Oral paracoccidioidomycosis in a single-center retrospective analysis from a Brazilian southeastern population.

BACKGROUND: Paracoccidioidomycosis (PCM) is the most prevalent endemic systemic fungal infection in Latin America. In Brazil, it stands out as the eighth-highest cause of mortality among chronic or recurrent infections and has the highest mortality rate among systemic mycoses. Oral mucosal lesions may be the first visible physical manifestation of the disease. This study traced the epidemiological and clinical profiles of patients with oral lesions treated at the University Hospital Cassiano Antonio Moraes, Federal University of Espirito Santo. METHODS: A retrospective cross-sectional analysis of patient medical records was performed. RESULTS: Among the 161 patients identified with a confirmed diagnosis of PCM, 97 (60.24%) presented with oral lesions. The male:female ratio was 15:1, the mean age was 50.5 years, and the chronic form of paracoccidioidomycosis was predominant. Most of the patients had smoking habits and were rural workers. The most common oral lesions present in various anatomical sites were mulberry-like ulcers, more frequently observed in the gingiva, with regression within one to three months. Patients completed the treatment in one to two years (32.99%), and 47.42% of cases discontinued treatment. CONCLUSIONS: In addition to the characteristics of the oral lesions, information from the clinical profiles of patients with oral PCM is a central tool for dentists for early diagnosis. Earlier diagnosis may result in fewer consequences, especially respiratory ones that may cause an inability to work and poor quality of life.

Cardiorespiratory, sedative and antinociceptive effects of dexmedetomidine alone or in combination with methadone, morphine or tramadol in dogs.

OBJECTIVE: To evaluate the cardiorespiratory, sedative and antinociceptive effects of dexmedetomidine alone or in combination with methadone, morphine or tramadol in dogs. STUDY DESIGN: Experimental, blinded, randomized, crossover study. ANIMALS: Six mixed breed dogs (two males and four females) weighing 10 ± 4 kg. METHODS: The animals were randomly divided into four treatments: D (10 µg kg(-1) of dexmedetomidine), DM (dexmedetomidine 10 µg kg(-1) and methadone 0.5 mg kg(-1)); DMO (dexmedetomidine 10 µg kg(-1) and morphine 0.5 mg kg(-1)), and DT (dexmedetomidine 10 µg kg(-1) and tramadol 2 mg kg(-1)). The combinations were administered intramuscularly in all treatments. The variables evaluated were heart rate (HR), respiratory rate (f(R)), rectal temperature (RT), systolic arterial pressure (SAP), sedation scale and pedal withdrawal reflex. These variables were measured at T0 (immediately before the administration of the protocol) and every 15 minutes thereafter until T105. RESULTS: A decrease in HR and f(R) occurred in all the treatments compared with T0, but no significant difference was observed between the treatments. The RT decreased from T45 onward in all the treatments. The SAP did not show a difference between the treatments, but in the DT treatment, the SAP was lower at T30 and T45 compared with T0. The D treatment had lower scores of sedation at T15 to T75 compared with the other treatments, and the DMO and DM treatments showed higher scores at T60 and T75 compared with DT. CONCLUSIONS AND CLINICAL RELEVANCE: The treatments with morphine and methadone added to the dexmedetomidine showed higher sedation scores than the control treatment and the treatment with tramadol added to the dexmedetomidine showed no relevant differences in any of the variables evaluated in the study.