considered an effective alternative to classical methods in terms of fungi identification, especially among HIV-positive patients, due to the different morphology of fungal colonies.

Oral cavity fungal flora among HIV-positive people.

BACKGROUND: Immunosuppressed patients, also those who are HIV-positive patients, are susceptible to oral cavity fungal infections. AIM OF STUDY: In this study, we aimed to show differences in qualitative composition of oral cavity flora between HIV-positive people and healthy controls and identify factors which affect fungal oral cavity flora. MATERIALS AND METHODS: The study group contained HIV-positive people and a control group of healthy people. All cultured species were analysed using MALDI-TOF MS. RESULTS: More HIV-positive people had two or more fungus species present than controls (p=0.008). Seven species were cultured in the study group compared to three in the control group. Smoking was associated with higher prevalence of C. albicans (p=0.03), C. glabrata (p=0.026), C. tropicalis (p=0.01). Dental prosthesis or braces was also associated with presence of more species (p=0.04).The lower level of lymphocytes CD4+ was not associated with fungus presence in oral cavity. CONCLUSIONS: HIV infection is associated with changes to oral cavity fungal flora. Given the higher number of non-albicans species among HIV-positive patients it is important to individually choose a treatment for such patients' fungal infections. Proper oral hygene and not smoking can reduce prevalence of fungi in oral cavity. Patients' immunological status did not have an impact on the frequency of Candida species isolation from the oral cavity.