Isolation of beta-lactamase-producing Bacteroides strains associated with clinical failures with penicillin treatment of human orofacial infections.
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Biomedical subjects
Publications and source records attributed to A Heimdahl.
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A clinical, radiographic and histopathologic report is presented of a case of acanthomatous ameloblastoma in relation to a cystic lesion surrounding an impacted third molar in the left mandible of a 37-year-old healthy woman. The histological examination of the removed specimen revealed the histopathological pattern of an acanthomatous ameloblastoma. In the discussion a survey is presented of the literature concerning acanthomatous ameloblastoma. Special attention is thereby given to the question of malignancy. It is stated that the metaplastic transformation into squamous epithelium which occurs in acanthomatous ameloblastoma does not predispose to malignant changes, to increased recurrent rate or to more extensive invasion of the tumor.
Twenty patients with denture-related papillary hyperplasia of the palate were surgically treated after careful instruction in oral and denture hygiene, insertion of new dentures and nutritional information. A tissue conditioner was used to cause detumescence of the palatal mucosa presurgically and to act as a wound dressing postsurgically. A knife with a semicircular blade made it possible to cut and plane off the papillary hyperplasia in all regions of the palate and accurately to control and vary the thickness of the extirpated tissue. The advantages of this gentle planning surgery were a short healing time (mean 12 days), no bleeding and no pain that necessitated the use of analgetics. After surgery a persistent erythema of the palatal mucosa appeared in five patients. Such a low rate of postsurgical erythema has not previously been reported. A microscopic examination of the extirpated tissue was performed and the findings are discussed.
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Capsules of phenoxymethylpenicillin were given orally to ten subjects in doses of 800 mg twice daily for 7 days. Saliva, throat and faecal specimens were taken over a 29-day period and bacterial cultivations were carried out. No changes in the normal flora of the saliva, throat or faeces were noted during this period. Clindamycin was given orally to ten other subjects in doses of 150 mg, four times per day for 7 days. No changes in the aerobic flora of the saliva and throat were observed while a significant decrease in the number of anaerobic bacteria occurred. Overgrowth of clostridia was seen in two cases. Pronounced changes in the faecal flora occurred. Among the aerobic bacteria, enterococci proliferated, and among the anaerobic bacteria significant decreases in the numbers of cocci and gram-negative rods were seen. In four subjects the number of clostridia increased significantly. Tinidazole was given orally to ten other subjects in doses of 150 mg every 12 hours for 7 days. Slight changes were noted in the anaerobic flora of the saliva while no differences were seen for the faecal flora.
Bacampicillin was given as tablets or syrup in doses of 400 mg three times per day for seven days to twelve subjects. Saliva, throat and faecal specimens were taken during fourteen days for cultivation of aerobic and anaerobic bacteria. No changes in the oral, throat and faecal flora were seen in the subjects receiving tablets while there was a decrease in the number of aerobic and anaerobic bacteria in those subjects receiving syrup. No increased resistance to ampicillin were found in the isolated bacterial strains. Bacampicillin was well-tolerated and no gastrointestinal disturbances were experienced.
Phenoxymethylpenicillin in capsules was given orally in doses of 800 mg twice daily for 7 days to 10 subjects. Saliva, throat and faecal specimens were taken up to 29 days for cultivation of aerobic and anaerobic bacteria. No changes in the normal flora in saliva, throat or faeces were noticed during the observation period. Clindamycin was given orally in doses of 150 mg 4 times daily to 10 other subjects. No changes in the aerobic oral flora were observed, while a significant decrease in the number of anaerobic bacteria occurred. In 2 volunteers, overgrowth of clindamycin-resistant clostridia were seen from days 4--16 in one and from days 2--7 in the other. The throat flora showed changes similar to the oral flora. Pronounced changes in the aerobic and anaerobic faecal bacterial flora occurred. Thus among the aerobes enterococci proliferated and among the anaerobes significant decreases in the number of cocci and gram-negative rods were noticed. In 4 subjects, clindamycin-resistant clostridia increased 4log. One of them developed diarrhoea and harboured an unidentified toxin-producing clostridial strain rather similar to Clostridium difficile.
The relief of pain after extraction of a mandibular third molar by two analgesics, rimazolium and acetylsalicylic acid (ASA) was studied in three groups of patients, who received either of these analgesics or a placebo. A questionnaire and careful instructions on its use were given to the patients. ASA had a better effect than both rimazolium and placebo. The results are discussed with regard to differences between analgesics with or without anti-inflammatory properties.
Reviews of the literature show that simple bone cysts of the jaws no longer can be considered rare. The clinical and radiographic appearances are mostly rather typical, but in some cases there are great variations. In this article an unusual case with both facial asymmetry and bilateral occurrence is described. The differential diagnosis between simple bone cysts, tumors, odontogenic cysts and vascular abnormalities is sometimes hard to establish. In those cases aspiration biopsy can be of great help.
The present article reports a case of multiple endocrine neoplasia (MEN) syndrome, type IIb, including the following components: pheochromocytoma, medullary thyroid carcinoma, hyperplastic corneal nerves and multiple mucosal oral and ocular neurofibromas. The patients, a 35-year-old male also exhibited a series of other pertinent findings, i.e. thickened eyelids, marfanoid habitus and widened mandibular canal and mental foramina. In the discussion the clinical and histopathologic characteristics of the present case are compared with similar findings in other previously published cases. The multiple oral mucosal neurofibromas are described clinically and histopathologically and are stated as a pathognomonic early sign of the syndrome.
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One hundred and forty-eight (72%) of 205 allogenic bone marrow transplant recipients developed mucosal lesions in the oral cavity during the aplastic period after transplantation. Lesions were most frequent 8 to 9 days after transplantation. Factors that correlated with the development of mucosal lesions after univariate and multivariate analysis were a marrow cell dose of less than 3 x 10(8) cells/kg body weight, (p less than 0.0001), prolonged aplastic period (white blood cell count less than 0.2 x 10(9) cell/l during more than 14 days (p less than 0.005), herpes simplex virus-1 seropositivity of the recipient (p less than 0.01), and conditioning with total body irradiation (p less than 0.02).
Fourteen healthy individuals were studied regarding the oropharyngeal microflora. Seven subjects were given a non-absorbable multi-drug regimen, consisting of 1% polymyxin B, 3% neomycin and 3% amphotericin B, that was directed against aerobic gram-negative rods and fungi for local decontamination of the oropharynx. Seven others were given another multi-drug regimen consisting of 1% polymyxin B, 1% neomycin, 3% amphotericin B and 0.5% vancomycin, that also included an agent directed against gram-positive bacteria. Both decontamination regimens were found to protect from new colonization with fungi and gram-negative rods in the oropharynx. Suppression of gram-positive cocci was only observed in those subjects receiving the regimen containing vancomycin.
In the present study the impact on the gastrointestinal microflora of peroral administration of penicillin, bacampicillin, clindamycin, erythromycin, doxycycline, and tinidazole was investigated. The effects on the colonic flora of parenteral administration of ampicillin plus sulbactam, cefoxitin, clindamycin, and tinidazole also were studied. Pronounced changes were observed in the oropharyngeal and colonic microflora in patients receiving clindamycin, erythromycin, and tinidazole (intravenous), whereas moderate changes were seen in those patients receiving doxycycline, cefoxitin, and ampicillin plus sulbactam. Penicillin, bacampicillin, and tinidazole (peroral) produced only minor changes. In most patients with an altered microflora, colonization with new bacterial strains was found.
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