The Effects of Prednisone/Ketoprofen Administration in Association with Amoxicillin Clavulanate Following Periodontal Surgical Therapy in Patients with Severe Chronic Periodontitis.

Background and Objectives: The aim of this study was to evaluate and compare the effects of two different anti-inflammatory drugs (ketoprofen and prednisone) combined with an antibiotic (amoxicillin + clavulanic acid) and periodontal surgery on dental and periodontal parameters in patients with severe chronic periodontitis. In addition, salivary stress expressed by cortisol levels was assessed. Materials and Methods: An interventional study was performed on 22 periodontal subjects and 19 clinical healthy controls. The patients were divided in four groups, depending on treatment planning, as follows: eight patients received prednisone and antibiotherapy, associated with surgical periodontal therapy; seven patients received ketoprofen and antibiotherapy, associated with surgical periodontal therapy (group II); seven patients received only prednisone. Periodontal healthy patients underwent routine scaling and polishing. Bleeding on probing (BOP), dental mobility and salivary cortisol (ng/mL) were assessed before and after treatment. The means and standard deviations for the salivary cortisol levels (SCLs), dental and periodontal parameters were calculated for all groups using each patient as a unit of analysis. Results: Data analyses showed that the two different anti-inflammatory drugs associated with or without surgical therapy were efficient on inflammation periodontal parameters (BOP, dental mobility). Prednisone treatment alone was associated with a significant decrease of SCLs between pretreatment and post-treatment. Conclusions: In the present study, the effects of either of the anti-inflammatory drugs on inflammation evolution and salivary stress were comparable in patients undergoing antibiotherapy and surgical periodontal therapy.

Study of antimicrobial effects of functionalized silver nanoparticles.

In recent decades, the study of nanoparticles (NPs) has gained a great scientific interest, due to a wide range of potential applications, in different fields: electronic, optical and biomedical. Some of the most studied effects of NPs are antibacterial ones, because the large, sometimes unjustified and uncontrolled administration of antibiotics has led to the emergence of multidrug-resistant (MDR) bacterial strains. In our study, starting from silver nitrate (AgNO3), we made approximately 30 nm spherical AgNPs that were coated with a thin layer of ethylene glycol (EG) or EG and polyvinylpyrrolidone (PVP). The microbial culture study showed that AgNPs have antibacterial effects, depending on the dose of the NPs and the type of bacteria.

Antimicrobial resistance in bacterial pathogens among hospitalised patients with severe invasive infections.

The most severe infections are invasive infections, due to the fact that the germs can accumulate in multiple sites and produce a body-wide infection known as sepsis. Septic shock has the highest mortality rate among non-traumatic medical conditions. In this study, we aimed to evaluate the incidence and prevalence of invasive infections in a hospital environment. Another second objective was to establish the aetiology of invasive infections in our hospital and the antibiotic resistance profile of the germs involved, which are both important for determining the therapeutic approach for the treatment of these infections. The study included 505 hospitalized patients from which we collected a total of 974 blood cultures. For the analysis of the blood cultures, we used an automated incubator. The bottles flagged as positive were subcultured on blood agar, and the grown colonies were identified using an identification system. Invasive infections had a prevalence rate of 27.72% in our hospital. From the 974 blood cultures, we isolated 170 bacterial strains: Staphylococcus aureus (SA; 63 strains, 37.06%), Klebsiella spp. (27 strains, 15.88%), coagulase-negative staphylococci (CoNS; 18 strains, 10.59%), Enterococcus spp. (17 strains, 10.00%), Escherichia coli (12 strains, 7.06%), Streptococcus spp. (11 strains, 6.47%) and other bacterial species. The prevalence of methicillin-resistant SA (MRSA) in our study was 36.51% from the SA strains. The MRSA prevalence differed significantly according to age (37.50% in adults vs. 28.57% in children, P=0.047) and ICU admission (42.42% in ICU patients vs. 30.00% in non-ICU patients, P=0.018). We performed a multivariate analysis of the invasive infection risk which detected as significant predictors the admission into the cardiology ward and plastic surgery ward. On the whole, the findings of this study indicate that the high prevalence of Gram-positive cocci in blood cultures, mostly SA, with multidrug resistance has important consequences for the management of invasive infections.

Immunohistochemistry predictive markers for primary colorectal cancer tumors: where are we and where are we going?

The aim of our study is to highlight and organize the recently published immunohistochemistry (IHC) predictive biomarkers of primary colorectal cancers (CRCs) that could lead to practical implementation. We reviewed articles that examined CRC samples with significant statistic correlation between the IHC marker expression and disease progression over time, relationships with the available clinical features and those who detect the prognosis of drug effects. Our analysis showed that nine markers could correlate with medical treatment response of CRCs in different stages. When using better overall survival (OS) and better disease-free survival (DFS) as a grouping factor, there were 14 markers that could be used in assessing CRC prognosis. By using poor prognostic for the OS and the DFS as a grouping factor, we found 43 markers. Subgroup analysis was also performed based on the 32 markers recently confirmed to predict metastasis evolution or the recurrence risks. Venous invasion could be predictable for tumors, statistically significant metastasis susceptibility was observed for markers and also the capacity to evaluate recurrence. CRCs integrate a variety of localizations and there are proofs that distinguish the sites of tumors. The studies reporting data specifically for rectal cancer separating it from colon cancer contained seven IHC markers. In order to be able to implement a predictive biomarker in clinical practice, it must comply with certain criteria as clinical value and analytical proof. Unique biological signature of CRC can be distinguished by identifying biomarkers expression. Several markers have shown potential, but the majority still need to render clinical utility.

Design, Synthesis, Characterization and Antimicrobial Evaluation of Some Heterocyclic Condensed Systems with Bridgehead Nitrogen from Thiazolotriazole Class.

In the present study, a series of new heterocyclic condensed systems with bridgehead nitrogen from the thiazolo[3,2-b][1,2,4]triazoles class was synthesized starting from some 4-(4-X-phenylsulfonyl)phenyl)-4H-1,2,4-triazole-3-thioles 1a-c (X=H, Cl, Br). The intermediates of S-alkylated 1,2,4-triazoles, 2-(5-(4-(4-X-phenylsulfonyl)phenyl)-2H-1,2,4-triazol-3-ylthio)-1-(4-fluorophenyl)ethanones 2a-c, were obtained by treatment of triazoles 1a-c with 2-bromo-4'-fluoroacetophenone. The 2-(4-(4-X-phenylsulfonyl)phenyl)-6-(4-fluorophenyl)thiazolo[3,2-b][1,2,4]triazoles 3a-c were obtained by cyclization of S-alkylated 1,2,4-triazoles 2a-c in sulfuric acid media, at 0 °C. For the synthesis of 2-(4-(4-X-phenylsulfonyl)phenyl)-5-(4-fluorobenzylidene)-thiazolo[3,2-b][1,2,4]triazol-6(5H)-ones 4a-c, the triazoles 1a-c were treated with 4-fluorobenzaldehyde, chloroacetic acid and anhydrous sodium acetate, in the presence of acetic acid and acetic anhydride. The structures of the newly synthesized compounds have been confirmed by elemental analysis and spectral methods (IR, 1H-NMR, 13C-NMR, MS). The antimicrobial activity of all new compounds has been screened against some bacteria and yeasts.

Antibiotic susceptibility of 33 Prevotella strains isolated from Romanian patients with abscesses in head and neck spaces.

The purpose of this study was to investigate the susceptibility of a series of 33 Prevotella strains isolated from patients with abscesses in the head and neck spaces, presented to one Romanian hospital. The Etest was applied to determine the value of the minimum inhibitory concentrations for: penicillin G, ampicillin, amoxicillin-clavulanate, metronidazole and clindamycin. In addition, the beta-lactamase activity was detected by the chromogenic cephalosporin disc method. The results indicated that 11 isolates were resistant to both penicillin G and ampicillin due to the beta-lactamase production. All the 33 Prevotella strains were susceptible to the other 3 antimicrobial agents tested, except for only one penicillin G - ampicillin resistant isolate of Prevotella buccae (MIC > 32 and MIC = 12 mg/L, respectively), which showed high resistance to clindamycin (MIC > 256 mg/L) too. Our data underline the necessity for antimicrobial testing including monitoring of beta-lactamase production in cases of oro-maxillo-facial mixed anaerobic infections where antimicrobial treatment is required in addition to the surgical drainage. The results of the study indicated that amoxicillin-clavulanate, like metronidazole, was fully active against the tested Prevotella strains. However, local and multicentre surveys on drug resistance among the clinically significant anaerobic isolates should be carried out periodically.

Susceptibility testing of Streptococcus pneumoniae and Viridans streptococcal isolates against: quinolones, oxazolidinones and glycopeptides.

UNLABELLED: The aim of this study was to test the susceptibility of 100 strains (pneumococci and viridans streptococci) isolated from oral and respiratory tract infections and their complications, against one antibiotic of each of the following classes: quinolones, oxazolidinones and glycopeptides. MATERIAL AND METHODS: The Etest has been used in order to investigate the susceptibility of the isolates against levofloxacin, linezolid and vancomycin. RESULTS AND CONCLUSIONS: As expected, the results of the study indicated that all isolates were susceptible to linezolid and vancomycin. In contrast to the pneumococcal isolates, which were all susceptible to levofloxacin, 10% of the viridans strains showed resistance to this quinolone. When fluoroquinolones are needed as an alternative to the beta-lactam antibiotics in infections in which oral streptococci are involved, the in vitro susceptibility testing is required.

New heterocyclic compounds from 1,2,4-triazole and 1,3,4-thiadiazole class bearing diphenylsulfone moieties. Synthesis, characterization and antimicrobial activity evaluation.

Some new 5-(4-(4-X-phenylsulfonyl)phenyl)-4-(R)-2H-1,2,4-triazol-3(4H)-thiones 4a,b; 5a,b and 5-(4-(4-X-phenylsulfonyl)phenyl)-N-(R)-1,3,4-thiadiazol-2-amines 6a,b; 7a,b were obtained by cyclization of new N(1)-[4-(4-X-phenylsulfonyl)benzoyl]-N(4)-(R)-thiosemicarbazides 2a,b; 3a,b (X=H, Br). The 1,2,4-triazoles were synthesized by intramolecular cyclization of acylthiosemicarbazides, in basic media. On the other hand, 1,3,4-thiadiazoles were obtained from same acylthiosemicarbazides, in acidic media. These new intermediates from thiosemicarbazide class were afforded by the reaction of 4-(4-X-phenylsulfonyl)benzoic acids hydrazides (X=H, Br) 1a,b with 4-trifluoromethoxyphenyl or 3,4,5-trimethoxyphenyl isothiocyanate. The newly synthesized compounds were characterized by IR, (1)H NMR, (13)C NMR, MS and elemental analysis. All the new compounds were screened for their antimicrobial activity against some bacteria (Staphylococcus aureus ATCC 25923, Bacillus cereus ATCC 13061, Escherichia coli ATCC 25922, Enterobacter cloacae ATCC 49141, Acinetobacter baumannii ATCC 19606 and Pseudomonas aeruginosa ATCC 27853) and yeasts (Candida albicans ATCC 90028 and Candida parapsilosis ATCC 22019).

Synthesis and antimicrobial evaluation of some fused heterocyclic [1,2,4]triazolo[3,4-b][1,3,4]thiadiazole derivatives.

A series of fused 1,2,4-triazoles with diphenylsulfone moiety are prepared utilizing 4-amino-5-[4-(4-X-phenylsulfonyl)phenyl]-4H-1,2,4-triazole-3-thiol 1 (X=H, Br). The latter on reaction with aromatic isothiocyanate in DMF, aromatic acid in POCl3 and CDI in dioxane gives five membered fused triazole derivatives 2a-c, 3a-c, 4a-g, 5a-g and 6a,b. The structures of newly synthesized compounds were confirmed on the basis of their elemental analysis and spectral data results (IR, 1H-and 13C NMR). New synthesized compounds were screened for their antimicrobial activities. The preliminary results revealed that some of the compounds exhibited promising antimicrobial activities.

Synthesis, characterization and evaluation of antibacterial activity of some thiazolo[3,2-b][1,2,4]triazole incorporating diphenylsulfone moieties.

A series of thiazolo[3,2-b][1,2,4]triazole incorporating diphenylsulfone moieties were synthesized starting from 5-[4-(4-X-phenylsulfonyl)phenyl]-4H-1,2,4-triazole-3-thioles 3a-c, X=H, Cl, Br. Thus, alkylation of 1,2,4-triazoles 3 with phenacyl bromide or 4-bromophenacyl bromide afforded S-substituted 1,2,4-triazoles 4, 5. These new intermediates 4 and 5, in the presence of H(2)SO(4) (c), were cyclized to 2-[4-(4-X-phenylsulfonyl)phenyl]-6-(4-Y-phenyl)[1,3]thiazolo[3,2-b]-[1,2,4]-triazoles 6, 7 (I) and not to isomeric thiazolo[2,3-c][1,2,4]-triazoles 6, 7 (II). The newly synthesized compounds were characterized by IR, (1)H, (13)C NMR and elemental analysis. MS spectra confirmed the formation of thiazolo[3,2-b][1,2,4]triazole 6, 7 (forms I) in detriment of [2,3-c] isomeric compounds (forms II). The potential antibacterial effects of the synthesized compounds were investigated using standard bacterial strains: Acinetobacter baumannii ATCC 19606, Citrobacter freundii ATCC 8090, Escherichia coli ATCC 11775, Pseudomonas aeruginosa ATCC 9027, Enterococcus faecalis ATCC 19433, Staphylococcus aureus ATCC 12600, Staphylococcus epidermidis ATCC 14990, Bacillus cereus ATCC 14579.

Contribution towards developing a new semi-selective medium for Streptococcus anginosus group.

UNLABELLED: The aim of this study was to develop a new selective medium for isolation of Streptococcus anginosus group (SAG) strains, by adding sulphamethazine and aztreonam as selective agents at Mitis-Salivarius agar (MSA), the medium commonly used for recovery of oral streptococci from oral samples. MATERIAL AND METHOD: The evaluation of Mitis-Salivarius--sulphamethazine--aztreonam agar (MSSAA) for SAG selectivity was performed by testing the growth of type strains and laboratory-stored clinical isolates of different oral streptococcal species on this medium and also by investigating the SAG recovery on MSSAA in comparison with MSA and the growth inhibition of non-SAG strains from 100 saliva and 11 pus samples (collected from healthy young subjects and from paediatric patients with upper respiratory tract infections, respectively) on MSSAA. RESULTS: The same SAG recovery rate was obtained on both MSSAA and MSA, while non-SAG strains failed to grow on the novel medium, except for enterococci. The results of the present study have indicated that MSSAA is a suitable medium for selecting SAG isolates from clinical specimens.

[Anaerobic Gram-negative bacilli involved in the etiopathogeny of the abscesses of superficial fascial spaces of the face and neck]. / Bacili Gram-negativi anaerobi implicati in etiopatogenia abceselor cu localizare in lojile superficiale ale fetei si gâtului.

UNLABELLED: The aim of this study was to isolate and identify at species level the strains of anaerobic Gram-negative bacilli (GNB) from pus samples collected in patients with abscesses of fascial spaces of the face and neck. Microscopy of Gram-stained smears and cultures were performed in each specimen. The strictly anaerobic GNB strains were identified using the conventional methods of diagnosis and the Rapid ID 32 A system. In addition, the other strains isolated in association with these bacteria were identified at least to genus level. The 28 anaerobic GNB isolates belonged to: Fusobacterium nucleatum and different species of Prevotella (4 species) and Bacteroides (3 species). CONCLUSIONS: The anaerobic GBN strains were recovered--either alone or in association with other migroorganisms--in more than half of all investigated samples and represented about 40% of all isolates. The most frequently isolated species were P> melaninogenica and B. ureolyticus.

Oral streptococcal strains isolated from odontogenic infections and their susceptibility to antibiotics.

The aim of this study was to identify at species level and to investigate the antibiotic susceptibility of oral streptococcal strains isolated from 100 pus samples collected from Romanian patients with different odontogenic infections. The isolates were identified at species level using the Rapid ID 32 STREP system and their susceptibility was testing by the Etest, against: penicillin G, ampicillin, erythromycin, clindamycin and tetracycline. For the investigation of erythromycin resistance phenotype the disk diffusion test was used. The isolates belonged to several species, with Streptococcus anginosus and Streptococcus oralis predominating. Reduced susceptibility to beta-lactam antibiotics was found only among the isolates belonging to S. mitis and S. sanguinis groups. Resistance to erythromycin was detected among all species, except for: S. constellatus, S. intermedius and S. gordonii, and the M phenotype was established, while resistance to tetracycline was detected within all species but S. gordonii. In contrast, clindamycin was fully active. As most odontogenic infections are mixed infections, often involving strictly anaerobic bacteria, which are frequently beta-lactamase producers, the association of a penicillin and a beta-lactamase inhibitor, like Amoxiclav, is recommended when the antimicrobial treatment is necessary.

[Epidemiologic aspects of the edentulous mouth (II). General and local features of the totally edentulous mouth]. / Aspecte epidemiologice privind edentatia totala (II). Aspecte generale si locale asociate edentatiei totale.

UNLABELLED: PREMISES AND AIM: The study wants to reveal the general and local clinical aspects, which may accompany the completely edentulous mouth and create difficulties in treatment. MATERIAL AND METHOD: The clinical and statistical study was carried out on 40 edentulous patients; we analyzed general aspects (the present medical status, the patient's medication and its effects) and local aspects (the etiology, the type of previous denture treatment, the type and number of denture's repairs, the extent of the residual ridge resorption, the relationship between residual ridges), the total difficulty of the treatment. RESULTS AND DISCUSSIONS: 80% of the edentulous patients suffered from general diseases, more frequent from cardiovascular, digestive, metabolic, renal, rheumatic diseases. 73% of the edentulous patients received daily medication, which generated in 30% of cases a decrease of the saliva volume. The demand for prosthetic treatment was greater for the recent edentulous patients (less then 1-2 years of edentulousness) or for those who lost their teeth more then 6 years ago. The majority of patients over 70 years are completely bimaxillary edentulous patients, 68% of them had previous bimaxillary dentures. We found the bone resorption moderate (50% of cases) and severe (33% of patients), the relationship of the residual ridges inverse in the anterior and posterior zones (60% of patients) and normal in the anterior zone and inverse in the posterior zone (28%). The difficulty of the treatment was frequently 3Pd degree for the maxilla and 4t' degree for the mandible (the maximum degree of difficulty). CONCLUSIONS: The completely edentulous patient presents a number of general and local modifications, which increase the difficulty of the treatment, demand supplementary therapeutic procedures, and increase the total cost. The modifications of the oral structures demand specific therapeutic procedures, and in some cases the frequent renewal or adaptation of dentures (every 3-5 years); all those costs must be took over by the insurance company, because of their social status (pensioners).

[Epidemiologic aspects of the totally edentulous mouth. (1) General aspects]. / Aspecte epidemiologice privind edentatia totala (1). Aspecte generale.

UNLABELLED: PREMISES AND AIM: This study analyses the evolution of the populational segment represented by edentulous patients, specific to our country, regarding the number of edentulous patients, related to age, sex. MATERIAL AND METHOD: We performed two statistical studies on edentulous patients in 1994 and in 2004 and we compared their results. In order to evaluate the present clinical aspects of the edentulous patients, we performed this year a clinical study on 40 patients, which were classified according to their age and sex. We compared the data from this study to those obtained ten years ago from another study performed on 360 edentulous patients. RESULTS: Comparing those two studies we could appreciate the evolution of the edentulous related to age, number of patients on age groups, patient's age when he (she) became edentulous, the age/sex ratio. The age of edentulousness's installation increased, but there still exist numerous edentulous patients on the age groups 60-70, 70-80 years. In this year study, the number of edentulous patients over 80 years is twice the number that we found ten years ago. The ratio age/sex is maintained the same in both studies. So, there are more women than man in the age groups 50-60, and 60-70 (multiplied by 2, respectively 2,5), and an almost equal number of man and women in the age groups of 70-80 years and over 80 years. CONCLUSIONS: The clinical evaluation of the edentulous patients in this study, related to age and to the age/sex ratio revealed modifications in other populational groups, i.e., the increasing age of the installation of edentulousness and the increasing number of elderly people result in a greater number of edentulous female patients after menopause. So we can find out practical conclusions for the realization of total dentures, regarding treatment attitudes and costs.

[Prevotella species involved in the onset of superficial face and neck abscesses]. / Specii de Prevotella implicate în producerea abceselor cu localizare în lojile superficiale ale fetei si gâtului.

The aim of the study was to identify at species level the Prevotella strains from 30 pus samples collected by needle aspiration in patients with abscesses of fascial spaces of the face and neck. Microscopy of Gram-stained direct smear and cultures on selective and nonselective media incubated aerobically and anaerobically were performed in each pus specimen. All strains of Gram-negative strictly anaerobic bacilli were identified to genus and species level using conventional methods of diagnosis and the Rapid ID 32 A system (BioMérieux, Marcy-l'Etoile, France). The Prevotella isolates were recovered (alone or in association with other bacteria) in 46.6% of the investigated specimens and were represented in reverse order of frequency by the following species: P. melaninogenica, P. denticola, P. oralis and P. loescheii. In conclusion, the rate of Prevotella isolation was relatively high and the most frequently isolated species was P. melaninogenica (followed by P. denticola), while no P. intermedia was found.

[Phenotypical characterization of some strains of anginosus streptococci isolated from superficial face and neck abscesses]. / Caracterizarea fenotipica a unor tulpini de streptococi din grupul anginosus izolate din abcese cu localizare în lojile superficiale ale fetei si gâtului.

The aim of the present study was to identify at species level and to characterize the strains of streptococci belonging to anginosus group isolated from 30 pus samples collected from patients with abscesses of fascial spaces of the face or neck. The identification of facultatively anaerobic Gram-positive cocci in chains at genus level was made by conventional diagnosis methods and at species level by the help of Rapid ID 32 STREP system. The cultural, biochemical and antigenic (limited at Lancefield Group identification by Slidex Strepto-Kit) characterization was performed in the mean time with the species identification. The anginosus streptococcal strains were isolated either in association with other bacteria or in pure culture and S. anginosus isolates clearly predominated. As expected, the anginosus streptococcal strains were found to be heterogeneous regarding the cultural, biochemical and antigenic features.