Erythematous candidosis in patients with complete dentures and HIV+/AIDS.

This investigation was designed to evaluate the frequency of erythematous candidosis (EC) and Candida species, proteinase and phospholipase exoenzyme production, and to compare clinical features in patients with complete dentures and HIV+/Acquired Immunodeficiency Disease Syndrome (AIDS). Fifty-one patients were selected from a total of 285 with EC: denture wearers (n = 30) and HIV+/AIDS (n = 21). The yeast prevalence and the production of exoenzymes, such as proteinase and phospholipase by Candida species were evaluated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) electrophoresis. The frequency of Candida albicans was significantly higher (P < 0.05) in both groups although other yeast species (Candida glabrata, Candida krusei, Candida parapsilosis, Candida guilliermondi and Candida tropicalis) were also found. Candida albicans showed greater levels of proteinase production in the denture wearers, when compared with the HIV+/AIDS group. There was no difference between groups with regard to phospholipase production. The protein bands presented similar molecular weights, showing the presence of proteinases in both groups. It could be concluded that the clinical manifestation of EC may be related to its proteinase production capacity. Combination therapies using proteinase inhibitors play an important role in inhibiting exoenzyme production by Candida species, mainly C. albicans.

Occurrence of Helicobacter pylori in dental plaque and saliva of dyspeptic patients.

BACKGROUND: Helicobacter pylori infection in the stomach is associated with gastric and duodenal ulcers, gastric cancers and gastric lymphoma. The organism is transmitted by ingestion, but the oral-oral route and the fecal-oral route are also suggested. The prevalence of infection with H. pylori in developing countries, including Brazil, is higher than in developed countries. PURPOSE: This study aimed to evaluate the role of the oral cavity as a reservoir of this species, by evaluating the occurrence of H. pylori in supragingival dental plaque and in saliva of Brazilian dyspeptic patients, whether harboring the organism or not in the stomach. MATERIAL AND METHODS: Forty-nine patients reporting dyspeptic symptoms were subjected to oral clinical examination and collection of saliva and supragingival dental plaque samples prior to the endoscopic examination. The detection of H. pylori in oral samples was performed by PCR using 16S rRNA primers. The bacteria were detected in stomach by means of the rapid urease test. RESULTS: Helicobacter pylori was detected in the stomach of 20 of 49 subjects reporting dyspeptic symptoms. The organism was detected in only one supragingival plaque sample, obtained from a patient positive for the urease test in the stomach and in none of the salivary samples. CONCLUSION: Supragingival dental plaque and saliva may not be relevant reservoirs of H. pylori.

Hypermethylation of the p16 gene in normal oral mucosa of smokers.

The oral cavity is the sixth most common anatomical localization of head and neck carcinoma in men. Detection of oral carcinomas in the early asymptomatic stages improves cure rates and the quality of life. Tobacco smoking and alcohol drinking are the most important known risk factors for the development of head and neck tumors, suggesting that the exposure to these risk factors may increase the predisposition for genetic and epigenetic alterations, such as DNA methylation. The presence of methylated CpG islands in the promoter region of human genes can suppress their expression due to the presence of 5-methylcytosine that interferes with the binding of transcription factors or other DNA-binding proteins repressing transcription activity. Hypermethylation leading to the inactivation of some tumor suppressor genes, such as p16, has been pointed out as an initial event in head and neck cancer. Our aim was to evaluate an early diagnostic method of oral pre-cancerous lesions through the analysis of methylation of the p16 gene. DNA samples from normal oral mucosa and posterior tongue border from 258 smokers, without oral cancer, were investigated for the occurrence of p16 promoter hypermethylation. The methylation status of the p16 gene was analyzed using MS-PCR (methylation-sensitive restriction enzymes and PCR amplification), MSP (Methylation-specific PCR) or direct DNA sequence of bisulfite modified DNA. Hyper-methylation was detected in 9.7% (25/258) of the cases analyzed. These findings provide further evidence that epigenetic alteration, leading to the inactivation of the p16 tumor suppressor gene is an early event that might confer cell growth advantages contributing to the tumorigenic process. Thus, the detection of abnormal p16 methylation pattern may be a valuable tool for early oral cancer detection.

Relation of oral yeast infection in Brazilian infants and use of a pacifier.

The frequency of oral yeast ingestion and its relationship with sucking and feeding habits was described in children from one to 18 months of age. Yeasts were detected in 58.3 percent of children and the most prevalent species were Candida parapsilosis and Candida albicans. The use of a pacifier was positively associated with the frequency of yeast infection and with the levels of these microorganisms in the mouth. No relationship was detected between the prevalence of yeast and breast-feeding or bottle-feeding habits. The results suggest that use of a pacifier is an important local factor in the colonization and proliferation of yeast in the oral cavity.

Association of unipolar major depressive disorder with genes of the serotonergic and dopaminergic pathways.

Major depressive disorder (MDD) is a severe psychiatric disorder with a lifetime prevalence of about 15%.1 The importance of the genetic component is well accepted,2 but the mode of inheritance is complex and non-Mendelian. A line of evidence suggests the involvement of serotonin and dopamine neurotransmitters in the pathophysiology of depression. In the present study, 102 unipolar MDD patients and 172 healthy controls were genotyped for polymorphisms in four serotonergic and three dopaminergic candidate genes [tryptophan hydroxylase (TPH), serotonin receptor 2A (HTR2A), serotonin receptor 2C (HTR2C), serotonin transporter promoter region (5-HTTLPR), dopamine receptor D4 (DRD4), dopamine transporter (DAT1) and catechol-O-methyl transferase (COMT)]. There were no statistical differences between MDD patients and healthy controls in the genotypic and allelic distribution of all polymorphisms investigated. Thus, our study does not support a major role for these polymorphisms in contributing to susceptibility to MDD, although it does not preclude minor effects.

Natal teeth: review of the literature and report of an unusual case.

An unusual case of a newborn with 12 erupted teeth is presented. Epidemiological, etiological, and therapeutical aspects of this developmental disturbance of dentition is reviewed in order to establish guidelines for the dentist and neonatologist to manage this problem with minimal damage to the future teeth and the patient.

Oral findings in pediatric AIDS: a case control study in Brazilian children.

A cross-sectional study was performed to verify the oral status in forty-one-children, four months to twelve years old, with antibodies anti-HIV detected by ELISA and Western-blot, in comparison to children with no risk for AIDS. Intraoral and extraoral examinations were performed, and dental and medical history was also obtained. Representative oral findings in AIDS group were cervical lymphadenopathy (53.7 percent), pseudomembranous candidosis (22 percent), angular cheilitis (9.8 percent), parotid enlargement (7.3 percent), erythematous candidosis (4.9 percent), and ulcers (4.9 percent). Control group included only two children with cervical lymphadenopathy. Considering the mean values for dmft and DMFT, there were no statistically significant differences (Student's t test) between the two groups (p < 0.05). While oral soft-tissue lesions were frequently observed in HIV antibodies in seropositive children, dental caries could not be associated primarily with AIDS.

Oral manifestations in Rett syndrome: a study of 17 cases.

Seventeen patients with a mean age of 7.33 (range 2.7-12.7) years with Rett syndrome (a progressive neurological disorder that occurs mainly in females) were evaluated for oral manifestations and habits. The most frequent habits were digit/hand sucking and/or biting (17/17), bruxism (14/17), mouth breathing (7/17), drooling (5/17), and tongue thrusting (5/17). Gingivitis (13/17) was the most common alteration of soft tissues. Only 2.7% of tooth surfaces were decayed. Nonphysiological dental attrition was present in 71% (12/17) of the children. Palatal shelving could be observed in 53% (9/17) of the children, probably related to the digit/hand sucking and/or biting habits. A high prevalence of anterior open bite (9/17) was observed. No patients exhibited anomalies of tooth number, size, form, structure, or eruption.

Candida albicans: Frequency and characterization in oral cancer (Stage I) from smokers and drinkers.

The frequency and the biotype of Candida albicans, from patients with epidermoid carcinoma of the oral mucosa (stage I) were evaluated. The patients chosen were habitual drinkers and smokers, aged 34 to 81 years who had not submitted previously to any treatment. They exhibited ulcero-vegetative lesions, mainly on the floor of the mouth, palate and tongue and were classified as stage TNM 100 - TNM 200. Samples from the buccal mucosa were collected for mycological study including: identification of yeasts, serotyping, determination of exo-enzymes as proteinase and phospholipase as well as "killer" assay for biotype characterization. Positive cultives for yeasts were observed in 51.5% of the patients(17/33), being 21.2% represented by C. albicans, all serotype A. The "killer" test demonstrated two different biotypes of C. albicans, namely 211(71.4%) and 611(28.6%), with high levels of proteinase (Prz < 0.30), while phospholipase presented intermediary levels (Pz > 0.29 and =/< 0.69). These data suggested a potentiality to virulence of C. albicans, although did not show an association of a particular biotype with the carcinogenic factors present or with the development of oral epidermoid carcinoma in this initial stage.

Oral manifestations of diabetes mellitus in controlled and uncontrolled patients.

The authors studied the oral manifestations of a sample of 70 diabetic patients, divided into controlled and uncontrolled patients. Medical history and stomatological data were analyzed and diabetic controlled patients were matched to uncontrolled patients. The main symptoms observed were hyposalivation, taste alterations and burning mouth, with the main sign being parotid enlargement. The lesions observed were candidosis of the erythematous type and proliferative lesions both associated to the use of total prosthesis. No pathognomic lesions or alterations could be observed in relation to the disease. The frequency of carriers of Candida albicans and also the lesions observed could be compared to normal patients also using total dentures.

Human papilloma virus--its association with epithelial proliferative lesions.

The Papillomaviruses are DNA viruses which belong to the Papova family, having a great affinity for epithelial tissue. They can produce proliferative lesions either in the skin or mucosa, in man and other animals. Various kinds of lesions, mainly benign, are caused by numerous types of HPV involving the well-known verruca vulgaris, oral papilloma, condiloma acuminatum and the focal epithelial hyperplasia, as well as a possible association with other alterations and lesions.

Oral yeasts in patients with cancer of the mouth, before and during radiotherapy.

The yeasts of patients with oral cancer has been studied before and during Xr-therapy. Gram and PAS smears revealed an increase of yeast-like structures, during treatment, from 56% to 66% of the cases. Before radiotherapy oral yeasts were isolated from 56% of the patients with cancer represented by Candida albicans (30%); C. tropicalis (12%); C. glabrata and C. krusei (4%), besides six other different species (2%). During radiotherapy yeasts were isolated in 72% of the cases, as follow: C. albicans (36%); C. tropicalis (16%); Rhodotorula rubra (6%); C. kefyr; C. krusei and Pichia farinosa (4%), besides other nine species (2%). C. albicans serotype A represented 93% of the isolated samples, before treatment and 88.8% during Xr-therapy.

[Long-term regional (catheter) infusion of anticoagulants and thrombolytics in the treatment of acute and chronic arterial occlusions in patients with thromboangiitis obliterans with severe ischemia of the limbs]. / Dlitel'naia regionarnaia (kateternaia) infuziia antikoaguliantov i trombolitikov v lechenii ostrykh i khonricheskikh okkliuzii arterii u bol'nykh obliteriruiushchim trombangiitom s tiazheloi ishemiei konechnostei.

Catheter heparin therapy combined with the intraarterial infusion of microcrystalline suspensions of antiinflammatory and immunosuppressive agents did not provide elimination of the microcirculation block in the affected limbs of the patients with severe ischemia of the limbs. Thrombolytics used in acute and chronic thromboses in most of cases did not help in complete recanalization of the arteries. Regional thrombolysis conducted before the basic course of the arterial infusion (heparin + immunosuppressants) in patients with distal forms of the arterial affections, promoted a significant improvement of conditions of the regional microcirculation. Application of this method has permitted lowering the rate of limb amputations.

[Evaluation of the histocompatibility of endodontic cement in subcutaneous connective tissue using three methods]. / Estudo da histocompatibilidade de cimento endodôntico no tecido conjuntivo subcutâneo utilizando três methodologias.

It was employed three methods to evaluate the histocompatibility of a root canal filling cement, as the N-Rickert paste: implantation of round glass cover slips, polyethylene tubes and pellets of the cement. The results demonstrated qualitative and quantitative differences among the methods utilized indicating as a good toll the use of glass cover slips covered by the cement, since they provide good conditions of work, major areas of study, as also facilities in obtaining the specimens for study. The pellets didn't simulate the clinical conditions of the cement and the very small areas of study of the polyethylene tubes don't give definitive conclusions.

[Study of some physical and biological properties of an endodontic sealer composed of calcium hydroxide]. / Estudo de propriedades físicas e biológicas de um cimento endodôntico à base de hidróxido de cálcio.

The authors present a study of the physical and biological properties of a new endodontic cement known as Sealapex. In its composition the presence of calcium hydroxide is introduced in order to induce calcification of the periapical tissue. Our results using glass round cover slips implanted on the subcutaneous tissue of mice indicated a persistent foreign body reaction (60 days). The physical properties studied compared to N-Rickert ciment indicated, a decreased leakage. Adhesivity tests didn't give us significant values. Laboratorial studies and clinical trials are necessary to a complete acceptance of this new ciment in endodontic treatment.

A postmortem study of senile amyloidosis of the tongue.

In a postmortem study, the authors examined 50 tongue specimens from old people, in order to detect amyloid deposits. No single case could be detected.

[Disorders of the system of regulation of the aggregative status of the blood in patients with thromboangiitis obliterans of the lower extremities]. / Narusheniia v sisteme reguliatsii agregatnogo sostoianiia krovi u bol'nykh obliteriruiushchim tromboangiitom nizhnikh konechnostei.

Predominantly regional disorders of blood aggregation control, aggravating with the progress of ischemia, were detected in patients with obliterating thromboangiitis of the legs. Local overstrain and exhaustion of compensatory anticoagulation and thrombolytic factors developed in the presence of critical ischemia of the limbs and were accompanied by developing regional prethrombotic state. Regional administration (intra-arterial infusions) of anticoagulants and thrombolytic agents appears to be the most justified line of remedial therapy in these patients.

Experimental paracoccidioidomycosis in high and low antibody-producer mice. I.--Evolution of the disease, its correlation with the humoral immune response and the patterns of tissue lesions.

High (H) and low (L) responder mice selected for their capacity to produce antibody against flagellar antigens of Salmonellae sp. were infected i.p. with 10(6) L forms of Paracoccidioides brasiliensis, strain 18. In H mice, the mortality ratio was 50%; the splenic index was high at the onset of infection (1.0), decreasing to normal levels after 30 days (0.45), with antibody titres such as 4-5 log2. In L mice, the mortality was 87.5%, the splenic index was above 0.6 and the antibody titres after 30 days were below 2 log2. In L mice, granulomas containing a high number of fungi, epithelioid cells, macrophages and a few polymorphonuclear cells were found. In H mice, focal or diffuse infiltrate of mononuclear cells with few or even the absence of fungi was seen. The passive transfer of immune ascitic fluid to L mice induced a reduction in the number of granulomas and fungi in the lesions.

The influence of inflammatory agents on giant cell formation.

The inoculation of live or dead BCG into the pocket formed by the insertion of glass coverslips into the subcutaneous tissue of mice caused a drastic reduction of giant cell formation on the glass surface. Conversely, when carrageenan was used, the number of polykaria increased. Live BCG also induced a decrease in the number of giant cell nuclei, whereas killed bacteria had no effect. In contrast, carrageenan caused the opposite phenomenon. The transformation of foreign body giant cells into Langhans type cells was almost blocked in the presence of live BCG. These data support the concept that inflammatory giant cell formation depends on the rate of macrophage turnover within the lesion.