RESUMEN

The 28(th) Drug Information Association (DIA) Annual EuroMeeting took place in Hamburg, Germany, gathering together participants from different industries, organizations, academic research centers, regulatory agencies and health ministries, mainly from the E.U. The conference began with a regulatory Town Hall meeting focusing on the E.U. Medicines Agencies Network strategy to 2020. This was followed by an opening plenary session where the diverse roles of innovation in drug development were discussed. Areas for discussion over the meeting were classified into 14 main themes, and for each session, profession¬als from the pharmaceutical industry, regulatory agencies and health ministries, as well as delegates from patient organizations, presented their considerations for debate. This report covers some regulatory sessions presented at the meeting.

RESUMEN

We report the cases of two patients with an occlusion of the left subclavian artery several years after left internal mammary bypass of the anterior interventricular artery. The effect on the myocardium was only apparent after scintigraphy in one case, and was clinical in the second with angina pain on exertion of the upper limb. Re-implantation of the subclavian artery in the common carotid relieved the signs of myocardial ischaemia. While the internal mammary artery is the conduit of choice for coronary revascularisation because it is not affected by atheromatous lesions, this does apply to the proximal subclavian artery. Stenosis or occlusion here can entail ischaemia in the revascularised myocardial territory. Regular clinical and ultrasound surveillance can detect these lesions.

Asunto(s)

Circulación Coronaria/fisiología , Anastomosis Interna Mamario-Coronaria , Síndrome del Robo de la Subclavia/fisiopatología , Endarterectomía , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/prevención & control , Síndrome del Robo de la Subclavia/cirugía

RESUMEN

PURPOSE: This prospective, observational study determined the long-term outcome in patients with abdominal aortic infection (primary or prosthetic graft) who were treated with simultaneous aortic/graft excision and cryopreserved arterial allograft reconstruction. METHODS: From April 1992 to March 2000, patients with abdominal aortic infection underwent complete or partial excision of the infected aorta/prosthetic graft and cryopreserved arterial allograft reconstruction. Arterial allografts were harvested from multiple organ donors and cryopreserved at -80 degrees C without rate-controlled freezing. The patients were observed for survival, limb salvage, persistence and/or recurrence of infection, and allograft patency. The results were calculated with life-table methods. RESULTS: During the 8-year study period, 28 consecutive patients (27 men, 1 woman; mean age, 64 years) underwent treatment for abdominal aortic infection (23 graft infections, including 7 graft-enteric fistulas and 5 primary aortic infections). Allograft reconstruction was performed as an emergency procedure in 13 patients (46%). The mean follow-up period was 35.4 months (range, 6-101 months). The overall treatment-related mortality rate was 17.8% (17% for graft infection, 20% for primary aortic infection). The overall 3-year survival was 67%. There was no early or late amputation. There was no persistent or recurrent infection, and none of the patients received long-term (> 3 months) antibiotic therapy. Reoperation for allograft revision, excision, or replacement was necessary in four patients (17%) who were available for examination, with no reoperative perioperative death. The 3-year primary and secondary allograft patency rates were 81% and 96%, respectively. CONCLUSION: Our experience with cryopreserved arterial allograft in the management of abdominal aortic infection suggests that this technique seems to be a useful option for treating one of the most dreaded vascular complications.

Asunto(s)

Aneurisma Infectado/cirugía , Aorta Torácica/trasplante , Aneurisma de la Aorta/cirugía , Implantación de Prótesis Vascular/efectos adversos , Criopreservación/métodos , Arteria Femoral/trasplante , Arteria Ilíaca/trasplante , Infecciones Relacionadas con Prótesis/etiología , Infecciones Relacionadas con Prótesis/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Amputación Quirúrgica/estadística & datos numéricos , Aneurisma Infectado/microbiología , Antibacterianos/uso terapéutico , Aneurisma de la Aorta/microbiología , Terapia Combinada , Criopreservación/normas , Femenino , Francia/epidemiología , Supervivencia de Injerto , Humanos , Tablas de Vida , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Infecciones Relacionadas con Prótesis/diagnóstico , Infecciones Relacionadas con Prótesis/mortalidad , Reoperación/estadística & datos numéricos , Factores de Riesgo , Análisis de Supervivencia , Factores de Tiempo , Trasplante Homólogo , Resultado del Tratamiento , Grado de Desobstrucción Vascular

RESUMEN

To explore aspects of cellular immune responses in the pathogenesis of periodontitis we analyzed phenotype and function of peripheral T cells. Two groups of subjects participated: one group consisted of 10 highly susceptible patients with severe periodontitis (mean age 29 years) and a control group consisted of 10 age, gender and race matched subjects with gingivitis. From all subjects peripheral blood was collected. The results showed that the numbers of CD3+, CD4+ and CD8+ T cells as well as the CD4/CD8 ratio, and the proliferative capacity of T cells, were not different between the two groups of subjects. Also, proportions of naive and memory T cells for both the CD4+ and CD8+ subpopulations were not different. Functional heterogeneity within the CD4+ and CD8+ T cell compartments was determined by intracellular analysis of interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) production. On the basis of these latter analyses among CD4+ and CD8+ cells, T helper (Th) 1 or Th2 function and T cytotoxic (Tc) 1 or Tc2 function, respectively, could be deduced. No significant differences in proportions of CD4+ and CD8+ T cells positive for intracellular IFN-gamma or IL-4 were observed between periodontitis patients and gingivitis controls; however a higher level of intracellular IL-4 in CD8+ T cells was seen in periodontitis patients. This might indicate that there is a shift towards a Tc2 function within the CD8+ T cell subpopulation. The current explorative study suggests that further research into the role of CD8+ T cells in the pathogenesis of periodontitis is warranted.

Asunto(s)

Linfocitos T CD8-positivos/inmunología , Periodontitis/inmunología , Subgrupos de Linfocitos T/inmunología , Adulto , Linfocitos T CD4-Positivos/citología , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD4-Positivos/metabolismo , Linfocitos T CD8-positivos/citología , Linfocitos T CD8-positivos/metabolismo , Estudios de Casos y Controles , División Celular , Distribución de Chi-Cuadrado , Femenino , Humanos , Inmunofenotipificación , Interleucina-4/biosíntesis , Masculino , Periodontitis/microbiología , Estadísticas no Paramétricas , Subgrupos de Linfocitos T/citología , Subgrupos de Linfocitos T/metabolismo , Linfocitos T Citotóxicos/citología , Linfocitos T Citotóxicos/inmunología , Linfocitos T Citotóxicos/metabolismo , Linfocitos T Colaboradores-Inductores/citología , Linfocitos T Colaboradores-Inductores/inmunología , Linfocitos T Colaboradores-Inductores/metabolismo

RESUMEN

The extensive homology between human and bacterial heat shock proteins (HSPs) may play a role in autoimmune reactions in periodontitis. Thus, we questioned whether peripheral blood mononuclear cell (PBMC) proliferative responses to HSPs are different between periodontitis patients and control subjects with gingivitis. The proliferative responses of PBMCs of patients (n = 10) and controls (n = 12) to recombinant mycobacterial HSP60 (MycHSP60) and HSP70 (MycHSP70), as well as recombinant human HSP60 (HumHSP60) and HSP70 (HumHSP70), were investigated. In addition, the proliferative responses to Candida albicans and purified protein derivatives of Mycobacterium (PPD) were included. Mean responses to HumHSP60, MycHSP60, and HumHSP70 were significantly lower for patients compared with controls. The responses to MycHSP70 showed a similar trend. However, when Candida and PPD were used as antigens, there was no difference in responses of the PBMCs between the periodontitis patients and controls. The level of IFN-gamma in the supernatants of the cells stimulated with HSPs was lower in the patients compared with controls. This concurs with the current hypothesis that periodontitis patients have a depressed Th1 response. Furthermore, we found that with an increasing estimated subgingival bacterial load, periodontitis patients mount a decreasing immune response to HSPs, while the controls showed a positive correlation between these two parameters. From these findings, we speculate that poor reactivity to HSPs may be a susceptibility factor for destructive periodontal disease and may need to be considered in the pathogenesis of this condition.

Asunto(s)

Proteínas de Choque Térmico/farmacología , Leucocitos Mononucleares/efectos de los fármacos , Periodontitis/sangre , Adulto , Antígenos Fúngicos/farmacología , Autoinmunidad/inmunología , Candida albicans/inmunología , División Celular/efectos de los fármacos , Chaperonina 60/farmacología , Femenino , Gingivitis/sangre , Gingivitis/inmunología , Proteínas HSP70 de Choque Térmico/farmacología , Humanos , Interferón gamma/análisis , Interferón gamma/efectos de los fármacos , Interleucina-4/análisis , Leucocitos Mononucleares/inmunología , Masculino , Mycobacterium bovis/inmunología , Mycobacterium tuberculosis/inmunología , Periodontitis/inmunología , Proteínas Recombinantes , Células TH1/efectos de los fármacos , Células TH1/inmunología , Tuberculina/farmacología

RESUMEN

BACKGROUND: Below-knee revascularization for limb salvage in the absence of a suitable autogenous saphenous vein is a frequent challenge associated with a high amputation rate. The aim of this prospective study was to evaluate the usefulness of cryopreserved arterial allografts in such cases. METHODS: Arterial allografts were harvested from multiple organ donors and cryopreserved at -80 degrees C. From March 1993 to December 1997, 35 cryopreserved arterial allografts were used as below-knee bypasses for repeated limb salvage in 32 patients. There were 15 men and 17 women with a mean age of 75 years (+/-10.7). Seven patients had rest pain and 25 patients (78%) had gangrene or nonhealing ulceration. Runoff was through a single tibial vessel in 25 cases (71%) and two vessels in 10 cases. Previous ipsilateral bypasses had been done in 26 of 35 limbs (74%). Patients were followed up prospectively for an average period of 18 months (range 2 to 56). RESULTS: Aneurysmal dilatation occurred in two patent grafts, requiring segmental replacement at 13 and 18 months, respectively. The overall primary patency rate was 75% at 6 months, 57% at 12 months, and 39% at 18 months. The overall secondary patency rate was 75% at 6 months, 75% at 12 months, and 59% at 18 months. Overall limb salvage rate was 80% at 12 months, 73% at 18 months. CONCLUSIONS: These early data indicate that below-knee bypass with arterial allografts results in acceptable patency and limb salvage. Arterial allografts may be a useful alternative to other arterial substitutes in a difficult group of patients with critical ischemia and no suitable saphenous vein.

Asunto(s)

Arteriopatías Oclusivas/cirugía , Criopreservación , Pierna/irrigación sanguínea , Terapia Recuperativa , Vena Safena , Arterias Tibiales , Anciano , Anciano de 80 o más Años , Anastomosis Quirúrgica , Angiografía , Arteriopatías Oclusivas/complicaciones , Arteriopatías Oclusivas/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Úlcera del Pie/diagnóstico por imagen , Úlcera del Pie/etiología , Úlcera del Pie/cirugía , Gangrena/diagnóstico por imagen , Gangrena/etiología , Gangrena/cirugía , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Vena Safena/trasplante , Arterias Tibiales/diagnóstico por imagen , Arterias Tibiales/cirugía , Trasplante Homólogo , Resultado del Tratamiento

RESUMEN

The periodontal bacteria Prevotella intermedia and Prevotella nigrescens have been recently separated from each other. The purpose of this study was to investigate the distribution and routes of transmission of these bacteria among family members. Seven patients with moderate to severe periodontitis were selected. These probands, their spouses and 14 of their children were investigated. The presence of Pr. intermedia and Pr. nigrescens was determined by culture techniques in pooled subgingival plaque samples, in the saliva, on the tongue, tonsils and buccal mucosa. Differentiation of Pr. intermedia and Pr. nigrescens was performed by enzyme electrophoretic mobility. From all 7 patients, as well as 4 spouses and 3 of the children, Pr. intermedia could be isolated. Pr. nigrescens was found in 2 of the 7 patients, in 5 of the spouses and in 5 of the 6 children aged 5-10 yr. In the 8 children aged 0-4 yr both species were seldom isolated. These data are in accordance with earlier findings that Pr. intermedia is associated with periodontitis and Pr. nigrescens with a relatively healthy periodontal condition. Ribotyping of bacteria was performed by hybridization of HindIII restriction endonuclease digests of chromosomal DNA with ribosomal DNA. Isolates from unrelated individuals always had distinct ribotypes. Indistinguishable ribotypes of Pr. intermedia and Pr. nigrescens were found both among married couples and among parents and children. This indicates that intrafamilial transmission of Pr. intermedia and Pr. nigrescens is possible both between adults and between parents and children.

Asunto(s)

Infecciones por Bacteroidaceae/transmisión , Periodontitis/microbiología , Prevotella/aislamiento & purificación , Adulto , Técnicas de Tipificación Bacteriana , Niño , Preescolar , Dermatoglifia del ADN , ADN Bacteriano/análisis , ADN Ribosómico/análisis , Transmisión de Enfermedad Infecciosa , Salud de la Familia , Femenino , Humanos , Lactante , Transmisión Vertical de Enfermedad Infecciosa , Masculino , Persona de Mediana Edad , Prevotella intermedia/aislamiento & purificación

RESUMEN

In children with a healthy periodontal condition the pocket depth may vary between 1 to 2 mm. In the mixed dentition it may increase up to 3 mm and in the permanent dentition the pocket depth usually decreases again to between 1 and 2 mm. If a pocket of 5 mm or more is diagnosed one should be aware of periodontal breakdown, i.e. periodontitis. Periodontitis is usually defined on the basis of age, localisation and the presence of systemic diseases. Frequent periodontal probing is necessary to detect periodontal breakdown in an early stage and enables subsequent periodontal treatment. Involvement of the parents in the treatment is important. Their major contribution in the treatment is daily careful cleaning of the dentition of the child.

Asunto(s)

Periodontitis/diagnóstico , Adolescente , Factores de Edad , Periodontitis Agresiva/diagnóstico , Periodontitis Agresiva/prevención & control , Periodontitis Agresiva/terapia , Niño , Atención Dental para Niños/métodos , Dispositivos para el Autocuidado Bucal , Femenino , Estado de Salud , Humanos , Masculino , Bolsa Periodontal/diagnóstico , Bolsa Periodontal/prevención & control , Bolsa Periodontal/terapia , Periodontitis/prevención & control , Periodontitis/terapia , Factores de Riesgo

RESUMEN

Products of periodontopathic bacteria exert immunomodulatory effects on various lymphoid cell populations, some of which have been implicated in the pathogenesis of periodontitis. It has recently been suggested that some of these bacterial products may possess superantigenic (SAg) activity. SAg bind simultaneously to the V beta chain of T cell receptors and to class II major histocompatibility complex molecules, thereby activating as many as 35% of T cells to proliferate and produce cytokines. In order to examine this question, the proliferation of splenic and thymic T cells from immunologically naive, 3-6-wk-old Balb/c (H-2d), C57BL/6 (H-2b) and C3H/HeJ (H-2k) mice was assessed in response to sonic extracts of periodontopathogens. Laboratory and/or reference strains of a.o. Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia and Prevotella nigrescens were used as stimulants. Staphylococcal enterotoxin B (SEB), a known superantigen, was utilized as a positive control. Unfractionated spleen cells responded to several of the tested preparations of the different bacteria, as well as to SEB, Con A and Escherichia coli LPS. Thymocytes responded to Con A and SEB, but not to LPS or to any sonic extract. Spleen cells depleted of B cells by panning responded to SEB and Con A, but not to LPS and showed a reduced response to sonicates. The residual response of B cell-depleted spleen cells was reduced essentially to background by treatment with anti-Thy 1.2 + C'. Similar results were obtained in the presence of 5% added mitomycin-treated antigen presenting cells, indicating that these cells were not limiting. These results demonstrate that extracts of periodontopathic bacteria do not stimulate murine T cells in a manner consistent with superantigenic activation.

Asunto(s)

Antígenos Bacterianos/análisis , Bacterias Gramnegativas/inmunología , Periodontitis/microbiología , Superantígenos/análisis , Linfocitos T/inmunología , Adyuvantes Inmunológicos/análisis , Aggregatibacter actinomycetemcomitans/inmunología , Animales , Células Presentadoras de Antígenos/inmunología , Antígenos Bacterianos/inmunología , División Celular , Concanavalina A/inmunología , Citocinas/inmunología , Enterotoxinas/análisis , Enterotoxinas/inmunología , Escherichia coli , Antígenos de Histocompatibilidad Clase II/inmunología , Lipopolisacáridos/inmunología , Activación de Linfocitos/inmunología , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C3H , Ratones Endogámicos C57BL , Ratones Endogámicos , Porphyromonas gingivalis/inmunología , Prevotella/inmunología , Prevotella intermedia/inmunología , Receptores de Antígenos de Linfocitos T alfa-beta/inmunología , Bazo/citología , Staphylococcus aureus/inmunología , Superantígenos/inmunología , Timo/citología

RESUMEN

Symptomatic bacteremia after dental treatment in an apparently healthy patient is an indication for preventive antibiotic treatment. This article describes the case of a patient with clinical symptoms of bacteremia after periodontal treatment, in whom the blood cultures remained positive after oral administration of amoxicillin (Chlamoxyl). Intramuscular administration of penicillin (Bicilline) was able to prevent the clinical symptoms as well as the bacteremia.

Asunto(s)

Profilaxis Antibiótica , Bacteriemia/prevención & control , Penicilinas/uso terapéutico , Enfermedades Periodontales/terapia , Administración Oral , Adulto , Amoxicilina/administración & dosificación , Amoxicilina/uso terapéutico , Bacteriemia/etiología , Femenino , Humanos , Inyecciones Intramusculares , Penicilinas/administración & dosificación , Enfermedades Periodontales/microbiología

RESUMEN

The aim of the present study was to investigate the prevalence of periodontopathic microorganisms and periodontal destruction in the spouses and children of adult periodontitis patients. For this study, 24 families were selected on the basis of one parent with severe periodontal breakdown and the presence of Actinobacillus actinomycetemcomitans and/or Porphyromonas gingivalis and/or more than 30% Prevotella intermedia subgingivally. The clinical examination of both parents and children included pocket depth and clinical attachment loss (CAL) measurements. Samples for bacterial examination were obtained from the mucous membranes, the saliva and pockets. Pocket selection was based on the most advanced periodontitis situation found in a subject. The samples were cultured for the detection of A. actinomycetemcomitans, P. gingivalis and P. intermedia. By phase-contrast microscopy, the % of spirochetes and motile microorganisms was assessed. The number of children within each family varied between 1 and 3. In total 49 children were investigated with a range in age of 3 months to 15 years. Results showed that under the age of 5 years, none of the children had CAL, whereas in the age group of 5-15 years, 26.5% had 1-5 sites in the primary and/or permanent dentition with 1-3 mm CAL. 3 of the spouses had no interproximal CAL. 16 of the 24 spouses had a light to moderate form of periodontitis, with at least one site with 1 to 4 mm CAL and 5 spouses had severe periodontal breakdown with sites showing at least 8 mm CAL. Spirochetes, motile microorganisms and P. intermedia were frequently present in all family members. 18 out of the 24 probands were positive for P. gingivalis. This organism was found once only in a 5-year-old boy and in 11 of the spouses. A. actinomycetemcomitans was detected in 13 probands; 5 children and 5 of the spouses were also positive for this bacterium. If a child harboured one of the periodontopathogens, at least 1 of the parents was also positive for that bacterium. This phenomenon may be due to transmission of microorganisms between family members. Comparison of the clinical data reported in the present study with similar clinical parameters from epidemiological studies of the Dutch population suggest that the spouses and children of adult periodontitis patients might be at relatively high risk of developing periodontal breakdown.

Asunto(s)

Aggregatibacter actinomycetemcomitans/aislamiento & purificación , Bacteroides/aislamiento & purificación , Salud de la Familia , Periodontitis/microbiología , Porphyromonas gingivalis/aislamiento & purificación , Adolescente , Adulto , Infecciones Bacterianas/transmisión , Distribución de Chi-Cuadrado , Niño , Preescolar , Placa Dental/microbiología , Índice de Placa Dental , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/patología , Índice Periodontal , Bolsa Periodontal/microbiología , Bolsa Periodontal/patología , Prevalencia , Spirochaetales/aislamiento & purificación

RESUMEN

The purpose of this study was to evaluate the survival in 3 transport media of 3 suspected periodontal pathogens, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia. Subgingival samples were taken from 10 patients with severe periodontitis, all harboring at least two of the above-mentioned species. The material was dispersed and aliquots were added to vials containing reduced transport fluid, reduced transport fluid containing 10% Fildes extract, or viability-maintaining microbiostatic medium, anaerobically prepared (VMGA III). Viable counts were determined after 1, 2, 4, 24 and 48 h of storage at 4 degrees C or at room temperature. The results showed that, for up to 4 h of storage, no significant differences existed for all parameters tested. A large increase of the total viable counts was found in VMGA III at room temperature after 24 and 48 h. This was due to an outgrowth of mainly streptococci. Incubation at 4 degrees C yielded often a significantly higher recovery compared to room temperature. After storage at room temperature, the tested bacteria were below detection level in some samples.

Asunto(s)

Aggregatibacter actinomycetemcomitans , Bacteroides , Medios de Cultivo , Porphyromonas gingivalis , Análisis de Varianza , Placa Dental/microbiología , Humanos , Periodontitis/microbiología , Preservación Biológica , Manejo de Especímenes

RESUMEN

The distribution and transmission of Porphyromonas gingivalis and Actinobacillus actinomycetemcomitans in 4 families were studied. The families were included, based on the isolation of P. gingivalis from a young child or adolescent. The probands of these 4 families were: a 5-year old periodontally healthy boy; a 17-year old girl with severe generalized juvenile periodontitis; an 11-year old girl with prepubertal periodontitis; 2 sisters, 5 and 17-years old, with untreated severe periodontitis as a component of the Papillon-Lefèvre syndrome. All members of the 4 families were examined clinically and microbiologically for the presence of P. gingivalis and A. actinomycetemcomitans. Most of the parents appeared to be adult periodontitis patients; the parents of one proband were edentulous. Results showed that in all cases at least one of the parents was positive for P. gingivalis. On the basis of indistinguishable restriction endonuclease patterns (REPs) of P. gingivalis and A. actinomycetemcomitans isolates from parents and their children, and distinct REPs from unrelated individuals, the present study indicates that P. gingivalis and A. actinomycetemcomitans were transmitted between parents and their children.

Asunto(s)

Aggregatibacter actinomycetemcomitans/aislamiento & purificación , Salud de la Familia , Periodontitis/microbiología , Periodoncio/microbiología , Porphyromonas gingivalis/aislamiento & purificación , Adolescente , Adulto , Aggregatibacter actinomycetemcomitans/clasificación , Aggregatibacter actinomycetemcomitans/genética , Periodontitis Agresiva/microbiología , Niño , Preescolar , ADN Bacteriano/análisis , Enfermedades en Gemelos , Femenino , Hemorragia Gingival/patología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Índice Periodontal , Bolsa Periodontal/patología , Periodontitis/genética , Porphyromonas gingivalis/clasificación , Porphyromonas gingivalis/genética , Gemelos Monocigóticos

RESUMEN

At present Actinobacillus actinomycetemcomitans is regarded as an important microorganism in the etiology of some forms of periodontitis. The purpose of the present investigation was to study the number of Restriction Endonuclease Analysis (REA)-types present in the oral cavity of A. actinomycetemcomitans positive subjects and to study the possibility of transmission of A. actinomycetemcomitans within families of adult periodontitis patients. DNA of A. actinomycetemcomitans isolates was digested with a combination of the restriction endonucleases PstI and BamHI, after which the DNA fragments were separated by agarose gel-electrophoresis. To study the number of REA-types, multiple A. actinomycetemcomitans isolates obtained from 8 different sites in the oral cavity of five subjects were typed. The results showed that in most cases only one REA-type is present. In the 13 families investigated in 4 of the 26 children (15%) and in 1 of the 13 spouses (8%) of the adult periodontitis patients an indistinguishable REA-type was found within the families. This suggests that also in the case of adult periodontitis transmission of A. actinomycetemcomitans is possible, but does not seem to occur easily.

Asunto(s)

Infecciones por Actinobacillus/transmisión , Aggregatibacter actinomycetemcomitans/aislamiento & purificación , Periodontitis Agresiva/microbiología , ADN Bacteriano/genética , Periodontitis/microbiología , Adolescente , Adulto , Aggregatibacter actinomycetemcomitans/genética , Aggregatibacter actinomycetemcomitans/patogenicidad , Técnicas de Tipificación Bacteriana , Niño , Preescolar , Dermatoglifia del ADN , ADN Bacteriano/análisis , Desoxirribonucleasa BamHI , Desoxirribonucleasas de Localización Especificada Tipo II , Electroforesis en Gel de Agar , Salud de la Familia , Femenino , Humanos , Lactante , Persona de Mediana Edad , Epidemiología Molecular , Prohibitinas

RESUMEN

In this study we determined the prevalence and distribution of Porphyromonas endodontalis in 26 families consisting of 107 subjects. P. endodontalis was present in 24% of the investigated subjects and was recovered most often from the dorsum of the tongue (50%). Isolation was also possible from the tonsils, the buccal mucosa, the saliva and the periodontal pocket. The usefulness of restriction endonuclease analysis as a typing method for this particular species was investigated by typing 19 isolates from unrelated individuals. All these isolates had unique restriction endonuclease patterns. The observed heterogeneity indicates that restriction endonuclease analysis is a sensitive measure of genetic dissimilarity between P. endodontalis isolates and is able to characterize individual isolates. Application of restriction endonuclease analysis to the obtained clinical isolates in this study shows the possibility of the presence of multiple clonal types within one subject. The DNA patterns of all P. endodontalis isolates from unrelated individuals were found to be distinct. In 3 families the DNA patterns of isolates from the mother and her child were indistinguishable. These data indicate the possibility of intrafamilial transmission of P. endodontalis.

Asunto(s)

Enzimas de Restricción del ADN , Boca/microbiología , Porphyromonas/genética , Porphyromonas/aislamiento & purificación , Adolescente , Adulto , Técnicas de Tipificación Bacteriana , Niño , Preescolar , Dermatoglifia del ADN , Familia , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Porphyromonas/clasificación , Prevalencia

RESUMEN

Porphyromonas gingivalis has been associated with severe forms of periodontitis. The question can be raised about the origin of this suspected periodontal pathogen. The purpose of the present investigation was to study the possibility of transmission of P. gingivalis between spouses. 18 patients were selected with severe periodontitis and colonized with P. gingivalis. 10 of their spouses appeared to be colonized with P. gingivalis too. 8 of the patients and their spouses were investigated further clinically and microbiologically. Microbiological evaluation revealed mostly high %s of P. gingivalis in the pockets, not only of the patients (5-48% of the cultivable flora), but also in 7 of the 8 spouses (0.2-61%). Furthermore, this species was isolated often from the saliva, the tongue, the buccal mucosa and the tonsillar area from both patients and spouses. For typing purposes, bacterial DNA was isolated, treated with the restriction endonucleases Bam HI or Pst I, after which the DNA fragments were separated by agarose gelelectrophoresis. With one exception, each individual was colonized with only one clonal type of P. gingivalis. The DNA patterns of all P. gingivalis isolates from unrelated individuals were found to be distinct. In contrast, in 6 of the 8 couples, the DNA patterns of isolates from husband and wife were indistinguishable. From these data, it can be concluded that it is most likely, that P. gingivalis can be transmitted between spouses. It remains to be investigated whether transmission of P. gingivalis is a risk factor for developing periodontal destruction.

Asunto(s)

Infecciones por Bacteroides/transmisión , Salud de la Familia , Periodontitis/microbiología , Porphyromonas gingivalis/aislamiento & purificación , Adulto , Técnicas de Tipificación Bacteriana , Dermatoglifia del ADN , ADN Bacteriano/análisis , Desoxirribonucleasa BamHI , Desoxirribonucleasas de Localización Especificada Tipo II , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca/microbiología , Porphyromonas gingivalis/genética

RESUMEN

This study focused on several factors that may influence the percentage of motile microorganisms in a sample from the tongue determined using a phase-contrast microscope. It was found that the time elapsing between sampling and analysis is crucially important. In both sterile saline and reduced transport fluid (RTF), a reduction of the percentage of motile microorganisms was found within 15-30 min after sampling respectively. In order to be able to prolong the time interval between sampling and analysis, it was found that storing a sample in a tuberculin syringe with RTF supplemented with Fildes extract preserved the motility of the microorganisms and gave no significant reduction in the percentage of motiles within 48 h.

Asunto(s)

Técnicas Bacteriológicas , Placa Dental/microbiología , Movimiento Celular , Medios de Cultivo , Humanos , Microscopía de Contraste de Fase , Manejo de Especímenes , Factores de Tiempo

Asunto(s)

Dentadura Parcial Fija , Enfermedades Periodontales , Humanos , Arcada Parcialmente Edéntula/complicaciones , Arcada Parcialmente Edéntula/rehabilitación , Enfermedades Periodontales/complicaciones