Oral presentation of 10 patients with Cowden syndrome Flores, Isadora Luana, DDS, MSc; Romo, Saray Aranda, DDS, MSc, PhD; Tejeda Nava, Francisco Javier, DDS, MSc, PhD ...
Oral surgery, oral medicine, oral pathology and oral radiology,
04/2014, Volume:
117, Issue:
4
Journal Article
Peer reviewed
Cowden syndrome (CS) is an autosomal dominant genodermatosis that frequently affects several tissues with hamartomatous growth. The oral cavity is quite commonly involved with papillomatous lesions, ...which can be crucial to early diagnosis of this disease. In this series, 10 patients with a great diversity of manifestations associated with CS are presented, in whom oral papillomatosis was a constant and relevant finding to establish the diagnosis of CS. The role of the dentist in recognizing the oral lesions, the other diagnostic criteria, the risk for the development of malignancies, and the importance of lifetime follow-up are discussed.
Nowadays, consumers, food industries, and researchers have a great interest in evaluating the total antioxidant value of foodstuffs and plasma samples. The 2,2′-azino-bis ...(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical cation scavenging assay is one of the most common antioxidant evaluations. However, this assay shows a great variability in its methodology, e.g., the use of a phosphate buffered saline (PBS) matrix. Moreover, all prior assays did not describe a complete validation procedure. This study demonstrated that the matrix of calibration standards had a significant effect on the accuracy of antioxidant measurements, under the ABTS radical cation scavenging assay. A PBS matrix should only be used in this assay during plasma analysis due to a negative matrix effect on calibration curves. Meanwhile, a PBS-free matrix should be used during analyses of water-based beverages. Our analytical validation showed that the current assay had an inverse lineal relationship, acceptable range, sensitivity, precision, accuracy, short and long-term stability, selectivity, identity, and short time of analysis. Additionally, this study showed that a traditional Southern Mexico beverage (tejate) had antioxidant properties (inhibition of the ABTS radical cation and ability to reduce the ferric ion) due to the presence of polyphenol compounds. The biological relevance was supported by a high plasma antioxidant activity in rats after a 7-day period of tejate consumption.
Graphic abstract
The ferric reducing antioxidant power assay was developed using rat plasma samples and validated according to the Food and Drug Administration guidelines as well as strategies for the lack of ...endogenous compounds-free samples of matrix. For validation procedures, the phosphate buffered saline solution was used as the artificial matrix because this led to a direct interpolation in calibration curves. The absorbance responses and antioxidant activities in curves showed a second order polynomial relationship (
R
2
value = 0.9982). The precision, accuracy, and stability of the method ranged from 1.7 to 7.2%, 89.8 to 100.0%, and 82.7 to 111.6%, respectively. This assay had a short time of analysis (96 samples per min) and absence of interferences during the spectrophotometric monitoring. For the application of the method, the plasma antioxidant capacity, blood distribution of levofloxacin, and biometry hematic were evaluated in samples obtained from rats under different experimental conditions. The in vitro condition applied to blood samples increased the plasma antioxidant capacity and volume of erythrocytes, whereas diminished the levofloxacin concentration in these cells. The high antioxidant activity was produced by a high amount of inosine, which in turn was caused by high oxidative stress leading to an impaired blood distribution of levofloxacin and erythrocyte swelling. This assay is a validated and rapid biomarker for the evaluation of the total antioxidant capacity in plasma samples.
Graphical abstract
We describe the clinical characteristics and outcomes of adults hospitalized with pneumonia during the pandemic (H1N1) 2009 outbreak. Patients admitted to a general hospital in San Luis Potosí, ...Mexico, from April 10 through May 11, 2009, suspected to have influenza virus-associated pneumonia were evaluated. We identified 50 patients with suspected influenza pneumonia; the presence of influenza virus was confirmed in 18: 11 with pandemic (H1N1) 2009 virus, 5 with unsubtypeable influenza A virus, 1 with seasonal influenza A virus (H3N2), and 1 in whom assay results for seasonal and pandemic (H1N1) 2009 viruses were positive. Eighteen patients were treated in the intensive care unit, and 10 died. During the pandemic (H1N1) 2009 outbreak, severe pneumonia developed in young adults who had no identifiable risk factors; early diagnosis and treatment of influenza virus infections may have a determinant role in outcome.
Objective. To evaluate the clinical effect of a probiotic mouthwash in reducing generalized marginal chronic gingivitis using positive and negative control groups. Methodology. Four-week study ...conducted in San Luis Potosí, Mexico, from January to March 2017. Participants were healthy, non-smokers with generalized marginal chronic gingivitis; age range 18-45 years. Subjects were randomized and divided into three groups: Group A: mouthwash based on 0.05% cetylpyridinium chloride (CPC) (positive control); Group B: mouthwash based on probiotics (experimental); Group C: placebo mouthwash (negative control). No oral hygiene practices or routines were modified; subjects were followed for 4 weeks. The primary outcome variable of interest was the Löe and Silness gingival index, and the secondary one, the Quigley Heinn plaque index modified by Turesky. Results. Of the 45 patients included, 19 (42.2%) were men and 26 (57.7%) women, mean age was 22.8±2.07. Each group consisted of 15 subjects; all subjects completed the study. There was no statistically significant reduction in gingival inflammation when comparing the 3 treatment groups (p=0.540) with respect to the gingival index. A comparison was made before and after the treatment and in the 3 groups there was no reduction of the gingival inflammation. Plaque reduction was not statistically significant when comparing the 3 groups (p=0.278). However, when doing intra-group comparison, it was found that the patients in group A had a reduction in plaque index (p<0.005), which was not observed in groups B (p=0.1103) and C (p=0.1508). Conclusions. The use of a probiotic mouth mouthwash did not reduce gingival inflammation or the accumulation of dentobacterial plaque in a period of 4 weeks. There were no statistically significant differences between the study groups.
Neurodegenerative diseases are characterized by the presence of abnormal aggregates of proteins in brain tissue. Among them, the presence of aggregates of phosphorylated Tau protein (p-Tau) is the ...hallmark of Alzheimer's disease (AD) and other major neurodegenerative disorders such as corticobasal degeneration and frontotemporal dementia among others. Although Tau protein has previously been assumed to be exclusive to the central nervous system, it is also found in peripheral tissues. The purpose of this study was to determine whether there is a differential Tau expression in oral mucosa cells according to cognitive impairment. Eighty-one subjects were enrolled in the study and classified per Mini-Mental State Examination test score into control, mild cognitive impairment (MCI), and severe cognitive impairment (SCI) groups. Immunocytochemistry and immunofluorescence revealed the presence of Tau and four p-Tau forms in the cytoplasm and nucleus of oral mucosa cells. More positivity was present in subjects with cognitive impairment than in control subjects, both in the nucleus and cytoplasm, in a speckle pattern. The mRNA expression of Tau by quantitative real-time polymerase chain reaction was higher in SCI as compared with the control group (
< 0.01). A significantly higher percentage of immunopositive cells in the SCI group was found
flow cytometry in comparison to controls and the MCI group (
< 0.01). These findings demonstrate the higher presence of p-Tau and Tau transcript in the oral mucosa of cognitively impaired subjects when compared with healthy subjects. The feasibility of p-Tau quantification by flow cytometry supports the prospective analysis of oral mucosa as a support tool for screening of proteinopathies in cognitively impaired patients.
Objective: The purpose of the study was to analyze the association between cytomegalovirus (CMV) infection in dental students with occupational risk factors and a genetic trait (NKG2C gene deletion). ...Study design: Case-control study. 176 students were included and divided in two groups according to CMV serological results: those with CMV infection (case group) and those without prior infection (control group). Demographic, occupational, and the presence of NKG2C gene deletion were compared between both groups. Results: The presence of CMV IgG antibodies was detected in 104 (59.1%) students (case group) while 72 (40.9%) students were CMV negative (control group). The frequency of patient contact, the use of protective barriers, and the number of reported accidents was compared between the study groups; no significant differences were noted. The appropriate use of infection-control measures was observed in the majority of students in both study groups. In the case group the frequency of NKG2C deletion was 9.7% compared to 5.6% in the control group (p=0.33). Conclusion: No association between the presence of CMV infection with occupational and genetic risk factors was found in this population. Dentists should be aware of the CMV prevalence and risks factors associated to this infection, particularly among child-bearing age dentist women.
Objetivo: El objetivo de este estudio fue analizar la asociación entre la infección por citomegalovirus (CMV) en estudiantes de odontología con factores de riesgo ocupacionales y un polimorfismo genético (deleción del gen NKG2C). Diseño del Estudio: Estudio de casos y controles. 176 estudiantes fueron incluidos y divididos en dos grupos de acuerdo al resultado serológico para CMV: aquellos con la infección por CMV (grupo de casos) y aquellos que no presentaron infección por CMV (grupo control). Las características demográficas, ocupacionales y la presencia de la deleción del gen NKG2C fueron comparadas entre ambos grupos. Resultados: La presencia de anticuerpos IgG de CMV fue detectada en 104 (59.1%) estudiantes (grupo de casos) mientras que 72 (40.9%) estudiantes fueron negativos a CMV (grupo control). Se comparó la frecuencia de contacto con el paciente, el uso de barreras protectoras y el número de accidentes ocupacionales reportados entre los grupos de estudio. No fueron detectadas diferencias significativas. El uso apropiado de las medidas de control de infección fue observado en la mayoría de los estudiantes de ambos grupos. En el grupo de casos la frecuencia de la deleción de NKG2C observada fue de 9.7% comparada con un 5.6% en el grupo control (p=0.33). Conclusión: No se encontró asociación entre la infección por CMV con los factores de riesgo ocupacionales y genéticos de esta población. Los dentistas deben conocer la frecuencia de la infección por CMV, así como los factores de riesgo asociados, particularmente las mujeres odontólogas en edad fértil.
•Oral candidiasis increased with age of 13.2–33.3% between 60 and >80 years.•Frequency of colonizing the oral cavity increased with age.•The frequency of oral colonization by multi-species of Candida ...increases with age.•The oral Candida albicans isolates shows increased resistance to fluconazole with increasing age range in older Mexican women.
To assess the epidemiologic and microbiologic profile and in vitro fluconazole susceptibility of yeasts isolated from the oral mucosa colonization/infection of elderly patients.
It has been reported that in older adults increases the oral colonization by Candida particularly C. non-albicans, showing a decreased response to fluconazole, which increases the risk of recalcitrant local and disseminated candidiasis.
This was a prospective cross-sectional study conducted in 120 elderly patients. Oral samples were obtained of mucosal Candida colonization or infection by swabbing. Each sample was plated on CHROMagar®Candida and incubated (36±1.5°C) for two days. The yeast species were identified using the API®ID32-C-AUX. Fluconazole susceptibility was tested using a broth microdilution assay according to the CLSI methods.
The yeast colonization/infection frequency in the total population was 65.8%. The frequency of the highest Candida carriers was 67.4% in the 70–79-year-old-group. Oral candidiasis was present in 20%, with a tendency to increase with age (33.3% of adults aged>80years), it was determined that the use of prosthesis is associated with a higher colonization rate (Chi2, p=0.011). The frequency of colonization/infection cases with more than one species showed a tendency to increase with age; 18.9% in the 60–69 year-old-group, 20.9% in the 70–79-year-old-group and 29.2% in the ≥80 year-old-group. About fluconazole susceptibility: for C. albicans, 20.3%, about Candida non-albicans species 15.3% were dose dependently susceptible (DDS) and 17.9% were resistant.
After 80 years of age, there is a considerable increase in Candida non-albicans species and a reduced susceptibility to fluconazole.
Oral ulcerative stomatitis may be seen in patients with autoimmunity in treatment with methotrexate, demonstrating a wide clinical and histopathologic spectrum that ranges from non-specific ...ulceration to EBV (+/-) lymphoproliferative disorders, disseminated necrotizing and ulcerative lesions affecting the gingiva extensive to the tongue has not been previously reported, we present a rare oral manifestation of methotrexate and summarize the clinicopathologic features of previously published cases.
A 62-year-old female patient with a 5-year history of Hodgkin lymphoma in remission, and one year of dermatomyositis in treatment with prednisone, colchicine and methotrexate, presented with burning and pain in the gingiva, which lasted 10 days. Physical examination revealed that there was multiple necrotic ulcers located in the upper and lower marginal gingiva, including the interdental papillae that extend to the palate. The inserted gingiva shows edema and petechiae, there is radicular exposure without dental mobility or bone destruction. In the left lateral border of the tongue, a crater-like ulcer is detected, irregular and indurated edges. Intervention and outcome: It was decided to suspend methotrexate previous medical interconsultation and take a biopsy. The result of pathology reported B-cell diffuse lymphoma, the large-sizes lymphoid cells were positive for CD20, CD3, CD30, EBV, Ki67 and negative for CD2, CD56, Grandzima, CD15, CD1a, k and l. After 15 days of having stopped the methotrexate there is total remission of the lesions. Based on the clinical-histological correlation, lymphoproliferative lesion associated with methotrexate was established.
Oral necrotizing and disseminated ulcerative lesions are part of the wide clinical presentation of lymphoproliferative disorders associated to methotrexate. Clinical, histopathologic and immunohistochemical evaluation, may provide the correct diagnosis.
The global burden of pediatric severe respiratory illness is substantial, and influenza viruses contribute to this burden. Systematic surveillance and testing for influenza among hospitalized ...children has expanded globally over the past decade. However, only a fraction of the data has been used to estimate influenza burden. In this analysis, we use surveillance data to provide an estimate of influenza-associated hospitalizations among children worldwide.
We aggregated data from a systematic review (n = 108) and surveillance platforms (n = 37) to calculate a pooled estimate of the proportion of samples collected from children hospitalized with respiratory illnesses and positive for influenza by age group (<6 mo, <1 y, <2 y, <5 y, 5-17 y, and <18 y). We applied this proportion to global estimates of acute lower respiratory infection hospitalizations among children aged <1 y and <5 y, to obtain the number and per capita rate of influenza-associated hospitalizations by geographic region and socio-economic status. Influenza was associated with 10% (95% CI 8%-11%) of respiratory hospitalizations in children <18 y worldwide, ranging from 5% (95% CI 3%-7%) among children <6 mo to 16% (95% CI 14%-20%) among children 5-17 y. On average, we estimated that influenza results in approximately 374,000 (95% CI 264,000 to 539,000) hospitalizations in children <1 y-of which 228,000 (95% CI 150,000 to 344,000) occur in children <6 mo-and 870,000 (95% CI 610,000 to 1,237,000) hospitalizations in children <5 y annually. Influenza-associated hospitalization rates were more than three times higher in developing countries than in industrialized countries (150/100,000 children/year versus 48/100,000). However, differences in hospitalization practices between settings are an important limitation in interpreting these findings.
Influenza is an important contributor to respiratory hospitalizations among young children worldwide. Increasing influenza vaccination coverage among young children and pregnant women could reduce this burden and protect infants <6 mo.
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