Most cases positive for antibiotic resistance genes were rendered negative after chemomechanical debridement. This confirms that endodontic treatment is effective in eliminating a possible reservoir of antibiotic resistance gene in the majority of

cases. However, in about 30% of the previously positive cases, resistance genes were still detected. It is not clear from our experiment whether these genes remained inside the owner bacterial cell that survived treatment or remained free in the environment. The results from PCR using universal bacterial primers suggest that both conditions may have occurred, Nutlin-3a purchase since not only cases that were positive for universal PCR also yielded positive results for resistance genes; instead, two negative cases for 16S rRNA gene were positive for resistance genes. Further interappointment medication and obturation are expected to contribute still more to elimination of bacteria carrying these genes. This requires further investigation. In conclusion, acute and chronic endodontic infections were shown to harbour species carrying resistance genes for 3 classes of widely used antibiotics.

These infections are characterized by multispecies bacterial biofilms and cells within biofilms are in close contact with one another. This makes cells within biofilms be very conducive to gene transfer,30 and 31 which may favour the spread of resistance genes to other species. Therefore, PAK5 it is important that root canal treatment eliminates these biofilms and the cells carrying resistance genes. In most cases, treatment was effective in this Proteasome inhibitor regard, but there were a few canals in which these genes persisted. The implications of such persistence are unknown but are expected to be minimal, if any, following further intracanal medication, root canal filling and coronal restoration. Direct detection of resistance genes in abscesses is possible and may be a potential method for rapid diagnosis and proactive therapy. Further studies evaluating the outcome of antibiotic

therapy dictated by the results of antibiotic resistance gene detection should be of great value. This study was supported by grants from Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazilian Governmental Institutions. None declared. The study protocol was approved by the Ethics Committee of the Estácio de Sá University, under the reference number 106-03. “
“Cardiovascular disease is a major public health problem in many societies, accounting for 17 million deaths each year.1 A large body of epidemiologic studies have clearly demonstrated a link between certain risk factors such as high cholesterol levels, smoking, sedentary lifestyle and diabetes and the development of cardiovascular diseases.