In Vitro Antifungal Susceptibility of Oral Candida Isolates from Patients Suffering from Caries and Chronic Periodontitis.

Caries and chronic periodontitis are common oral diseases where a higher Candida colonization is reported. Antifungal agents could be adjuvant drugs for the therapy of both clinical conditions. The aim of the current study has been to evaluate the in vitro activities of conventional and new antifungal drugs against oral Candida isolates from patients suffering from caries and/or chronic periodontitis. In vitro activities of amphotericin B, fluconazole, itraconazole, miconazole, nystatin, posaconazole and voriconazole against 126 oral Candida isolates (75 Candida albicans, 18 Candida parapsilosis, 11 Candida dubliniensis, six Candida guilliermondii, five Candida lipolytica, five Candida glabrata, four Candida tropicalis and two Candida krusei) from 61 patients were tested by the CLSI M27-A3 method. Most antifungal drugs were highly active, and resistance was observed in less than 5% of tested isolates. Miconazole was the most active antifungal drug, being more than 98% of isolates susceptible. Fluconazole, itraconazole, and the new triazoles, posaconazole and voriconazole, were also very active. Miconazole, fluconazole and voriconazole have excellent in vitro activities against all Candida isolates and could represent suitable treatment for a hypothetically adjunctive therapy of caries and chronic periodontitis.

Clinicopathological and prognostic characterization of oral lichenoid disease and its main subtypes: A series of 384 cases

BACKGROUND: To clinicopathologically characterize the diagnosis of oral lichenoid disease (OLD) and its main subtypes: oral lichen planus (OLP) and oral lichenoid lesion (OLL), in order to correctly asses their prognosis. MATERIAL AND METHODS: Ambispective cohort study of 384 patients with diagnosis of OLD, based on pre-established clinical and histopathological criteria. We have analysed 272 (70.8%) women and 112 (29.2%), whose mean age was 57.1+/-11.8 years (range 21-90); minimum follow-up time was 36 months. A specific protocol was designed for this study, where we gathered the data of each patient, including malignant transformation. RESULTS: OLP was diagnosed in 229 cases (77.9%) and OLL in 85 (22.1%). Tobacco consumption was found in 20.3% of the patients and alcohol intake in 41.1%. Liver pathology was present in 10.7% of the cases, thyroid pathology in 11.5%, arterial hypertension in 15.6%, diabetes mellitus in 7.6%, psycho-emotional disorders in 33.3%, skin involvement in 12% and genital involvement in 4.9%. Ten patients (2.6%) developed an oral squamous cell carcinoma, 5 (1.7%) with OLP and 5 (5.9%) with OLL. CONCLUSIONS: OLD is a potentially malignant disorder of the oral mucosa which has to be correctly diagnosed as either OLP or OLL, since the risk of malignancy of these subtypes is significantly different

No disponible

Acquired immunodeficiency syndrome: manifestations in the oral cavity.

Human immunodeficiency virus (HIV) infection is a pandemic disease characterised by impairment of the immune system; the main parameter is a progressive decline in the number of CD4 lymphocytes. This circumstance paves the way for opportunistic infections and the development of neoplastic processes that can lead the patient to a state known as acquired immunodeficiency syndrome (AIDS) and ultimately, results in death. The incorporation of treatment based on a cocktail of different active drugs (highly active antiretroviral therapy) has made it possible to drastically change the panorama of the disease in developed nations; improving quality of life for the patient and delaying the progression of the disease. The oral manifestations of HIV infection have been and continue to be an important component of the disease from the very first descriptions and are indicative of progression. At some point in the course of the disease, nine out of every ten patients will present oral manifestations and, on occasion, these symptoms will be the first sign of the syndrome. It is essential that oral healthcare professionals recognize the hallmarks of the illness. In developed countries, the emergence of new therapies has made it possible to significantly reduce immune deficiency-related oral manifestations, both in terms of frequency, as well as severity. This review analyses the most important oral lesions associated with HIV infection and the current state of affairs in this regard.

Síndrome de inmunodeficiencia adquirida: manifestaciones en la cavidad bucal / Acquired immunodeficiency syndrome: manifestations in the oral cavity

La infección por el virus de la inmunodeficiencia humana (VIH) es una pandemia caracterizada por una alteración del sistema inmunológico cuyo principal dato es una progresiva disminución de los linfocitos CD4. Esta circunstancia facilita la aparición de infecciones oportunistas y el desarrollo de procesos neoplásicos, que pueden llevar al paciente a un estado conocido como síndrome de inmunodeficiencia adquirida (SIDA) y a la muerte. La incorporación terapéutica de la combinación de diferentes fármacos activos (terapia antirretroviral altamente activa) ha permitido cambiar drásticamente el panorama de la enfermedad en los países desarrollados, mejorando la calidad de vida del paciente y retrasando la evolución de la enfermedad (1,2). Las manifestaciones orales de la infección por el VIH forman una parte importante de la enfermedad desde las primeras descripciones y son componentes indicativos de su progresión. En algún momento del proceso, en nueve de cada diez pacientes, van a aparecer manifestaciones orales, y en algunas ocasiones estas manifestaciones van a ser el primer signo de la enfermedad. Es fundamental que los profesionales de la salud oral conozcan sus características (1-3). En los países desarrollados, el advenimiento de las nuevas terapias, ha propiciado una disminución significativa de las manifestaciones orales asociadas a la inmudeficiencia, tanto en su frecuencia como en su gravedad (4-6). En este trabajo de revisión se analizan las principales lesiones orales asociadas a la infección por VIH y su situación actual (AU)

Human immunodeficiency virus (HIV) infection is a pandemic disease characterised by impairment of the immune system; the main parameter is a progressive decline in the number of CD4 lymphocytes. This circumstance paves the way for opportunistic infections and the development of neoplastic processes that can lead the patient to a state known as acquired immunodeficiency syndrome (AIDS) and ultimately, results in death. The incorporation of treatment based on a cocktail of different active drugs (highly active antiretroviral therapy) has made it possible to drastically change the panorama of the disease in developed nations; improving quality of life for the patient and delaying the progression of the disease (1, 2). The oral manifestations of HIV infection have been and continue to be an important component of the disease from the very first descriptions and are indicative of progression. At some point in the course of the disease, nine out of every ten patients will present oral manifestations and, on occasion, these symptoms will be the first sign of the syndrome. It is essential that oral healthcare professionals recognize the hallmarks of the illness (1-3). In developed countries, the emergence of new therapies has made it possible to significantly reduce immune deficiency-related oral manifestations, both in terms of frequency, as well as severity (4-6). This review analyses the most important oral lesions associated with HIV infection and the current state of affairs in this regard (AU)