Sialochemistry in mucosal lesions of the tongue: electrolytes and total protein

A total of 39 patients with tongue diseases and 17 controls were subjected to chemical analysis of saliva to determine whether tongue lesions are correlated with the composition of the saliva. The salivary flow rate, total protein, phosphate and electrolyte content (Na, K, Ca) were measured in unstimulated and stimulated saliva. The results indicate that disturbed salivary secretion could be revealed in patients with filiform atrophy and those with hairy tongue. The hormonal imbalance might be a factor in the etiology of filiform atrophy and geographic tongue. No significant difference between the sialochemistry of patients with fissured tongue and controls was found.     

Clinical and radiographic study of pulpectomy and root canal therapy.

A clinical and radiographic reexamination of 2,459 roots 2-7 years after initial pulpectomy or root canal therapy is presented. The overall success rate, which was 53%, was not affected by the sex or age of the patient, or by the jaw in which the tooth was situated. The tooth group, however, had a significant influence on the success rate, the worst results being obtained for incisors and especially the mandibular central and maxillary lateral incisors. The prognosis was clearly better for the pulpectomies than for the root canal therapy. Mortal pulpectomy was found to succeed more often than vital. The presence of a primary periapical rarefaction worsened the success rate. The success rate was lower for the teeth in which a posttreatment prosthetic crown had been fitted. Fillings which went beyond the apex had a significantly lower success rate than those which nearly or exactly reached the apex.     

Eikenella corrodens prosthetic valve endocarditis in a patient with ulcerative colitis

A 33-y-old male with ulcerative colitis developed prosthetic valve endocarditis (PVE) caused by Eikenella corrodens. The outcome of conservative treatment was successful. Only 2 cases of E. corrodens PVE were found in a survey of the English-language medical literature. In contrast to previous data indicating that eikenella infections usually derive from the oral cavity, our patient most likely acquired the infection by colonoscopy and mucosal biopsies, which were performed a few days before onset of the disease.     

Inaccuracy of the disk diffusion method compared with the agar dilution method for susceptibility testing of Campylobacter spp

The agar dilution method has been standardized by the CLSI for the susceptibility testing of Campylobacter species, and according to these standards, the disk diffusion method should be used only in screening for macrolide and ciprofloxacin resistance. Nevertheless, the disk diffusion test is currently widely used, since it is easy to perform in clinical microbiology laboratories. In this study, the disk diffusion method was compared to the agar dilution method by analyzing the in vitro activities of seven antimicrobial agents against 174 Campylobacter strains collected in Finland between 2003 and 2008. Recommendations of the CLSI were followed using Mueller-Hinton agar plates with 5% of sheep blood. For each strain, the disk diffusion tests were performed two to four times. Of the 33 erythromycin-resistant strains (MIC, ≥16 μg/ml), 24 (73%) constantly showed a 6-mm erythromycin inhibition zone (i.e., no inhibition), while for seven strains the inhibition zone varied from 6 to 44 mm in repeated measurements. Among the 141 erythromycin-susceptible strains (MIC, <16 μg/ml), erythromycin inhibition zones varied between 6 and 61 mm. Of the 87 ciprofloxacin-resistant strains, 47 (54%) showed 6-mm inhibition zones, while 40 strains showed inhibition zones between 6 and 60 mm. Significant differences between the repetitions were observed in the disk diffusion for all antimicrobial agents and all strains except for the macrolide-resistant strains regarding the macrolides. For 17 (10%) strains, the variation in repeated measurements was substantial. These results show that the disk diffusion method may not be a reliable tool for the susceptibility testing of Campylobacter spp. Further studies are needed to assess whether the disk diffusion test could be improved or whether all susceptibilities of campylobacters should be tested using an MIC-based method.     

Quantitative analysis of complement receptors, CR1 (CD35) and CR3 (CD11b), on neutrophils improves distinction between bacterial and viral infections in febrile patients: comparison with standard clinical laboratory data

There is an ongoing need for sensitive and specific markers of bacterial infection. In this prospective study, standard clinical laboratory data (neutrophil count, serum C reactive protein level, erythrocyte sedimentation rate) and quantitative flow cytometric analysis of neutrophil complement receptors, CR1 and CR3, were obtained from 289 hospitalized febrile patients. After microbiological confirmation or clinical diagnosis, 135 patients were found to have either bacterial (n = 89) or viral (n = 46) infection. The patient data was compared to 60 healthy controls. In bacterial infections, all measured variables were significantly increased, particularly the average amounts of CR1 and CR3 on neutrophils were over three-fold and two-fold higher, respectively, compared to viral infections and controls. We described a novel marker of local and systemic bacterial infections designated 'clinical infection score (CIS) point', which incorporates quantitative analysis of complement receptors on neutrophils and standard clinical laboratory data. CIS point varied between 0 and 8, and displayed 98% sensitivity and 97% specificity in distinguishing between bacterial and viral infections [average (S.D.); CIS points: 6.2 (1.7) vs. 0.6 (1.0); p < 0.001]. These findings suggest that the proposed CIS-based diagnostic test could potentially assist physicians in deciding whether antibiotic treatment is necessary.