HIV with initial ocular Kaposi sarcoma / HIV com sarcoma de Kaposi ocular inicial

ABSTRACT We present an interesting case of a 62-year-old black female, presented to the ophthalmological hospital with a little "nevus" on the left eye previously visualized at the mirror, with one month of development. Physical examination with slit lamp (biomicroscopy) showed a group of painless veins, with vascular redness, and a mass nodular aspect in the mid temporal bulbar conjunctiva, of approximately 2mmx4mm.

RESUMO Apresentamos o interessante caso de uma mulher negra de 62 anos, que deu entrada no hospital oftalmológico com um pequeno nevo no olho esquerdo previamente visualizado ao espelho, com 1 mês de evolução. O exame físico com lâmpada de fenda (biomicroscopia) mostrou um grupo de veias indolor e vermelhidão vascular, com uma massa de aspecto nodular na conjuntiva bulbar temporal média, de aproximadamente 2mmx4mm.

Diagnóstico precoce da sífilis em gestantes: Prevalência de sorologia positiva do teste VDRL e realização do teste rápido imunocromatográfico em um hospital do Sul de Santa Catarina / Early diagnosis of syphilis in pregnant women: Prevalence of positive VDRL test serology and rapid immunochromatographic testing in a hospital in southern Santa Catarina

RESUMO Introdução: Quando a sífilis é diagnosticada ainda no pré-natal, torna-se possível estabelecer uma estratégia de prevenção para a sífilis congênita. Em situações especiais, esta detecção é feita através do teste não treponêmico (VDRL), ou ainda por teste rápido imunocromatográfico. O objetivo deste estudo foi verificar a prevalência de sorologia positiva do teste VDRL em gestantes, bem como a realização do teste rápido imunocromatográfico, por meio da análise de registros da carteira de pré-natal e registros de testes rápidos imunocromatográficos em um hospital de referência do Sul do Brasil, o Hospital Nossa Senhora da Conceição (HNSC), no ano de 2015. Métodos: Estudo epidemiológico de delineamento transversal. A coleta de dados foi realizada no período compreendido entre agosto a setembro de 2017. Nos procedimentos do estudo foram coletados os dados de VDRL nas carteiras de pré-natal pelo sistema TASY® e registros de execução do teste rápido imunocromatográfico pelo livro disponibilizado no setor de obstetrícia referente ao ano de 2015. Resultados: Das 2.367 gestantes analisadas no HNSC, 29 (1,2%) apresentaram resultado positivo para o teste de triagem para a sífilis, o VDRL, durante a gestação. No ano de 2015 foram realizados 61 testes rápidos imunocromatográficos, com quatro resultados positivos (6,5%) de gestantes encaminhadas ao hospital para parto sem dados e exames feitos no pré-natal. Conclusões: A partir dos resultados deste estudo, sugere-se que sejam realizadas análises epidemiológicas constantes referentes à sífilis congênita, principalmente a partir da introdução dos testes rápidos imunocromatográficos em hospitais. PALAVRA-CHAVE: Sífilis, Sífilis congênita, Sorodiagnóstico da sífilis, Imunocromatografia, Infecções por treponema

ABSTRACT Introduction: When syphilis is diagnosed prenatally, it becomes possible to establish a prevention strategy for congenital syphilis. In special situations, this detection is done through the non-treponemal test (VDRL), or even through the rapid immunochromatographic test. The aim of this study was to verify the prevalence of positive serology of the VDRL test in pregnant women, as well as rapid immunochromatographic testing, through the analysis of prenatal care records and rapid immunochromatographic test records in Hospital Nossa Senhora da Conceição (HNSC), a reference hospital in Southern Brazil, in 2015. Methods: Cross-sectional epidemiological study. Data collection was carried out in the period from August to September 2017. In the study procedures, VDRL data were collected from prenatal care cards through the TASY® system and rapid immunochromatographic testing records from the book available in the obstetrics sector for the year 2015. Results: Of the 2,367 pregnant women analyzed at HNSC, 29 (1.2%) had a positive result for VDRL, the screening test for syphilis, during pregnancy. In 2015, 61 rapid immunochromatographic tests were carried out, with four positive results (6.5%) of pregnant women referred to the hospital for delivery without data and tests performed in the prenatal period. Conclusions: Based on the results of this study, it is suggested that constant epidemiological analyses be carried out regarding congenital syphilis, especially after the introduction of rapid immunochromatographic tests in hospitals. KEYWORDS: Syphilis, Congenital Syphilis, Syphilis serodiagnosis, Immunochromatography, Treponemal infection

Perfil epidemiológico dos portadores de sífilis entre 2010 e 2018 no Estado do Paraná, Brasil / Epidemiological profile of syphilis patients between 2010 and 2018 in Paraná State, Brazil

O objetivo desse trabalho foi analisar os casos de sífilis no Estado do Paraná, e descrever o perfil epidemiológico dos infectados, entre os anos de 2010 e 2018. O presente estudo é quantitativo, descritivo e observacional, foi desenvolvido com dados secundários do Sistema Nacional de Agravos de Notificação (SINAN), com a análise das taxas de detecção da sífilis adquirida. Entre 2010 e 2018 o Paraná registrou 39.900 casos de sífilis adquirida, sendo que 58,5% ocorreram em homens e 41,5% em mulheres. A faixa etária de maior incidência foi entre 20-29 anos (26,9%), seguida por 30-39 anos (21,4%). Quanto a escolaridade, a maioria dos infectados possuía ensino fundamental (18,5%) e médio (19%). A macrorregião leste do Estado apresentou a maior incidência de casos (59,28% dos casos em 2016). Devido ao aumento dos casos de sífilis adquirida no Paraná entre os anos de 2010 a 2018, conclui-se a necessidade do direcionamento de ações de prevenção e rastreio. (AU)

The study aimed to analyze the syphilis cases in Paraná State, and to describe the epidemiological profile of infected individuals, between 2010 and 2018. The present study is quantitative, descriptive and observational; it was developed with secondary data from the National System of Disorders notification, evaluating the detection rate of syphilis acquired. Between 2010 and 2018 Paraná registered 39,900 cases of Acquired Syphilis, being 58.5% in males and 41.5% in females. The age group with the highest incidence was between 20-29 years (26.9%), followed by 30-39 years (21.4%). As for schooling, most of the individuals in the identified cases had elementary (18.5%) and high school education (19%). The eastern macro- region of the state had the highest cases incidence (59.28% of cases in 2016). Due to the increase in syphilis cases acquired in Paraná between 2010 and 2018, it concludes the need to target prevention and screening actions. (AU)

Norma técnica de salud para la prevención de la transmisión Madre-Niño del VIH y la Sífilis / Technical health norm for the prevention of Mother-Child transmission of HIV and Syphilis

La presente publicación describe las pautas y procedimientos a ser utilizados a nivel nacional basados en conocimiento científico, dirigidos a la profilaxis de la transmisión madre-niño del VIH y el Treponema pallidum, para la reducción de la transmisión del VIH a menos del 2% y la incidencia de sífilis congénita, según los escenarios que corresponda a la madre infectada y su niño

Prevalence of Treponemaspp. in endodontic retreatment-resistant periapical lesions

This study investigated the presence of the Treponema species in longstanding endodontic retreatment-resistant lesions of teeth with apical periodontitis, the association of this species with clinical/radiographic features, and the association among the different target species. Microbial samples of apical lesions were collected from twenty-five adult patients referred to endodontic surgery after unsuccessful root canal retreatment. Nested-PCR and conventional PCR were used for Treponema detection. Twenty-three periradicular tissue samples showed detectable levels of bacterial DNA. Treponema species were detected in 28% (7/25) of the cases. The most frequently detected species were T. socranskii (6/25), followed by T. maltophilum (3/25), T. amylovorum (3/25), T. lecithinolyticum(3/25), T. denticola (3/25), T. pectinovorum (2/25) and T. medium(2/25). T. vicentii was not detected in any sample. Positive statistical association was found between T. socranskiiand T. denticola,and between T. maltophilumand T. lecithinolyticum. No association was detected between the presence of any target microorganism and the clinical or radiographic features. Treponemaspp.are present, in a low percentage, in longstanding apical lesions from teeth with endodontic retreatment failure.

Periodontopathogen profile of healthy and oral lichen planus patients with gingivitis or periodontitis / 国际口腔科学杂志·英文版

Oral lichen planus (OLP) is a chronic inflammatory disease that is frequently detected in oral tissues. The aim of our study was to identify the prevalence of the detection of periodontopathogenic microorganisms (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola in OLP patients and to compare with this prevalence of periodontopathogenic microorganisms in healthy non-OLP patients. Our study included 27 (18 chronic periodontitis (OLPP) and 9 gingivitis (OLPG)) patients diagnosed with OLP along with 26 (13 chronic periodontitis (HP) and 13 gingivitis (HG)) healthy non-OLP patients. The multiplex polymerase chain reaction (PCR) with subsequent reverse hybridization method (micro-IDent) was used for identifying periodontopathogenic microorganisms present in subgingival plaque samples. The percentages of detection for A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia and T. denticola in subgingival plaque samples taken from OLP patients (OLPG and OLPP) were 18.5%, 85.1%, 81.4%, 88.8% and 74%, respectively. Meanwhile, in the non-OLP patients (HG and HP), these values were 7.6%, 50%, 46.1%, 73% and 57.7%, respectively. Thus, comparing the non-OLP groups with the OLP groups, the periodontopathogens' percentages of detection in the OLP groups were higher than those in the non-OLP groups. According to our study results, OLP patients have higher levels of infection with A. actinomycetemcomitans, P. gingivalis, P. intermedia, T. forsythia and T. denticola than non-OLP patients. We argue that the high percentages in patients with OLP may help identify the importance of periodontopathogenic microorganisms in the progress of periodontal diseases of OLP.

Prevalence survey of infection with Treponema pallidum among HIV-positive patients in Tehran

<p><b>OBJECTIVE</b>To identify the frequency of syphilis among Iranian HIV-positive patients.</p><p><b>METHODS</b>A cross-sectional study on the prevalence of syphilis and HIV co-infection among 450 patients diagnosed with HIV infection was conducted between 2004 and 2008 at Imam Khomeini hospital, Tehran, Iran. The lab tests including CD4 cell count, cerebrospinal fluid, veneral disease research laboratory (VDRL), fluorescent treponema antibody-absorption (FTA-Abs) and viral load were performed for all the patients. Data regarding medical history and their demographics were also collected.</p><p><b>RESULTS</b>Of all 450 HIV-positive patients, 24 (5.3%) had a positive VDRL test and only two men had a FTA-Abs positive test which means 0.45% of them had a definite co-infection of syphilis. 65.3% of the HIV-positive patients were injection drug users that the co-infection prevalence of them was 0.7%. We did not find any patient with neurosyphilis.</p><p><b>CONCLUSIONS</b>Considering the increasing prevalence of HIV and also extensive use of highly active antiretroviral therapy in developing nations, the diagnosis of syphilis should be timely established using screening tests among such patients.</p>

Detected of associated contagious parameters of blood recipients before transfusion and their clinical significance / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the significance in prevention of nosocomial infection of the testing of the associated contagious parameters of blood recipients before transfusion.</p><p><b>METHODS</b>A retrospective analysis was adopted, 44 968 pre-transfusion patients were tested the serum hepatitis B virus surface antigen (HBsAg), antibody against hepatitis C virus (anti-HCV), antibody against T. pallidum (anti-TP) and antibody against human immunodeficiency virus(anti-HIV).</p><p><b>RESULTS</b>The total positive rate was 22.41%. Positive rate of HBsAg, anti-HCV and anti-TP were 20. 67% (9294/44 968) , 0.33% (148/ 44 968) and 1.65% (9741/44968), respectively; anti-HIV was positive in 39 patients, 23 cases coinfection of the other three indicators at least one positive in 39 cases of anti-HIV-positive blood recipients, of which was mostly observed T. pallidum; co-infection of HBV, HCV and/or TP were 117 cases, and were mostly observed between HBV and HCV, HCV and TP; for HBV infection the department of digestive medicine was prevalent(Chi2>or=83.0, P <0.01).</p><p><b>CONCLUSION</b>Part of blood recipients before admission had been infected with a contagious disease. The testing of the associated contagious parameters of blood recipients before transfusion is not only useful for both of the hospital and the patients, but also more important to ensure safe blood transfusion, decrease medial dissatisfaction and to prevent nosocomial infection.</p>

Intervención basada en pruebas diagnósticas para un enfoque integral de las infecciones de transmisión sexual / Intervention based on diagnostic tests for a sexual transmitted diseases' integral approach

Se realizó un estudio transversal descriptivo en diversas comunidades del municipio Manicaragua para Identificar la infección por el Virus de Inmunodeficiencia Humana, Virus de Hepatitis B, Virus de Hepatitis C y Treponema pallidum en 448 personas sexualmente activas entre 15 y 59 años de población general. A partir del consentimiento informado y con una explicación de la dinámica de la investigación se procedió a la toma de la muestra y a la entrevista personal. Se aplicaron los principios de Atención Primaria de Salud (APS): equidad, integración y empoderamiento. Se realizó intervención educativo-preventiva y consejería. Las muestras fueron procesadas por tecnología SUMA y se realizó la determinación de anticuerpos al Treponema pallidum por serología VDRL. La positividad general fue de 2,6 por ciento a expensas de los virus de hepatitis y dentro de éstos la reactividad serológica al Virus de Hepatitis C fue 1,33 por ciento y al Virus de Hepatitis B de 0,88 por ciento. A su vez se detectaron dos personas con serología VDRL débil reactiva. No se identificaron personas infectadas por el VIH. Las personas con reactividad serológica VHC y VHB desconocían su estatus serológico. La población que resultó reactiva a las pruebas realizadas fueron mayoritariamente mujeres, en las edades medias de la vida. Se hizo entrega de los resultados al médico de atención primaria. Las personas que accedieron voluntariamente a la prueba de VIH tuvieron otras opciones pues dispusieron de información sobre las ITS-VIH, participaron de un instante de reflexión y análisis personal sobre su percepción de riesgo y finalmente conocieron su estatus serológico ante cuatro agentes causales de estas infecciones.

We carried out a cross-sectional, descriptive study in several communities of the municipality of Manicaragua to identify the infection by the Human Immunodeficiency Virus, Hepatitis B Virus, Hepatitis C Virus, and Treponema pallidum in 448 sexually active people aged 15-59 years from the general population. Starting with the informed consent and a dynamic explanation of the investigation we took samples and did personal interviews. We applied the principles of the Primary Health Care: equity, integration and empowering. We developed an educative-preventive intervention and advisory. The samples were processed by SUMA technology, and the determination of the Treponema pallidum was made by VDRL serology. The general positivity was 2,6 per cent at the expenses of the hepatitis viruses, and among them, the serologic reactivity to the Hepatitis C Virus was 1,33 per cent, and to the Hepatitis B Virus of 0,88 per cent. We also detected two persons with mild reactive VDRL serology. We did not identified persons infected with the HIV. The persons with VHC and VHB serologic reactivity did not know their serologic status. The population who resulted reactive to the tests was mainly middle/aged women. We gave the results to the primary care physician. The persons who voluntarily agreed the HIV tests had other options because they had information on STD/HIV, made a reflection and personal analysis on their risk perception and finally knew their serologic status about four causal agents of these infections.

Community periodontal index of treatment needs index: An indicator of anaerobic periodontal infection.

Background : Community periodontal index of treatment needs (CPITN) index is commonly used to measure periodontal disease. It's uniqueness, apart from assessing the periodontal status, also gives the treatment needs for the underlying condition. Benzoyl-DL-arginine napthylamide (BANA) test is a chair side diagnostic test used to detect the presence of putative periodontal pathogens. We correlated the CPITN scores of patients with BANA test results to assess the validity of CPITN as an indicator of anaerobic periodontal infection. Objectives : The present study was aimed to correlate the CPITN scores with the BANA activity of subgingival plaque. The objective was to assess the validity of CPITN index as indicator of anaerobic periodontal infection. Patients and Methods : A total of 80 sites were selected from 20 patients with generalized chronic periodontitis. After measuring the probing depth with CPITN C probe, the highest score from each sextant was selected according to the CPITN criteria and subgingival plaque samples were collected using a sterile curette and the BANA test was performed. Results : Kendall's tau-b and Chi- square test were used to assess the correlation between the BANA test results and CPITN scores. Results indicated sensitivity (92.86%), specificity (80%) and agreement (91.25%); indicating the validity of CPITN in assessing anaerobic infection. Conclusion : There was a significant correlation between BANA test results and scores 3 and score 4 of CPITN index (P < 0.001) clearly indicating the presence of anaerobic periodontal infection.

Pathologic diagnosis of specific infections in upper aerodigestive tract / 中华病理学杂志

<p><b>OBJECTIVE</b>To find a fast and simple method for detection of specific pathogens in upper aerodigestive tract.</p><p><b>METHODS</b>Sixty-one cases of specific infections in upper aerodigestive tract encountered during a 10-year period in Beijing Tongren Hospital were retrospectively studied. Six histochemical stains, including PAS, Giemsa, Gram, methylene blue, modified Warthin-Starry and acid-fast stains were applied. The morphology of different pathogens was studied and the staining patterns were compared.</p><p><b>RESULTS</b>There were 23 cases of pharyngeal treponemal infection, 10 cases of short treponemal infection, 4 cases of mycobacterial infection, 4 cases of infection by rhinoscleroma bacilli, 1 case of sinonasal fungal infection, 1 case of combined infection of bacteria and Oidium albicans, 2 cases of tonsillar Actinomycetes and 16 cases of non-specific bacterial infections. Both pharyngeal treponemal infection and infection by rhinoscleroma bacilli could be detected by modified Warthin-Starry stain. As for sinonasal fungal infection, PAS, Giemsa and modified Warthin-Starry stains were useful in differentiating different types of fungi. Mycobacteria were best demonstrated by conventional acid-fast stain.</p><p><b>CONCLUSIONS</b>Special histochemical stains performed on histologic sections are useful for diagnosing specific infections in upper aerodigestive tract.</p>

Diagnóstico da sífilis a partir das manifestações bucais / Syphilis diagnosis through oral manifestation

A sífils é uma doença sexualmente transmissível causada pelo Treponema pallidium. Pode ser transmitida também pelas vias hematogênicas e materno-fetal. A sífilis primária é caracterizada pelo cancro, observado na mucosa bucal na forma de úlcera firme indolor. As placas mucosas representam a manifestação oral da sífilis secundária. A sífilis terciária é caracterizada pela formação de gomas que podem levar a perfuração do palato. O diagnóstico de sífilis deve ser baseado de acordo com o estágio da doença. O tratamento da sífilis consiste em antibioticoterapia. A sífilis pode ser diagnosticada a partir de lesões bucais, sendo portanto, de fundamental importância o conhecimento desta doença pelo cirurgião-dentista.

Comparação de testes nao treponêmicos utilizados no diagnóstico da sifilis e interferência da inativação do soro / Comparison of non treponemic assays used in syphilis diagnosis and interference of serum inactivation

A sífilis é uma doença infecciosa crônica causada pelo Treponema pallidum, cujo diagnóstico incorreto propicia a transmissão da doença via sexual e placentária. O trabalho avaliou comparativamente os testes Veneral Diseases Research Laboratory (VDRL) e Rapid Plasm Reagin (RPR) na triagem sorológica e determinou a interferência da inativação do soro. Foram empregados reagentes comerciais na avaliação de amostras de soro de 110 indivíduos saudáveis e de 20 pacientes portadores de sífilis, antes e após a inativação a 56ºC/30min. O procedimento técnico seguindo as instruções do fabricante mostrou sensibilidade de 100% para ambos os testes, embora 45% das amostras reativas tenham mostrado títulos superiores no VDRL. A especificidade foi de 100% no VDRL e 97,3% no RPR. A inativação do soro mostrou não interferir nos resultados do VDRL, enquanto que o RPR mostrou maior especificidade para amostras inativadas, embora sem diferença significativa (p=0,248).

Syphilis is a chronic infectious illness caused by the Treponema pallidum, which incorrect diagnosis propitiates the transmission mainly by sexual contact and from mother to child (trans-placentary). The present work evaluated the Veneral Diseases Research Laboratory (VDRL) and the Rapid Plasm Reagin (RPR) assays and also determined the interference of the serum inactivation. Commercial reagents were used to evaluate sera samples from 110 healthful individuals and 20 patients with syphilis, before and after inactivation at 56ºC/30min. In the technical procedure according the manufacturers’ instructions, both assays had presented 100% of sensitivity, although 45% of the reactive samples have shown bigger values in VDRL. The specificity was 100% for VDRL and 97.3% for RPR. The serum inactivation showed no interference in VDRL results, while in RPR was observed a greater specificity with inactivated samples, although with no significant difference (p=0,248).

Sífilis congênita / Congenital syphilis

A sífilis é uma doença infecciosa cujo agente etiológico é o Treponema pallidum, que se transmite ao feto por via hematogênica. A infecção do feto está na dependência do estado da doença na gestante: quanto mais recente a infecção materna, mais treponemas estarão circulantes e, portanto, mais severo será o comprometimento fetal. A infecção materna nos últimos meses de gestação, dependendo da carga de treponema recebida e de sua virulência, poderá determinar uma evolução fulminante, se o diagnóstico não for feito rapidamente. A taxa de infecção da transmissão vertical do T. pallidum em mulheres não tratadas é de 70 a 100 porcento, nas fases primária e secundária da doença, reduzindo-se para aproximadamente 30 porcento nas fases tardias da infecção materna (latente tardia e terciária). Apesar de a sífilis congênita ser doença de notificação compulsória no país, não se conhece a sua exata magnitude, devido à elevada subnotificação. No Brasil, estudos de representatividade nacional estimam uma prevalência em gestantes de 1,6 porcento da infecção, em 2004, representando cerca de 50.000 parturientes com sífilis ativa e uma estimativa de 15.000 crianças nascendo com sífilis congênita para aquele ano, em média. A medida de controle mais eficaz para a sífilis é oferecer a toda gestante uma assistência pré-natal adequada, realizando testes sorológicos que permitam o diagnóstico precoce e, conseqüentemente, o tratamento em tempo adequado. A triagem pode ser feita com o VDRL, altamente sensível, necessitando confirmação com um teste treponêmico como o FTA-Abs. A sífilis congênita é uma das doenças mais facilmente preveníveis, bastando que a gestante infectada seja detectada e tratada prontamente, bem como os seus parceiros sexuais.

Tricobezoar congénito: a propósito de un caso / Congenital tricobezoar: a case report

El tricobezoar congénito en el período neonatal es una entidad poco habitual. Se presenta la evolución clínica de una recién nacida femenina portadora de un tricobezoar congénito, el primero diagnosticado en la Maternidad "Concepción Palacios". La madre de la recién nacida era portadora de una prueba de sífilis reactiva. Se describe el manejo médico con antibióticoterapia, y estimulaciones rectales. No hubo necesidad de abordaje qurúrgico, ni endoscópico. La paciente evolucionó en formaclínica satisfactoria y fue egresada a los 24 días

Diagnóstico antenatal de sífilis congénita por PCR en líquido amniótico y sus posibles aplicaciones / Prenatal diagnosis of congenital syphilis by PCR in amniotic liquid and its possible applications

Se presenta un caso clínico de sífilis congénita diagnosticada antenatalmente mediante el uso de la reacción de la polimerasa en cadena (PCR) en líquido amniótico. La PCR permitiría identificar la espiroqueta en diferentes medios, como en sangre, líquido amniótico y líquido céfalo-raquídeo. Deberán desarrollarse nuevos protocolos para poder probar la efectividad de los tratamientos en base a esta técnica diagnóstica.

Study on the detection of P. gingivalis, A. actinomycetemcomitans and T. denticola and the correlation between coinfections of the microbes and levels of chronic periodontitis lesion / 中华流行病学杂志

<p><b>OBJECTIVE</b>To establish a 16S rDNA multiplex polymerase chain reaction (PCR) for simultaneously detecting P. gingivalis, A. actinomycetemcomitans and T. denticola in clinical specimens of chronic periodontitis and to study the correlation between different modes of infection and severity of the disease.</p><p><b>METHODS</b>Periodontal pocket specimens from 152 patients with mild, moderate or advanced chronic periodontitis and gingival sulcus specimens from 30 periodontally healthy individuals were collected and placed in 200 microl lysis buffer. The specimens were incubated in 100 degrees C for 10 min and 10 microl of the supernatant was directly used as PCR template. DNAs from P. gingivalis strain ATCC33277, A. actinomycetemcomitans strain Y4, T. denticola strain FM and E. coli strain DH5alpha were used as positive and negative controls in PCR with all of which were prepared by routing phenol-chloroform method. A multiplex PCR assay, using three sets of primers specific to 16S rDNA genes of the three anaerobes, was developed to detect the specimens. The target amplification fragments from 3 cases of PCR products positive for all the three anaerobes were sequenced after T-A cloning. Chi-square test was applied to analyze the correlation between different coinfection of the three anaerobes and severity of the disease.</p><p><b>RESULTS</b>The established 16S rDNA multiplex PCR assay was able to detect P. gingivalis, A. actinomycetemcomitans and T. denticola at a minimum of 10, 20 and 20 cells, respectively. In comparison with the reported corresponding sequences, similarities of the nucleotide sequences from the three anaerobes 16S rDNA amplification fragments were as high as 99.45%, 97.08% and 96.59%, respectively. Of the 30 periodontally healthy gingival sulcus specimens, only one (3.3%) positive for P. gingivalis and two (6.7%) for A. actinomycetemcomitans could be identified but all of the rest were negative. In the 152 CP periodontal pocket specimens, 147 cases (96.7%) were positive for P. gingivalis, A. actinomycetemcomitans and/or T. denticola, respectively, and 5 cases (3.3%) were negative for all the three anaerobes. The positive rate of P. gingivalis detection (91.5%, 139/152) was significantly higher than those of A. actinomycetemcomitans (72.4%, 110/152) and T. denticola (80.9%, 123/152) (chi(2) = 7.07, 18.67; P < 0.01). 89.8% of the specimens from patients showed coinfections with two (26.5%) or three anaerobes (63.3%), and the coinfection rates in the specimens from moderate and advanced CP were remarkably higher than that from mild CP (chi(2) = 10.43, P < 0.01).</p><p><b>CONCLUSION</b>The 16S rDNA multiplex PCR established in this study showed high sensitivity and specificity, which could be used to detect P. gingivalis, A. actinomycetemcomitans and T. denticola in clinical specimens. CP was an disease caused by multiple pathogenic microbes while the synergistic pathopoiesis of the three microbes was closely related to the severity of the disease.</p>

La treponematosis precolombina en Cuba / Pre-Columbian treponematosis in Cuba

Se realiza una revisión de la infección por treponema pallidum, agente de la sífilis, en aborígenes cubanos con una discusión sobre su existencia en la Isla en una etapa presumiblemente anterior al 3 000 ANE, habida cuenta la antigüedad de los restos datados y los contextos culturales a que estos están asociados. Se presume que la entidad se presentó en su variante endémica y no bajo las formas venéreo o congénitas. Las poblaciones más atacadas fueron las del período mesolítico cubano, sin que existan reportes dentro del material estudiado que alcancen a los sujetos ubicados dentro del neolítico del occidente del país, detalle que contrasta con los hallazgos de Luna Calderón en La Española. Se analizan además, las posibles vías de migración de la entidad patológica a Cuba, excluyendo la ruta norte-sur, toda vez que las dataciones de restos con evidencias de treponematosis aborigen americana no alcanzan datas remotas como las observadas en Cuba. En su lugar se plantea la ruta sur-norte desde el continente a la Isla , sin cruzar, en esta etapa, por el arco de las Antillas. En este estudio se presentan las características de las secuelas óseas y sus elementos diferenciales con otras noxas infecciosas en aborígenes

Bilateral treponema periostitis

Symmetrical exuberant periostitis is a rare disease caused, by variety of infectious and non-infectious causes. Treponematosis is one of the rare causes of this condition. We report a patient who presented with left arm swelling, secondary to onion peel periostitis of the humerus, which was caused by Treponema species