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A clinical case of an adult horse with invasive, ulcerative, proliferative, pyogranulomatous disease of the skin (tumor) in the shoulder region is presented. The mass had a granulomatous and crater-shaped appearance, with serosanguinous discharge and the presence of fistulas with caseous material. The tumor was removed by surgery and sent to the laboratory for diagnosis. Histopathology was performed using Grocott-Gomori methenamine silver stain. The presence of necrotic material, fibrosis, infiltrated cells, and brown-colored hyphae, characteristic of members of the genus Pythium, were observed. To identify the infecting species, conventional PCRs for the amplification of the ITS-1 was carried out. Histopathological and PCR tests confirmed infection by a Pythium insidiosum strain closely associated with previous records from the US and Central America. Our report represents the first molecularly confirmed case of equine pythiosis in Mexico.
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Doenças dos Cavalos , Pitiose , Pythium , Animais , Pitiose/diagnóstico , Pitiose/microbiologia , Pitiose/patologia , Cavalos , Pythium/isolamento & purificação , Pythium/genética , Pythium/classificação , Doenças dos Cavalos/parasitologia , Doenças dos Cavalos/microbiologia , Doenças dos Cavalos/diagnóstico , México , Reação em Cadeia da Polimerase , DNA Espaçador Ribossômico/genética , Masculino , Histocitoquímica , Pele/patologia , Pele/microbiologia , Pele/parasitologiaRESUMO
INTRODUCTION AND HYPOTHESIS: Dysuria is a common symptom present in several urological and gynecological conditions. Management relies on the underlying disease but may require additional symptomatic treatment. This study evaluated the combination of methenamine 250 mg and methylthioninium chloride 20 mg in the treatment of dysuria versus phenazopyridine. METHODS: This was a multicenter, single-blind, randomized, superiority clinical trial, including individuals over 18 with dysuria and a score ≥ 5 points on the pre-treatment categorical scale for pain. The primary outcome was the proportion of participants presenting excellent clinical response within 24 h after treatment. Improvement up to 72 h, time to reach improvement, sustained healing, investigators' opinion, and safety were also evaluated. RESULTS: Three hundred and fifteen participants were evaluated. Demographic characteristics and symptoms of dysuria were comparable between groups at baseline. The difference in the excellent response rate between treatments within 24 h was 12.7% (95% CI 6.16, 19.21) for pain, 9.4% (95% CI 3.32, 15.39) for burning, and 12.7% (95% CI 6.37, 18.99) for burning on urination, all in favor of the test drug, which was also superior from 36 to 48 h. Treatments were similar concerning time to reach the absence of symptoms and in the percentage of participants with sustained healing after 72 h. CONCLUSIONS: The association of methenamine with methylthioninium is superior to phenazopyridine in the treatment of dysuria.
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Disuria , Metenamina , Humanos , Disuria/tratamento farmacológico , Disuria/etiologia , Azul de Metileno , Dor , Fenazopiridina/uso terapêutico , Método Simples-Cego , AdultoRESUMO
PURPOSE: Urinary antiseptics including methenamine and methylene blue are used in the symptomatic treatment of urinary tract infections (UTIs). PATIENTS AND METHODS: This was a prospective, double-blind, randomized, double-dummy safety and efficacy study of 2 urinary antiseptic combinations in the symptomatic treatment of recurrent cystitis: methenamine 120mg + methylene blue 20mg (Group A) versus acriflavine 15mg + methenamine 250mg + methylene blue 20mg + Atropa belladonna L. 15mg (Group B). All subjects underwent pretreatment urine culture and antibiotic sensitivity tests prior to 3-day oral treatment with study drug, followed by 3 days of antibiotic therapy (based on urine culture) + study drug treatment. Efficacy was evaluated using the Urinary Tract Infection Symptoms Assessment Questionnaire (UTISA). The primary endpoint was the percentage of patients presenting improvement in cystitis manifestations on the UTISA domain "Urination Regularity" at Visit 2. The primary safety variable was the incidence of treatment-related adverse events. RESULTS: A total of 144 subjects were randomized per group and 272 completed the study. Primary endpoint analysis demonstrates homogeneity between treatment groups, with 69.4% and 72.2% subjects, respectively, showing improvement in the score of the urinary regularity UTISA domain after 3 days of treatment (p= 0.87). At Visit 2, incidence of treatment-related adverse events was higher in Group B (Group A: n= 11, Group B: n= 31, p= 0.0057). CONCLUSION: Both treatments were effective in reducing UTI symptoms assessed by UTISA questionnaire after 3 days of treatment. The two regimens were comparable in incidence of adverse events, but the combination of methenamine + methylene blue resulted in fewer treatment-related adverse effects.
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The present study developed Galleria mellonella and murine infection models for the study of Trichosporon infections. The utility of the developed animal models was demonstrated through the assessment of virulence and antifungal efficacy for 7 clinical isolates of Trichosporon asahii, T. asteroides and T. inkin. The susceptibility of the Trichosporon isolates to several common antifungal drugs was tested in vitro using the broth microdilution and the E-test methods. The E-test method depicted a lower minimal inhibitory concentration (MIC) for amphotericin and a slightly higher MIC for caspofungin, while MICs observed for the azoles were different but comparable between both methods. All three Trichosporon species established infection in both the G. mellonella and immunosuppressed murine models. Species and strain dependent differences were observed in both the G. mellonella and murine models. T. asahii was demonstrated to be more virulent than the other 2 species in both animal hosts. Significant differences in virulence were observed between strains for T. asteroides in the murine model. In both animal models, fluconazole and voriconazole were able to improve the survival of the animals compared to the untreated control groups infected with any of the 3 Trichosporon species. In G. mellonella, amphotericin was not able to reduce mortality in any of the 3 species. In contrast, amphotericin was able to reduce murine mortality in the T. asahii or T. inkin models, respectively. Hence, the developed animal infection models can be directly applicable to the future deeper investigation of the molecular determinants of Trichosporon virulence and antifungal resistance.
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Antifúngicos/farmacologia , Modelos Animais de Doenças , Rim/microbiologia , Mariposas/microbiologia , Trichosporon/efeitos dos fármacos , Trichosporon/patogenicidade , Tricosporonose/microbiologia , Anfotericina B/farmacologia , Anfotericina B/uso terapêutico , Animais , Antifúngicos/uso terapêutico , Caspofungina , Farmacorresistência Fúngica , Equinocandinas/farmacologia , Equinocandinas/uso terapêutico , Fluconazol/uso terapêutico , Hospedeiro Imunocomprometido , Rim/patologia , Rim/fisiopatologia , Rim/ultraestrutura , Larva/microbiologia , Lipopeptídeos , Camundongos , Testes de Sensibilidade Microbiana , Trichosporon/isolamento & purificação , Trichosporon/ultraestrutura , Tricosporonose/tratamento farmacológico , Tricosporonose/mortalidade , Voriconazol/farmacologia , Voriconazol/uso terapêuticoRESUMO
OBJECTIVE: To evaluate the hybridization quality and bond strength of adhesives to dentin. MATERIALS AND METHODS: Ten human molars were ground to expose the dentin and then sectioned in four tooth-quarters. They were randomly divided into 5 groups according to the adhesive used: Two single-step self-etch adhesives - Adper Prompt (ADP) and Xeno III (XE), two two-step self-etching primer systems - Clearfil SE Bond (SE) and Adhe SE (ADSE), and one one-step etch-and-rinse system - Adper Single Bond (SB). Resin composite (Filtek Z250) crown buildups were made on the bonded surfaces and incrementally light-cured for 20 s. The restored tooth-quarters were stored in water at 37°C for 24 h and then sectioned into beams (0.8 mm(2) in cross-section). Maximal microtensile bond strength (µ-TBS) was recorded (0.5 mm/min in crosshead speed). The results were submitted to one-way ANOVA and Tukey's test (α = 0.05). Thirty additional teeth were used to investigate the hybridization quality by SEM using silver methenamine or ammoniacal silver nitrate dyes. RESULTS: SE reached significantly higher µ-TBS (P < 0.05); no significance was found between ADSE and XE (P > 0.05), and between SB and ADP (P > 0.05); ADSE and XE were significantly higher than SB and ADP (P < 0.05). The bonding interface of SB showed the most intense silver uptake. SE and ADSE showed more favorable hybridization quality than that observed for ADP and XE. CONCLUSIONS: The bond strength and hybridization quality were affected by the interaction form of the adhesives with dentin. The hybridization quality was essential to improve the immediate µ-TBS to dentin.
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Introduction: Urinary tract infection (UTI) is a very common condition in clinical practice, affecting an estimated 50% of all adult women during a lifetime. The most common causative agent is E. coli UTI may also be caused by S. saprophyticus, Enterobacteria (Klebsiella sp and Serratia sp.), Enterococcus sp., and P. aeruginosa. Recurrent UTIs occur at least twice per semester or three times a year. Prophylactic measures to prevent recurrent UTIs include changes in contraception methods, cranberry products, increased fluid intake, urination after intercourse, vaginal estrogen therapy for post-menopausal women, antibiotics, and urinary tract antiseptic agents. Objectives: To evaluate the use of a combination of methenamine and methylthioninium chloride in the prophylaxis of recurrent uncomplicated lower UTIs, with respect to: · Signs and symptoms of UTI· Etiologic agent(s)· Recurrence rates· Need for antibiotic therapy in case of recurrence · Incidence of adverse events associated with the treatment, including any reported alterations of laboratory testsMaterials & methods: A descriptive, analytic, restrospective study was performed at Hospital Universitário Constantino Otaviano - UNIFESO. Medical charts from patients presenting recurrent uncomplicated lower UTI attended from 2001-present were analyzed, including the following information: Demographic data (age, gender, weight, ethnicity, living conditions) medical history/ signs and symptoms of UTI identification of treatment and dosing regimens treatment duration recurrence rates and need for antibiotic therapy in case of recurrence other medications prescribed and records of adverse events. Results: E. coli was identified as etiologic agent in 80% of the patients. Following antibiotic therapy, all patients received prophylactic treatment with the combination of methenamine and methylthioninium chloride. Treatment duration ranged from three to six months. Adverse events were observed in 13/60 patients...
Introdução: A infecção do trato urinário é bastante comum na prática clínica, afetando aproximadamente 50% de todas as mulheres adultas em algum momento da vida. O agente etiológico mais comum é a E. coli. A ITU pode também ser causada por S. saprophyticus, Enterobactérias (Klebsiella sp. e Serratia sp.), Enterococcus sp. e P. aeruginosa. ITUs recorrentes ocorrem ao menos duas vezes por semestre ou três vezes ao ano. Medidas profiláticas para prevenir a recorrência incluem alterações nos métodos contraceptivos, produtos de oxicoco, aumento da ingestão de fluidos, micção após a relação sexual, e terapia vaginal de estrogênio para mulheres em pós-menopausa, bem como antibióticos e anti-sépticos urinários. Objetivos: Avaliar o uso da combinação de de metentamina e cloreto de metiltionínio na profilaxia de ITUs recorrentes não-complicados, com respeito à: · Sinais e sintomas de ITU · Agente etiológico · Número de recorrências · Necessidade de terapia antibiótica em caso de recorrência · Incidência de efeitos adversos do tratamento, inclusive quaisquer alterações de exames laboratoriais. Materiais e métodos: Foi realizado um estudo descritivo, analítico, retrospectivo no Hospital Universitário Constantino Otaviano UNIFESO. Prontuários médicos disponíveis de pacientes apresentando ITU recorrente não complicada, atendidos de 2001-presente foram analisados, incluindo-se as seguintes informações: dados demográficos (idade, sexo, peso, etnia, condições habitacionais) histórico médico/ sinais e sintomas de ITU identificação do tratamento e regime de tratamento recorrência necessidade de tratamento antibiótico no caso de recorrência outros medicamentos prescritos e registro de efeitos adversos. Resultados: E. coli foi identificado como agente etiológico em 80% dos pacientes. Após terapia antibiótica, todos os pacientes receberam tratamento profilático com a combinação de metenamina e cloreto de metiltionínio. A duração do tratamento variou entre três a seis meses...
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FUNDAMENTOS - A análise dos cortes histológicos de lesöes cutâneas corados pela prata metenamina (PM) e hematoxilina-eosina (HE) revelam diferenças na coloraçäo do P.loboi, agente causador da doença de Jorge Lobo. Nos cortes corados pela PM observa-se também depósito de uma substância granulosa, de tonalidade marrom-escura, semelhante àquela exibida pelo parasita. OBJETIVOS - Interpretar as alteraçöes da coloraçäo do P.loboi corado pela PM em cortes histológicos e suspensöes fúngicas e comparar os resultados com os obtidos por meio da coloraçäo vital pelo diacetato de fluoresceína-brometo de etídio (DF-BE). Interpretar, também, a natureza do material granuloso e argentófilo observado em algumas localizaçöes das lesöes cutâneas. PACIENTE E MÉTODOS - Biópsias da pele de cinco pacientes foram processadas em soluçäo salina 0,85 porcento e incluídas em parafina para obtençäo de cortes histológicos. A suspensäo de fungos foi corada pelo DF-BE e PM, e os cortes histológicos, pela HE e PM com a finalidade de avaliar a viabilidade dos fungos. RESULTADOS - Os percentuais de viabilidade do P.loboi em suspensäo variaram de 37 a 51 porcento e de 39 a 59 porcento com os corantes DF-BE e PM, respectivamente. Nos cortes histológicos corados pela PM, os percentuais variaram de 36 a 57 porcento. Observou-se material granuloso argentófilo em todos os cortes analisados, tanto no interior de células em que havia grande número de cápsulas vazias quanto em áreas com número de fungos reduzido. CONCLUSÖES - Os resultados obtidos sugerem que, por meio da coloraçäo dos cortes histológicos pela PM, é possível estimar o índice de viabilidade do P.loboi, embora a coloraçäo dos fungos em suspensäo pelo DF-BE seja método mais preciso. As observaçöes feitas também sugerem que a presença do material argentófilo está relacionada com a destruiçäo do P.loboi no interior dos macrófagos