ABSTRACT
Últimamente, el uso del láser en endodoncia ha ganado aceptación llegando a considerarse como un complemento a la terapia endodóntica, la cual tiene como objetivo realizar una efectiva conformación, limpieza y desinfección del sistema de canales radiculares (SCR), permitiendo una eliminación eficaz de microorganismos presentes, y así prevenir la reinfección del canal. Se han adoptado diferentes métodos de aplicación del láser para mejorar la desinfección del SCR, los cuales podrían ser eficaces para reducir la población microbiana presentes al interior de los canales, por medio de la activación del irrigante utilizado. El empleo de láser también podría ser útil en procedimientos endodónticos quirúrgicos los cuales tienen por objetivo mantener el diente y sus raíces cuando el tratamiento convencional ha fallado, los efectos positivos del láser se centrarían en el descenso de la inflamación y del aumento de volumen, además de la disminución de la filtración de los materiales de sello ortógrado en dientes apicectomizados. Otro de los usos de láser en esta materia está relacionado con el manejo del dolor post-terapia endodóntica, el que se ha visto ser prometedor. Se definen dos tipos de láseres: de baja potencia, que produce una acción bioestimulante, analgésica y antiinflamatoria de los tejidos biológicos, utilizada además en procesos de descontaminación del SCR, y de alta potencia o láser quirúrgico, con el que se pueden realizar incisiones, exéresis, realizando funciones de corte y coagulación.
Lately, the use of laser in endodontics has gained acceptance, being considered as a complement to endodontic therapy, which aims to carry out an effective shaping, cleaning and disinfection of the root canal system (RCS), allowing an effective elimination of microorganisms present, and thus prevent reinfection of the canal. Different laser application methods have been adopted to improve the disinfection of the RCS, which could be effective in reducing the microbial population present inside the canals, by activating the irrigant used. The use of laser could also be useful in surgical endodontic procedures which aim to maintain the tooth and its roots when conventional treatment has failed, the positive effects of laser would focus on reducing inflammation and increasing volume, in addition of the reduction in the filtration of orthograde seal materials in apicoectomized teeth. Another use of laser in this area is related to post-endodontic therapy pain management, which has shown promise. Two types of lasers are defined; low-power, which produces a biostimulant, analgesic and anti-inflammatory action of biological tissues, also used in RCS decontamination processes, and high-power or surgical laser, with which incisions, excision, performing cutting functions and coagulation.
Subject(s)
Endodontics , Laser Therapy , Low-Level Light TherapyABSTRACT
Cryptococcal infection is not frequent in immunocompetent patients. The most commonly involved sites are the lungs and the central nervous system. Cryptococcal osteomyelitis occurs in 5-10% of patients with disseminated cryptococcosis with few reports of cryptococcal arthritis in elderly adults. We describe the case of a 92-year-old woman with a Cryptococcus neoformans knee joint infection associated to osteomyelitis.
Subject(s)
Arthritis, Infectious/microbiology , Cryptococcosis/diagnosis , Cryptococcus neoformans/isolation & purification , Aged , Aged, 80 and over , Antifungal Agents/therapeutic use , Arthritis, Infectious/diagnosis , Arthritis, Infectious/drug therapy , Cryptococcosis/drug therapy , Female , Fluconazole/therapeutic use , HumansABSTRACT
Cryptococcal infection is not frequent in immunocompetent patients. The most commonly involved sites are the lungs and the central nervous system. Cryptococcal osteomyelitis occurs in 5-10 percent of patients with disseminated cryptococcosis with few reports of cryptococcal arthritis in elderly adults. We describe the case of a 92-year-old woman with a Cryptococcus neoformans knee joint infection associated to osteomyelitis.
La infección por Cryptococcus neoformans es infrecuente, los sitios más comunes de presentación son pulmón y SNC. La osteomielitis criptococóccica ocurre en 5 a 10 por ciento de los pacientes con criptococcosis diseminada. La mayoría de casos ocurre entre 21 y 59 años de edad, hay pocos reportes de artritis criptococóccica en adultos mayores.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Arthritis, Infectious/microbiology , Cryptococcosis/diagnosis , Cryptococcus neoformans/isolation & purification , Antifungal Agents/therapeutic use , Arthritis, Infectious/diagnosis , Arthritis, Infectious/drug therapy , Cryptococcosis/drug therapy , Fluconazole/therapeutic useABSTRACT
Liver oxidative stress, Kupffer cell functioning, and cell injury were studied in control rats and in animals subjected to L-3,3',5-tri-iodothyronine (T3) and/or acute iron overload. Thyroid calorigenesis with increased rates of hepatic O2 uptake was not altered by iron treatment, whereas iron enhanced serum and liver iron levels independently of T3. Liver thiobarbituric acid reactants formation increased by 5.8-, 5.7-, or 11.0-fold by T3, iron, or their combined treatment, respectively. Iron enhanced the content of protein carbonyls independently of T3 administration, whereas glutathione levels decreased in T3- and iron-treated rats (54%) and in T3Fe-treated animals (71%). Colloidal carbon infusion into perfused livers elicited a 109% and 68% increase in O2 uptake in T3 and iron-treated rats over controls. This parameter was decreased (78%) by the joint T3Fe administration and abolished by gadolinium chloride (GdCl3) pretreatment in all experimental groups. Hyperthyroidism and iron overload did not modify the sinusoidal efflux of lactate dehydrogenase, whereas T3Fe-treated rats exhibited a 35-fold increase over control values, with a 54% reduction by GdCl3 pretreatment. Histological studies showed a slight increase in the number or size of Kupffer cells in hyperthyroid rats or in iron overloaded animals, respectively. Kupffer cell hypertrophy and hyperplasia with presence of inflammatory cells and increased hepatic myeloperoxidase activity were found in T3Fe-treated rats. It is concluded that hyperthyroidism increases the susceptibility of the liver to the toxic effects of iron, which seems to be related to the development of a severe oxidative stress status in the tissue, thus contributing to the concomitant liver injury and impairment of Kupffer cell phagocytosis and particle-induced respiratory burst activity.
Subject(s)
Hyperthyroidism/metabolism , Iron Overload/metabolism , Kupffer Cells/metabolism , Oxidative Stress , Animals , Hyperthyroidism/pathology , Iron Overload/pathology , Kupffer Cells/pathology , Male , Oxygen Consumption , Rats , Rats, Sprague-Dawley , Triiodothyronine/metabolism , Triiodothyronine/pharmacologyABSTRACT
Enterohemorrhagic escherichia coli (EHEC) has been recognized as the main etiologic agent of hemorrhagic colitis and hemolytic uremic syndrome (HUS). The usefulness of antibiotic treatment in patients with EHRC infections is a matter of current debate. Knowledge on EHEC antimicrobial susceptibility patterns in different geographic areas is important for both treatment considerations and for strain characterization. We studied by diffusion disk agar technique the antibiotic susceptibility of 83 EHEC strains obtained from stools of patients with HUS or diarrhea. Eleven antimicrobials were tested (ampicillin, cotrimoxazole, tetracycline, chloramphenicol, furazolidone, gentamycin, amikacin, ciprofloxacin, erythromycin, vancomycin and metronidazol). Resistant strains by disk diffusion were tested for MIC (mg/ml) by agar dilution. SLT-I and SLT-II were detected with specific biotinylated gene probes. All 83 strains were susceptible to furazolidone, ciprofloxacin, gentamycin and amikacin. Resistance was detected to tetracycline 4 percent, chloramphenicol 5 percent, cotrimoxazole 24 percent and ampicillin 25 percent. As expected for EHEC strains all were resistant to erythromycin, vancomycin and metronidazol. Resistant strains were significantly more common in non toxigenic and SLT-I producing strains (p=0.01). Resistant strains were similarly distributed among patients who had diarrhea only and those who developed HUS (p=0.3). In Chile, resistant EHEC strains seem to be more common and of different genotypes than those reported in more developed countries. Regional differences of EHEC antibiotic susceptibility patterns indicate a need for continious monitoring, specially if antibiotic prove to be useful in disease prevention
