Radiopaque concretions in the maxillary sinus in cases of sinusitis are often observed in infections with aspergillosis. For several authors, such features are considered to be typical of these infections. For us this foreign body in most cases is believed to be related to overfilling of the teeth. We have previously drawn attention to this fact. We report 85 cases of aspergillosis of the maxillary sinus. Cases involving immunosuppressed patients were excluded because of very different clinical conditions. A radiopaque foreign body was seen in 94% of the cases. Of this group, 85% were believed to be related to overfilling of maxillary teeth with dental paste, particularly since evidence for endodontic treatment was found in the premolar/molar region. An image of intrasinus dental paste was demonstrated in 12% of the cases as a direct extension of filling paste from affected teeth. The nature of the dental paste is important because the zinc contained can stimulate the growth of Aspergillus fumigatus. In vitro studies in our laboratory also showed that the growth of A. fumigatus was stimulated with a low concentration of zinc.

The present findings suggest the preferential use of pantoprazole compared with omeprazole in patients receiving clopidogrel to avoid any potential negative interaction with CYP2C19.

Variability in platelet response to antiplatelet therapy and its clinical relevance have been well described. However, the underlying mechanisms remain unclear. It was the aim of the present study to assess whether the response to aspirin and clopidogrel may be influenced by the 807 C/T polymorphism of the glycoprotein Ia (GpIa) gene in patients with non-ST elevation acute coronary syndrome (NSTE ACS). Six hundred one NSTE ACS patients were included in our study and were divided into three groups: CC homozygotes, CT heterozygotes ad TT homozygotes. All patients received loading doses of 600 mg clopidogrel and 250 mg aspirin at least 12 hours before blood samples were drawn. Post-treatment platelet reactivity was assessed by post treatment ADP 10 microM-induced platelet aggregation (ADP-Ag), VASP phosphorylation (PRI VASP) and P-selectin expression. Non-response to dual antiplatelet therapy was defined by high post-treatment platelet reactivity (HPPR=ADP-Ag > 70%). Significant variability in the distribution of platelet parameters was observed in the overall study population. No significant difference in platelet parameters profiles was observed within patients having the same genotype, for ADP-Ag (p=0.33), PRIVASP (p=0.72) and P-selectin expression (p=0.37). The genotype frequencies of the 807 C/T polymorphism of the GpIa gene were similar in responders and non-responders defined by persistent HPPR (p=0.104). In conclusion, our study did not show any influence of 807 C/T polymorphism of GpIa gene on post-treatment platelet reactivity assessed by ADP-Ag, PRI VASP or P-selectin expression in 601 NSTE ACS patients.

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