Clinical trial for evaluation of Ricinus communis and sodium hypochlorite as denture cleanser

Abstract The development of opportunistic infections due to poor denture hygiene conditions justified the search for effective hygiene protocols for controlling denture biofilm. Objective This study evaluated Ricinus communis and sodium hypochlorite solutions in terms of biofilm removal ability, remission of candidiasis, antimicrobial activity, and participant satisfaction. Material and Methods It was conducted a controlled clinical trial, randomized, double-blind, and crossover. Sixty-four denture wearers with (n=24) and without candidiasis (n=40) were instructed to brush (3 times/day) and immerse their dentures (20 min/day) in different storage solutions (S1 / S2: 0.25% / 0.5% sodium hypochlorite; S3: 10% R. communis; S4: Saline).The trial period for each solution was seven days and a washout period of seven days was used before starting the use of another solution. The variables were analyzed at baseline and after each trial period. The biofilm of inner surfaces of maxillary dentures was disclosed, photographed, and total and dyed areas were measured (Image Tool software). The percentage of biofilm was calculated. Remission of candidiasis was assessed by visual scale and score were attributed. Antimicrobial activity was assessed by the DNA-Checkerboard hybridization method. Patient satisfaction was measured using a questionnaire. Results S1 (4.41±7.98%) and S2 (2.93±5.23%) were more effective then S3 (6.95±10.93%) in biofilm remotion(P<0.0001). All solutions were different from the control (11.07±11.99%). S3 was the most effective solution in remission of candidiasis (50%), followed by S1 (46%). Concerning antimicrobial action, S1/S2 were similar and resulted in the lowest microorganism mean count (P=0.04), followed by S3. No significant differences were found with patient's satisfaction. Conclusions 10% R. communis and 0.25% sodium hypochlorite were effective in biofilm removal, causing remission of candidiasis and reducing the formation of microbial colonies in denture surfaces. All solutions were approved by patients.

Influence of glycemic control on the levels of subgingival periodontal pathogens in patients with generalized chronic periodontitis and type 2 diabetes

Abstract Objective This study evaluated the influence of glycemic control on the levels and frequency of subgingival periodontal pathogens in patients with type 2 diabetes mellitus (DM) and generalized chronic periodontitis (ChP). Material and Methods Fifty-six patients with generalized ChP and type 2 DM were assigned according to the levels of glycated hemoglobin (HbA1c) into one of the following groups: HbA1c<8% (n=28) or HbA1c≥8% (n=28). Three subgingival biofilm samples from sites with probing depth (PD)<5 mm and three samples from sites with PD≥5 mm were analyzed by quantitative Polymerase Chain Reaction (PCR) for the presence and levels of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Eubacterium nodatum, Parvimona micra, Fusobacterium nucleatum ssp. and Prevotella intermedia. Results The mean counts of F. nucleatum ssp. were statistically significantly higher in the sites with PD≥5 mm of the HbA1c≥8% group (p<0.05). Frequencies of detection of T. forsythia, E. nodatum, P. micra and F. nucleatum ssp. were all higher in the sites with PD≥5 mm of the patients with HbA1c≥8%, compared with those of patients with HbA1c<8% (p<0.05). Frequency of detection of P. intermedia was higher in the sites with PD<5 mm of the patients with HbA1c≥8% than those of the patients with HbA1c<8% (p<0.05). Conclusions Poor glycemic control, as indicated by HbA1c≥8%, is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of subjects with type 2 DM and ChP.

Avaliação clínica e microbiológica relacionada à doença periodontal em pacientes com lúpus eritematoso sistêmico / Clinical and microbiological analysis of parameters related to periodontal disease in systemic lupus erythematous patients

O lúpus eritematoso sistêmico (LES) é uma doença autoimune caracterizada por hiperatividade imunológica crônica pela ação de autoanticorpos que afetam diversos órgãos. Embora o uso crônico de imunossupressores predisponha o paciente a infecções, poucas pesquisas avaliaram uma possível associação entre doença periodontal e LES. Os objetivos deste trabalho foram investigar, por meio de estudo caso-controle, a prevalência e a gravidade da doença periodontal em pacientes com LES, e identificar e quantificar as principais bactérias periodontais presentes no biofilme subgengival. Foram incluídas 60 mulheres em atendimento no Setor de Reumatologia do Hospital Universitário de Brasília, de 20 a 65 anos de idade, sendo subdivididas em LES-A (ativo; n= 31) e LES-I (inativo; n=29). O grupo controle foi composto por 31 mulheres com os mesmos critérios de inclusão, porém sem doenças sistêmicas. As pacientes foram avaliadas quanto às medidas de profundidade de sondagem (P.S), perda de inserção clínica (PIC), índice de sangramento do sulco (ISS) e índice de placa (IPl) no exame inicial. Foram coletados biofilmes subgengivais dos quatro sítios mais profundos para identificação e quantificação de periodontopatógenos por meio de hibridação DNA-DNA checkerboard. Não houve diferenças estatisticamente entre os grupos relativamente aos parâmetros clínicos periodontais, exceto para o ISS, que foi menor no LESA (11,19% ± 14,62%) comparativamente ao grupo controle (17,30% ± 14,88%), porém sem diferenças quando comparado com o grupo LES-I (11,34% ± 11,59%). Houve baixa prevalência de bolsas periodontais, de PIC ≥ 4 mm e de espécies de Actinomyces em todos os grupos. Verificou-se aumento na contagem de bactérias do complexo vermelho no grupo LES-I (4,07 x 105; 95% CI: 0,16-0,79) em relação ao grupo controle (2,50 x 105; 95% CI: 1,23-3,77), com diferenças estatisticamente significante apenas referente ao grupo LES-A (p< 0,05; Kruskal Wallis pós-teste Dunn; 0,45 x 105; 95% CI: 0,16-0,79). Os resultados desse estudo demonstraram que os parâmetros periodontais são semelhantes entre pacientes com LES e grupo controle. O grupo de LES-I apresentou maior tempo dessa doença; aumento da contagem de microorganismos (especialmente dos complexos vermelho e verde em amostras de biofilme subgengival) e pior condição periodontal.(AU)

Systemic lupus erythematous (SLE) is an autoimmune disorder characterized by chronic immunological hyperactivity resultant from the action of autoantibodies, affecting many organs. Although the use of immune suppressors may predispose infections, few studies have investigated the prevalence and severity of periodontal disease in SLE patients. The aim of this study is to investigate the prevalence and severity of periodontal disease in SLE patients and the sub gingival levels of different pathogens. A total of 60 women attending of Brasília University Hospital, aged 18-65 years, were invited to participate in the study. SLE patients were allocated in two subgroups according with disease activity: SLE-A (active disease; n= 31) and SLE-I (inactive disease; n= 29). A number of 31 systemically healthy women at the same age range composed control group. Patients were clinically examined according to probing depth (PD), clinical attachment level (CAL), sulcular bleeding index (SBI) and plaque index (PLI) at baseline examination. Sub gingival biofilm samples were collected from the deepest four sites before periodontal treatment in order to identify and quantify the level of periodontopathogens by checkerboard DNA-DNA hybridization. No significant differences were found between groups in PD, CAL and PLI. Significant differences were observed in GBI between SLE-A (11,19% ± 14,62%) compared to controls (17,30% ± 14.88%), although with no differences when compared to SLE-I (11,34% ± 11,59%). There was a low prevalence of PD and attachment loss ≥ 4 mm at all groups. A low prevalence of Actinomyces was observed at all groups, with an increase in red complex species at LES-I (4,07 x 105; 95% CI: 0,16-0,79) compared to control (2,50 x 105; 95% CI: 1,23-3,77), although with significant differences (p< 0,05; Kruskal Wallis post hoc Dunn) only when compared to SLE-A (0,45 x 105; 95% CI: 0,16-0,79). These findings show no differences in the periodontal conditions of SLE compared to systemically healthy patients, except for a decrease in gingival bleeding index, especially at SLE-A. Reductions in microorganisms' count were observed at SLE-A, while an increase in bacterial count, especially at red and green complex, were observed at subgingival biofilm of SLE-I patients.(AU)

RELATED FACTORS FOR COLONIZATION BY Candida SPECIES IN THE ORAL CAVITY OF HIV-INFECTED INDIVIDUALS / Fatores relacionados a colonização da cavidade bucal de indivíduos portadores do HIV por espécies de Candida

The colonization of the oral cavity is a prerequisite to the development of oropharyngeal candidiasis. Aims: The aims of this study were: to evaluate colonization and quantify Candida spp. in the oral cavity; to determine the predisposing factors for colonization; and to correlate the levels of CD4+ cells and viral load with the yeast count of colony forming units per milliliter (CFU/mL) in HIV-positive individuals treated at a University Hospital. Saliva samples were collected from 147 HIV patients and were plated on Sabouraud Dextrose Agar (SDA) and chromogenic agar, and incubated at 30 ºC for 72 h. Colonies with similar morphology in both media were counted and the result expressed in CFU/mL. Results: Of the 147 HIV patients, 89 had positive cultures for Candida spp., with a total of 111 isolates, of which C. albicans was the most frequent species (67.6%), and the mean of colonies counted was 8.8 × 10³ CFU/mL. The main predisposing factors for oral colonization by Candida spp. were the use of antibiotics and oral prostheses. The use of reverse transcriptase inhibitors appears to have a greater protective effect for colonization. A low CD4+ T lymphocyte count is associated with a higher density of yeast in the saliva of HIV patients.

RESUMO A colonização da cavidade oral pode ser considerada um pré-requisito para o desenvolvimento de candidíase orofaríngea. Os objetivos deste estudo foram: avaliar e quantificar espécies de Candidaisoladas da cavidade oral, para determinar os fatores predisponentes para a colonização, e correlacionar os níveis de células CD4+ e carga viral em indivíduos HIV-positivos atendidos em um hospital universitário. Foram coletadas amostras de saliva de 147 pacientes portadores do HIV, as quais foram semeadas em Ágar Sabouraud Dextrose (ASD) e ágar cromogênico e incubadas a 30 °C por 72 horas. As colônias com morfologia semelhante em ambos os meios foram contadas e o resultado expresso em unidade formadora de colônias por mililitro (UFC/mL). Dos 147 pacientes HIV positivos, 89 apresentaram culturas positivas para Candidaspp., totalizando 111 isolados, e C. albicansfoi a espécie mais frequente (67,6%). A contagem média de colônias foi de 8.8 × 10³ UFC/mL. Os principais fatores predisponentes para colonização oral por Candidaspp. foram a utilização de antibióticos e de próteses orais. O uso de antirretroviral da classe de inibidores da transcriptase reversa pareceu ter maior efeito protetor para a colonização. Baixa contagem de linfócitos T CD4+ está relacionada com maior densidade de leveduras na saliva de indivíduos HIV positivos.

Alteraciones morfo-cardiovasculares producidas por bacterias periodontopatógenas en modelo murino / Morphological and cardiovascular alterations produced by periodontopathic bacteria in a murine model

Diferentes autores han descrito a la enfermedad periodontal como un factor de riesgo de ateroesclerosis. Este estudio tuvo como objetivo determinar la posible relación entre las bacterias periodontopatógenas y alteraciones cardiovasculares en modelos murinos con ingesta hiperlipídica. Se utilizaron 30 ratas Wistar divididas en un grupo control (n=5) y tres grupos experimentales (n=15): Grupo I (n=5): dieta normal e infectados; Grupo II (n=5): dieta hiperlipídica y sin infectar y Grupo III (n=5): dieta hiperlipídica e infectados. La infección del surco gingival se logró previa sedación a través de hilos de sutura contaminados, colocados durante 6 días consecutivos, con Pophyromonas gingivalis (P. gingivalis) (5x10a-4 UFC) y Agregatibacter actinomycetemcomitans (A. actinomycetemcomitans) (5x10-4 UFC) obtnidas de muestras de pacientes con periodontitis crónica. A los 30 días posinfección se fijaron muestras de corazón y arteria aorta para su procesamiento. En el grupo control no se encontraron alteraciones. En el grupo I se observó en el endocardio valvular abundante exudado fibrinoleucocitario y focos hemorrágicos. En el miocardio, neovascularización y sufusiones hemorrágicos y en la pared de vasos arteriales, engrosamiento intimal. En el grupo II se observaron depósitos lipídicos en el interior de las células endoteliales, estrías grasas y pequeños ateromas. El grupo III mostró en un 100 por ciento de los casos, placas ateromatosas bien detalladas con abundante depósito de colesterol, calcificaciones, hemorragias y neovascularización. La suma de estos factores de riesgo: dieta hiperlipídica e infección con bacterias periodontopatógenas, potenciarían la expresión de alteraciones cardíacas y coronarias, incrementando la formación de ateromas

Presença de Candida sp. em sítios doentes e saudáveis em pacientes com periodontite crônica / Presence oi Candida sp. in diseased and healthy sites in patients with Chronic Periodontitis

O objetivo deste estudo foi verificar a presença de Candida sp em sítios de pacientes com Periodontite Crônica (PC) e controle, buscando correlacionar a presença deste microrganismo com a presença da doença em 13 pacientes com PC, escolhidos aleatoriamente, 7 sítios foram avaliados: 3 com PC, 3 sem PC e o dorso da língua. Também foram selecionados 7 pacientes sem doença (grupo controle). Quatro sítios foram avaliados: 3 sítios saudáveis e o dorso da língua. Nestes sítios, foram inseridos cones de papéis estéreis por 30 segundos. Na língua, o cone era passado em seu dorso 5 vezes. a exame micológico foi realizado no laboratório de micologia do Ipec/Fio-cruz. Dos 20 pacientes, 8 apresentaram fungos, sendo 6 do grupo com pc e 2 no grupo controle. Na avaliação por sítios, verificou-se que apenas 10,71% dos sítios do grupo controle e 10,99% do grupo com PC apresentaram Candida. Estas diferenças não foram significativas (p¼ 0,05). Os sítios mais afetados no grupo controle e com pc foram respectivamente a língua (66,67%) e sítios profundos (50%). Conclui-se que, embora a Candida esteja presente na cavidade bucal de pacientes com PC e saudáveis, é encontrada em proporções distintas nos diferentes sítios avaliados

The aim of this study was to verify the presence of Candida sp in sites of patients with chronic periodontitis (CP) and control, to correlate the presence of this microorganism with the presence of the disease. 7 sites were evaluated in 13 CP patients: 3 sites with PC, 3 sites without PC and dorsum of the tongue . 7 patients without disease (control group) were also selected; four sites were evaluated: 3 healthy sites and the dorsum of the tongue. In ali sites, sterile paper points were inserted for 30 seconds. In tongue, the point was passed 5 times. Mycological examination was performed in the laboratory of mycology of IPEC I Fiocruz. Of the 20 patients, 8 had fungi; 6 of CP group and 2 of control group. In the evaluated sites, it was found that only 10.71 % and 10.99% of control and CP groups showed Candida, respectivelv These differences were not significant (p¼ 0.05). The most affected sites in the control and CP groups were tongue (66.67 %) and deep sites (50 010), respectively. In conclusion, although the Candida is present in the oral cavity of healthy and PC patients, it is found in different proportions according to the evaluated sites

Aislamiento ambiental de Sporothrix globosa en relación a un caso de esporotricosis linfo-cutánea / Sporothrix globosa isolation related to a case of lymphocutaneous sporotrichosis

Introduction: Sporothrix schenckii complex comprises a group of environmental dimorphic fungi that cause sporotrichosis. In Chile, isolated cases have been reported in humans, though no environmental isolates have been described. Objective: To achieve isolation of Sporothrix complex from the soil where a 75 year old patient with lymphocutaneous sporotrichosis performs horticulture work. Materials and Methods: In March and July 2011 soil and plant debris from five sectors where the patient does his work in horticulture was extracted. The soil samples were diluted and inoculated in Sabouraud agar with cycloheximide and chloramphenicol at 26 °C. The plant debris was directly inoculated in the same medium. Colonies suggestive of Sporothrix complex were reseeded in PDA agar at 26 ° C and identified as recommended by Marimon et al. Results: Of the 10 plates from the first sampling, one colony was identified as Sporothrix globosa. In the second sampling, Sporothrix globosa grew in two plates seeded with soil, with a total of 6 colonies. There was no growth of Sporothrix complex in plant debris. The isolate from the patient was also identified as Sporothrix globosa. Conclusion: For the first time in Chile a species of Sporothrix complex was isolated from the environment. Sporothrix globosa was the species identified both in the ground and from the patient with sporotrichosis.

Introducción: Sporothrix schenckii complex comprende un grupo de hongos dimórficos ambientales que provocan esporotricosis. En Chile se han comunicado casos aislados en humanos; sin embargo, no se han descrito aislamientos de este hongo desde el ambiente. Objetivos: Orientados por un caso de esporotricosis linfo-cutánea en una paciente de 75 años, se realizó un estudio ambiental para lograr el aislamiento de S. complex desde el suelo donde la paciente realizaba labores de horticultura. Materiales y Métodos: Se extrajo tierra y restos vegetales de cinco sectores donde la paciente efectuaba sus labores de horticultura. Se realizaron diluciones de tierras y siembra en agar Sabouraud con cicloheximida y cloranfenicol a 26°C. Los restos vegetales fueron sembrados directamente en el mismo medio. Las colonias sugerentes de S. complex se resembraron en agar PDA a 26°C y se identificaron según recomendación de Marimon y cols. Resultados: De las diez placas del primer muestreo, una colonia de la siembra de tierra se identificó como Sporothrix globosa. En el segundo muestreo hubo desarrollo de S. globosa en dos placas sembradas con tierra, con un total de seis colonias. No hubo desarrollo de S. complex en los restos vegetales. La cepa aislada desde la paciente también fue identificada como S. globosa. Conclusión: Por primera vez en Chile se logra el aislamiento del ambiente de una especie de S. complex. Sporothrix globosa fue la especie identificada tanto del suelo como desde la paciente con esporotricosis.

The ability of the BANA test to detect different levels of P. gingivalis, T. denticola and T. forsythia

The aim of this study was to evaluate the ability of the BANA Test to detect different levels of Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia or their combinations in subgingival samples at the initial diagnosis and after periodontal therapy. Periodontal sites with probing depths between 5-7 mm and clinical attachment level between 5-10 mm, from 53 subjects with chronic periodontitis, were sampled in four periods: initial diagnosis (T0), immediately (T1), 45 (T2) and 60 days (T3) after scaling and root planing. BANA Test and Checkerboard DNA-DNA hybridization identified red complex species in the subgingival biofilm. In all experimental periods, the highest frequencies of score 2 (Checkerboard DNA-DNA hybridization) for P. gingivalis, T. denticola and T. forsythia were observed when strong enzymatic activity (BANA) was present (p < 0.01). The best agreement was observed at initial diagnosis. The BANA Test sensitivity was 95.54 percent (T0), 65.18 percent (T1), 65.22 percent (T2) and 50.26 percent (T3). The specificity values were 12.24 percent (T0), 57.38 percent (T1), 46.27 percent (T2) and 53.48 percent (T3). The BANA Test is more effective for the detection of red complex pathogens when the bacterial levels are high, i.e. in the initial diagnosis of chronic periodontitis.

In vivo efficacy of alkaline peroxide tablets and mouthwashes on Candida albicans in patients with denture stomatitis

OBJECTIVE: Effective cleaning of dentures is important for the maintenance of good oral hygiene for denture stomatitis patients. The in vivo efficacy of three different brands of alkaline peroxide tablets (Polident, Efferdent, and Fittydent) and two mouthwashes (CloSYS II and Corsodyl) to eliminate Candida albicans on dentures was evaluated in this in vivo study. MATERIAL AND METHODS: Ninety denture wearers with clinical evidence of denture stomatitis were randomly divided into 5 test groups and 1 control group. Each group was further divided into three subgroups in which the dentures were subjected to 15-, 30-, and 60-min disinfection procedures. The dentures of each test group were treated with one of the cleaners, while those of the control group were treated with distilled water. Swab samples from the palatal surfaces (2 cm x 2 cm template delimited area) of the upper dentures were obtained before and after 15, 30, and 60 min periods of cleaner use and examined mycologically. RESULTS: The reduction in the number of colony-forming units (CFU) of C. albicans before, and after 15, 30, and 60 min of use of CloSYS II and Corsodyl was significantly greater than that of the control group (p<0.05). Moreover, there was no statistically significant difference (p>0.05) among Polident, Efferdent and the control group in any of the treatment periods. Dentures treated with Fittydent appeared to have a significantly greater reduction in the number of Candida spp. only after 60 min of treatment. CONCLUSIONS: The results of this study showed that the use of mouthwashes significantly reduced the number of microorganisms on dentures.

Medición de cambios cuantitativos de la microbiota subgingival posterior a la remoción de placa bacteriana supragingival / Measurement of quantitative changes of the microbiota subgingival after to removal of bacterial plaque supragingival

Uno de los campos de interés en el estudio de la microbiología periodontal para muchos investigadores ha sido identificar si es posible que los microorganismos responsables del origen y progresión de la enfermedad periodontal que habitan sobre el margen gingival (supragingival) y bajo este (subgingival) tengan una relación directa que permita mantener interacciones influyentes en el crecimiento y desarrollo de las diferentes especies bacterianas que habitan en los tejidos periodontales. Por lo tanto, al remover los microorganismos que se ubican supragingivalmente sería posible encontrar cambios en el medio subgingival al no existir un intercambio entre los ambientes aerobios (supragingival) y anaerobios (subgingival) una vez desorganizada la placa bacteriana supragingival. Para demostrar esta relación se seleccionaron 7 individuos con diagnóstico de periodontitis crónica moderada y severa a los cuales se les realizó un destartraje supragingival de boca completa para lograr desorganizar la placa bacteriana supragingival. A su vez se tomaron muestras microbiológicas de los sacos periodontales más profundos de cada cuadrante de estos individuos, siendo la primera muestra tomada previo al destartraje supragingival considerada como muestra basal (día 0), luego se tomaron a las 24 horas, a los 7 y 21 días de removida la placa bacteriana supragingival. De los resultados del presente estudio pudimos concluir que al desorganizar el biofilm supragingival se observa una disminución en la cantidad total de microorganismos subgingivales, así como también disminuye de manera considerable la proporción de Porphyoromona gingivalis presente en el medio subgingival. Lo cual permitiría establecer la existencia de una relación directa y dependiente entre los microorganismos que habitan el medio supragingival y subgingival.

One of the fields of interest in the study of the microbiology periodontal for many investigators has been to identify if it is possible that the microorganisms responsible for the origin and progression of the disease periodontal that live on the margin gingival (supragingival) and under this (subgingival) they have a direct relation that allows to support influential interactions in the growth and development of the different bacterial species that they live in the tissue periodontal.Therefore having removed the microorganisms that are located supragingivalmente would be possible to find changes in the way subgingival when an exchange not to exist between the aerobic environments (supragingival) and anaerobic (subgingival) once disorganized the bacterial plate supragingival. To demonstrate this relation 7 individuals selected with diagnosis of periodontitis chronicle moderate and severe to which they there was realized a destartraje supragingival of complete mouth to achieve supragingival to disorganize the bacterial plate. In turn microbiological samples of the sacks took periodontales deeper of every quadrant of these individuals, being the first taken sample before the destartraje supragingival considered as sample basal (the 0th), then they took at to 1, 7 and 21 days of removed the bacterial plate supragingival anaerobios (subgingival) once disorganized the bacterial plate supragingival Of the results of the present study we could conclude that on having disorganized the biofilm supragingival a decrease is observed in the total quantity of microorganisms subgingivales, as well as also it diminishes in a considerable way the proportion of present Porphyoromona gingivalis in the way subgingival. Which would lead to thinking that there exists a direct and dependent relation between the microorganisms that live the way supragingival and subgingival.

Semen and urine culture in the diagnosis of chronic bacterial prostatitis

OBJECTIVE: To assess the diagnostic accuracy of semen and urine culture in the diagnosis of chronic bacterial prostatitis (CBP). MATERIALS AND METHODS: In 70 consecutive men suspected of having chronic bacterial prostatitis along with 17 asymptomatic controls, we obtained urine and semen cultures followed 1 week later by the Meares and Stamey test, our reference standard. The interpretation of each of the cultures was blind to the results of other tests. RESULTS: 139 men were referred for evaluation of chronic bacterial prostatitis and 70 received all tests. Additionally, 17 control men volunteered to participate. The Meares and Stamey Test was positive in 69 (79 percent) patients. The semen culture had a sensitivity of 45 percent and a specificity of 94 percent. The likelihood ratio associated with a positive semen culture was 8.1 (95 percent confidence interval (CI) 1.2 to 55.3); the likelihood ratio associated with a negative semen culture was 0.6 (95 percent CI 0.5 to 0.7). The urine culture had a sensitivity of 4 percent and a specificity of 100 percent. The likelihood ratio of a positive urine culture was infinity and of a negative urine culture was 0.96 (95 percent CI 0.9 to 1). CONCLUSIONS: While a positive semen culture in a symptomatic patient may suffice to select and start antibiotic treatment against chronic bacterial prostatitis, a negative culture does not rule out the condition. Urine cultures alone are not useful for diagnosing CBP. The Meares and Stamey test remains important for the diagnosis of CBP in practice.

Microbiologia do meato médio na rinossinusite crônica / Microbiology of middle meatus in chronic rhinosinusitis

Este foi um estudo prospectivo que visou identificar a microbiologia do meato médio em pacientes com rinossinusite crônica (RSC) e compará-la com a de indivíduos sadios. MATERIAL E MÉTODOS: Foram incluídos 134 pacientes RSC e 50 voluntários sadios, que constituíram o grupo controle. As amostras foram coletadas endoscopicamente e submetidas a exames pelo método de Gram com contagem leucocitária e culturas para aeróbios, anaeróbios e fungos. RESULTADOS: Nos pacientes com RSC foram cultivados 220 microorganismos, dentre os quais os mais freqüentes foram o Staphylococcus aureus, presente em 31 por cento das amostras, e o Staphylococcus coagulase-negativo (SCN) em 23 por cento. Gram-negativos ou facultativos foram isolados em 37 por cento das amostras, anaeróbios em 12 por cento, e fungos em 14 por cento. Ao exame bacterioscópico evidenciou-se alguns ou numerosos leucócitos em 74 por cento das amostras com culturas positivas. Nos indivíduos sadios o SCN foi isolado em 40 por cento das amostras e o Staphylococcus aureus em 18 por cento. Em 12 por cento dos indivíduos a cultura para fungos foi positiva, e o exame direto negativo. Todas as culturas anaeróbias foram estéreis. Quanto à contagem leucocitária todos apresentaram nenhum ou raros leucócitos. CONCLUSÃO: Os grupos apresentaram resultados semelhantes quanto à microbiologia, entretanto, diferiram em relação à contagem leucocitária, o que auxilia na diferenciação um microorganismo infectante de um colonizante.

This was a prospective study which assessed endoscopically collected middle meatus secretions in patients with chronic rhinosinusitis (CRS) and compared those findings with microbiological data of healthy individuals. METHODS: Middle meatus samples were collected from 134 CRS patients. In the laboratory, samples were Gram stained for microscopic examination with white blood cels (WBCs) count and also send for aerobic, anaerobic and fungal cultures. Fifty volunteers served as control. RESULTS: In CRS patients a total of 220 microorganisms were isolated. The most frequent microorganisms were Staphylococcus aureus (31 percent), coagulase-negative Staphylococcus (CNS) (23 percent). Gram-negative or facultative microorganisms were isolated in 37 percent of the samples, anaerobes in 12 percent and fungi in 14 percent. Seventy four percent of the samples with positive cultures presented many or few WBC. In the control group, 76 percent of cultures were positive for aerobes and 12 percent for fungi. No anaerobes were isolated. There were rare or no WBC in the fifty samples. The most frequent microorganisms were CNS (40 percent), Staphylococcus aureus (18 percent). CONCLUSION: The microbiology of the middle meatus is similar in CRS patients and healthy individuals. Despite this, there was an important difference between the WBC count in these two groups, which helps to distinguish an infective from a saprophitic microorganism.

Transmission of Aggregatibacter actinomycetemcomitans between Brazilian women with severe chronic periodontitis and their children

This study evaluated the transmission of Aggregatibacter actinomycetemcomitans (Aa) in women with severe chronic periodontitis and their children. Thirty women (mean age = 36.1±6.0 years) who were mothers of at least one child aged 7 to 16 years were enrolled. In order to investigate mother-child transmission of Aa, the children were also evaluated when their mothers were colonized by the bacterium. Subgingival plaque samples of each woman were collected from 3 sites (mean probing depth of 7.3±1.2 mm and mean clinical attachment level of 7.9±1.5 mm) and pooled in reduced transport fluid (RTF). These samples were processed, inoculated onto TSBV-agar selective medium and incubated at 37°C in microaerophilic atmosphere for 5 days. Aa was identified on the basis of colony morphology, Gram staining, catalase and oxidase reactions. Aa was found in 8 out of 30 women. Therefore, 8 children from these women (mean age= 12 ± 3.7 years) were evaluated, but Aa was found only in 2 of them. Aa strains of the two mother-child pairs were evaluated by arbitrarily-primed polymerase chain reaction (AP-PCR), although it was not found similarity between the amplitypes of each pair. No Aa transmission was found between Brazilian women with severe chronic periodontitis and their children.

Este estudo avaliou a transmissão de Aggregatibacter actinomycetemcomitans (Aa) entre mulheres com periodontite crônica severa e seus filhos. A amostra constituiu-se de 30 mulheres com idade média de 36,1 ± 6,0 anos, mães de filhos com idade entre 7 e 16 anos. Apenas crianças cujas mães haviam sido colonizadas por Aa foram incluídas. Amostras de placa dentária subgengival foram colhidas de três sítios com profundidade de sonagem média de 7,3 ± 1,2 mm e perda de inserção clínica média de 7,9 ±1,5 mm e agrupadas em fluido de transporte reduzido (RTF). Estas amostras foram processadas e semeadas em meio seletivo ágar TSBV e incubados a 37ºC em atmosfera de microaerofilia por 5 dias. Aa foi identificado baseado na morfologia colonial, coloração de Gram e testes da catalase e oxidase. Aa foi detectado em 8 das 30 mulheres . Assim, 8 filhos destas mulheres, com idade média de 12 ± 3,7 anos foram investigados, mas Aa foi detectado em apenas 2 deles. Cepas de Aa dos 2 pares de mães e filhos foram submetidos a análise pela técnica de reação em cadeia de polimerase usando primers arbitrários (AP-PCR), mas os amplitipos de cada par não demonstraram similaridade. Portanto, não foi encontrada transmissão de Aa entre mulheres brasileiras com periodontite crônica severa e seus filhos.

Burning mouth syndrome: clinical profile of Brazilian patients and oral carriage of candida species

Burning mouth syndrome (BMS) is a complex disease of unknown cause. It is characterized by a burning sensation in the oral mucosa, notwithstanding its clinical normal aspect. BMS is particularly seen in postmenopausal women. The purpose of this study was to investigate this syndrome on a clinical basis and, in addition, to analyze its possible relation to the frequency of Candida species. Thirty-one patients (28 women and 3 men; 13 Caucasians and 18 non-Caucasians; mean age = 61.3, range 30-85 years) were evaluated. Most patients (80.6 percent) were under long-term medication, antihypertensive, ansiolitic and antidepressant drugs being the most used. Burning mouth complaint was associated with other secondary oral complaints in 83.8 percent of the cases. Tongue was the most commonly affected site (70.9 percent), followed by the vermillion border of the lower lip (38.7 percent) and hard palate (32.2 percent). The association of the burning sensation with oral cancer (cancer phobia) was reported by 67.7 percent of the patients. Haematologic examination (hematocrit, haemoglobin and fasting blood glucose level) revealed 2 cases each of anemia and type 2 diabetes. Local factors, tooth extractions and dentures wearing, were associated with the onset of symptoms in 35.5 percent of the cases. Daily activities were changed as a consequence of BMS in 29 percent of the patients. Among the species of the genus Candida, C. albicans was the most frequent in BMS patients (9 - 29.03 percent) and controls (12 - 38.70 percent), followed respectively by C. parapsilosis (2 - 6.45 percent and 0 - 0 percent); C. tropicalis (1 - 3.22 percent and 2 - 6.45 percent); C. krusei and C. kefyr (1 - 3.22 percent and 0 - 0 percent). Therefore, such difference did not reach valuable results. In conclusion, these data were similar to those reported in other studies. The highlights of the present findings were the possible relation of BMS with chronic drug...

A Síndrome de ardência bucal (SAB) é uma doença complexa, de etiologia desconhecida. Caracteriza-se por uma sensação de queimação na mucosa bucal, não obstante seu aspecto clínico normal, sendo bastante freqüente em mulheres após a menopausa. O propósito deste estudo foi o de investigar a SAB em bases clínicas e, em adição, analisar sua possível relação com a freqüência de espécies do gênero Candida isoladas da cavidade bucal desses indivíduos. Foram estudados trinta e um pacientes, 28 mulheres e 3 homens, 13 caucasianos e 18 não caucasianos, média de idade 61,3 (faixa dos 30 - 85 anos). A maioria deles (80,6 por cento) estava sob medicação por longo período. Anti-hipertensivos, ansioliticos e antidepressivos foram as drogas mais utilizadas. A ardência bucal estava associada a outras queixas secundárias em 83,8 por cento dos pacientes. A língua foi o sítio mais afetado (70,9 por cento), seguida pelo vermelhão do lábio inferior (38,7 por cento) e palato duro (32,2 por cento). A associação de sensação de ardência com câncer bucal (cancerofobia) foi referida por 67,7 por cento dos pacientes. Exames hematológicos (hematócrito, hemoglobina e glicemia em jejum) revelaram dois casos cada, de anemia e diabetes tipo 2. Fatores locais, exodontias, e uso de próteses estavam associados com o conjunto de sintomas em 35,5 por cento dos casos. Foram referidas alterações importantes nas atividades cotidianas, em conseqüência da SAB, em 29 por cento dos pacientes. Leveduras do gênero Candida foram isoladas da cavidade bucal de 45,16 por cento dos indivíduos com SAB e igualmente do grupo-controle, não constituindo dado qualitativamente importante. Dentre as espécies do Gênero Candida, C. albicans foi a mais freqüente (9 - 29,03 por cento e 12 - 38,70 por cento), seguida de C. parapsilosis (2 - 6,45 por cento e 0 - 0 por cento), C. tropicalis (1 - 3,22 por cento e 2 - 6,45 por cento), C. krusei e C. kefyr (1 - 3,22 por cento e 0 - 0 por cento). Em conclusão, nossos...

Clinical and microbial evaluation of dental scaling associated with subgingival minocycline in chronic periodontitis subjects

O objetivo deste estudo randomizado duplo-cego foi avaliar a presença de periodontopatógenos e o comportamento clínico de bolsas periodontais tratadas com raspagem e aplainamento radicular (RAR) associado à minociclina subgengival (MS). Foram incluídos no presente estudo 36 indivíduos de 26 a 60 anos de idade (40,7 ± 9,1), previamente diagnosticados com periodontite crônica. Dezoito indivíduos foram selecionados para o grupo teste (GT), tratado com RAR e MS (novo tratamento), e 18 indivíduos, para o grupo controle (GC), que recebeu RAR e veículo (tratamento convencional). Foram selecionados dois sítios homólogos em cada indivíduo com profundidade de sondagem (PS) > 6 mm para testar a hipótese proposta. Para avaliar o comportamento clínico após o tratamento, a mensuração da PS foi realizada inicialmente e após 90 dias. A avaliação microbiana foi realizada para detecção de 7 periodontopatógenos através de reação em cadeia da polimerase, inicialmente e após 30 e 120 dias. Observou-se redução média de 2,8 e 2,1 mm na PS nos grupos teste e controle, respectivamente. Inicialmente, P. gingivalis foi o microrganismo mais prevalente tanto no GT (65,8%) quanto no GC (48,6%). Após 120 dias, houve redução para 30,8% no GT e 23,1% no GC. Não houve diferenças estatisticamente significativas entre os grupos em relação à PS (teste Wilcoxon - p > 0,05) e presença dos periodontopatógenos (teste Wilcoxon e qui-quadrado - p > 0,05 e teste do sinal - p > 0,01). Os resultados observados demonstraram que o novo tratamento foi tão efetivo quanto o tratamento convencional na redução de periodontopatógenos e de PS em indivíduos com periodontite crônica.

Clinical and microbiological associations in chronic periodontitis

La periodontitis crónica es la forma más prevalente de enfermedad periodontal. La microflora subgingival ha sido relacionada con la iniciación y progresión de la enfermedad. El objetivo de este trabajo fue asociar y correlacionar los indicadores clínicos y los estudios microbiológicos de placa subgingival en pacientes con periodontitis crónica moderada y severa. Se seleccionaron 100 sitios en 25 pacinetes (17 no fumadores y 8 fumadores) con profundidad al soandaje (PS) <- 5 mm. en los que se realizó: índice de placa (IP), índice gingival (IG), índice de sangrado al sondaje (SS), profundidad de sondaje (PS) y nivel de inserción clínica (NIC). El estudio microbiológico de placa subgingival se realizó por cultivos en medios selectivos y no selectivos y pruebas para la identificación de Porphyromonas gingivalis (Ps), Prevotella intermedia/nigrescens (Pi/n), Actinobacillus actinomycetemcomitans (a), Fusobacterium (F) y Peptostreptococcus micros(Pm). La microscopía de fondo oscuro (MFO) fue utlizada para analizar las proporciones relativas de morfotipos microbianos. Los resultados mostraron asociación y correlación significativa entre PS y PgX2 = 15,22, r = 0,39 (p<.001); NI y Pg X2 = 10,72, r = 0,32 (p<.001); SS y F X2 = 8,93, r = -0,30. Pg y Pi/n X2 = 12,65, r = -0,33 (p<.001). Los resultados muestran asociaciones y correlaciones entre algunos indicadores clínicos y microorganismos de placa subgingival en pacientes con periodontitis crónica.

Relación entre variables sociodemográficas y de estilo de vida con la salud bucal en infantes de 6 a 18 meses de edad / Relationship between sociodemographic variables and lifestyle with oral health in 6- to 18-month old infants

Objetivo: el objetivo del presente estudio fue analizar la relación entre variables sociodemográficas y de estilo de vida y las biológicas en un grupo de infantes pertenecientes a familias con riesgo social. Metodología: fueron incluidos 23 infantes con edades entre 6 y 18 meses (x=11,13 +- 0,78) asistentes al Servicio de Pediatría de un Centro de Salud del Area Metropolitana de Buenos Aires (AMBA). Se realizó (1) una entrevista a las madres para obtener la sigueintes información: (a) historia médica; (b) factores socioeconómicos del núcleo familiar; (c) factores vinculados con el estilo de vida del infante y su núcleo familiar (Quiñonez 2001) para la obtención de datos específicos. (2) Exámenes clínico y de laboratorio sobre los infantes consistentes en: (a) toma de saliva no estimulada, siembra, incubación e identificación de Streptococcus grupo mutans (S. mutans)(Marcantoni, 2000 modificado) y recuento (Jordan 1987) (b) registro de estado dentario, incluyendo mancha blanca y obtención del ceod. Resultados: (1) la frecuencia de consumo de azúcar diario fue de 4,04 +- 0,53 veces/día. (2) La media del ceod fue de 0. (3) El promedio de aparición de mancha blanca fue de 0,26 +- 0,18 por niño. (4) Los niveles de S. mutans alcanzaron a 63478 UFC +- 26334. (5) Se registró asociación y correlación significativa entre (a) la edad y la presencia de mancha blanca (X2 = 5,14; r=0,48; p<0,02); (b) la cantidad de dientes presentes y la aparición de mancha blanca (X2 = 5,70; r=0,50; p<0,01); (c) el consumo de bebidas azucaradas más bebidas azucaradas) y el nivel de infección estreptococcica (X2 = 4,05; r = 0,42; p<0,05). Conclusiones: (1) Se ha demostrado (a) la existencia de infección temprana de S. mutans, (b) aumento significativo en la frecuencia de consumo de azúcar con el aumento de la edad de los infantes; (c) tendencia al aumento de manchas blancas con el aumento de la edad y el número de dientes presentes, (2) Parece adecuado iniciar los programas educativos-preventivos-asistenciales antes de la erupción dentaria

Experimental paracoccidioidomycosis in ethyl alcohol-fed rats

1. The course of experimental paracoccidioidomycosis was studied in alcohol-fed rats and compared with pair-fed and ad libitum controls. The alcohol-fed rats were fed a regular commercial solid diet plus a 32% (v/v) ethyl alcohol-25% sucrose (w/v) solution 4 weeks prior to the infection and throughout the study. The inoculum was standardized in terms of virulance, age of culture, percentage of multicellular fungal units containing 1-3 cells and viability. 2. Th extent of infection was measured by quantitative counts of fungal units (FU), colony-forming units (CFU) or Paracoccidioides brasiliensis from infected pulmonary tissue and histopathological examination of the main organs involved. The specific humoral response and cell-mediated immunity of the animals were assessed by measuring the specific serum antibody levels by counterimmunoelectrophoresis (CIE) and by the footpad swelling test (FST), respectively. 3. Alcohol-fed rats and pair-fed controls did not differ significantly in mean body weight or the extent of disease after 5 and 10 weeks of infection. In contrast, the alcohol-fed group when compared with the ad libitum group presented a significantly lower mean body weigh (301.6 ñ 0.6 vs 389.6 ñ 0.7g) and a larger number of fungi recovered from the lung: 81.1 ñ 4.1 x 10**4 vs 13.4 ñ 8.0 x 10**4 FU; 24.3 ñ 8.6 x 10**4 vs 2.9 ñ 0.5 x 10**4 CGU after 5 weeks of infection. There were no significant differences in the specific antibody levels, FST indices, histopathological pattern or frequency of disseminated lesions between groups. 4. We conclud tahta alcohol per se neither aggravated the infection by P. brasiliensis nor affected the especific humoral reponse and delayed hypersensitivity. However, the high alcohol intake resulted in malnourished animals associated with a more marked degree of infection