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1.
J Mycol Med ; 30(3): 101009, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32620497

ABSTRACT

Chronic renal disease patients under chronic dialysis (CRDD) have a multifactorial immunological deterioration with an increased risk of Candida infections. Incidence of Candida infections is increasing. Choice of suitable antifungal agents is limited due to the resistance of some species to several antifungals. Aim of the present study was to identify the distribution and antifungal susceptibility patterns of oral isolated Candida species from infected and colonized patients, as well as to investigate the risk factors for oral infection in patients on dialysis. Cross-sectional study, approved by the institutional bioethics committees was performed in CRDD patients. Demographic, clinic data, and oral mucosa samples were obtained. Infection diagnosis was established clinically and confirmed with exfoliative cytology, each sample was plated on CHROMagar Candida and incubated at 36°C for 2 days. Yeast species were identified by carbohydrate assimilation ID 32C AUX system and the apiweb database. For the antifungal susceptibility test, the M44 A-3 method (CLSI) using fluconazole (FCZ), miconazole (MCZ), nystatin (NYS), and voriconazole (VCZ). Study included 119 participants, the main cause of CRD was nephropathy due to DM2 (58%), and three-fourths of the patients were under hemodialysis. Candida prevalence was 56.3% of 67 colonized or infected patients, 88 isolates were obtained. Principal identified species were C. albicans (51.1%), C. glabrata (25%), and C. tropicalis (14.8%). C. glabrata showed a reduced response to FCZ in 50% of isolates and C. albicans had a reduced response in 16% of the isolates. Antifungal agent with the least efficacious response or with the lowest susceptibility in the isolates of these patients was MCZ, followed by VCZ and FCZ, whereas NYS induced the best antifungal response.


Subject(s)
Antifungal Agents/pharmacology , Candida/drug effects , Candida/isolation & purification , Candidiasis, Oral/microbiology , Mouth/microbiology , Renal Insufficiency, Chronic/microbiology , Adult , Aged , Aged, 80 and over , Candida/classification , Candidiasis, Oral/complications , Candidiasis, Oral/diagnosis , Candidiasis, Oral/epidemiology , Cross-Sectional Studies , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/microbiology , Diabetes Mellitus, Type 2/therapy , Diabetic Nephropathies/epidemiology , Diabetic Nephropathies/microbiology , Diabetic Nephropathies/therapy , Drug Resistance, Fungal/drug effects , Female , Humans , Male , Mexico/epidemiology , Microbial Sensitivity Tests , Middle Aged , Renal Dialysis/adverse effects , Renal Dialysis/statistics & numerical data , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/therapy , Young Adult
2.
Nefrologia ; 29(5): 474-8, 2009.
Article in Spanish | MEDLINE | ID: mdl-19820760

ABSTRACT

AIM: To assess gingival overgrowth prevalence and severity in a group of kidney transplant (KT) patients, and analyze the effect of immunosuppressor drugs Cyclosporin A (CsA), Tacrolimus (Tac), Sirolimus (Siro), Azathioprine (Aza) and Mofetil Mycophenolate on this complication. METHODS: Gingival overgrowth presence and severity was classified, and the impact of immunosuppressor drugs, age, oral hygiene, verapamil and nifedipine on this condition was analyzed by multiple logistic regression. RESULTS: 172 KT pts. were examined; 137 used CsA, 25 Tac, 6 Sirolimus, 107 Aza and 56 MMF. Gingival overgrowth prevalence was 59.1% on CsA, 12.0% on Tac, and 16.7% on Sirolimus. CsA odds ratio (OR) 15.2, age <45 OR 5.6, and poor oral hygiene OR 3.2, increased, and Aza OR 0.05 and MMF OR 0.03, decreased GO prevalence. CONCLUSIONS: Aza and MMF effect was a significant protection against GO prevalence in this group of KT patients.


Subject(s)
Azathioprine/adverse effects , Cyclosporine/adverse effects , Gingival Hypertrophy/chemically induced , Immunosuppressive Agents/adverse effects , Kidney Transplantation , Mycophenolic Acid/analogs & derivatives , Adult , Cross-Sectional Studies , Female , Gingival Hypertrophy/epidemiology , Humans , Male , Mycophenolic Acid/adverse effects , Severity of Illness Index
3.
Oral Oncol ; 38(5): 460-7, 2002 Jul.
Article in English | MEDLINE | ID: mdl-12110340

ABSTRACT

In this double-blind, randomized trial, we compared the clinical efficacy of intralesional vinblastine (VNB) and 3% sodium tetradecyl sulfate (STS) in the treatment of oral Kaposi's sarcoma (OKS). Subjects with OKS were randomly assigned to receive a single intralesional injection of either VNB or STS, at a standard dose (0.2 mg/cm(2)). Differences were evaluated by the Mann-Whitney U and Fisher's exact tests. Sixteen HIV-infected patients were included, eight received VNB and eight received STS; clinical response was evaluated at days 7, 14, and 28 following treatment. Tumor size reduction was 0.68 and 0.61 cm in the VNB and STS groups, respectively (P=0.80). Two VNB patients had complete or partial response whereas four STS subjects had partial responses (P=0.61). Patients in both groups experienced minimal toxicity. We conclude that intralesional vinblastine or STS are adequate for the management of OKS. The benefits of STS are its low cost and ease of use.


Subject(s)
Antineoplastic Agents, Phytogenic/therapeutic use , Mouth Neoplasms/drug therapy , Sarcoma, Kaposi/drug therapy , Sclerosing Solutions/therapeutic use , Sodium Tetradecyl Sulfate/therapeutic use , Vinblastine/therapeutic use , Adult , Double-Blind Method , Follow-Up Studies , HIV Infections/complications , Humans , Injections, Intralesional , Male , Middle Aged , Mouth Neoplasms/complications , Sarcoma, Kaposi/complications , Treatment Outcome
4.
Int J Paediatr Dent ; 9(2): 129-32, 1999 Jun.
Article in English | MEDLINE | ID: mdl-10530223

ABSTRACT

A case of leiomyomatous hamartoma located on the anterior third of the tongue in an otherwise healthy 6-year-old boy is reported. The lesion had been present since birth as an asymptomatic, pedunculated tubular tumour. The lesion was surgically excised and histopathological examination disclosed a non-neoplastic mass composed of irregularly arranged bundles of smooth muscle embedded in a fibrovascular stroma. No recurrence was observed after 1 year of follow-up.


Subject(s)
Hamartoma/pathology , Tongue Diseases/pathology , Child , Humans , Male , Muscle, Smooth/cytology
5.
Article in English | MEDLINE | ID: mdl-8784896

ABSTRACT

This report describes a case of secondary syphilis in a patient with the human immunodeficiency virus (HIV) in whom the main clinical presentation of the disease was an extensive oral lesion. Few reports in the literature have focused on oral manifestations of syphilis in HIV-infected patients; most of these reports have dealt with a rare manifestation of secondary syphilis, the ulceronodular variety or lues maligna. However, in the case reported here the lesions were painless, smooth, white, oral plaques and papules on an erythematous base with a serpentine and reddish outline corresponding to the description of mucous patches. The differential diagnosis of this lesion may include oral squamous carcinoma, leukoplakia, erythroleukoplakia, candidosis, lichen planus, and granulomatous diseases. This case report emphasizes the importance of considering secondary syphilis in the differential diagnosis of oral lesions in HIV-infected patients, reinforces the importance of follow-up on the patient, and highlights the consideration for routine serologic testing for syphilis in all HIV-infected patients.


Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Mouth Diseases/etiology , Syphilis/etiology , Adult , Candidiasis, Oral/diagnosis , Diagnosis, Differential , Disease Progression , Humans , Male , Mouth Diseases/diagnosis , Mouth Diseases/microbiology , Mouth Diseases/pathology , Syphilis/diagnosis , Syphilis/pathology
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