Oral Fluid Research Articles

1868 Eight to Hydrate: Promoting oral hydration of elderly patients in hospital

Abstract Introduction Dehydration is associated with prolonged hospital admissions and complications. Elderly patients are more susceptible due to physiology, dexterity and cognition. The British Dietetic Association recommends minimum 7 beverages per day whilst The British Nutrition Foundation advises proactive dehydration risk management in hospital. This project aimed to reduce the proportion of elderly patients at risk of dehydration in hospital. Methods Staff documented oral hydration over 24 hours for patients on the Care of the Elderly ward. Additional factors obtained retrospectively included demographics, dementia diagnosis, fluid prescriptions and fluid restriction. Criteria adapted from a ‘Hydration Care Assessment Tool’ defined risk of dehydration by daily intake as low (>1500mls), medium (800-1500mls), high (400-800mls) or very high (<400mls). Approximating each drink as 200mls, we set a daily target of 8 beverages; equating to low risk. Visual hydration trackers were placed at patients' bedsides and junior doctors reminded the multi-disciplinary team each morning. Data collection was repeated after 2 weeks. Results First cycle recruited 13 males, 16 females with mean age 78.5. Over 50% were Very High Risk (5/29) or High Risk (12/29) of dehydration whilst the remainder were Medium Risk (10/29), or Low risk (2/29). 4/5 (80%) at Very High Risk received intravenous fluids. Of the High-Risk group, more than half had a diagnosis of dementia and 3/12 (25%) received fluids intravenously. Following intervention, 12 males and 7 females were recruited with mean age 76. Proportion at highest risk was reduced: Very High Risk (5/29 to 0/19; -100%), High Risk (12/29 to 3/19; -61%). Therefore, more were at Medium Risk (10/29 to 13/19; +101%) and Low Risk (2/29 to 3/19; +131%). Conclusion Though improved, few patients meet hydration recommendations. However simple visual reminders are an effective starting point. Further interventions could include oral fluid prescriptions and reflect staff and patient feedback.

Microleakage Under Orthodontic Brackets Bonded Using a Conventional Adhesive System, Nanocomposites, and Nanoionomers: A Comparative Study.

Background Microleakage under orthodontic brackets has a role in early bracket debonding and white spot lesions due to the ingress of oral fluids in the bracket-adhesive-tooth interface. This in vitro study aimed to evaluate and compare the microleakage under orthodontic brackets bonded with the conventional adhesive system, nanocomposites, and nanoionomers. Materials and methods Forty-five human premolars were extracted for therapeutic reasons and collected for this study. Teeth were randomly assigned to three groups: Group A: conventional etching with conventional adhesive, Group B: conventional etching with nanocomposite, and Group C: conventional etching with nanoionomer. Stainless steel premolar brackets were used for bonding. After thermocycling, the extracted teeth were submerged in a 0.5% solution of basic fuchsine for 24 hours. They were then cut longitudinally. A stereomicroscope was used to assess microleakage along the occlusal and gingival interfaces. Results To compare the microleakage scores between gingival and occlusal aspects within each group, the student's t-test was performed. Analysis of variance (ANOVA) and the post-hoc Tukey test were applied to the data for intergroup comparison of microleakage scores. On comparing the microleakage scores, the gingival side of interfaces depicted higher microleakage than the occlusal side gingival side across all groups, demonstrating statistically significant results (P <0.05).On intergroup comparison, the occlusal bracket adhesive interface and gingival tooth adhesive interface revealed significantly higher microleakage values for Group B followed by Group C withGroup Athe least. However, there was no significant difference in the microleakage scores between Group B and Group C on intergroup comparison of mean microleakage scores(P <0.05). Conclusion The gingival side showed higher microleakage scores than the occlusal side. Nanoionomers showed microleakage values higher than the Transbond XT but lower than nanocomposites. Based on the results of thepresent study, in terms of microleakage, Transbond XT demonstrated lower microleakage when compared to nanoionomers and nanocomposites.

Comparison of Early and Delayed Feeding after Elective Gut Anastomosis

Objective: To compare the effects of early and delayed feeding after elective gut anastomosis in relation to a mean number of days of audible bowel sounds.Study Design: A cross-sectional study.Place and Duration of Study: The study was conducted at the Department of Surgery, Combined Military th th Hospital (CMH), Rawalpindi, Pakistan, from 11th May 2019 to 10th November 2019.Methods: A total of 60 individuals undergoing gut anastomosis were divided into two groups. In group A, the NG tube was removed within 6 to 24 hours of surgery, and clear oral liquids (30ml/hour) were started. Oral fluids, including juices and soups on the other day after surgery, tailed by semisolid food at 3rd day, then regular food at 4 day and finally discharge at the 5 day. In group B, the NG tube was detached three to five days after the procedure, observing NG tube output &lt;30-50cc daily. Then, patients were followed up in post-surgical wards for 48 hours. Patients were noted and informed of the time when bowel sounds were audible, the first flatus passed, and the first stool passed. Results: The mean age in group A was 40.23 ± 15.66 years, and in group B was 37.93 ± 15.23 years. Most of the patients, 31 (51.67%), were between 16 to 30 years of age. Out of 60 patients, 36 (60.0%) were males and 24 (40.0%) were females, with male to female ratio of 1.5:1. The mean number of days of audible bowel sounds in Group A (early feeding) was 1.57 ± 0.63 days while in Group B (delayed feeding) was 3.90 ± 0.76 days (p-value = 0.0001). Conclusion: This research established that the outcome of early feeding is better than the outcome of delayed feeding after elective gut anastomosis.&#x0D; How to cite this: Jabbar G, Ahmed MS, Malik AS, Akhtar S, Minhas FS, Makshoof MT, Shahid Z. Comparison of Early and Delayed Feeding After Elective Gut Anastomosis. Life and Science. 2024; 5(1): 101-106. doi: http://doi.org/10.37185/LnS.1.1.411

Pharmacokinetics and pharmacodynamics of five distinct commercially available hemp-derived topical cannabidiol products.

Products containing cannabidiol (CBD) have proliferated after the 2018 Farm Bill legalized hemp (cannabis with ≤0.3% delta-9-tetrahydrocannabinol (Δ9-THC)). CBD-containing topical products have surged in popularity, but controlled clinical studies on them are limited. This study characterized the effects of five commercially available hemp-derived high CBD/low Δ9-THC topical products. Healthy adults (N = 46) received one of six study drugs: a CBD-containing cream (N = 8), lotion (N = 8), patch (N = 7), balm (N = 8), gel (N = 6) or placebo (N = 9; matched to an active formulation). The protocol included three phases conducted over 17 days: (i) an acute drug application laboratory session, (ii) a 9-day outpatient phase with twice daily product application (visits occurred on Days 2, 3, 7 and 10) (iii) a 1-week washout phase. In each phase, whole blood, oral fluid and urine specimens were collected and analyzed via liquid chromatography with tandem mass spectrometry (LC-MS-MS) for CBD, Δ9-THC and primary metabolites of each and pharmacodynamic outcomes (subjective, cognitive/psychomotor and physiological effects) were assessed. Transdermal absorption of CBD was observed for three active products. On average, CBD/metabolite concentrations peaked after 7-10 days of product use and were highest for the lotion, which contained the most CBD and a permeation enhancer (vitamin E). Δ9-THC/metabolites were below the limit of detection in blood for all products, and no urine samples tested "positive" for cannabis using current US federal workplace drug testing criteria (immunoassay cut-off of 50 ng/mL and confirmatory LC-MS-MS cut-off of 15 ng/mL). Unexpectedly, nine participants (seven lotions, one patch and one gel) exhibited Δ9-THC oral fluid concentrations ≥2 ng/mL (current US federal workplace threshold for a "positive" test). Products did not produce discernable pharmacodynamic effects and were well-tolerated. This study provides important initial data on the acute/chronic effects of hemp-derived topical CBD products, but more research is needed given the diversity of products in this market.

The utility of salivary CRP and IL-6 as a non-invasive measurement evaluated in patients with COVID-19 with and without diabetes.

The available evidence suggests that inflammatory responses, in both systemic and oral tissue, contribute to the pathology of COVID-19 disease. Hence, studies of inflammation biomarkers in oral fluids, such as saliva, might be useful to better specify COVID-19 features. In the current study, we performed quantitative real-time PCR to measure salivary levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in saliva obtained from patients diagnosed with mild COVID-19, in a diabetic group (DG; n = 10) and a non-diabetic group (NDG; n = 13). All participants were diagnosed with periodontitis, while six participants with periodontitis but not diagnosed with COVID-19 were included as controls. We found increases in salivary total protein levels in both the DG and NDG compared to control patients. In both groups, salivary CRP and IL-6 levels were comparable. Additionally, the levels of salivary CRP were significantly correlated with total proteins, in which a strong and moderate positive correlation was found between DG and NDG, respectively. A linear positive correlation was also noted in the relationship between salivary IL-6 level and total proteins, but the correlation was not significant. Interestingly, the association between salivary CRP and IL-6 levels was positive. However, a moderately significant correlation was only found in COVID-19 patients with diabetes, through which the association was validated by a receiver operating curve. These finding suggest that salivary CRP and IL-6 are particularly relevant as potential non-invasive biomarker for predicting diabetes risk in mild cases of COVID-19 accompanied with periodontitis.

Quantification of prohibited substances and endogenous corticosteroids in saliva using traditional, alternative microextraction-based, and novel 3D printed sample-preparation methods coupled with LC-MS

Oral fluid has gained significant interest as an alternative matrix for drug testing due to its easy and non-invasive collection. Despite these advantages, achieving suitably low limits of detection remains a clear challenge in the use of oral fluids for drug screening. In this study, we demonstrate that the application of commercially available SPME fibers followed by liquid chromatography tandem mass spectrometry can enable the comprehensive detection and confirmation of drugs in oral fluid samples. To this end, we develop and test a sample-preparation protocol for a panel of 46 drugs covering the most popular drugs of abuse and doping agents available worldwide. Human saliva samples were collected using a Salivette® device (CE IVD certified) and sampled using SPME devices coated with a C18 extraction phase. The proposed protocol was validated with respect to its lower limits of quantification (LLOQ), linearity, matrix effects, precision, and extraction recovery. Linearity was confirmed for all compounds (R2 > 0.97), except for testosterone (R2 = 0.953) and metandrostenolon (R2 = 0.958). Furthermore, 4 compounds suffered from matrix effects, with less than 10 % deviation from acceptance criteria. After analytical validation, saliva samples from volunteers were analyzed to determine free concentrations of cortisol at different times after awaking. Finally, a 3D-printed prototype device was designed and successfully applied to extract small molecules, thus demonstrating a new modern low-cost approach for bioanalysis.

Drug driving in Italy. The results of the first roadside drug testing service utilizing on-site confirmatory analysis between 2019 and 2022

BackgroundDrug driving represents a public safety concern, and the size of this issue in Italy is not fully known. Drug testing is composed of two steps: 1) screening and 2) confirmatory analysis. The second step, and the associate medical examination to assess the state of impairment, usually are not performed right after the screening as they require specialized personnel and instrumental equipment that are not historically available at roadblocks. These pitfalls make this process both complicated and time-consuming. MethodsA mobile laboratory was set up in 2019 by the Forensic Lab Service S.r.l. (limited liability company) to improve roadblock timing, planning, as well as to shed light on the extent of the drug driving issue in Italy. Drug screenings were performed using DrugWipe® Saliva testing. Confirmatory analysis was performed on oral fluids by liquid chromatography coupled with tandem mass spectrometry. A dedicated room of the mobile laboratory was also designed for drug driving medical assessment. Result2082 samples were collected during 88 road safety services held in different locations across Italy. In total, 9 % of the tested subjects were positive to both the screening and the confirmatory analysis. The most prevalent illicit drugs found in this study were THC (72 %), followed by cocaine (41 %). Drug drivers were mostly male (93 %) and younger than 30 years of age (58 %). ConclusionsThe prevalence of drivers testing positive for illicit drugs resulted to be higher compared to the results obtained in the DRUID project and to other surveys previously performed in Italy. These data demonstrate the need for control services to improve road safety in regards to drug driving.

The Reparative Function of MMP13 in Tertiary Reactionary Dentinogenesis after Tooth Injury.

MMP13 gene expression increases up to 2000-fold in mineralizing dental pulp cells (DPCs), with research previously demonstrating that global MMP13 deletion resulted in critical alterations in the dentine phenotype, affecting dentine-tubule regularity, the odontoblast palisade, and significantly reducing the dentine volume. Global MMP13-KO and wild-type mice of a range of ages had their molar teeth injured to stimulate reactionary tertiary dentinogenesis. The response was measured qualitatively and quantitatively using histology, immunohistochemistry, micro-CT, and qRT-PCR in order to assess changes in the nature and volume of dentine deposited as well as mechanistic links. MMP13 loss affected the reactionary tertiary dentine quality and volume after cuspal injury and reduced Nestin expression in a non-exposure injury model, as well as mechanistic links between MMP13 and the Wnt-responsive gene Axin2. Acute pulpal injury and pulp exposure to oral fluids in mice teeth showed upregulation of the MMP13 in vivo, with an increase in the gene expression of Mmp8, Mmp9, and Mmp13 evident. These results indicate that MMP13 is involved in tertiary reactionary dentine formation after tooth injury in vivo, potentially acting as a key molecule in the dental pulp during dentine-pulp repair processes.

Developing and Evaluating the Greenness of a Reliable, All-in-One Thin-Film Microextraction Protocol for Determining Fentanyl, Methadone, and Zolpidem in Plasma, Urine, and Oral Fluid.

This paper proposes an all-in-one microextraction-based protocol capable of determining and quantifying fentanyl, methadone, and zolpidem in plasma, urine, and saliva at concentrations below those required by international regulatory organizations. A homemade thin-film microextraction device featuring an octyl-cyanopropyl stationary phase was coupled with LC-MS/MS. The proposed method was developed and validated according to FDA criteria, providing extraction efficiency values ranging from 26.7% to 76.2% with no significant matrix effects (2.6% to 15.5% signal suppression). The developed protocol provided low limits of quantification (mostly equal to 1 ng mL-1) and good reproducibility (intra- and inter-day RSDs of less than 9.6% and 12.0%, respectively) and accuracy (89% to 104% of the test concentration). An assessment of the protocol's environmental impact indicated that attention must be devoted to eliminating the use of toxic reagents and developing its capability for in situ sampling and in-field analysis using portable instruments. The proposed TFME-based protocol provides clinical laboratories with a versatile, one-step tool that enables the simultaneous monitoring of fentanyl, methadone, and zolpidem using the most popular biological matrices.

A protocol for a comparative evaluation of the fracture resistance of endodontically treated teeth reinforced with Cention N, resin-modified glass ionomer cement (RMGIC) and short fiber reinforced flowable composite as an intraorifice barrier

Background: Endodontic treatment is the most common method for resolving pulpal and periapical pathology. However, various studies have reported that almost 11%–13% of all teeth that undergo extraction after endodontic treatment show the presence of cracks, craze lines, and vertical root fractures. Teeth with inadequate post endodontic restoration are more prone to fracture and coronal leakage, resulting in the diffusion of oral fluids, bacteria, bacterial products, and possibly root canal treatment failure. Furthermore, studies have advocated the use of endodontically treated teeth with restorative materials that have a similar or higher elastic modulus than the tooth for providing stiffness against forces that cause root fracture. Intraorifice barriers made of restorative materials that can bond to radicular dentin could thus be used to reinforce the radicular dentin while also preventing coronal microleakage. Although the sealing ability of intraorifice barriers has been widely compared in the literature, there have been few studies on the strengthening effect of the materials used in the study as intraorifice barriers when placed into the root canal. As a result, the current in vitro study aims to assess the effect of various materials as intraorifice barriers (Cention N, Resin modified glass ionomer cement, and short fiber reinforced flowable composite) on the force required fracture teeth after root canal treatment. Methods: This in vitro study will be done on extracted human mandibular premolars with single root canal where after doing root canal treatment 2-3 mm obturating material would be replaced by intra orifice barriers (Cention N, resin modified glass ionomer cement [RMGIC], and short fiber reinforced flowable composite). The force required to fracture teeth will be calculated using universal testing machine.

Comparison of immunoassay and LC-tandem mass spectrometry analyses of ractopamine in hog oral fluid

The accurate detection of ractopamine in food animals is crucial for marketing since some entities require animals or animal carcasses to be free of ractopamine residues. Field-based ractopamine screening tests that are rapid, sensitive, and capable of high-throughput are highly desirable to ensure that inadvertent exposure to ractopamine did not occur in animals marketed as animals that have not been fed ractopamine. An immunochemically based lateral flow assay was used to analyze oral fluids from hogs never exposed to ractopamine and from hogs that were presumed positives and results were confirmed using an enhanced sensitivity LC-MSMS method. We found that an immunochemically based lateral flow system having a working range of 2.5 to 15 ng mL−1 worked well as a screening assay with 1.7% false positive results in freshly collected hog oral fluids. Using ractopamine glucuronide standards and LC-MSMS, we determined that the false positive results were not due to the presence of ractopamine glucuronide metabolites in oral fluids.

Domestic pigs are susceptible to experimental infection with non-human primate-derived Reston virus without the need for adaptation

Domestic pigs are a critical component of the food supply and one of the most commonly raised production animals. Pork consumption has driven the intensification of pig production expanding into environments conducive to increased emergence and spread of infectious diseases, including the spillover of pathogens into human populations. One of these emerging viruses, Reston virus (RESTV), is an enigma among the Orthoebolavirus genus in that its lack of human pathogenicity is in stark contrast to the high virulence associated with most other ebolaviruses. RESTV is, however, associated with outbreaks of highly lethal hemorrhagic disease in non-human primates (NHP), as well as poorly understood clinical manifestations of mixed virulence and lethality in naturally and experimentally infected domestic pigs. Our results show it is possible for RESTV derived from an NHP to infect domestic pigs resulting in a spectrum of disease, from asymptomatic to severe respiratory distress. Further, we report on the first experimental transmission of RESTV between infected pigs and a co-housed, naïve animal, as well as the first report of the successful use of group oral fluids for the detection of RESTV RNA and virus-specific IgA antibodies.

Usability and acceptability of oral fluid- and blood-based hepatitis C virus self-testing among the general population and men who have sex with men in Malaysia.

Hepatitis C self-testing (HCVST) is emerging as an additional strategy that could help to expand access to HCV testing. We conducted a study to assess the usability and acceptability of two types of HCVST, oral fluid- and blood-based, among the general population and men who have sex with men (MSM) in Malaysia. An observational study was conducted in three primary care centres in Malaysia. Participants who were layman users performed the oral fluid- and blood-based HCVST sequentially. Usability was assessed by calculating the rate of errors observed, the rate of difficulties faced by participants as well as inter-reader (self-test interpreted by self-tester vs interpreted by trained user) and inter-operator concordances (self-test vs test performed by trained user). The acceptability of HCV self-testing was assessed using an interviewer-administered semi-structured questionnaire. Participants were also required to read contrived test results which included "positive", "negative", and "invalid". There was a total of 200 participants (100 general population, 100 MSM; mean age 33.6 ± 14.0 years). We found a high acceptability of oral fluid- and blood-based HCVST across both general population and MSM. User errors, related to timekeeping and reading within stipulated time, were common. However, the majority of the participants were still able to obtain and interpret results correctly, including that of contrived results, although there was substantial difficulty interpreting weak positive results. The high acceptability of HCVST among the participants did not appreciably change after they had experienced both tests, with 97.0% of all participants indicating they would be willing to use HCVST again and 98.5% of them indicating they would recommend it to people they knew. There was no significant difference between the general population and MSM in these aspects. Our study demonstrates that both oral fluid- and blood-based HCVST are highly acceptable among both the general population and MSM. Both populations also showed comparable ability to conduct the tests and interpret the results. Overall, this study suggests that HCVST could be introduced as an addition to existing HCV testing services in Malaysia. Further studies are needed to establish the optimal positioning of self-testing alongside facility-based testing to expand access to HCV diagnosis in the country.

Rehydration post-transport: duration of oral fluid therapy on behavior, biochemical measures of hydration, and health of neonatal dairy calves.

The objective of this study was to determine the impact of 0, 1, 2, or 3d of oral electrolyte solutions (OES) following transport on calf behavior, biochemical measures of hydration, and subsequent health. Two cohorts of 60 Holstein bull calves ~3 to 7d of age were included in this experiment. Calves (n = 30/treatment) were randomized to 1 of 4 treatments on arrival at a calf-raising facility: (1) 1-d OES, (2) 2-d OES, (3) 3-d OES, or (4) no OES (control). Calves were evaluated for signs of arthritis, depression, dehydration, diarrhea, fever, navel inflammation, and respiratory disease on arrival (day 0) and 1, 2, 3, and 7d after arrival. Blood was obtained following each examination to assess biochemical measures of hydration, including serum electrolytes, glucose, hematocrit, lactate, pH, and serum total protein (STP). Calves were fitted with 3D accelerometers attached to the right hind leg along the metatarsus bone to continuously measure lying time. Linear regression models with Gaussian or Poisson link functions were used to test differences between treatments in blood parameters, as well as disease frequency and behavior, respectively. Calves spent the most time lying immediately post-transport (day 0); however, there was no effect of OES treatment on lying time. On arrival, 90% (95% CI: 84.6% to 95.4%) of calves had mild to moderate dehydration, and there was no significant difference in hydration status across treatments. Mildly dehydrated calves that received 1- and 2-d OES had higher STP concentration compared to the control. Moderately dehydrated calves that received 3- vs. 1-d OES had higher (101.4 vs. 93.7mmol/L, respectively; P = 0.01) glucose concentration, and 3- vs. 2-d OES (101.4 vs. 96.2, respectively; P = 0.07) calves tended to have higher glucose concentration. The prevalence of failed transfer of passive immunity (STP < 5.1g/dL) and hypoglycemia (glucose < 4.95mmol/L) was 26.7% (18.6% to 34.7%) and 76.5% (68.7% to 84.2%), respectively. The frequency of moderate dehydration was lower for calves that received 2-d OES compared to the control (count ratio: 0.4; 0.2% to 0.8%; P = 0.009). These results underline the need for more research on rehydration strategies to help inform calf processing protocols. Future research should investigate preconditioning strategies to minimize the impact of marketing and transport on dairy calves. Continued nutritional-based research is also needed to better support calves' recovery post-transport.

Prevalence Estimation and Genetic Characterization of Porcine Parainfluenza Virus 1 (PPIV-1) in Hungary and the First Report of the Virus in Slovakia

In the last few decades, many new paramyxoviruses have been discovered, causing diverse, mostly respiratory diseases in animals and humans. The porcine parainfluenza virus 1 (PPIV-1, species Porcine respirovirus 1), which has been reported in many countries worldwide, was found in both healthy and clinically ill pigs showing respiratory signs. Here, we report the expected prevalence and genetic diversity of PPIV-1 in Hungarian pig herds and the detection in one Slovakian pig farm, which is the first report of evidence for the presence of the virus in the country. To estimate the prevalence in Hungary 211 oral fluid samples were collected from 23 large-scale swine herds in a systematic way and tested by real-time quantitative RT-PCR. The presence of the virus was detected in 10 of the 23 Hungarian farms (43%) included in our study. One hundred eighty-one nasal swab samples were collected cross-sectionally from three Hungarian and one Slovakian PPIV-1-positive herd and PPIV-1 was most prevalent in 6-week-old pigs on farms located in Hungary and in the 2-week-old pigs on the Slovakian farm. Phylogenetic analysis of three Hungarian and two Slovakian PPIV-1 F-gene sequences showed high-nucleotide identity (&gt;93%) and all belonged to Clade I, together with the other European strains.

Dynamics of the content of reactive oxygen species and the state of the glutathione system in the oral cavity during subchronic intoxication wuth the fungicide thiram and its antioxidant correction.

Thiram is a dithiocarbamate derivative, which is used as a fungicide for seed dressing and spraying during the vegetation period of plants, and also as an active vulcanization accelerator in the production of rubber-based rubber products. In this study the content of reactive oxygen species (ROS) and the state of the glutathione system have been investigated in the oral fluid and gum tissues of adult male Wistar rats treated with thiram for 28 days during its administration with food at a dose of 1/50 LD50. Thiram induced formation of ROS in the oral cavity; this was accompanied by an imbalance in the ratio of reduced and oxidized forms of glutathione due to a decrease in glutathione and an increase in its oxidized form as compared to the control. Thiram administration caused an increase in the activity of glutathione-dependent enzymes (glutathione peroxidase, glutathione transferase, and glutathione reductase). However, the time-course of enzyme activation in the gum tissues and oral fluid varied in dependence on the time of exposure to thiram. In the oral fluid of thiram-treated rats changes in the antioxidant glutathione system appeared earlier. The standard diet did not allow the glutathione pool to be fully restored to physiological levels after cessation of thiram intake. The use of exogenous antioxidants resviratrol and an Echinacea purpurea extract led to the restoration of redox homeostasis in the oral cavity.

Rationale and design of the THIRST Alert feasibility study: a pragmatic, single-centre, parallel-group randomised controlled trial of an interruptive alert for oral fluid restriction in patients treated with intravenous furosemide

IntroductionAcute heart failure (HF) is a major cause of unplanned hospitalisation characterised by excess body water. A restriction in oral fluid intake is commonly imposed on patients as an adjunct...

The effect of vitamin D deficiency on the content of some soluble signaling molecules in the oral fluid in individuals with dental caries

The aim of the sthudy is to sthudy the level of soluble Immune Checkpoint Molecules (B7.2, CTLA-4, Tim-3, Lag-3, PD-1) in the oral fluid during dental caries with the background of a lack and/or deficiency of 25-hydroxy-vitamin D in body. During the research 3 groups of people were formed, each one of them included 17 people aged from 20 to 24 years. The first group included students with high-intensity caries (above 9 DMFt index) and 25-hydroxy-vitamin D levels in blood serum >30 ng/ml, the second included students with high caries intensity and 25-hydroxy-vitamin D levels <30 ng/ml. The control group consisted of students with an average DMFt index of 1.5 (from 0 to 3) and a level of 25(OH)D in the blood more than 30 ng/ml. To determine the content of B7.2 (CD86), CTLA-4, Tim-3, Lag-3, PD-1, the Human Vascular Inflammation Panel 1 multiplex analysis kit from Biolegend (USA) was used. The results of the research showed that during dental caries with a normal level of 25-hydroxy-vitamin D there are no significant changes in the content of Immune Checkpoint Molecules. With the background of deficiency and lack of 25-hydroxy-vitamin D there is a decrease in the amount of B7.2, LAG-3, Tim-3 and PD-1. These changes are being aggravated with an increase of the caries intensity. Vitamin D deficiency leads to a decrease in mucosal immunity of the oral cavity, the multiplication of pathogenic microorganisms, which in turn, releasing various metabolites, including cytokine-like substances, aggravate the pathological process and intensify carious lesions.

Сучасні методи діагностики захворювань тканин пародонта в концепції системного підходу лікування (Огляд літератури. Частина 2)

Resume. Diagnostics is one of the most urgent tasks of modern medicine, the latest achievement of which inspire the for new methods of detecting and predicting the course of diseases. Careful diagnosis is the key to successful prevention and treatment of such an extremely common and complex disease as periodontitis. The diagnosis of periodontitis includes several stages and has different levels of research depth, which in practice strongly depends on the professional training of the doctor, the capabilities of the clinic, the availability of the laboratory and the motivation of the patient. But, despite the wide possibilities, all diagnostic, treatment and preventive activities of the doctor are related to forecasting, timely prediction of complications, possible development of disease relapses. Therefore, implementation of the system of diagnostic monitoring with the definition of predictors of disease, its biological markers, criteria for evaluating its course, forecasting possible results and the effectiveness of treatment measures is absolutely necessary. From this point of view, the development of laboratory methods and the possibility of their application in the diagnostics of periodontal diseases is a very urgent problem and requires not only technical perfection, but also considering the peculiarities of the etiopathogenesis of oral cavity lesions. The optimal choice of biomarkers is closely related to the choice of the source and method of sampling the material for diagnostics. Based on the requirements for an ideal biomarker, saliva, gingival fluid (GCF), peri-implant sulcus fluid (PISF) and residual mouthwash can be reliable sources of biomarkers in the oral cavity. Our review of foreign literature describes the following biomarkers contained in oral fluids: interleukin 1-beta (IL-1â), interleukin 6 (IL-6) and matrix metalloproteinase-8 (MMP8). The advantages and disadvantages of such immuno-biochemical methods for determining the level of biomarkers as immunoblotting and enzyme-linked immunosorbent assay (ELISA) were also analyzed. Given that biomarkers can be used as a basis for early detection of periodontal diseases, prediction of further progression and response to treatment, their use can provide better treatment planning, particularly with the use of a personalized approach, and a stable positive outcome, even in patients with complex general somatic pathologies. Key words: periodontitis, non-invasive diagnostics, biomarkers, interleukins, matrix metalloproteinases.

Point-of-care diagnostic devices for periodontitis - current trends and urgent need.

Point of care (POC) diagnostic devices provide a method for rapid accurate identification of disease through analysis of biologically relevant substances. This review focuses on the utility of POC testing for early detection of periodontitis, a critical factor in treating the disease. Accessing the oral cavity for biological sampling is less invasive when compared to other internal test sites, and oral fluids contain biomarkers indicative of periodontitis. The ease of access makes the mouth an excellent target location for the development of POC devices. In this review, accepted standards in industry by which these devices must adhere, provided by the World Health Organization such as REASSURED and CLIA, are discussed. An overview is provided for many periodontal biomarkers currently being investigated as a means of predicting periodontal disease and its progression. POC devices currently being investigated for the identification and monitoring of periodontal disease such as paper-based and lab-on-a-chip based devices are outlined. Limitations of current POC devices on the market are provided and future directions in leveraging biomarkers as an adjunctive method for oral diagnosis along with AI-based analysis systems are discussed. Here, we present the ESSENCE sensor platform, which combines a porous non-planar electrode with enhanced shear flow to achieve unprecedented sensitivity and selectivity. The combination of the ESENCE chip with an automated platform allows us to meet the WHO's ASSURED criteria. This platform promises to be an exciting POC candidate for early detection of periodontitis.