OBJECTIVES: Although individuals with Down syndrome have considerable oral disease, the prevalence of dental caries in this group is low. The present study aimed to compare known risk factors for dental caries development in children with Down syndrome and a matched population (siblings). In both populations, the number of acidogenic microorganisms, such as mutans streptococci, lactobacilli and Candida species, and the paraffin-stimulated pH, flow rate and IgA concentration in whole saliva were evaluated and compared. METHOD: Saliva was collected, and the caries index was evaluated in 45 sibling pairs aged between 6 and 18 years old. The salivary IgA concentration was determined by immunoturbidimetry. Salivary mutans streptococci, lactobacilli and Candida species were quantified on mitis salivarius agar containing bacitracin and 20% sucrose, rogosa agar supplemented with glacial acetic acid and sabouraud agar supplemented with chloramphenicol, respectively. RESULTS: Down syndrome children had a higher caries-free rate (p<0.05) and lower salivary mutans streptococci counts (p<0.03) compared to their siblings. Similar numbers of lactobacilli and Candida species were found in both groups. Salivary flow rates were 36% lower in Down syndrome children compared to their siblings (p<0.05). The salivary pH did not differ between Down syndrome children and controls. The Down syndrome children had an IgA secretion rate 29% lower than that of their siblings, but this difference was not statistically significant. CONCLUSIONS: In conclusion, the lower number of mutans streptococci in the saliva may be one of the factors contributing to the lower caries rate observed in Down syndrome children, despite evidence of hyposalivation.

A sessile swelling in the floor of the mouth appeared three years ago in a 29-year old Caucasian female located laterally to the opening of the right duct of Wharton. The mass covered by normal looking mucosa exhibited slight growth since then. After excision, histological examination revealed the presence of a tumor formed by areas of mature adipose cells interspersed with extensions of tightly disposed fusiform fibroblasts immunoreactive for vimentin and CD-34. There were foci of concentric fibroblasts forming dense whorls. When large these conglomerates exhibited chondrocytes in the center. Mast-cells were not rare throughout the fibroblastic areas. No signs of malignancy occurred. These features led to the diagnosis of a spindle cell lipoma with chondrous metaplasia. The relative rarity of such a tumor in this location, especially in the chondrous variety, was considered worth of presentation, while the differential diagnosis with other intraoral tumors, namely mucoceles, dermoid cysts, mesenchimomas, fibromas and myxomas of the floor of the mouth, is discussed.

Background: Burning mouth syndrome (BMS) is a chronic, intraoral burning sensation seen mainly in middle-aged and post-menopausal females, without identifiable oral lesions or abnormal laboratory findings, but often associated with psychogenic disorders such as depression. The latter can have a range of causes, including hormonal. Objective: Since there may be connections between BMS, psychogenic changes, hormonal changes and taste abnormalities , we have examined aspects of taste and thyroid function. Patients and methods: We selected 50 patients with BMS (study group) and 50 healthy subjects (control group) and analysed their ability to taste bitter, acid and spicy substances and analysed their thyroid function and Undertook thyroid echography. Results: Taste sensation was normal in all controls. However, 30 of the patients with BMS reported ageusia for bitter taste and 2 had ageusia for acid. The use of pepper sauce (Tabasco®) (spicy substance) produced a strong burning to the tongue in 28 patients of the BMS group but only in 10 controls. No control patients showed abnormality of thyroid function or echograpic abnormality. Five patients in the BMS group had biochemical evidence of hypothyroidism, 4 patients had raised levels of thyroid auto-antibodies and, of the 41 remaining BMS patients, most (34) had thyroid echographic changes cative of nodularity. Conclusions: Hypothyroidism may be responsible for a negative influence on taste and consequent increase in trigeminal sensorial sensation (tactile, thermal and painful sensation).

-Objective: to study the frequency and spectrum of oral manifestations of HIV-infected drug-users in the Perm region. -Subjects: 104 seropositive HIV-infected drug-users (69 male, 35 female ; ages15 to 32 years; 13 co-infected with hepatitis viruses) and 13 AIDS-infected drug-users (7 male, 6 female ; ages16 to 37 years; 12 co-infected with hepatitis viruses). -Results: the most frequent forms of oral mucosal lesions in the HIV-infected group - candidiasis (32.7%), herpetic lesions (15.4%), cheilitis glandularis (3.9%), recurrent aphthous stomatitis (2%). Regional lymphadenopathy was observed in 31% cases. The ulceronecrotic oral mucosal lesions were seen in the sublingual region and tongue in 11.5% patients and manifested with pain, dysarthria, dysphagia, and dysgeusia. These lesions were found in drug-users who injected the opioids sublingually. AIDS patients had oral candidiasis (84.6%), herpetic lesions (53.8%), recurrent aphthous stomatitis (15.4%) and cheilitis glandularis (7%). All AIDS-patients had severe xerostomia, and 15.4% had unilateral or bilateral swelling of the parotid glands. Generalized ulceronecrotic gingivostomatitis was found in 50% of the patients but the sublingual ulceronecrotic lesions were not identified. -Conclusions: 1. The spectrum of oral cavity lesions of HIV/AIDS patients in Perm region is widespread enough. 2. Dissemination of oral cavity lesions is increasing in proportion of disease progression. 3. Dental care of HIV/AIDS patients should include periodic oral examinations to monitor their disease progression and to alleviate symptoms of oral opportunic and neoplastic diseases, to improve the life-style of the patients infected with HIV.

-Objetivo: estudiar la frecuencia y el espectro de las manifestaciones orales de consumidores de drogas infectados por VIH en la región de Perm. -Sujetos: 104 consumidores de droga seropositivos (69 hombres, 35 mujeres; edades desde 15 a 32; 13 co-infectados con virus de la hepatitis) y 13 consumidores de droga con SIDA (7 hombres, 6 mujeres; edades entre 16 y 37; 12 co-infectados con virus de la hepatitis). -Resultados: las formas más frecuentes de lesiones de la mucosa oral en el grupo de pacientes infectados por el VIH- candidiasis (32.7%), lesiones herpéticas (15.4%), queilitis glandular (3.9%), estomatitis aftosa recidivante (2%). La linfadenopatía regional fue observada en el 31% de los casos. Las lesiones ulceronecrotizantes de la mucosa oral fueron vistas en la región sublingual y la lengua en el 11.5% de los pacientes y se manifestaron con dolor, disartria, disfagia y disgeusia. Estas lesiones fueron halladas en consumidores de droga que se inyectaban los opioides sublingualmente. Los pacientes con SIDA tenían candidiasis oral (84.6%), lesiones herpéticas (53.8%), estomatitis aftosa recidivante (15.4%) y queilitis glandular (7%). Todos los pacientes con SIDA tenían xerostomía severa, y el 15.4% tenían hinchazón unilateral o bilateral de las glándulas parótidas. Se halló gingivoestomatitis ulceronecrotizante generalizada en el 50% de los pacientes pero no se identificaron las lesiones ulceronecrotizantes sublinguales. -Conclusiones: 1. El espectro de las lesiones de la cavidad oral de pacientes VIH/SIDA en la región de Perm es bastante amplio. 2. La diseminación de las lesiones de la cavidad oral está aumentando en proporción con la progresión de la enfermedad. 3. El cuidado dental de los pacientes VIH/SIDA debería incluir exámenes orales periódicos para monitorizar la progresión de su enfermedad y para aliviar los síntomas de las enfermedades oportunistas y neoplásicas, para mejorar la calidad de vida de los pacientes infectados por el VIH.

-Objective and study design This open study of 192 otherwise healthy persons with burning mouth syndrome, examined the efficacy on control of symptoms of psychotherapy alone with two hour sessions weekly for two months; alpha lipoic acid (ALA, tioctic acid; Tiobec) 600 mg/day alone for two months; or combination therapy of psychoanalysis and 600mg/day ALA for two months. Controls received placebo alone. -Results Most benefit was obtained with combination therapy. Combination therapy of psychoanalysis and alpha lipoic acid (ALA , tioctic acid; Tiobec. 600mg/day) for two months gave most benefit and significantly more than psychoanalysis alone for two 1 hour sessions weekly for two months (p<0.0005), or ALA 600 mg/day alone for two months (p<0.0005) . -Conclusion The present results suggest that alpha lipoic acid may complement psychotherapy and can be an acceptable alternative to psychoactive agents, but trials to compare the two approaches are now warranted.

En este estudio de 192 personas sanas con Síndrome de boca ardiente, se analizó la eficacia del control de los síntomas de la psicoterapia sola durante dos sesiones semanales de 1 hora durante dos meses, del ácido alfa lipoico (ALA, ácido tioctico, Tiobec) 600 mg al día durante dos meses, y de la combinación de la psicoterapia y los 600 mg / día de ALA durante 2 meses. Los controles solo recibieron placebo. RESULTADOS. Se obtuvo el mayor beneficio con la terapia combinada. La combinación de los tratamientos con psicoanálisis y ácido alfa lipoico (ALA, acido tioctico, Tiobec 600 mgr al día), durante 2 meses fue significativamente más beneficiosa que el psicoanálisis solo durante dos sesiones semanales de una hora durante dos meses ( p< 0.0005) o el ALA 600 mgr al día solo, durante dos meses (p< 0,0005). CONCLUSIÓN. Los resultados sugieren que el ácido alfa lipoico podría complementar la psicoterapia y ser una alternativa aceptable a los fármacos psicoactivos, por lo que estudios de comparación de ambas alternativas están actualmente justificados.

OBJETIVO: O objetivo do presente artigo foi revisar a literatura recente em relação ao herpesvírus humano tipo 8, com ênfase especial aos aspectos relacionados à etiopatogênese do sarcoma de Kaposi. MÉTODOS: Os autores pesquisaram artigos de pesquisa original e revisões de literatura nos aspectos específicos da infecção pelo herpesvírus humano tipo 8, incluindo, virologia, epidemiologia, transmissão, diagnóstico, história natural e terapia. O material considerado relevante foi avaliado e revisado. RESULTADOS: O sarcoma de Kaposi é considerado ainda a malignidade mais comumente observada em pacientes infectados pelo HIV. Estudos epidemiológicos, assim como os baseados em técnicas de biologia molecular indicam que um agente sexualmente transmissível, independente do HIV, deve estar envolvido na etiologia do sarcoma de Kaposi, possivelmente como resultado da ação das cell signaling proteins superando os aspectos da resposta imune. O herpesvírus humano tipo 8 tem sido ainda sugerido como agente causal na patogênese de outras desordens, incluindo mieloma múltiplo, multicentric Castleman's disease, body cavity-based lymphoma, além de outras condições não-proliferativas como sarcoidose e pênfigo vulgar, embora grande parte dos estudos sorológicos apontem para uma soroprevalência em torno de 2 a 10%. O herpesvírus humano tipo 8 parece então, ser um vírus restrito a pessoas sob risco de desenvolver o sarcoma de Kaposi, associado à imunossupressão. O tratamento para o sarcoma de Kaposi é normalmente paliativo, e inclui a aplicação de vimblastina intra-lesional, crio-cirurgia, interferon-alpha e outras formas de terapia. Mais recentemente, os inibidores da protease, foram também sugeridos como possíveis agentes implicados na remissão do sarcoma de Kaposi associado ao HIV e no desaparecimento do herpesvírus humano tipo 8 das células mononucleares do sangue periférico. CONCLUSÃO: O herpesvírus humano tipo 8 está fortemente associado a todas as formas de sarcoma de Kaposi, multicentric Castleman's disease e body cavity-based lymphoma. Ainda, não existe tratamento definitivo para o sarcoma de Kaposi.

OBJECTIVE: To review the current literature on human herpesvirus 8 with particular attention to the aspects related to the etiopathogenesis of Kaposi's sarcoma. MATERIALS AND METHODS: The authors searched original research and review articles on specific aspects of human herpesvirus 8 infection, including virology, epidemiology, transmission, diagnosis, natural history, therapy, and Kaposi's sarcoma etiopathogenesis. The relevant material was evaluated and reviewed. RESULTS: Human herpesvirus 8 is a recently discovered DNA virus that is present throughout the world but with major geographic variation. In the Western world, the virus, transmitted mainly by means of sexual contact, is strongly associated with Kaposi's sarcoma and body cavity-based lymphoma and more controversially with multiple myeloma and other non-proliferative disorders. There is no specific effective treatment, but HIV protease inhibitors may play an indirect role in the clearance of human herpesvirus 8 DNA from peripheral blood mononuclear cells of HIV-infected patients. Human herpesvirus 8 DNA is present in saliva, but there are as yet no documented cases of nosocomial transmission to health care workers. The prevalence of human herpesvirus 8 among health care workers is probably similar to that in the general population. CONCLUSION: Human herpesvirus 8 appears to be, at least in Western Europe and United States, restricted to a population at risk of developing Kaposi's sarcoma. Human herpesvirus 8 certainly has the means to overcome cellular control and immune responses and thus predispose carriers to malignancy, particularly Kaposi's sarcoma. The wide diffusion of Human herpesvirus 8 in classic Kaposi's sarcoma areas appears to represent an important factor in the high incidence of the disease. However, additional co-factors are likely to play a role in the development of Kaposi's sarcoma.