RESUMEN
BACKGROUND: The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in saliva has alerted health professionals to the possibility of contamination by aerosols generated in a number of procedures. The indication of preoperative mouthwash containing 1% hydrogen peroxide for reducing the viral load of SARS-CoV-2 in saliva prior to oral procedures has been significantly disseminated through several citations and influenced various dental associations in the elaboration of dental care protocols during this pandemic period, including patients admitted to hospital wards and intensive care units. AIM: To Our aim was to perform a systematic review to answer the following question: does hydrogen peroxide mouthwash (at any concentration) have a virucidal effect? METHODS: The Cochrane, LILACS, PubMed, Scopus, and Embase databases were searched by using the following key-words: 'hydrogen peroxide', 'mouthwash', 'mouth rinse', 'rinse', 'oral rinse', 'mouth bath', 'mouth wash', and 'mouth washes'. Reviews, letters to the editor, personal opinions, book chapters, case reports, congress abstracts, studies with animals and studies on mouthwash containing other compounds other than hydrogen peroxide were excluded. FINDINGS: During the initial search 1342 articles were identified on the five electronic databases. After excluding some duplicates, 976 articles remained. Only studies assessing the virucidal effect of hydrogen peroxide mouthwash were selected, regardless of publication date. CONCLUSION: After reading titles and abstracts, no article met the eligibility criteria. In conclusion, there is no scientific evidence supporting the indication of hydrogen peroxide mouthwash for control of the viral load regarding SARS-CoV-2 or any other viruses in saliva.
Asunto(s)
Antiinfecciosos Locales/farmacología , COVID-19/virología , Peróxido de Hidrógeno/farmacología , SARS-CoV-2/efectos de los fármacos , Aerosoles/efectos adversos , COVID-19/diagnóstico , COVID-19/epidemiología , Personal de Salud/educación , Humanos , Control de Infecciones/métodos , Antisépticos Bucales/farmacología , Antisépticos Bucales/provisión & distribución , SARS-CoV-2/genética , Saliva/virología , Carga Viral/efectos de los fármacosRESUMEN
Little is known about the prevention and management of acquired coagulopathies, such as those affecting cirrhotic patients. The objective of this analytic retrospective observational study was to evaluate patients on the liver transplant waiting list according to the following outcomes: (1) presence of unusual intraoperative bleeding (>10min after routine haemostatic procedures); and (2) presence of postoperative haemorrhagic complications. The outcomes were analysed according to clinical and laboratory variables. A total of 190 visits were performed for extraction of 333 teeth (ranging from 1 to 9 teeth per visit), with platelet count ranging from 16,000 to 216,000 and international normalized ratio (INR) below 3. Twelve cases (6.31%) had unusual intraoperative bleeding and 12 had postoperative haemorrhagic complications. All the events were controlled by local measures. Intraoperative bleeding was associated with low count of platelets (P=0.026). However, this counting could explain only 16% (adjusted R2=0.16) of the cases of bleeding (P=0.44), meaning that platelet function changes might be involved. Our results show that cirrhotic patients presenting platelet count above 16,000 and INR below 3 need no previous blood transfusion, with local measures being enough to manage haemorrhagic events.
Asunto(s)
Cirrosis Hepática/complicaciones , Hemorragia Posoperatoria/prevención & control , Extracción Dental , Brasil , Femenino , Humanos , Relación Normalizada Internacional , Masculino , Persona de Mediana Edad , Recuento de Plaquetas , Estudios RetrospectivosAsunto(s)
Infecciones Bacterianas/complicaciones , Enfermedad Hepática en Estado Terminal/complicaciones , Cirrosis Hepática/complicaciones , Periodontitis/complicaciones , Animales , Infecciones Bacterianas/diagnóstico , Atención Odontológica , Enfermedad Hepática en Estado Terminal/diagnóstico , Humanos , Inflamación , Cirrosis Hepática/diagnóstico , Ratones , Modelos Teóricos , Periodontitis/diagnóstico , Factores de RiesgoRESUMEN
OBJECTIVE: This study aimed to identify and quantify polyomaviruses (BKPyV and JCPyV) in the saliva, mouthwash, blood and urine of liver pretransplant patients. MATERIALS AND METHODS: A case-control study was performed using a convenience sample of 21 end-stage liver disease patients (EG = experimental group) and 20 normoreactive controls (CG = control group). In total, 162 samples were collected. Detection and quantification of polyomaviruses were performed using real-time PCR method. RESULTS: In the EG, 21 samples (25%) were positive for BKPyV and 10 (11.90%) for JCPyV, while in the CG, 27 samples (34.61%) were positive for BKPyV and six (7.69%) for JCPyV. With regard to the number of samples positive for BKPyV and JCPyV, there was no statistically significant difference between EG and CG (p = .52 and p = .25). In the EG, we observed a panorama similar to that of the CG regarding the presence of polyomaviruses in mouthwash, blood and urine. The greatest difference between the samples was that regarding the identification of BKPyV in saliva. CONCLUSION: Cirrhotic patients on the liver transplant waiting list did not show higher prevalence of BKPyV and JCPyV compared to normoreactive controls.
Asunto(s)
Virus BK/aislamiento & purificación , Virus JC/aislamiento & purificación , Infecciones por Polyomavirus/virología , Saliva/virología , Infecciones Tumorales por Virus/virología , Adulto , Sangre/virología , Estudios de Casos y Controles , Enfermedad Hepática en Estado Terminal/cirugía , Femenino , Humanos , Trasplante de Hígado , Masculino , Persona de Mediana Edad , Periodo Preoperatorio , Orina/virología , Carga ViralRESUMEN
In spite of the possibility of triggering thromboembolic events, many professionals indicate the suspension of antiplatelet agents before dental surgical procedures. The aim of this study was to perform a quantitative assessment of intraoperative bleeding in patients on dual antiplatelet therapy. A case-control study was conducted in patients on dual antiplatelet therapy (APT group) and in patients who did not use these medications (control group). The following examinations were requested: complete blood cell count, blood coagulation tests, and platelet aggregation. The quantity of bleeding was measured intraoperatively by collection of aspirated blood. The mean volume of blood lost during the surgical procedure was 6.10ml in the control group and 16.07ml in the APT group (P=0.002). The mean volume of blood lost per minute was 0.60ml/min in the control group and 1ml/min in the APT group (P=0.001), with local haemostatic methods being sufficient to control the bleeding. There was no postoperative bleeding complication in any case. Patients on dual antiplatelet therapy presented a larger volume of bleeding, but this could be controlled by means of local haemostatic measures. Therefore, there is no need to stop either of the two dual antiplatelet therapy medications before dental extractions.
Asunto(s)
Aspirina/administración & dosificación , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Hemorragia/epidemiología , Inhibidores de Agregación Plaquetaria/administración & dosificación , Ticlopidina/análogos & derivados , Extracción Dental , Enfermedades Cardiovasculares/tratamiento farmacológico , Estudios de Casos y Controles , Clopidogrel , Atención Dental para Enfermos Crónicos , Femenino , Hemostasis Quirúrgica/métodos , Humanos , Masculino , Persona de Mediana Edad , Ticlopidina/administración & dosificaciónRESUMEN
In spite of the possibility of triggering thromboembolic events, many professionals indicate the suspension of antiplatelet agents before dental surgical procedures. The aim of this study was to perform a quantitative assessment of intraoperative bleeding in patients on dual antiplatelet therapy. A case-control study was conducted in patients on dual antiplatelet therapy (APT group) and in patients who did not use these medications (control group). The following examinations were requested: complete blood cell count, blood coagulation tests, and platelet aggregation. The quantity of bleeding was measured intraoperatively by collection of aspirated blood. The mean volume of blood lost during the surgical procedure was 6.10ml in the control group and 16.07ml in the APT group (P=0.002). The mean volume of blood lost per minute was 0.60ml/min in the control group and 1ml/min in the APT group (P=0.001)...
Asunto(s)
Complicaciones Intraoperatorias , Enfermedades de las Arterias Carótidas , Extracción Dental , Hemorragia , Técnicas HemostáticasRESUMEN
OBJECTIVE: Human T-cell lymphotropic virus type 1 (HTLV-1) was the first human retrovirus discovered and its pathogenesis is related to T cells infection. This study aimed to verify the presence of oral manifestations in a Brazilian population of patients who was seropositive for HTLV, and identify risk factors for oral manifestations. SUBJECTS AND METHODS: An assessment was made of 139 patients at the Emilio Ribas Institute of Infectious Diseases. RESULTS: A total of 112 (80.5%) patients were HTLV-1, 26 (18.7%) were HTLV-2+. About 35.2% of patients had myelopathy/tropical spastic paraparesis (HAM/TSP), with 48 of them being HTLV-1+ and one patient was seropositive for HTLV-1 and -2. The most common oral manifestations were: xerostomia (26.8%), candidiasis (20.8%), fissured tongue (17.9%), and loss of tongue papillae (10.0%). A multivariate logistic regression analysis showed that HAM/TSP is an independent risk factor for xerostomia (P = 0.02). The patients who were HAM/TSP+ were three times more likely to develop xerostomia when compared with patients without HAM/TSP (odds ratio = 2.69, 95% confidence interval = 1.17-6.17). CONCLUSION: Despite the fact that the findings of this study suggest a relationship between xerostomia and HAM/TSP, more studies should be developed to show what the association would be between xerostomia presented by HTLV patients and pathogenesis of the virus.
Asunto(s)
Infecciones por HTLV-I/diagnóstico , Enfermedades de la Boca/diagnóstico , Adulto , Consumo de Bebidas Alcohólicas , Brasil , Recuento de Linfocito CD4 , Linfocitos T CD8-positivos/patología , Candidiasis Bucal/diagnóstico , Enfermedad Crónica , Trastornos Relacionados con Cocaína/diagnóstico , Femenino , Infecciones por HTLV-II/diagnóstico , Humanos , Recuento de Linfocitos , Masculino , Abuso de Marihuana/diagnóstico , Paraparesia Espástica Tropical/diagnóstico , Factores de Riesgo , Fumar , Papilas Gustativas/patología , Enfermedades de la Lengua/diagnóstico , Lengua Fisurada/diagnóstico , Carga Viral , Xerostomía/diagnósticoRESUMEN
BACKGROUND: The difference between dental age (DA) and chronological age (CA) indicates an advance or delay in comparison with the normal standard. Considering that DA has a very close correlation with CA in a developing child, this study aimed to investigate the relationship between the effects of antiretroviral therapy on the development of HIV positive children, by observing the timing of dental mineralization. METHODS: A retrospective examination was made of the medical records and dental panoramic radiographs of 50 HIV-positive pediatric patients, aged 37-168 months of age. Through these radiographs, their DA was estimated and compared with their CA. RESULTS: The mean DA was significantly lower than the mean CA in the entire studied sample (P < 0.01). There was a statistical difference between children who received antiretroviral drugs and those who used no drugs (P = 0.02), i.e. the non-treated individuals presented practically no difference between CA and DA, while the treated patients showed a difference of 10.67 months. CONCLUSION: We conclude that the DA of HIV infected children was delayed when compared to the CA, and there was a positive association between the use of antiretroviral therapy and a delay in the chronology of dental mineralization in the sample.
Asunto(s)
Antirretrovirales/efectos adversos , Seropositividad para VIH/tratamiento farmacológico , Calcificación de Dientes/efectos de los fármacos , Adolescente , Determinación de la Edad por los Dientes , Factores de Edad , Fármacos Anti-VIH/efectos adversos , Terapia Antirretroviral Altamente Activa , Niño , Preescolar , Femenino , Inhibidores de la Proteasa del VIH/efectos adversos , Humanos , Masculino , Odontogénesis/efectos de los fármacos , Radiografía Panorámica , Estudios Retrospectivos , Inhibidores de la Transcriptasa Inversa/efectos adversosRESUMEN
Plasmablastic lymphoma (PBL) is an HIV-associated non-Hodgkin's lymphoma that primarily affects the oral cavity. We describe the case of an HIV patient with a lesion in the maxilla that lasted four months. He was diagnosed with PBL and received highly active antiretroviral therapy as well as chemotherapy and local radiotherapy. The lesion regressed after the third cycle of chemotherapy. The patient interrupted antiretroviral treatment and the lesion recurred. The immune reconstitution secondary to the use of antiretroviral therapy seems to participate in the regression of PBL and maintains the remission of the tumour, but it might not be enough to prevent the development of PBL.
Asunto(s)
Antirretrovirales/uso terapéutico , Linfoma Relacionado con SIDA/tratamiento farmacológico , Neoplasias Maxilares/tratamiento farmacológico , Cumplimiento de la Medicación , Neoplasias de la Boca/tratamiento farmacológico , Recurrencia Local de Neoplasia/prevención & control , Adulto , Terapia Antirretroviral Altamente Activa , Humanos , Linfoma Relacionado con SIDA/patología , Masculino , Neoplasias Maxilares/patología , Boca/patología , Neoplasias de la Boca/patología , Recurrencia Local de Neoplasia/patologíaRESUMEN
AIM: To assess the efficacy of a medicated dressing in the socket on the healing after dental extractions in HIV positive patients. PATIENTS AND METHODS: Forty HIV positive patients with CD4 counts below 200 cells/mm(3) who were to have molar teeth extracted were randomly allocated to have the socket dressed with a medicated paste (Rifocort) with camphorated parachlorophenol and iodoform) and sutured (treated group), or merely sutured (control group). RESULTS: The sockets in the treated group healed more quickly than in the control group.
Asunto(s)
Antibacterianos/uso terapéutico , Seropositividad para VIH/complicaciones , Diente Molar/cirugía , Prednisolona/análogos & derivados , Rifamicinas/uso terapéutico , Extracción Dental , Alveolo Dental/efectos de los fármacos , Administración Tópica , Adulto , Antibacterianos/administración & dosificación , Antiinfecciosos Locales/administración & dosificación , Antiinfecciosos Locales/uso terapéutico , Antiinflamatorios/administración & dosificación , Antiinflamatorios/uso terapéutico , Recuento de Linfocito CD4 , Alcanfor , Clorofenoles , Portadores de Fármacos , Combinación de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Hidrocarburos Yodados/administración & dosificación , Hidrocarburos Yodados/uso terapéutico , Masculino , Persona de Mediana Edad , Pomadas , Polietilenglicoles , Prednisolona/administración & dosificación , Prednisolona/uso terapéutico , Rifamicinas/administración & dosificación , Cicatrización de Heridas/efectos de los fármacosRESUMEN
The use of saliva samples to detect the anti-HIV antibody has been described recently as an interesting alternative in relation to blood samples. We have analyzed 172 saliva samples from HIV positive and negative patients assisted at CASP, 108 of them adults and 64 children, in order to assess the specificity and sensitivity of the GACELISA test. A specificity was found of 85% and 80% respectively for the adult and children groups and sensitivity of 97.7% and 100% respectively for the adult and children groups. The statistical analysis revealed no differences in specificity and in sensitivity between these groups. We concluded that GACELISA test is useful for children.