Tomographic, microbiological and histological characterization of secondary apical periodontitis: case series

Abstract This case series included a tomographic, microbiological, and histopathological description of 15 secondary apical periodontitis (SAP) lesions obtained by apical microsurgery performed in 10 patients to better understand the etiology and pathogenesis of SAP. Preoperative tomographic analyses were performed through Cone beam computerized tomography - Periapical index (CBCT-PAI), and apical microsurgeries were then carried out. The removed apices were used for microbial culturing and for molecular identification using PCR for the detection of 5 strict anaerobic bacteria (P. gingivalis, P. intermedia, P. nigrescens, T. forsythia, and T.denticola) and 3 viruses Herpes simplex viruses (HSV), Cytomegalovirus (CMG) and Epstein-Barr Virus (EBV) by nested PCR. The removed apical lesions were histologically described. Univariate statistical analyses were performed by using STATA MP/16 (StataCorp LLC, College Station, TX, United States). CBCT-PAI analyses revealed PAI 4 and PAI 5 score lesions that involved cortical plate destruction. Eight SAPs were positive by culture, while nine SAP lesions were positive by PCR. Fusobacterium species were the most frequently cultured organisms in 7 SAP lesions, followed by D. pneumosintes in 3. In contrast, by single PCR, T. forsythia and P. nigrescens were detected in 5 lesions, T. denticola in 4 lesions, and P. gingivalis in 2 lesions. Twelve periapical lesions were granulomas, and the remaining three SAP lesions were radicular cysts. In conclusion, this case series study revealed that secondary apical lesions presented tomographic involvement of PAI 3 to 5, and that most SAP lesions were apical granulomas containing anaerobic and facultative microorganisms.

Resumo Esta série de casos incluiu uma descrição tomográfica, microbiológica e histopatológica de 15 lesões de periodontite apical secundária (SAP) obtidas por microcirurgia apical realizada em 10 pacientes para melhor compreender a etiologia e patogénese do SAP. As análises tomográficas pré-operatórias foram realizadas através de tomografia computadorizada de feixe cônico - índice Periapical (CBCT-PAI), e as microcirurgias apicais foram então realizadas. Os ápices removidos foram utilizados para a cultura microbiana e também para a identificação molecular por PCR para a detecção de 5 bactérias anaeróbias rigorosas (P. gingivalis, P. intermedia, P. nigrescens, T. forsythia, e T.denticola) e 3 vírus Herpes simplex (HSV), Cytomegalovirus (CMG) e Epstein-Barr Virus (EBV) por PCR aninhada. As lesões apicais removidas foram descritas histologicamente. Foram realizadas análises estatísticas univariadas utilizando STATA MP/16 (StataCorp LLC, College Station, TX, Estados Unidos da América). As análises CBCT-PAI revelaram lesões PAI 4 e PAI 5 que envolveram a destruição da placa cortical. Oito SAPs foram positivos por cultura, enquanto nove lesões de SAP foram positivas por PCR. As espécies de Fusobacterium foram os organismos mais frequentemente cultivados em 7 lesões SAP, seguidas por D. pneumosintes em 3. Em contraste, por PCR simples, T. forsythia e P. nigrescens foram detectados em 5 lesões, T. denticola em 4 lesões, e P. gingivalis em 2 lesões. Doze lesões periapicais foram granulomas, e as restantes três lesões SAP foram cistos. Em conclusão, este estudo de série de casos revelou que as lesões apicais secundárias apresentavam envolvimento tomográfico de PAI 3 a 5, e que a maioria das lesões de SAP eram granulomas apicais contendo microrganismos anaeróbios e facultativos.

Os desafios na conduta terapêutica em pacientes acometidos com feridas crônicas / Challenges in the therapeutic conduct in patients affected with chronic wounds / Retos en la conducta terapéutica en pacientes afectados de heridas crónicas

Considerado um grave problema em saúde pública, as feridas crônicas são patologias que desafiam o manejo terapêutico e infelizmente acometem milhares de pessoas em todo o mundo. Essa doença apresenta altos índices de morbidade impactando negativamente na qualidade de vida dos seus portadores, além de influenciar negativamente no domínio "bem-estar", principalmente quando associado aos fatores clínicos podendo estar relacionado há anos de tratamento sem cura da ferida. As feridas crônicas são caracterizadas por demora ou dificuldade nos processos de cicatrização e reparação ordenada da integridade anatômica e funcional da pele durante um período de no mínimo três meses. Porém, algumas lesões permanecem por anos e até décadas sem cicatrizar. Objetivo: O escopo dessa revisão é mostrar o limitado arsenal terapêutico bem como a dificuldade no manejo clínico e dessa forma proporcionar uma reflexão sobre sua fisiopatologia e a urgente necessidade de novas opções e condutas terapêuticas que possam auxiliar no tratamento desses pacientes. Metodologia: Trata-se de uma revisão integrativa da literatura sobre feridas crônicas, cujo critérios de inclusão foram artigos publicados no período de janeiro de 2005 a fevereiro de 2023. Conclusão: A problemática acerca dessa patologia é vasta, tratando de uma doença de difícil cura, com uma gama de fatores associados que dificultam a cura da lesão, estendendo essa doença a altos índices de morbidade. Novas condutas terapêuticas e novos fármacos, precisam ser desenvolvidos urgentemente. Destaca-se que o uso de probióticos e o emprego da nanotecnologia tem mostrado um grande potencial inovador no tratamento de pacientes portadores de feridas crônicas.

Considered a serious public health problem, chronic wounds are pathologies that defy therapeutic management and unfortunately affect thousands of people around the world. This disease has high morbidity rates, negatively impacting the quality of life of its patients, in addition to negatively influencing the "well-being" domain, especially when associated with clinical factors, which may be related to years of treatment without healing of the wound. Chronic wounds are characterized by delay or difficulty in healing processes and orderly repair of the anatomical and functional integrity of the skin over a period of at least three months. However, some injuries remain for years and even decades without healing. Objective: The scope of this review is to show the limited therapeutic arsenal as well as the difficulty in clinical management and thus provide a reflection on its pathophysiology and the urgent need for new options and therapeutic approaches that can help in the treatment of these patients. Methodology: This is an integrative review of the literature on chronic wounds, whose inclusion criteria were articles published from January 2005 to February 2023. Conclusion: The problem surrounding this pathology is vast, dealing with a difficult-to-cure disease, with a range of associated factors that make healing of the lesion difficult, extending this disease to high morbidity rates. New therapeutic approaches and new drugs need to be developed urgently. It is noteworthy that the use of probiotics and the use of nanotechnology have shown great innovative potential in the treatment of patients with chronic wounds.

Consideradas un grave problema de salud pública, las heridas crónicas son patologías que desafían el manejo terapéutico y que, lamentablemente, afectan a miles de personas en todo el mundo. Esta enfermedad presenta altas tasas de morbilidad, impactando negativamente en la calidad de vida de sus pacientes, además de influir negativamente en el dominio "bienestar", especialmente cuando se asocia a factores clínicos, que pueden estar relacionados con años de tratamiento sin curación de la herida. Las heridas crónicas se caracterizan por un retraso o dificultad en los procesos de cicatrización y reparación ordenada de la integridad anatómica y funcional de la piel durante un periodo de al menos tres meses. Sin embargo, algunas heridas permanecen durante años e incluso décadas sin cicatrizar. Objetivo: El alcance de esta revisión es mostrar el limitado arsenal terapéutico así como la dificultad en el manejo clínico y así aportar una reflexión sobre su fisiopatología y la urgente necesidad de nuevas opciones y enfoques terapéuticos que puedan ayudar en el tratamiento de estos pacientes. Metodología: Se trata de una revisión integradora de la literatura sobre heridas crónicas, cuyos criterios de inclusión fueron artículos publicados desde enero de 2005 hasta febrero de 2023. Conclusiones: La problemática que rodea a esta patología es amplia, tratándose de una enfermedad de difícil curación, con una serie de factores asociados que dificultan la cicatrización de la lesión, extendiendo esta enfermedad a altas tasas de morbilidad. Es urgente desarrollar nuevos enfoques terapéuticos y nuevos fármacos. Cabe destacar que el uso de probióticos y el empleo de nanotecnología han mostrado un gran potencial innovador en el tratamiento de pacientes con heridas crónicas.

Molecular identification of microbial contaminations in the fitness center in Makkah region

As the condition increases and seeks to remain healthy, the number of people who plan to join a fitness center or "gym" has increased markedly. From where this individual does understand, the study of the variety of bacteria showing the stolen has led him to care for people, with a popular fitness center located in the province of Makka, Saudi Arabia. Different bacteria must be eliminated from other gyms in Makkah, Saudi Arabia, in a total of three areas 46 two sports equipment. Both types and characteristics of bacteria, while some have been tested in hemolytic surgery for antibiotic resistance. Corynebacterium antibiotics in different forms did not react the same; however, isolates tested for M17 and N12 showed the greatest resistance to antibiotics. Furthermore, sixteen bacterial strains of human blood ß-agar displayed high hemolytic activity. In the gym isolates 2 (9 strains) followed in gym 1 (7 modes), B row hemolytic activity was highest. It is important to note that gram-positive bacteria were positive in all kinds of ways, and catalase was positive. Six strains belonging to the genus Bacillus, Brachybacterium, Geobacillus, Microbacterium, Micrococcus, and Staphylococcus and other pathogenic bacteria were known as possible individuals to use the morphological, biochemical, and rRNA gene of the 16S series. In general, this research illustrates the health and fitness centers in the individual being studied and the risks that are considered necessary to periodically study possible microbial contamination in the mixture in the gym to ensure people's protection.

Prevalence of microbial infection and strategic pattern of antimicrobial resistance among intensive care unit patients in a tertiary care teaching hospital from rural Northern India.

Background: Better management of patients cannot be ensured and the antibiotic policy cannot be designed till one knows the profile of prevalent strains along with their antimicrobial resistance pattern. Objective: To assess the strategic patterns of the organisms and its resistance patterns that were isolated from the patients admitted in various ICUs in a tertiary care hospital. Material and methods: The present study was undertaken based on reports of bacterial isolates of various clinical specimens from different ICUs of a tertiary care teaching hospital, that were submitted to the Microbiology laboratory for culture and sensitivity during the period of October 2012 to September 2014. All the organisms were identified morphologically and biochemically by standard laboratory procedure and antibiotic susceptibility pattern was determined by disc diffusion methods. Results: Out of the total samples (2920) received; organisms were isolated from 66.57%. One organism was isolated in 71.19% samples whereas 2 or more organisms were obtained in 28.8% were obtained in 28.8% samples. The most frequently isolated bacteria were P. aeruginosa (38.17%). Among P. aeruginosa, tobramycin had the highest susceptibility rate (94.2%) followed by meropenem (93.93%), carbenecillin (79.11%), and levofloxacin (73.45%). Most of the frequently isolated organisms like K. pneumoniae, Acinetobacter anitratus, Enterobacter were highly resistant to ampicillin, cephalexin, cefepime, ciprofloxacin. Conclusion: Appropriate antibiotic utilization in ICU is crucial not only to ensure an optimal outcome, but also to prevent the emergence of multi drug resistance. Antibiotic policies and effective surveillance are needed for better management of ICU infections with resistant organisms, Alteration and rotation in antibiotic prescribing patterns would decline the antibiotic resistance.

T cell recognition of non-peptidic antigens in infectious diseases.

The immune system has evolved to recognize a wide range of antigenic molecules of self and non-self origin. The stimulatory antigens form complexes with antigen-presenting molecules and directly interact with the T cell receptor (TCR). Peptidic antigens associate with major histocompatibility complex (MHC) molecules and therefore, are indicated as MHC-restricted. Non-peptidic antigens do not bind to MHC molecules and are presented by other classes of antigen-presenting molecules. These non-MHC restricted antigens include glycolipid molecules, phosphorylated metabolites of the mevalonate pathway and vitamin B2 precursors. T cells specific for non-peptidic antigens have important roles in host defense against infections, autoimmunity, allergies and tumour immunosurveillance. Hence, understanding the molecular interactions between the antigen presenting cell (APC) and the T cells with non-peptidic specificity is of great relevance. Here, we review current knowledge of this type of T cells, their TCR repertoire, the structural aspects of recognized antigens, the mode of antigen recognition, and their function with special emphasis on their role in infectious diseases.

Prediction of Microbial Infection of Cultured Cells Using DNA Microarray Gene-Expression Profiles of Host Responses

Infection by microorganisms may cause fatally erroneous interpretations in the biologic researches based on cell culture. The contamination by microorganism in the cell culture is quite frequent (5% to 35%). However, current approaches to identify the presence of contamination have many limitations such as high cost of time and labor, and difficulty in interpreting the result. In this paper, we propose a model to predict cell infection, using a microarray technique which gives an overview of the whole genome profile. By analysis of 62 microarray expression profiles under various experimental conditions altering cell type, source of infection and collection time, we discovered 5 marker genes, NM_005298, NM_016408, NM_014588, S76389, and NM_001853. In addition, we discovered two of these genes, S76389, and NM_001853, are involved in a Mycolplasma-specific infection process. We also suggest models to predict the source of infection, cell type or time after infection. We implemented a web based prediction tool in microarray data, named Prediction of Microbial Infection (http://www.snubi.org/software/PMI).

A study of the hematological effects of chloramphenicol on Filipino children (a one-year study at the Childrens Memorial Hospital Foundation)

The results of a one-year study on 100 children ranging in age from infancy to 12 years treated with chloramphenicol for various microbial infections is reviewedOut of 100 children who received 20 to 40 mg./kg. body weight of chloramphenicol for from 5 days to two weeks, not one developed any hematologic side effectsChloramphenicol, a widely used antibiotic because of many indications in pediatric practice is safe to use for over a two-week period. (Summary and Conclusions)

Microbial Contaminations of Ultrasonic Scalers, High-Speed Handpieces and Water Syringe Lines / 대한치주과학회지

The purpose of this study was to evaluate various methods of decontamination of ultrasonic scalers, high-speed handpieces and air-water syringes in dental equipments. Eimination of possible sources of microbial infection in dental operatories should be of primary importance. Microbial contamination levels of high speed handpieces, air-water syringes and ultrasonic scalers of 11 dental units in Seoul National University Hospital were evaluated after flushing the lines, alcohol sponge rubbing, or soaking in 0.1% chlorhexidine for 1,3 and 5 minutes. The result suggests that flushing the lines or soaking the tips in 0.1% chlorhexidine before use of the water systems may reduce the microbial levels. Soaking in 0.1% chlorhexidine for 5 minutes was most effective in reducing bacterial contamination.