Prevalence of Treponema Species Detected in Endodontic Infections: Systematic Review and Meta-regression Analysis

Introduction: This systematic review and meta-regression analysis aimed to calculate a combined prevalence estimate and evaluate the prevalence of different Treponema species in primary and secondary endodontic infections, including symptomatic and asymptomatic eases. Methods: The MEDLINE/PubMed, Embase, Scielo, Web of Knowledge, and Scopus data-bases were searched without starting date restriction up to and including March 2014. Only reports in English were included. The selected literature was reviewed by 2 authors and classified as suitable or not to be included in this review. Lists were compared, and, in case of disagreements, decisions were made after a discussion based on inclusion and exclusion criteria. A pooled prevalence of Treponema species in endodontic infections was estimated. Additionally, a meta-regression analysis was performed. Results: Among the 265 articles identified in the initial search, only 51 were included in the final analysis. The studies were classified into 2 different groups according to the type of endodontic infection and whether it was an exclusively primary/secondary study (n = 36) or a primary/secondary comparison (n = 15). The pooled prevalence of Treponema species was 41.5% (95% confidence interval, 35.9-47.0). In the multivariate model of meta-regression analysis, primary endodontic infections (P < .001), acute apical abscess, symptomatic apical periodontitis (P < .001), and concomitant presence of 2 or more species (P = .028) explained the heterogeneity regarding the prevalence rates of Treponema species. Conclusions: Our findings suggest that Treponema species are important pathogens involved in endodontic infections, particularly in cases of primary and acute infections.

Microbiological Profile Resistant to Different Intracanal Medications in Primary Endodontic Infections

Introduction: This clinical study aimed to determine the microbiological profile resistant to different intracanal medications in primary endodontic infections by using both microbiological culture and the checkerboard DNA-DNA hybridization technique. Methods: Twenty primarily infected root canals were selected and then instrumented before being randomly divided into 2 groups according to the intracanal medications: calcium hydroxide (Ca[OH](2)) or Ca(OH)(2) + chlorhexidine (CHX). Samples were collected before and after root canal procedures, which consisted in submitting them to microbiological culture and processing them for checkerboard DNA-DNA hybridization. Results: No differences were found between the Ca(OH)(2) (99.98%) and Ca(OH)(2) + CHX groups (99.76%) regarding the median percentage values for the reduction of cultivable bacteria. The most frequently detected species were Capnocytophaga ochracea (70%) and Fusobacterium nucleatum ssp. vincentii (70%) in the initial samples. After instrumentation, the most frequently detected species were E. faecium (60%). After root canal treatments using either Ca(OH)(2) or Ca(OH)(2) + CHX as intracanal medications, the most frequently detected species were E nucleatum ssp. vincentii (90%) and Enterococcus faecium (40%), respectively. Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, this reduction was significantly greater in the Ca(OH)(2) + CHX group (P < .05). This difference was also observed when evaluating the total bacterial load (P < .05). Conclusions: The use of Ca(OH)(2) associated with CHX as an intracanal medication showed better results by acting on gram-positive and gram-negative microorganisms although such an action to eradicate enterococci should also be sought.

Parasitic infections in ornamental cichlid fish in the Peruvian Amazon

The aim of this study was to evaluate the prevalence and seasonal distribution of the main parasite species in Amazonian ornamental cichlids that affect their trade. The study was conducted from August 2007 to September 2009. We sampled 3042 specimens from 9 different species, of which 9.47% had at least one type of external parasite. 81.25% of the cases occurred in the dry season. Crenicichla anthurus (28.57%) was the most parasitized, followed by Aequidens diadema (26.32%), Pterophyllum scalare (22.69%), Cichlasoma sp. (9.52%), Apistogramma sp. (3.88%) and Symphysodon aequifasciatus (3.66%). Monogenea was the most abundant group of parasites, occurring in 66.67% of the cases, of which 96.88% occurred in the dry season. This parasite infested 95.68% of Pterophyllum scalare, 76.67% of Apistogramma sp, 33.33% of Cichlasoma sp. and 23.81% of Symphysodon aequifasciatus cases. Ichthyophthirius multifiliis infested 100% of Aequidens diadema, 76.19% of Symphysodon aequifasciatus, 66.67% of Cichlasoma sp, 41.67% of Crenicichla anthurus and 23.33% of Apistogramma sp cases. Myxosporidia infested 58.33% of Crenicichla anthurus. Trichodina infested 4.32% of Pterophyllum scalare. The prevalence of these parasites is related to the season, preferred habitat, fish behavior, individual susceptibility and handling of animals during transportation by fishermen.

Could histoplasma capsulatum be related to healthcare-associated infections?

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Detection of Mayaro virus infections during a dengue outbreak in Mato Grosso, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Community-associated methicillin-resistant Staphylococcus aureus in non-outbreak skin infections

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Gastrointestinal nematode infections in sheep raised in Botucatu, state of Sao Paulo, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Immunohistochemical approach to the pathogenesis of clinical cases of bovine Herpesvirus type 5 infections

Meningoencephalitis by Herpesvirus type 5 (BoHV-5) in cattle has some features that are similar to those of herpetic encephalitis in humans and other animal species. Human Herpesvirus 3 (commonly known as Varicella-zoster virus 1), herpes simplex viruses (HSV), and equid Herpesvirus 1 (EHV-1) induce an intense inflammatory, vascular and cellular response. In spite of the many reports describing the histological lesions associated with natural and experimental infections, the immunopathological mechanisms for the development of neurological disorder have not been established. A total of twenty calf brains were selected from the Veterinary School, University of São Paulo State, Araçatuba, Brazil, after confirmation of BoHV-5 infection by virus isolation as well as by a molecular approach. The first part of the study characterized the microscopic lesions associated with the brain areas in the central nervous system (CNS) that tested positive in a viral US9 gene hybridization assay. The frontal cortex (Fc), parietal cortex (Pc), thalamus (T) and mesencephalon (M) were studied. Secondly, distinct pathogenesis mechanisms that take place in acute cases were investigated by an immunohistochemistry assay. This study found the frontal cortex to be the main region where intense oxidative stress phenomena (AOP-1) and synaptic protein expression (SNAP-25) were closely related to inflammatory cuffs, satellitosis and gliosis, which represent the most frequently observed neurological lesions. Moreover, MMP-9 expression was shown to be localized in the leptomeninges, in the parenchyma and around mononuclear infiltrates (p < 0.0001). These data open a new perspective in understanding the role of the AOP-1, MMP-9 and SNAP-25 proteins in mediating BoHV-5 pathogenesis and the strategies of host-virus interaction in order to invade the CNS.

Influence of hypertension on oral infections and endodontic treatment

Hypertension is characterized by peripheral vascular resistancethat leads to blood pressure increase and severalsystemic changes that may negatively influence one s oralhealth. Thus, the aim of this study was to conduct a literaturereview on the influence of hypertension over oral conditionsand endodontic treatment. Hypertension mainly affects theblood vessels, brain and kidneys. A hypertensive conditioncan lead to increased levels of parathyroid hormones, abnormalvitamin D metabolism, reduction in the concentrationof ionized calcium and decreased calcium absorption.Therefore, hypertension can be closely associated with oralproblems such as periodontal diseases, implant loss, difficultyin bone healing, reduced salivary flow and protein concentrationin saliva, increased number of neutrophils and, as a consequence,favoring of inflammatory processes. It has alsobeen suggested that the success rate of endodontic treatmentin hypertensive patients is lower than in normotensiveones. The response of hypertensive patients to root canaltreatment, intracanal medications and sealers should be furtherstudied in order to provide knowledge on the changes,failures and success of endodontic treatment.

Microbiota asociated with infections of the jaws

The microbial infections involving the craniofacial skeleton, particularly maxilla and mandible, have direct relationship with the dental biofilm, with predominance of obligate anaerobes. In some patients, these infections may spread to bone marrow or facial soft tissues, producing severe and life-threatening septic conditions. In such cases, local treatment associated with systemic antimicrobials should be used in order to eradicate the sources of contamination. This paper discuss the possibility of spread of these infections and their clinical implications for dentistry, as well as their etiology and aspects related to microbial virulence and pathogenesis.

Isolation and molecular identification of Fusobacterium nucleatum from Nigerian patients with oro-facial infections.

Fusobacterium nucleatum is one of the most common anaerobic bacteria present in the oral cavity and is often isolated from infections involving other body sites. To characterise F. nucleatum strains from patients attending a teaching hospital in Nigeria in order to provide information on the methods for accurate identification of anaerobes in clinical specimen. Fusobacterium nucleatum specie from 50 patients presenting with oro-facial infections were studied by culture on Fusobacterium selective agar and fastidious anaerobe agar. The isolates were characterised based on colonial morphology, microscopy, lipase production, susceptibility to kanamycin and colistin and resistance to vancomycin. Biochemical tests were performed using a commercial test kit. The identity of the isolates was confirmed based on molecular characterization performed using polymerase chain reaction (PCR) analysis. Forty-eight (96%) F. nucleatum isolates were obtained from the 50 patients by culture and all the isolates were identified by colonial appearance and microscopy based on their unique spindle shape with tapered ends. Only 26 (54.2%) of the 48 isolates were identified by commercial API 20A test kit while PCR confirmed the identity of all the isolates. Anaerobes are involved in human infections and their study is quite cumbersome due to tedious nature and high cost of the techniques involved. Cultural method is reliable in the isolation and identification of F. nucleatum species. PCR is a rapid and simple method that can complement the phenotypic identification of anaerobes and would assist in their full identification.

Effect of oral infections on serum creatinine levels in diabetic rats

Aim: The aim of this study was to evaluate the relationship between pulpal and/or periodontal disease and serum creatinine levels in a rat model of diabetes mellitus. Methods: Eighty male rats (Rattus norvegicus albinus, Wistar) were divided into the following 8 groups compris-ing 10 animals each: normal (G1), with pulpal disease (G2), with periodontal disease (G3), with both pulpal and periodontal disease (G4), diabetic (G5), diabetic with pulpal disease (G6), diabetic with periodontal disease (G7), and diabetic with both pulpal and periodontal disease (G8). Diabetes was induced by injecting streptozotocin, pul-pal disease were induced by exposing pulpal tissue to the oral environment, and periodontal disease was induced by periodontal ligature. After 30 days, blood was collected by cardiac puncture and the animals were killed. The maxillae were processed for histopathology. Serum creatinine levels were measured by the enzymatic method. The total assessed values were statistically analyzed by analysis of variance and Tukey’s test (p < 0.05). Results: Serum creatinine levels were significantly higher in diabetic rats than that in all normoglycemic rats (p < 0.05). The presence of pulpal and periodontal disease increased the serum creatinine levels in normoglycemic and diabetic rats, but there was no statistical difference between the groups (p > 0.05). Conclusions: We found that the serum creatinine level was higher in diabetic rats and may be related to the pres-ence of oral infections. Clinical significance: Changes in serum creatinine level may be related to the presence of oral infections and diabetes.

Genital infections of HIV-infected women assisted by a specialized service

The present study aimed at analyzing the persistence/recurrence of genital infections and its associated factors in HIV-infected women. Fifty-eight women treated for chlamydial infection, trichomoniasis, vulvovaginal candidiasis, and/or bacterial vaginosis (BV) and who had specimens collected for cure control up to one year after treatment were studied. Diagnoses were performed by the Gram staining method for cases of BV and candidiasis and by T. vaginalis culture and qualitative PCR for C. trachomatis. Antiretroviral therapy was used by 79.3% of patients, and 62.1% showed an undetectable HIV plasma load. The most frequent infection was BV with persistence/recurrence of 52.4%, which was associated with a longer time period between treatment and cure control (P = 0.0455), postmenopausal period (P = 0.0451), and having a steady partner (P = 0.007). Persistence/recurrence of vulvovaginal candidiasis was observed in 25%, trichomoniasis in 23.1%, and chlamydial infection in 10.5%. The letter was associated with inadequate treatment of the partner (P = 0.073) among patients with low T CD4 lymphocyte counts. The majority of women in the present study showed good HIV-infection control and a vulnerable sexual behavior, which stress the importance of maintaining gynecological followup.

Infecção por strigea falconis em buteo magnirostris no Brasil

Background: Buteo magnirostris, popularly known as roadside hawk belongs to the family Accipitridae, Ciconiiformes. The specimen is common throughout Brazil inhabiting open areas, tolerating disturbed areas very well, but avoiding dense forests. The trematodes are common parasites in the intestines of birds of prey, with scant notice of pathogenic infections. However, severe infections of trematodes Strigeidae family have been previously reported as a cause of anemia, diarrhea, enteritis, weight loss and death. This paper aims to report the occurrence of infection in S. Falconis in B. magnirostris diagnosed by post mortem examination. Case: The specimen of B. magnirostris, male, young was sent for necropsy at the Laboratory of Veterinary Pathology, Federal Rural University of Semi-Arid (UFERSA), Mossoró-RN, Brazil. With a history of apathy, anorexia, diarrhea and death in one course of 24 h. The free bird life and even puppy had been captured for training and practice of falconry shortly before the clinical manifestation of infection (time of captivity uninformed). On physical examination ruffled feathers, cachexia and pallor of skeletal muscle was observed. At necropsy there was severe enteritis with petechiae and accumulation of liquid contents into the duodenum. Fifty-two trematodes were found set in duodenal mucosa. The other organs and structures showed no changes. Fragments of all organs were harvested, fixed in 10% formalin buffered, routinely processed for histopathology and stained with hematoxylin and eosin (HE). Parasites were carefully collected, washed in saline, fixed, processed and identified according to the morphology and taxonomy. Histologically, the lesions were restricted to the duodenum and were characterized by melting, severe atrophy and necrosis of the epithelial cells of the intestinal villi; inflammatory infiltrate (consisting of lymphocytes, plasma cells and eosinophils) in the lamina propria, in addition to trematodes infiltrated the mucosa and lamina propria. These were 60-80 mm in diameter, consisted of parenchymal body enclosed by the integument. In some cross sections of the parasite was possible to observe the presence of cecum, testis and uterus, with some variations between sections; there were also yellowish eggs and coated with a delicate membrane. The trematodes contain approximately 1 mm in length and used as morphology and taxonomy has been identified as S. Falconis. Discussion: S. Falconis is a trematode intestinal parasite of birds of prey, with reports of its occurrence in Europe, North America and Central. In neotropical regions is described the occurrence of the subspecies S. Falconis brasiliana. Although the absence of clinical signs is a common pattern, parasitism by trematodes may become evident, common to captivity stress conditions, and thus infections, even for low pathogenic parasites can cause diarrhea, anorexia, weight loss and death, as reported in this paper. A factor that possibly contributed to the scant notice is its small size, which makes the observation of this parasite in analysis of necropsy in non-pathological conditions and also not familiar with the technical laboratories in the morphological shape of the eggs, which creates difficulty in finding the parasite in parasitological analysis in captive animals. Despite being considered poorly pathogenic trematodes, epidemiologically, the presence of the parasite should be considered a health risk to free-living predators, newly captive in parks, zoos, veterinary hospitals, triage center for wildlife and creators, as they may express pathogenicity in immunosuppressed animals. This work contributes to recording the presence S. falconis parasitizing the duodenal mucosa of B. magnirostris in Brazil.