Denture stomatitis presents as a chronic disease in denture-bearing patients, especially under maxillary prosthesis. Despite the existence of a great number of antifungal agents, treatment failure is observed frequently. Propolis, a natural bee product, possesses well-documented antifungal and anti-inflammatory activities. The purpose of this study was to evaluate the clinical efficacy of a new Brazilian propolis gel formulation in patients diagnosed with denture stomatitis. Thirty complete-denture wearers with denture stomatitis were enrolled in this pilot study. At baseline, clinical evaluation was performed by a single clinician and instructions for denture hygiene were provided. Fifteen patients received Daktarin (Miconazole gel) and 15 received Brazilian propolis gel. All patients were recommended to apply the product four times a day during one week. Clinical evaluation was repeated by the same clinician after treatment. All patients treated with Brazilian propolis gel and Daktarin had complete clinical remission of palatal edema and erythema. This new Brazilian propolis gel formulation had efficacy comparable to Daktarin and could be an alternative topical choice for the treatment of denture stomatitis.
This study evaluated the susceptibility of oral pathogenic microorganisms Candida albicans, Streptococcus mutans, Staphylococcus aureus, and Aggregatibacter actinomycetemcomitans to Brazilian medicinal plant extracts of Schinus terebinthifolius (aroeira), Croton campestris (velame), Lafoensia pacari (pacari), Centaurium erythraea (centáurea), Stryphnodendron adstringens (barbatimão), and Anacardium humile (cajuzinho-docerrado), as compared to standardized antimicrobial agents (nystatin, chloramphenicol and tetracycline hydrochloride). Ethanol, hexane and butane fractions from stem barks, rinds, leaves, and/or roots were extracted and tested. Antimicrobial diffusion agar test and MIC were performed according to CLSI. After 24 h of incubation at 37 °C, the diameter of inhibition zones and spectrophotometer readings were measured and compared. The results were reported as means ± standard deviation (M ± SD). With the exception of five extracts that showed no antimicrobial activity, all the extracts tested showed antimicrobial activity, in different levels. This study suggests that extracts from the plants tested could be an alternative therapeutic option for infectious conditions of the oral cavity, such as denture stomatitis, dental caries, and periodontitis.
The objective of this phase II study was to determine the effectiveness of a mucoadhesive propolis gel in the prevention of radiation-induced oral mucositis. Twenty-four patients who were selected to undergo radiation therapy for oral cancer were included in this open-label trial. They were advised to use a mucoadhesive gel containing propolis 5,0% w/v three times a day starting one day before the course of radiation therapy and concluding after 2 weeks of radiation therapy. A weekly follow-up for evaluation of food intake, pain and grading of mucositis was performed. In order to confirm the absence of Candida-related mucositis in patients who developed mucositis, it was performed exfoliative cytology of buccal mucosa, palate and tongue and the material for Candifast(®) Candida species identification. At the end of the study was made the compliance of patients, quality, appreciation and acceptance of product evaluation. Twenty patients did not develop mucositis, two patients developed grade 1 mucositis and two patients developed grade 2 mucositis. None of the patients discontinued food intake and no pain was observed during the study. Candidosis was not detected in any patient. Mucoadhesive propolis gel could be considered as a potential topical medication for preventing radiation-induced oral mucositis. However, comparative phase III study with larger number of patients should be done for confirmation of the efficacy of the product.
INTRODUCTIONPrimary hepatic lymphoma is a rare malignancy which misdiagnosis and mistreatment is very frequent. Differential diagnosis of the hepatic lesion, based on the noninvolvement of blood vessels, includes: fatty infiltration, cirrhosis, amyloid infiltration, primary hepatomas, and metastatic neoplasms.PRESENTATION OF CASEWe describe a case of a 69-year-old man who presented with 15% weight loss and general fatigue over the previous 9 months. Physical examination revealed hepatomegaly without lymphadenopathy or splenomegaly. Magnetic resonance imaging showed a 13 cm × 9 cm × 11 cm tumor on the right liver associated with normal levels of alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA). After two negatives ultrasonography-guided needle liver biopsies, the third one showed diffuse infiltration of large sized lymphoid cells. Immunohistochemical findings demonstrated the B-lymphocyte lineage of the tumor. The patient received R-CHOP therapy (cyclophosphamide, doxorubicin, vincristine, prednisone, and rituximab) with good response.DISCUSSIONIt is important to recognize PHL because it responds favorably to chemotherapy and may have a better prognosis than hepatocellular carcinoma or metastatic disease of the liver. When imaging findings on CT scans and MRI are nonspecific, a biopsy is needed not only for a definitive diagnosis but also for identifying the immunophenotype of the PHL. This type of lesion is highly chemosensitive and early aggressive chemotherapy may result in sustained remission.CONCLUSIONThis case emphasizes the importance of effective recognition of PHL considering its good response to chemotherapy and the possibility of sustained remission if early aggressive treatment is implemented.
Despite advances in diagnosis and treatment, infective endocarditis still shows considerable morbidity and mortality rates. The dermatological examination in patients with suspected infective endocarditis may prove very useful, as it might reveal suggestive abnormalities of this disease, such as Osler’s nodes and Janeway lesions. Osler’s nodes are painful, purple nodular lesions, usually found on the tips of fingers and toes. Janeway lesions, in turn, are painless erythematous macules that usually affect palms and soles. We report a case of infective endocarditis and highlight the importance of skin examination as a very important element in the presumptive diagnosis of infective endocarditis.
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