Frequency of BRAF V600E immunoexpression in ameloblastomas: a multi-institutional analysis of 86 cases in Latin America and comprehensive review of the literature.

BACKGROUND: Paracoccidioidomycosis (PCM) is the leading cause of death among systemic mycoses in Brazil. On the other hand, oral squamous cell carcinoma (OSCC) is the most prevalent malignant neoplasm of the mouth. Both lesions rarely affect the tongue dorsum and may share similar clinical characteristics. This study aimed to retrieve cases of single oral ulcers diagnosed as PCM or OSCC. MATERIAL AND METHODS: A cross-sectional retrospective study was conducted. All patients who had a single ulcer on dorsum of the tongue and confirmed diagnosis of PCM or OSCC were evaluated. RESULTS: A total of 9 patients (5 women and 4 men) were evaluated, 5 patients had OSCCs (mean age = 69,8 years old), and 4 patients PCM (mean age = 51 years old). Most of the lesions were infiltrated and indurated in the palpation exam. Duration ranged from 1 to 12 months (mean time of 5.2 months and 4.7 months for OSCC and PCM, respectively). OSCC was the main clinical diagnosis hypothesis. CONCLUSIONS: Although uncommon, PCM and OSCC should be considered as a differential diagnosis hypothesis in infiltrated ulcers on the tongue dorsum. Incisional biopsy is mandatory to confirm the diagnosis and indicate the appropriate treatment.

Is teriparatide therapy effective for medication-related osteonecrosis of the jaw? A systematic review and meta-analysis.

Considering the lack of studies determining the real TPTD efficacy in individuals who develop MRONJ, our objective was to combine the available data on MRONJ cases treated with TPTD. The findings demonstrated that TPTD in combination with another therapy, especially antibiotic therapy, can be considered an effective protocol for MRONJ. PURPOSE: To integrate the data published on the effect of teriparatide (TPTD) therapy on cases of medication-related osteonecrosis of the jaws (MRONJ) into a comprehensive analysis of clinical features. METHODS: An electronic search was undertaken in six databases. Descriptive analyses of clinicodemographic data of MRONJ were carried out. Poisson regression was also run to evaluate predictors of total resolution of MRONJ treated with TPTD. RESULTS: Twenty-six publications comprising 111 cases were included. Most reported cases affected female individuals (82.0%) with a mean age of 76.54 years. Osteoporosis (76.5%) represented the main reason for using antiresorptive drugs, with bisphosphonates (98.1%) as the most frequently reported. Comorbidities were commonly present. The most related trigger factor of MRONJ was dental extraction (61.7%). Mandible (75.8%) was the most commonly affected site, with a mean evolution time of 5 months. MRONJ stage 2 (61.3%) was the most prevalent. Regarding TPTD treatment, in 45.1% cases, TPTD was used alone, with the total resolution being observed in 59.5% of the individuals. Associated therapy (54.9%) included surgery, antibiotic therapy, and laser therapy. Mean follow-up was 8.7 months. Poisson regression demonstrated that individuals with MRONJ stage 1 were 1.21 times more likely to present total resolution of osteonecrosis than individuals with MRONJ stage 3 (CI = 1.02-1.43; p < 0.023). Individuals who had undergone treatment with TPTD in association with another therapeutic modality were 1.21 times more likely to present total resolution of osteonecrosis than those who had undergone treatment with TPTD alone (CI = 1.40-1.39; p < 0.010). CONCLUSION: TPTD in combination with another therapy, especially antibiotic therapy, should be considered an effective therapeutic modality for MRONJ.

Forty cases of acquired oral syphilis and a review of the literature.

The aim of this study was to describe 40 cases of acquired oral syphilis (AOS) and to discuss the distribution of demographic characteristics, clinical features, and differential diagnosis of the disease. A retrospective study was conducted covering a 17-year period at a single institution in southern Brazil. Moreover, a literature review was performed through a search of the PubMed database for articles on AOS published between 1955 and March 2018. Data were analyzed descriptively. The predominant group within the case series was male patients in their twenties. The vast majority of cases (92.5%) were in the secondary stage of the disease. The lips were the most commonly affected site, with greyish-white mucous patches and reddish ulcers. In the literature review, the largest number of reported cases came from North America. Male patients in the third and fourth decades of life were most affected. AOS occurred more commonly as mucous patches and ulcers on the tongue and palate. Similarities regarding the distribution by sex, age, and anatomical location were found in the present study when compared to cases reported elsewhere. Clinicians, oral pathologists, and maxillofacial surgeons should familiarize themselves with the variable spectrum of signs and symptoms of AOS in their clinical practice to improve diagnosis and management.

In vitro activity of disinfectants against Aspergillus spp.

Fungi of the Aspergillus genus are widespread and contaminate the environment. Thousands of conidia are released from each phialide and dispersed in the air every day. These fungi are considered important mycose-causing agents in hospitals. Due to this, research to determine prevalent fungi from the Aspergillus genus in hospital environments, and an adequate disinfection program in these areas is are needed. This study evaluated the susceptibility of Aspergillus spp. isolated from a veterinary environment against four disinfectants. Successive dilutions of disinfectants (log2) were used according to CLSI M38-A2 microdilution technique adapted to chemical agents against 18 isolates of this genus. After 72 hours of incubation, the Minimum Inhibiting Concentration and Minimum Fungicidal Concentration capable of inhibiting 50% and 90% of the isolates were determined. Chlorexidine-cetrimine, benzalconium chloride and a chlorophenol derivative proved to be effective against all isolates with a lower MIC than that suggested by the manufacturer, except for the A. flavus strain. Sodium hypochlorite was ineffective against three A. fumigatus, three A. flavus and one A. niger isolate. These results demonstrated that all studied disinfectants were effective against environmental isolates, with the exception of sodium hypochlorite, which showed lower effectiveness.

In vitro activity of disinfectants against Aspergillus spp

Fungi of the Aspergillus genus are widespread and contaminate the environment. Thousands of conidia are released from each phialide and dispersed in the air every day. These fungi are considered important mycose-causing agents in hospitals. Due to this, research to determine prevalent fungi from the Aspergillus genus in hospital environments, and an adequate disinfection program in these areas is are needed. This study evaluated the susceptibility of Aspergillus spp. isolated from a veterinary environment against four disinfectants. Successive dilutions of disinfectants (log2) were used according to CLSI M38-A2 microdilution technique adapted to chemical agents against 18 isolates of this genus. After 72 hours of incubation, the Minimum Inhibiting Concentration and Minimum Fungicidal Concentration capable of inhibiting 50% and 90% of the isolates were determined. Chlorexidine-cetrimine, benzalconium chloride and a chlorophenol derivative proved to be effective against all isolates with a lower MIC than that suggested by the manufacturer, except for the A. flavus strain. Sodium hypochlorite was ineffective against three A. fumigatus, three A. flavus and one A. niger isolate. These results demonstrated that all studied disinfectants were effective against environmental isolates, with the exception of sodium hypochlorite, which showed lower effectiveness.

In vitro activity of disinfectants against Aspergillus spp

Fungi of the Aspergillus genus are widespread and contaminate the environment. Thousands of conidia are released from each phialide and dispersed in the air every day. These fungi are considered important mycose-causing agents in hospitals. Due to this, research to determine prevalent fungi from the Aspergillus genus in hospital environments, and an adequate disinfection program in these areas is are needed. This study evaluated the susceptibility of Aspergillus spp. isolated from a veterinary environment against four disinfectants. Successive dilutions of disinfectants (log2) were used according to CLSI M38-A2 microdilution technique adapted to chemical agents against 18 isolates of this genus. After 72 hours of incubation, the Minimum Inhibiting Concentration and Minimum Fungicidal Concentration capable of inhibiting 50% and 90% of the isolates were determined. Chlorexidine-cetrimine, benzalconium chloride and a chlorophenol derivative proved to be effective against all isolates with a lower MIC than that suggested by the manufacturer, except for the A. flavus strain. Sodium hypochlorite was ineffective against three A. fumigatus, three A. flavus and one A. niger isolate. These results demonstrated that all studied disinfectants were effective against environmental isolates, with the exception of sodium hypochlorite, which showed lower effectiveness.(AU)

Eficácia da clorexidina-cetrimida na desinfecção ambiental contra Aspergillus spp. / Chlorexidine-cetrimide efficacy in ambient disinfection against Aspergillus spp

Avaliou-se a ação in loco da clorexidina-cetrimida no controle de Aspergillus spp., considerando-se a influência de fatores climáticos e populacionais, em um centro de recuperação de animais marinhos. Durante dois anos, realizaram-se colheitas de amostras de ar por meio da técnica de sedimentação, com implantação no segundo ano de um programa de desinfecção com clorexidina-cetrimida. Os resultados do isolamento fúngico nos dois anos foram comparados estatisticamente pelo programa Epinfo 8.0. Demonstrou-se que o isolamento de Aspergillus spp. não apresentou relação significativa com fatores climáticos e populacionais e que a diminuição da concentração de conídios de Aspergillus spp. do ambiente ocorreu devido ao programa eficaz de desinfecção com a clorexidina-cetrimida.

The study evaluated the in loco activity of chlorexidine-cetrimide for environmental control of Aspergillus spp. considering the climatic influence and population variations, in a recuperation center of marine animals. Samples of air were collected throughout two years by the sediment method, and the disinfection program was established in the second year. Data collected during the two years were statistically compared by Epinfo 8.0. program. It was demonstrated that both population and climate had no influence on the fungal isolation, and the disinfection program with chlorexidine-cetrimide was considered effective in the reduction of conidia Aspergillus concentration indoor.

Eficácia da clorexidina-cetrimida na desinfecção ambiental contra Aspergillus spp / Chlorexidine-cetrimide efficacy in ambient disinfection against Aspergillus spp

Avaliou-se a ação in loco da clorexidina-cetrimida no controle de Aspergillus spp., considerando-se a influência de fatores climáticos e populacionais, em um centro de recuperação de animais marinhos. Durante dois anos, realizaram-se colheitas de amostras de ar por meio da técnica de sedimentação, com implantação no segundo ano de um programa de desinfecção com clorexidina-cetrimida. Os resultados do isolamento fúngico nos dois anos foram comparados estatisticamente pelo programa Epinfo 8.0. Demonstrou-se que o isolamento de Aspergillus spp. não apresentou relação significativa com fatores climáticos e populacionais e que a diminuição da concentração de conídios de Aspergillus spp. do ambiente ocorreu devido ao programa eficaz de desinfecção com a clorexidina-cetrimida.(AU)

The study evaluated the in loco activity of chlorexidine-cetrimide for environmental control of Aspergillus spp. considering the climatic influence and population variations, in a recuperation center of marine animals. Samples of air were collected throughout two years by the sediment method, and the disinfection program was established in the second year. Data collected during the two years were statistically compared by Epinfo 8.0. program. It was demonstrated that both population and climate had no influence on the fungal isolation, and the disinfection program with chlorexidine-cetrimide was considered effective in the reduction of conidia Aspergillus concentration indoor.(AU)

Atividade in vitro do óleo essencial de Origanum vulgare frente à Sporothrix Schenckii / In vitro activity of the essential oil of Origanum vulgare against Sporothrix schenckii

In vitro activity of the essential oil Origanum vulgare against Sporothrix schenckii was determined by the MIC (Minimum Inhibitory Concentration). For this, seven samples of S. schenckii were studied, two isolated from two cases of human sporotrichosis and five isolated from cats. Analysis of the essential oil was carried out in a gas chromatograph (GC/FID) for the identification and quantification of thymol and carvacrol (antifungal agents). MIC was obtained based on the microdilution method according to the adapted document NCCLS-M 27A2 for fitopharmacy. All the isolates presented sensibility to the essential oil. S. schenckii was inhibited in a concentration of 0.25 percent (250m l/ml). Chromatographic analysis showed that thymol concentration was bigger than carvacrol. The antifungal activity demonstrated by the essential oil of O. vulgare against S. Schenckii stimulates the accomplishment of more studies, including in vivo studies.

Atividade in vitro do óleo essencial de Origanum vulgare frente à Sporothrix Schenckii / In vitro activity of the essential oil of Origanum vulgare against Sporothrix schenckii

In vitro activity of the essential oil Origanum vulgare against Sporothrix schenckii was determined by the MIC (Minimum Inhibitory Concentration). For this, seven samples of S. schenckii were studied, two isolated from two cases of human sporotrichosis and five isolated from cats. Analysis of the essential oil was carried out in a gas chromatograph (GC/FID) for the identification and quantification of thymol and carvacrol (antifungal agents). MIC was obtained based on the microdilution method according to the adapted document NCCLS-M 27A2 for fitopharmacy. All the isolates presented sensibility to the essential oil. S. schenckii was inhibited in a concentration of 0.25 percent (250m l/ml). Chromatographic analysis showed that thymol concentration was bigger than carvacrol. The antifungal activity demonstrated by the essential oil of O. vulgare against S. Schenckii stimulates the accomplishment of more studies, including in vivo studies.(AU)

Atividade in vitro de três agentes químicos frente a diferentes espécies de aspergillus

ABSTRACT Aspergillosis is caused by ubiquitous and opportunist moulds of the genus Aspergillus, which contaminate the atmosphere by liberating thousands of conidia in the air, making it extremely important to use air filters and to implement proper programs of antisepsis and disinfection for the prevention of this disease. This study evaluated the in-vitro effectiveness of the chemical agents iodophor, quaternary ammonia and chlorexidine against A. fumigatus (8), A. niger (8), A. flavus (6) and A. terreus (1). Successive dilutions of disinfectants/antiseptics (log2) were prepared in RPMI for the test, and the suspension was adjusted until a final concentration of 5 x 104 UFC/mL. The microdilution test was done in agreement with NCCLS M-38 adapted for chemical agents, with microplates incubation at 35° C in constant agitation. The visual results were evaluated after 96 hours, and all Aspergillus spp. isolates used were resistant to iodophor at all concentrations tested. Quaternary ammonia and chlorexidine showed effectiveness against Aspergillus spp. isolates, except for one A. fumigatus and one A. terreus. According to these results the use of quaternary ammonia and chlorexidine is indicated for the prevention of aspergillosis, while the use of iodophor is questionable.

RESUMO A aspergilose é causada por fungos ubíquos e oportunistas do gênero Aspergillus, que liberam milhares de conídios no ar, contaminando o ambiente, sendo de extrema importância a utilização de filtros de ar e programas corretos de anti-sepsia e desinfecção para prevenção da enfermidade. Este estudo avaliou a eficácia in vitro dos agentes químicos, iodóforo, amônia quaternária e clorexidina, frente a isolados de Aspergillus fumigatus (8), Aspergillus niger (8), Aspergillus flavus (6) e Aspergillus terreus (1). Para o teste foram preparadas diluições sucessivas dos desinfetantes/antisépticos (log2) em caldo RPMI, e os inóculos foram ajustados até uma concentração final de 5 x 104 UFC/mL. Foi realizada a técnica de microdiluição em caldo de acordo com NCCLS M-38, adaptada para agentes químicos, com incubação das microplacas a 35° C em agitação constante. A leitura visual dos resultados foi realizada após 96 horas, e os isolados de Aspergillus spp. utilizados foram resistentes ao iodóforo nas concentrações testadas. A amônia quaternária e a clorexidina mostraram-se eficazes contra os isolados de Aspergillus spp., com exceção de um A. fumigatus e um A. terreus. Com estes resultados indica-se a utilização da amônia quaternária e da clorexidina na prevenção da aspergilose, questionando-se o uso de iodóforos para este fim.

Felino doméstico como transmissor da esporotricose em trabalhador rural- relato de caso

ABSTRACT Sporotrichosis is a mycosis caused by the geophilic fungus Sporothrixschenckii that can infect different species of animals, including humans. The mycosis has a worldwide distribution, mainly in the tropical and subtropical regions. The infection is usually associated with the traumatic inoculation of soil, vegetables or organic materials contaminated by the fungus, being, therefore, considered an occupational mycosis, affecting mainly rural workers. The zoonotic potential of the domestic feline has been recognized since the 1980s, due to the presence of a great number of microorganisms present in this animal species. Concerning the important epidemiological role of the domestic feline, this study describes a case of cutaneous sporotrichosis with ascendant lymphangitis in a rural worker contaminated by an asymptomatic feline. One 40-year-old human male presented nodular injuries 15 days after being scratched by a cat. Samples of lesion exudates were collected for mycological analysis, which resulted in the isolation of the S. schenckii. After the diagnostic confirmation of sporotrichosis, treatment with cetoconazol was started, which resulted in the regression of the lesions. This study emphasizes the importance of the domestic feline as an important carrier of the sporotrichosis agent for humans.

RESUMO A esporotricose é uma micose causada pelo fungo geofílico Sporothrix schenckii que pode infectar diferentes espécies de animais, inclusive o homem. A micose tem distribuição mundial, principalmente nas regiões tropicais e subtropicais. A infecção está, normalmente, associada com a inoculação traumática de solo, vegetais ou materiais orgânicos contaminados pelo fungo, sendo, portanto, considerada uma micose ocupacional, afetando, principalmente trabalhadores rurais. O potencial zoonótico do felino doméstico tem sido reconhecido desde a década de 80, possivelmente devido ao grande número do organismo presente nessa espécie animal. Em vista do importante papel epidemiológico do felino doméstico, este estudo descreve um caso de esporotricose cutânea com linfangite ascedente em um trabalhador rural contaminado por um felino assintomático. Um humano, com 40 anos, do sexo masculino, apresentou lesões nodulares 15 dias após ter sido arranhado por um gato hígido. Foram coletadas amostras de exsudato das lesões para análise micológica, a qual resultou no isolamento do S. schenckii. Após a confirmação do diagnóstico de esporotricose, foi iniciado o tratamento com o cetoconazol que resultou na regressão das lesões. O estudo ressalta a importância do felino doméstico como importante carreador do agente da esporotricose para o homem.

Neorickettsia (ehrlichia) risticii no sul do brasil: heleobia spp. (mollusca: hydrobilidae) e parapleurolophocecous cercariae (trematoda: digenea) como possíveis vetores / Neorickettsia (ehrlichia) risticii in southern brazil: heleobia spp. (mollusca: hydrobilidae) and parapleurolophocecous cercariae (trematoda: digenea) as possible vectors

RESUMO Para pesquisa de possíveis vetores envolvidos na transmissão da erliquiose monocítica eqüina (EME) no Rio Grande do Sul, Brasil, caramujos dulciaquícolas dos gêneros Drepanotrema, Physa, Pomacea, Biomphalaria e Heleobia foram coletados em propriedades com histórico de ocorrência de EME localizadas nos Municípios de Rio Grande, Arroio Grande e Santa Vitória do Palmar, extremo sul do Estado. A Neorickettsia (Ehrlichia) risticii foi detectada através de PCR em uma freqüência de 13,33%, em caramujos do gênero Heleobia (H. piscium, H. parchappei e H. davisi). Nesses caramujos, estágios de cercárias e rédias de um trematódeo não identificado foram encontrados. Cercárias emergidas de H. piscium foram classificadas como Parapleurolophocercous cercariae. Esses trematódeos testados por PCR foram positivos para N. risticii em 20% das amostras. Com esses resultados pode-se afirmar que a N. risticii está no ambiente veiculada por caramujos do gênero Heleobia presentes em canais de irrigação e rios da região costeira da Lagoa Mirim, e em trematódeos portados por eles.

ABSTRACT In order to study possible vectors involved in the transmission of Equine monocytic Ehrlichiosis (EME) in Rio Grande do Sul state, Brazil, fresh water snails were collected from establishments with a history of EME occurrence. The snails were collected from the area of Rio Grande, Santa Vitoria and Arroio Grande counties. Snails belonging to the genera Drepanotrema, Physa, Pomacea, Biomphalaria, and Heleobia were found. Neorickettsia (Ehrlichia) risticii were detected in 13.33% of the snails of the genus (Heleobia H. piscium, H. parchappei, H. davisi) using the PCR method, but not in the other genera. In these snails we found cercariae that were classified as Parapleurolophocercous cercariae. It was observed that 20% of the P. cercariae were positive for N. risticii by PCR. Based in our observations we concluded that N. risticii is present in this area of Brazil. Also, we can suggest that its transmission is mediated by the snail of genus Heleobia since this snail harbors the trematode and is present in irrigation channels, rivers and in the coastal area of Mirim Lake.

Equine monocytic Ehrlichiosis (Potomac horse fever) in horses in Uruguay and southern Brazil.

A disease named locally as churrío or churrido equino (i.e., equine scours) has occurred for at least 100 years in Uruguay and southern Brazil in farms along both shores of the Merín lake. This report describes cases of churrido equino and provides serologic, pathologic, and DNA-based evidence indicating that the disease is in fact equine monocytic ehrlichiosis (Potomac horse fever). Results of an epidemiological investigation conducted on an endemic farm are also presented. Clinical signs in 12 horses were fever, depression, diarrhea, dehydration, and sometimes colic and distal hind limb edema. Postmortem findings of 3 horses were of acute enterocolitis. Inclusion bodies containing ehrlichial organisms were found in the cytoplasm of macrophages of the large colon of 1 horse. Eleven of the 12 horses were serologically positive to Ehrlichia risticii (indirect fluorescent antibody assay) and, of 3 paired samples, 2 showed seroconversion. Ehrlichia risticii DNA was identified by a nested polymerase chain reaction in peripheral blood of an affected horse. A healthy horse inoculated with peripheral blood from an affected horse developed the disease and antibodies to E. risticii. The disease had a peak incidence in March (summer) and was statistically associated with a marshy ecosystem near the Merín lake, where large numbers of Pomacea spp. (Ampullariidae) snails were found. Incidence density was almost 8 times higher in nonnative horses than in native horses. It was concluded that the previous diarrheic disease of horses known in Uruguay and southern Brazil as churrido equino is equine monocytic ehrlichiosis.