Structural and Functional Alterations Caused by Aureobasidin A in Clinical Resistant Strains of Candida spp.

Candida species are one of the most concerning causative agents of fungal infections in humans. The treatment of invasive Candida infections is based on the use of fluconazole, but the emergence of resistant isolates has been an increasing concern which has led to the study of alternative drugs with antifungal activity. Sphingolipids have been considered a promising target due to their roles in fungal growth and virulence. Inhibitors of the sphingolipid biosynthetic pathway have been described to display antifungal properties, such as myriocin and aureobasidin A, which are active against resistant Candida isolates. In the present study, aureobasidin A did not display antibiofilm activity nor synergism with amphotericin B, but its combination with fluconazole was effective against Candida biofilms and protected the host in an in vivo infection model. Alterations in treated cells revealed increased oxidative stress, reduced mitochondrial membrane potential and chitin content, as well as altered morphology, enhanced DNA leakage and a greater susceptibility to sodium dodecyl sulphate (SDS). In addition, it seems to inhibit the efflux pump CaCdr2p. All these data contribute to elucidating the role of aureobasidin A on fungal cells, especially evidencing its promising use in clinical resistant isolates of Candida species.

Garré`s osteomyelitis: a case report with a 6-month follow-up

Introduction: Garrè's osteomyelitis is a rare, chronic infection associated with proliferative periostitis that induces reactional bone neoformation. Objective: To report the clinical case of successful treatment of Garre's osteomyelitis in a young patient. Case report: An 11-year-old girl visited a dental clinic with complaints of volume increase in the mandibular border accompanied by pain and facial asymmetry. Computed tomography revealed extensive tooth destruction, a periapical lesion, and several radiopaque bone laminations parallel to the mandible cortex, all findings suggestive of Garrè's osteomyelitis. The patient was treated by tooth removal and antibiotic therapy, and the condition was completely resolved, with decreased facial asymmetry at the 6-month follow up. Conclusion: Once the diagnosis of Garrè's osteomyelitis is established and proper treatment is provided, the prognosis tends to be extremely favorable and bone remodeling should be considered until the affected surface returns to its normal anatomy.

Introdução: A osteomielite de Garrè é um tipo raro e crônico de infecção óssea associado a periostite proliferativa que induz neoformação óssea reacional. Objetivo: relatar o caso clínico de osteomielite de Garrè em uma paciente jovem tratada com sucesso. Relato de caso : Paciente do gênero feminino, 11 anos compareceu ao serviço odontológico com queixa de aumento de volume em borda de mandíbula acompanhada de dor e assimetria facial. A tomografia computadorizada revelou extensa destruição dentária associada a lesão periapical e a presença de várias laminações ósseas radiopacas paralelas ao cortical da mandibula, sugerindo o diagnóstico de osteomielite de Garrè. O caso foi tratado com a remoção do elemento dentário associado a antibioticoterapia, o que resolveu completamente a infecção e diminuiu a assimetria facial conforme constatado após 6 meses de proservação. Conclusão: Uma vez estabelecido o diagnóstico de osteomielite de Garrè, e a infecção adequadamente tratada, o prognóstico tende a ser extremamente favorável e a remodelação óssea deve ocorrer continuamente até que a superfície retorne à sua anatomia normal.

Salivary pH and colonization by oral Candida in children and adolescents submitted to haemodialysis.

BACKGROUND: Fungal infections are a serious problem among haemodialysis patients. AIM: The aims of this study were to estimate the frequency of oral Candida species among children and adolescents undergoing haemodialysis (HD), to identify the isolated species, and to study the relationship between haemodialysis duration, amounts of colony-forming units, and salivary pH. DESIGN: A matched sample of 52 patients undergoing HD and 52 healthy individuals were selected. The samples were obtained from the dorsum of the tongue, and the colonies were identified through a substrate assimilation test. Stimulated whole saliva was collected from each patient for evaluation of salivary pH. RESULTS: The frequency of oral Candida species was 34.6% (18/52) and 46.20% (24/52) in the HD and control groups (P = 0.23), respectively. Candida parapsilosis complex was the most frequently isolated fungi species in the HD group (P = 0.03). A HD therapy duration of more than 1 year was statistically correlated with a higher number of colony-forming units (P = 0.03) but was not statistically related to salivary pH. CONCLUSIONS: Candida parapsilosis complex was the most frequently isolated fungal species in the young HD patients, and the duration therapy was associated with higher oral colonization.

Effect of the secretory leucocyte proteinase inhibitor (SLPI) on Candida albicans biological processes: a therapeutic alternative?

OBJECTIVES: The aim of this study was to evaluate the effect of SLPI on the growth and biological processes of Candida albicans. METHODS: Two C. albicans strains were used in this study, a clinical isolate resistant to fluconazole (PRI) and a reference strain ATCC 24433. The minimal inhibitory concentration (MIC) was determined according to the CLSI methodology. The influence of SLPI on secreted serine proteinase activities (SSP) was measured by the cleavage of specific substrate, and surface hydrophobicity was determined by the aqueous-hydrocarbon biphasic separation method. Flow cytometry was performed to investigate receptors for SLPI and variations in the cell wall mannoprotein expression. Interaction between yeast and epithelium was assessed using the MA-104 cells lineage. Ultrastructure was analyzed by transmission electron microscopy (TEM). RESULTS: MIC values were calculated as 18 and 18.9µM for the PRI and ATCC 24433, respectively. SSP activity was reduced by 48.8% by 18µM of SLPI and cell surface hydrophobicity increased by 11.1%. Flow cytometry suggest the existence of SLPI binding sites on the surface of the yeast. Results showed a reduction in the expression of mannoproteins in 20.8% by the cells treated with 80µM of SLPI, and 18µM reduced the adhesion of yeasts to mammalian cells in 60.1%. TEM revealed ultrastructural changes in cells treated with 80µM of SLPI, such as the presence of membrane-like structures within the cytoplasm. CONCLUSIONS: SLPI exerts a significant influence on C. albicans viability and biological processes. Considering its constitutive and physiologic features, SLPI may become a promising tool for the development of new methodologies for the treatment and control of candidiasis.

Validation study of a scale of life quality evaluation in a group of pediatric patients infected by HIV.

With the advent of potent antiretroviral therapy and the increase in life expectancy of pediatric patients infected with HIV, the quest for the promotion of enhanced quality of life should currently be the main focus in care of children with HIV/Aids. The scope of this study was to validate the Scale of Children's Quality of Life in a group of children infected with HIV receiving clinical care in Aids Service Units in Rio de Janeiro, Brazil. This scale consists of 26 questions and was tested on 100 children, with ages varying between 4 and 12, and their respective parents or guardians. Statistical analysis was conducted using canonical correlation and confidence interval analysis and the X² test. The results showed that the cut-off point obtained was 49; the internal consistency with Cronbach's alpha was 0.73 for the children and 0.67 for parents or guardians. The response profile revealed marked satisfaction with aspects such as vacations and birthdays, though less satisfaction with items including hospitalization and playing alone. The conclusion was that the scale revealed satisfactory psychometric measurements, proving to be a reliable, consistent, valid and recommended instrument for measuring the quality of life of children infected with HIV.

Validation study of a scale of life quality evaluation in a group of pediatric patients infected by HIV / Estudo de validação de uma escala de qualidade de vida em um grupo de pacientes pediátricos infectados pelo HIV

With the advent of potent antiretroviral therapy and the increase in life expectancy of pediatric patients infected with HIV, the quest for the promotion of enhanced quality of life should currently be the main focus in care of children with HIV/Aids. The scope of this study was to validate the Scale of Children's Quality of Life in a group of children infected with HIV receiving clinical care in Aids Service Units in Rio de Janeiro, Brazil. This scale consists of 26 questions and was tested on 100 children, with ages varying between 4 and 12, and their respective parents or guardians. Statistical analysis was conducted using canonical correlation and confidence interval analysis and the c² test. The results showed that the cut-off point obtained was 49; the internal consistency with Cronbach's alpha was 0.73 for the children and 0.67 for parents or guardians. The response profile revealed marked satisfaction with aspects such as vacations and birthdays, though less satisfaction with items including hospitalization and playing alone. The conclusion was that the scale revealed satisfactory psychometric measurements, proving to be a reliable, consistent, valid and recommended instrument for measuring the quality of life of children infected with HIV.

Atualmente, com o advento da terapia antirretroviral potente e o aumento da sobrevida dos pacientes pediátricos infectados pelo HIV, a busca da promoção de uma melhor qualidade de vida deve ser o foco principal na atenção a crianças vivendo com HIV/Aids. Torna-se necessária a utilização de um instrumento adequado a este grupo visando à investigação e à avaliação da sua qualidade de vida. Este estudo objetivou realizar validação da Escala de Qualidade de Vida da Criança em crianças infectadas pelo HIV atendidas em Serviços de Sida/Aids do Rio de Janeiro (RJ). Esta escala é composta de 26 perguntas e sua aplicação ocorreu em 100 crianças entre quatro e 12 anos e seus responsáveis. A análise estatística realizada utilizou correlações canônicas, intervalo de con­fiança e teste c². O ponto de corte obtido foi 49; a consistência interna expressa por um alfa de Cronbach da ordem de 0,73 para as crianças e 0,67 para os responsáveis. O perfil de resposta demonstrou satisfação elevada para itens como férias e aniversário, e os de menor satisfação foram internação e brincar sozinho. Conclui-se que a escala apresentou medidas psicométricas satisfatórias, tornando-se um instrumento confiável, consistente, válido e recomendável de mensuração da qualidade de vida de crianças infectadas pelo HIV.

O potencial da saliva para métodos diagnósticos / The potential of saliva for diagnostic methods

A relação entre os resultados obtidos dos constituintes salivares analisados bioquimicamente, quandocomparados com parâmetros bioquímicos tradicionais do plasma e da urina têm mostrado correlaçãopositiva. A simplicidade da coleta da saliva e o aspecto não invasivo do método fazem da análise doscomponentes salivares um método promissor de diagnóstico com validade e reprodutibilidade na detecçãode doenças sistêmicas. O objetivo deste estudo foi revisar a composição básica da saliva e algunsdos métodos de análise bioquímica disponíveis para este propósito e associá-los ao potencial diagnósticodesse fluido. Concluiu-se que a variação na concentração dos componentes da saliva dificulta o desenvolvimentode tecnologias analíticas e a fixação dos valores referenciais de análises confiáveis; vários sãoos métodos bioquímicos que podem ser utilizados para a análise do fluido salivar, entretanto nenhumdeles sozinho consegue avaliar com integridade a composição total da saliva. Além do diagnóstico dedesordens orais e sistêmicas, a análise do fluido salivar pode ser aplicada em outras avaliações, como nomonitoramento de drogas licitas e ilícitas e no controle do meio ambiente.

The relationship between the results of salivary constituents analyzed biochemically, when comparedwith traditional biochemical parameters of plasma and urine have shown a positive correlation. Thesimplicity of the collection of saliva and the aspect of non-invasive method, makes the analysis of salivarycomponents a promising method of diagnosis with valid and reproducible in detecting systemic diseases.This study aimed to review the composition of saliva and some basic methods of biochemical analysisavailable for this purpose and link them to the potential diagnosis of fluid. It was concluded that the variationin concentration of the components of saliva hampers the development of analytical technologiesand setting the reference values of reliable analysis; several are biochemical methods that can be usedfor the analysis of salivary fluid, however none of them alone with integrity to be able to evaluate the totalsaliva. Besides the diagnosis of oral and systemic disorders, the analysis of salivary fluid can be appliedin other evaluations, as in the monitoring of legal and illegal drugs and the control of the environment.

Análise da saliva nas desordens sistêmicas: [revisão] / Analysis of saliva in systemic disorders: [review]

Introdução: A saliva humana possui um amplo grupo de constituintes proteicos e não proteicos que possuem um imenso potencial informativo para a detecção de doenças sistêmicas. De forma geral, as alterações sistêmicas alteram o funcionamento das glândulas salivares de forma direta ou indireta, e essas alterações, ao serem detectadas e mensuradas, podem contribuir para o diagnóstico precoce de doenças. O objetivo deste estudo é revisar a literatura sobre as possíveis aplicações diagnósticas fornecidas pela análise da saliva e de suas alterações perante as desordens sistêmicas. Conclusão: Concluiu-se que a análise do fluido salivar com finalidade diagnóstica se fundamenta na possível correlação entre os constituintes salivares e os parâmetros bioquímicos tradicionais, como do plasma. Dentre as possíveis aplicações diagnósticas da saliva, pode-se destacar a comprovação de desordens hereditárias, a identificação e monitoramento de alterações imunológicas o diagnóstico e acompanhamento de processos infecciosos, além do controle da resposta imunológica e dos níveis hormonais.

Introduction: The human saliva has a wide range of constituent protein for maintenance of the oral cavity,which has a huge potential information for the detection of systemic diseases. The systemic changes, in general, deregulate the functioning of the salivary glands in a direct or indirect way, and the changes detected may contribute to early diagnosis of diseases. This study reviewed the literature on the potential diagnostic applications provided through the analysis of saliva and its amendments facing systemic disorders. Conclusion: It was concluded that the analysis of salivary fluid for diagnostic purposes is based on the possible correlation between salivary constituents and traditional biochemical parameters, especially the plasma. Among the possible diagnostic applications of saliva, we can highlight the evidence of hereditary disorders, the identification and monitoring of immunological changes the diagnosis and monitoring of infection and control of immune response and hormone levels.

Úlceras Aftosas Recorrentes e sua possível associação ao estresse / Recurrent Aphthous Ulcers and a possible association with stress

A lesão de afta é considerada a alteração mais comum da mucosa oral em humanos e se caracteriza por uma lesão circular, claramente definida, dolorosa, com centro necrótico, bordas elevadas e halo eritematoso. Até hoje, não ocorreu a caracterização de um agente etiológico especifico para essa afecção. No entanto, várias são as referências, na literatura, que consideram o estresse um dos fatores predisponentes para sua patogenia. Visando a estabelecer uma correlação entre esses processos, este trabalho teve como objetivo realizar uma revisão da literatura sobre os efeitos do estresse no sistema imunológico e a possível atuação desse sistema na origem das lesões de afta.

Enzimas citocromo P450 e sua correlação com os fatores de risco para o desenvolvimento do câncer de boca: um estado da arte / Cytochrome P450 enzymes and their correlation with the risk factors for the development of the oral cancer: state of the art

O desenvolvimento do câncer de boca está associado a fatores de risco herdados e extrínsecos, como o uso do tabaco, o consumo de álcool, a dieta e outros. Xenobióticos (substâncias estranhas ao organismo) sofrem biotransformação, principalmente por enzimas citocromo P450, que apresentam localização hepática e extra-hepática, como na cavidade oral e no esôfago, e são ativados em compostos altamente reativos, que podem interagir com macromoléculas, como o DNA, causando mutações, o que pode, assim, levar ao aparecimento do câncer. O objetivo deste estudo é realizar uma revisão da literatura sobre o papel das enzimas citocromo P450 na carcinogênese oral e discutir as diversas correlações dessas enzimas com os fatores de risco que estão envolvidos no processo bioquímico e genético de formação neoplásica.