Prevalence of the colonization of Helicobacter pylori among students of the school of dentistry, University of Granada, Spain.

BACKGROUND: The oral cavity is a reservoir for Helicobacter pylori, and occupations that involve close contact with it, like Dentistry, could entail a higher risk of colonization. The aim of this study was to evaluate if the length of stay at the School of Dentistry of the University of Granada could influence colonization by H. pylori, , and to furthermore correlate colonization by H. pylori, with the state of oral health and oral hygiene habits. MATERIAL AND METHODS: The study groups were: Group 1, 35 students of Odontology in their first year of studies; Group 2, the same 35 students when they were in their fifth academic year; Group 3, 35 students from University study programs unrelated with Health and of the same age as the group 2 students. All underwent H. pylori, colonization determinations by means of the urea breath test (UBT), stool antigen test and a serological test. Also studied were the variables plaque index, gingival index and the number of times teeth were brushed per day. The Student t test was used for comparisons among the three studied groups. The Chi-squared test and Pearson correlation coefficient were used to determine any connection between colonization by H. pylori, and the variables studied. RESULTS: Comparisons between groups 1 and 2 and between groups 2 and 3 showed significant differences regarding colonization by H. pylori, plaque index, gingival bleeding index and tooth brushing. A positive correlation was found between being colonized by H. pylori, and having a gingival index higher than 10% and tooth brushing once a day or less, in all the studied groups. CONCLUSIONS: Colonization by H. pylori, among Dentistry students at the University of Granada decreased over a four-year time period at the University. Factors related with better oral health, such as a lower gingival index and more frequent tooth brushings, would explain these results.

Serologic control against hepatitis B virus among dental students of the University of Granada, Spain.

BACKGROUND: To evaluate the immunological situation against hepatitis B virus (HBV) of a cohort of dentistry students, to analyze the behavior of the levels of hepatitis B surface antigen (anti-HBs) after the administration of one or three vaccine doses, and to determine the influence of age and sex on the immune response. MATERIAL AND METHODS: This retrospective cohort study included students attending the School of Dentistry of the institution where the study was performed from 2005 to 2012 who had completed the public health vaccination calendar for HBV at the age of 12-13. Data on age, sex, basal anti-HBs levels, post-vaccination anti-HBs results and final anti-HBs levels were collected. Comparisons of the basal and final levels, as well as associations regarding age and sex, were performed by means of the Student t and Chi-square tests. RESULTS: Of the 359 students, 97 (27.02%) had basal antibody concentrations <10 mIU/ml, whereas in 262 the levels of anti-HBs were ≥10 mIU/ml (72.98%). Of the 288 participating students who completed the School's protocol for immunization, 287 (99.65%) attained a level of protection ≥10 mIU/ml. Globally, there were statistically significant differences between the basal antibody levels and those achieved after administration of the vaccine and booster, but no association with age or sex was observed. CONCLUSIONS: About 70% of dental students vaccinated as pre-adolescents had serologic evidence of protection against HBV. Administering a booster is associated with the presence of an excellent immune memory. There is clearly a need to reinforce control of the antibody levels in groups at risk, such as Dentistry students.

Discriminant ability for caries risk of modified colorimetric tests.

OBJECTIVE: The aim of this study was to evaluate the relationship between the caries risk in children over a two-year period and their baseline caries status, salivary levels of mutans streptococci and lactobacilli, and results of the Alban test and modifications thereof using different substrates. STUDY DESIGN: Ninety-five children aged 6-7 were examined in Granada (southern Spain) for dental caries at baseline and every six months. Stimulated saliva was sampled and inoculated in 7 colorimetric tests based on Snyder's medium with different sugars and polyalcohols. A mutans streptococci and lactobacilli count was performed (Dentocult SM strip® and Dentocult LB®). Caries risk proportions were contrasted against the potential predictor variables, i.e., basal caries history and salivary tests, by means of the Mantel Haenszel test for linear association, based on a chi-square distribution with 1 degree of freedom (df). RESULTS: Caries index, lactobacillus count and colorimetric tests showed significant, but limited, and non-different discriminant abilities. Increasing values of all predictor variables, except for Dentocult SM®, were related to increasing caries risk proportions. CONCLUSION: Colorimetric test results and caries history showed similar correlation values as caries predictors.

Detection and identification of Bartonella sp. in fleas from carnivorous mammals in Andalusia, Spain.

A total of 559 fleas representing four species (Pulex irritans, Ctenocephalides felis, Ctenocephalides canis and Spilopsyllus cuniculi) collected on carnivores (five Iberian lynx Lynx pardinus, six European wildcat Felis silvestris, 10 common genet Genetta genetta, three Eurasian badger Meles meles, 22 red fox Vulpes vulpes, 87 dogs and 23 cats) in Andalusia, southern Spain, were distributed in 156 pools of monospecific flea from each carnivore, and tested for Bartonella infection in an assay based on polymerase chain reaction (PCR) amplification of the 16 S-23 S rRNA intergenic spacer region. Twenty-one samples (13.5%) were positive and the sequence data showed the presence of four different Bartonella species. Bartonella henselae was detected in nine pools of Ctenocephalides felis from cats and dogs and in three pools of Ctenocephalides canis from cats; Bartonella clarridgeiae in Ctenocephalides felis from a cat, and Bartonella alsatica in Spilopsyllus cuniculi from a wildcat. DNA of Bartonella sp., closely related to Bartonella rochalimae, was found in seven pools of Pulex irritans from foxes. This is the first detection of B. alsatica and Bartonella sp. in the Iberian Peninsula. All of these Bartonella species have been implicated as agents of human diseases. The present survey confirms that carnivores are major reservoirs for Bartonella spp.

Genotypes of Streptococcus mutans in saliva versus dental plaque.

OBJECTIVE: The aim of this study was to investigate whether genotypes of Streptococcus mutans strain can be detected as effectively in saliva samples as in plaque samples from buccal surfaces and occlusal surface fissures of permanent first molars. DESIGN: The study included 20 school children aged 6-7 years who were positive for mutans streptococci. Samples of stimulated saliva and of dental plaque on buccal surfaces and occlusal surface fissures of permanent first molars were collected. Samples were cultivated in MSB agar. Up to nine isolates compatible with mutans streptococci were obtained and identified by means of biochemical tests. All isolates identified as S. mutans were genotyped by arbitrarily primed polymerase chain reaction. RESULTS: A total of 28 genotypes of S. mutans were isolated: 23 in saliva samples, 23 in buccal surface plaque samples, and 16 in plaque samples from occlusal surface fissures. CONCLUSIONS: Although, saliva sampling did not reveal all genotypes isolated, it was equally as effective as plaque sampling from the buccal surfaces of permanent first molars, and more effective than plaque sampling from fissures on their occlusal surfaces.

Incidence and distribution pattern of Rickettsia felis in peridomestic fleas from Andalusia, Southeast Spain.

The presence of Rickettsia felis was investigated in three species of pulicid fleas (Ctenocephalides felis, Ctenocephalides canis and Pulex irritans) collected in 38 locales in Andalusia (Spain) over the period 1999-2004. Amplification of a fragment of OmpB gene was positive in 54.17 % of lots of Ct. felis. The identity of the PCR bands was confirmed as R. felis by sequence data obtained directly from the PCR amplicon. No rickettsia was found in Ct. canis nor P. irritans.

Evaluation of the capacity of oral streptococci to produce hydrogen peroxide.

The capacity of 11 strains of oral streptococcal species (Streptococcus sanguis, S. oralis, S. mitis and S. sobrinus) to produce hydrogen peroxide (H2O2) was studied in vitro. Detection of this property in solid media, particularly with trypticase soy agar-benzidine-peroxidase, was more sensitive than in liquid media. The addition of carbohydrates (arabinose, xylose, mannose, sorbose and lactose), sorbitol and saccharine to buffered trypticase soy broth increased H2O2 production in S. oralis NCTC 11427, although the concentrations obtained with some substrates (glucose, galactose, mannitol and xylitol) were lower than those obtained in controls. In S. sanguis NCTC 7863, H2O2 production was detected only with galactose, sorbitol, lactose and saccharin.

Post-pH effect in oral streptococci.

OBJECTIVES: To study the post-pH effect (PpHE) in 11 strains of oral streptococci belonging to Streptococcus sanguis, S. mitis, S. gordonii, S. mutans and S. sobrinus by using the BacT/Alert microbial detection system. METHODS: The bacterial cultures were exposed to a different pH (3.6, 4.0, 4.6, 5.0, 5.6, 7.0, 7.5, 8.0 and 8.6) for 1 h, and then returned to a neutral medium. The automated BacT/Alert system determined resumed microbial growth by measuring CO2 generation. The PpHE expresses the time difference between resumed growth (after pH shock) and optimal growth (pH 7.0 used as the control). RESULTS: PpHE was found to be minimal for alkaline pH values, and to be strain and species dependent. CONCLUSIONS: The PpHE may be useful as an ecological determinant or as an indicator of the cariogenicity of oral streptococci.

In vitro activity of macrolides and lincosamides against oral streptococci: a therapeutic alternative in prophylaxis for infective endocarditis.

Susceptibility to macrolides and lincosamides was tested in a total of 446 strains of oral streptococci belonging to eleven species, all isolated from dental plaque and/or saliva in 1991. Minimum inhibitory concentrations (MIC) were determined by the double serial dilutions method in agar. Clindamycin was the most effective antibiotic against all species tested. The results of nearly all parameters (range, mean, MIC(50), MIC(90)) in all species showed erythromycin to be less effective than josamycin, making the latter antibiotic a possible alternative to erythromycin in prophylaxis for infective endocarditis caused by oral streptococci, not only in patients allergic to penicillin, but also in all patients with low-risk lesions, who will be treated with low-risk dental procedures. In these latter patients, antibiotic prophylaxis may be indicated if, after careful evaluation of the individual's situation, no other alternatives are available.

Epidemiological application of a new bacteriocin typing scheme for Streptococcus mutans.

We propose a new bacteriocin typing scheme for Streptococcus mutans (Biotype I) using nine producer strains and a numerical code with three figures. Its application in 75 unrelated S. mutans strains allowed us to type all microorganisms and to obtain a total of 15 bacteriocin types. Its epidemiological use in two family groups allowed us to obtain two bacteriocin types in each one and to show the type relations between the different family components.

Action of sodium fluoride on phagocytosis by systemic polymorphonuclear leucocytes.

Alterations in phagocytosis appear to be important in the onset and development of periodontitis. We investigated new substances that may be of use in the treatment of periodontitis. In a preliminary study, we tested the effect of sodium fluoride on phagocytosis by circulating polymorphonuclear leucocytes (PMNs) in 10 replicate assays using blood from six healthy subjects. Sodium fluoride was tested at concentrations of 1.0 micron to 4.0 microns against Streptococcus oralis, Streptococcus mutans, Streptococcus sobrinus and Streptococcus sanguis. The phagocytic index against all microorganisms increased significantly at all concentrations of sodium fluoride assayed; this effect was dose dependent. Sodium fluoride appeared to stimulate phagocytosis via two mechanisms: an apparent increase in bacterial susceptibility to phagocytosis, and direct stimulation of phagocytosis by PMNs.

[A study of clinical response to antibiotic treatment in subjects with chronic bacterial prostatitis]. / Estudio de la respuesta clínica al tratamiento antibiótico en sujetos con prostatis bacteriana crónica.

A study was carried out on the clinical response to antibiotics in 105 patients with chronic bacterial prostatitis. Two groups of patients were compared in a retrospective study. The results of rectal examination, ultrasound scan, microbiological analysis, and response to different antibiotic therapy regimens were compared. There was a high incidence of perineal-testicular pain and sexual potency reduction; prostate congestion and pain on rectal examination were frequently reported. All the patients had positive microbial cultures, with Gram-negative microorganisms being predominantly isolated. Following the administration of different antibiotic therapy regimens, symptoms either disappeared or diminished, irrespective of whether positive cultures remained. A poorer clinical response was observed in patients with positive prostate ultrasound and rectal examination, and with isolated Gram-negative bacilli. No differences were observed between either group in clinical response to different antimicrobial regimens.

Antibacterial activity of resin adhesives, glass ionomer and resin-modified glass ionomer cements and a compomer in contact with dentin caries samples.

A total of 103 clinical samples of carious dentin were used to study the antibacterial action of different dental resin adhesive materials (Gluma 2000, Syntac, Prisma Universal Bond 3, Scotchbond Multi-Purpose and Prime&Bond 2.0) glass ionomer cements (Ketac-Cem, Ketac-Bond, Ketac-Silver, Ketac-Fil) resin-modified glass ionomer cements (Fuji II LC, Vitremer and Vitrebond) and a compomer (Dyract). The agar plate diffusion method was used for the microbial cultures and a chlorhexidine control. The growth of the caries-producing microorganisms was effectively inhibited by the Vitremer and Vitrebond cements, and to a lesser extent by the Scotchbond Multi-Purpose adhesive system. Overall, there were statistically significant differences in the antibacterial activity of the products tested.

Environmental microbial contamination. Pilot study in a dental surgery.

Environmental contamination by bacterial aerosols occurs every day in the dental surgery. The aim of this study was to determine bacterial levels in five different areas of a dental surgery during ultrasonic scaling procedures using bacterial cultures. Two areas with markedly different amounts of infective aerosols were identified. The role of the air conditioning system was also assessed. There was evidence that the air conditioning system could act as a vehicle for the transmission of microorganisms.

[Exercise-induced atrioventricular block. Significance of the ischemic component. Report of 4 new cases]. / Bloqueo auriculoventricular inducido por el esfuerzo. Importancia del componente isquémico. Presentación de cuatro nuevos casos.

We report four new cases of exercise-induced atrio-ventricular block (appearing during treadmill exercise testing). The mechanism was ischemia in two patients and the conduction disturbance disappeared after coronary artery bypass grafting. The literature on this matter is reviewed. Also the etiology, the natural history and management are discussed in these cases.

[Syncope associated with glossopharyngeal neuralgia and parapharyngeal tumor]. / Síncope asociado a neuralgia del glosofaríngeo y tumoración parafaríngea.

The reflex-induced cardiovascular syncope is rarely associated with facial neuralgia and neck neoplasms. We report the case of a male with vasopressor and cardioinhibitor syncopes, despite the implantation of a pacemaker. Because of a glossopharyngeal neuralgia, a neoplasm of the left parapharyngeal fossae is diagnosed. The pathophysiology and the therapeutic approach is discussed.

[Late reopening of patent ductus arteriosus after complete closure with the Rashkind prosthesis. Possible traumatic origin]. / Reapertura tardía del conducto arterioso tras cierre completo con la prótesis de Rashkind. Posible origen traumático.

We report the case of a symptomatic adult with an occluded persistent duct with a transcatheter proceeding using a Rashkind prosthesis. After a month of follow up the color-coded Doppler-flow echocardiogram did not show residual shunt, posteriorly the patient's symptoms disappeared and the left ventricular dimensions were reduced. At the thirteen month of follow-up, the patient had an accident while working, falling down from a scaffold. Afterwards, a ductal jet was observed in the echocardiogram with an increased size of the left ventricle, symptoms also appeared. A cardiac catheterism was then performed showing a pulmonary/systemic flow rate of 2 and a 3 mm flow jet at the superior border of the prosthesis. A second prosthesis was implanted with no residual shunts.

[Experience with Palmaz stent in pulmonary branch stenosis]. / Experiencia con el stent de Palmaz en la estenosis de rama pulmonar.

INTRODUCTION AND OBJECTIVES: Since 1989, the balloon expandable Palmaz stent (Johnson & Johnson Interventional Systems) has been used for the treatment of congenital heart disease. This study reports the results and the technique used for its implantation in native and post surgical retraction pulmonary branch stenosis. MATERIALS AND METHODS: From february 1995 to june 1996, we have performed this technique in 11 symptomatic children/adolescents with pulmonary branch stenosis, the mean age was 11 +/- 2 years. Fourteen procedures were made and 16 stents were implanted. The mean condition of the patients was: 7 with tetralogy of Fallot after a previous complete correction, 1 with Noonan syndrome and a surgically corrected atrial septal defect, 1 with pulmonary trunk aneurysm and a previous surgical correction for pulmonary valve and branch stenosis, 1 with pulmonary atresia and an intact septum who underwent a surgical valvotomy and posterior percutaneous valvuloplasty with a good ventricular development, and final was a tricuspid atresia with a previous Waterston anastomosis which produced a stenosis at the right pulmonary branch who underwent a modified Fontan operation with the result of a severe stenosis at the medial and inferior right pulmonary artery. The branch ostium was affected in five cases, and in one case with diffuse hypoplasia of the right branch, the stenosis was at both sites. The stenosis was native in nine cases and post surgery in the other five (2 Waterston, 1 Blalock-Taussig, 1 Fontan). We used the right and/or left femoral vein in all cases except two, in which we used the internal jugular vein. We followed the technique reported by the Boston-Houston experience, with an extra stiff guide and Mullins sheath towards the site of the stenosis. RESULTS: The procedure was effective in all cases except one. The mean pulmonary branch and balloon diameter was 11 +/- 3 mm and 14 +/- 2 mm, respectively, rate 1.2. The stenosis diameter rose from 4.8 +/- 1 to 11 +/- 2 mm (p < 0.001) with a percentage fall from 63 +/- 5 to 2 +/- 1% (p < 0.001). The pressure gradient fell from 30 +/- 5 to 5 +/- 1 mmHg (p < 0.001) and the right ventricle systolic pressure fell from 77 +/- 6 to 48 +/- 3 mmHg (p < 0.01). The mean followup was 10 +/- 3 months, a symptomatic and pulmonary perfusion improvement was seen. After 8 +/- 4 months, we evaluated six patients/nine stents with angiography, and we excluded thrombosis, aneurysms and occlusion of lobar or segmental branches. One case had a proximal stent re-stenosis as it did not cover the whole stenosis, so a new stent was implanted. Three patients/four stents underwent redilatation getting a slightly higher diameter than previously. COMPLICATIONS: One patient had a stent migration and he underwent surgical stent retrieval. CONCLUSIONS: Implantation of the Palmaz stent is a useful procedure for the treatment of native or post-operative pulmonary stenosis. It is possible to apply it to hypoplastic and ostial pulmonary stenosis. We confirm the effectiveness of redilatation at mid term.

[Analysis using ELISA test of antibody response to Fusobacterium nucleatum and Eikenella corrodens in subjects with periodontal disease]. / Análisis mediante una prueba de ELISA de la respuesta de anticuerpos frente a Fusobacterium nucleatum y Eikenella corrodens en sujetos con enfermedad periodontal.

BACKGROUND: To know the synthesis of IgG, IgA, and IgM to Fusobacterium nucleatum and Eikenella corrodens in serum, crevicular liquid and saliva in subjects with periodontal disease, using ELISA test. PATIENTS AND METHODS: We studied 26 patients with high bias to the disease aged less than 35 years and 30 individuals with comparable age and with scarce bias to the disease. RESULTS: No differences were found for IgG and IgM titers between the groups, except for IgM to E. corrodens. For IgA, differences were found when the saliva and crevicular liquid were studied for both bacteria, as occurred in serum IgA compared to E. corrodens. In all the cases antibody levels were lower in the patients. CONCLUSIONS: The lower synthesis of IgM and IgA, fundamentally the latter, to F. nucleatum and E. corrodens in patients with periodontal disease would contribute to the pathogenesis of this illness.

Physiopathology of primary periodontitis associated with plaque. Microbial and host factors. A review. Part 2.

To a considerable extent, host factors condition the initiation and progression of periodontitis. The integrity of the periodontal structures and the immune elements in the gingival fluid may act as a defensive barrier against microorganisms. However, immune over-response may lead to tissue damage and bone resorption from anaphylactic reactions, immunocomplex reactions, type IV hypersensitivity, complement hyperactivation via the alternative pathway, or direct action of leukocytes and macrophages. Moreover, insufficient host response allows bacteria to escape control, allowing more rapid progression of the disease.