Oral Symptoms Research Articles

Sicca syndrome post-COVID-19 infection: a case report

Introduction and importance: The COVID-19 pandemic has led to a post-acute syndrome that can persist for a prolonged period. Case presentation: The authors’ case reported a 31-years-old male presented with the sensation of sand in his eyes and a dry mouth for 3 months after infection with COVID-19 confirmed by nasopharyngeal swab 3 months ago. Laboratory tests including immunological profile were normal. Schirmer’s test was positive. He was treated with artificial tears with corticosteroid drops and water drinking. Within 15 days he noticed an improvement in his sicca symptoms. Clinical discussion: The post-acute COVID-19 syndrome can persist for a longer duration than expected, even after the acute onset of the disease. Some patients may experience ocular and oral symptoms such as dry mouth, dysgeusia, and dry eye diseases. The pathophysiology of these symptoms may be related to viral pathophysiologic changes, immunologic aberrations, and inflammatory reactions that destroy the tissue of salivary glands. Additionally, there is evidence of elevated autoantibodies in post-COVID-19 patients. Future studies are needed to understand the sequela of this infection. Conclusion: What makes this case special is the combination of dry eyes and dry mouth with a negative immunological profile in a young patient who had COVID without severe symptoms.

Development of a School-Based Online Periodontal Education Programme for Adolescents

Introduction and aimsThis study aimed to investigate the effects of a developed school-based online health education programme with a periodontal examination results sheet for high school students on their subjective oral symptoms, knowledge and attitudes regarding oral health, and oral health behaviours. MethodsThe participants were first- and second-year students aged 15 to 17 years (n = 847) at a high school in Japan. The students underwent a periodontal examination and were divided into periodontal condition (PC) and nonperiodontal condition (non-PC) groups. The students participated in the online oral health education programme, which included a periodontal examination results sheet after the examination. The data for identifying the effect of the programme were collected via questionnaire surveys at the periodontal examination (baseline), after 3 months, and after 1 year, and they were compared between baseline and 3 months later and between baseline and 1 year later by the chi-square test. Logistic regression analysis was used to determine the associations between the measured variables related to oral health at 3 months or 1 year and the presence/absence of periodontal conditions after adjustment for sex and variables at baseline. ResultsA total of 628 students (74.1%) participated in this study. The percentages of individuals with knowledge of how many teeth they had, knowledge of periodontal disease, and experience with toothbrushing instruction increased significantly after 1 year in both groups (p < .05). The awareness of gingival swelling and bleeding and the use of fluoride toothpaste at 3 months were positively associated with the presence of periodontal conditions. ConclusionsThis study showed that an online oral health education programme contributed to improving oral health knowledge and behaviours among high school students and that the awareness of periodontal conditions according to the periodontal examination results sheet might improve the awareness of gingival swelling and bleeding at 3 months.

청소년들의 생활 습관 및 스트레스 등이 구강질환 증상에 미치는 영향

Objectives: The The aim of this study was to investigate the prevalence of oral disease symptoms among adolescents, and to examine the relationship between the number of oral disease symptoms and lifestyle habits, sleep, and stress. Methods: The participants included 30,229 middle school students from grades 1 to 3 and 29,811 high school students from grades 1 to 3. Results: For both the middle school and high school students, the factors associated with an increase in the number of oral disease symptoms were grade level (higher grades), economic status, alcohol consumption, frequency of cariogenic beverage intake, stress, and sleep. Conclusions: It was determined that national policies are needed to improve those factors that negatively affect the oral health of adolescents.

Oral discomfort and health behavior of patients with typical vs. atypical antipsychotic drugs.

Psychiatric patients suffer from oral diseases and side effects of antipsychotic medication. In particular, the typical antipsychotic drugs may cause severe hyposalivation with subsequent oral symptoms. We therefore aimed to compare oral health behavior and oral side effects of in-hospital patients taking typical vs. atypical antipsychotic drugs with the hypothesis that the former drugs cause more oral pain than the newer drugs. This cross-sectional questionnaire and interview study investigated subjective oral symptoms and their health behavior in 170 hospitalized psychiatric patients, comparing those taking typical vs. atypical antipsychotic drugs. Cross-tabulations and chi-square tests were used for analyses. Persistent oral pain lasting throughout the day was reported by 46% in the typical, and 5% in the atypical antipsychotic group patients, respectively. In both groups, the pain was mainly in the tongue and buccal mucosa and was described as a burning sensation. A significantly higher prevalence of xerostomia was reported in the typical antipsychotic medication group (66%) compared with the atypical antipsychotic medication group (53%, p<0.01). Self-assessed dental health was assessed as poor by two-thirds of the patients of whom 69% reported toothbrushing once daily. Approximately half of them reported having had a visit to a dentist within the previous year. Of the women 28%, and of the men 17%, respectively, had received professional consultations for oral symptoms. The current results on psychiatrically hospitalized patients emphasize the need for awareness of oral discomfort and its subsequent effects on the quality of life in this challenging patient group. Focus should also be placed on a wide range of support encouraging the patients to maintain good daily oral hygiene and seek professional dental help when needed.

Local manifestations of cross food allergy in children with clinical symptoms of respiratory allergy to birch pollen: solutions

Introduction. According to modern data, Oral Allergy Syndrome (OAS) is most often formed by patients sensitized to the birch family: up to 73% of patients allergic to birch experienced OAS. 86% of them experience their oral symptoms year-round, which significantly affects the quality of life of these patients. The effectiveness of AIT in the treatment of respiratory allergy symptoms is beyond doubt, while the effect on the manifestations of cross-food allergies requires additional study.Objective. To study the clinical effectiveness of the formation of oral tolerance to fruits and vegetables under the influence of allergen-specific immunotherapy (ASIT) with the allergen Staloral® “Birch pollen allergen” (Stallergenes Greer, France).Material and methods. The study (prospective open comparative longitudinal) included 184 patients with respiratory allergy to birch pollen aged 5 to 16 years with confirmed sensitization to the major molecule (Bet v 1). Children of the main group (n = 134, 7.0 [5.0; 9.0] years) had OAS. Children from the comparison group (n = 50, 7.0 [6.0; 10.0] years) did not have OAS. A clinical examination, general clinical and allergological examinations were carried out for each child. Component allergy diagnostics was performed using a multiplex panel (ISAC-112, ImmunoCAP) for children with OAS (n = 40) who had multiple manifestations of cross-food allergies. Patients of both groups (n = 184) received a three-year course of AIT with the allergen Staloral® “Birch pollen allergen”.Results. In patients with OAS, it was possible to achieve the formation of oral tolerance (total or partial) to fresh vegetables and fruits in 88.81% (n = 119, p = 0.000). There was a decrease in the intensity and duration of respiratory allergy symptoms during the pollination season, and the need for pharmacotherapy after a three-year course of AIT Staloral® “Birch pollen allergen” in children of both groups.Conclusions: three-year AIT with the allergen Staloral® “Birch pollen allergen” is able to form oral tolerance in children with cross food allergies to PR-10 proteins of vegetables and fruits.

The Role and Significance of Trace Elements in Oral Submucosal Fibrosis.

Oral cancer represents the greatest cause of cancer-related morbidity and death in the majority of areas where tobacco useis common. There is accumulating evidence that the quantities of essential elements change with the beginning and progression of malignant disease. Essential elements operate as a micro-source in numerous metabolic reactions. To provide an area for the particularly important or necessary trace elements like selenium, excess of iodine (I), iron (Fe), zinc (Zn), and other minor elements other trace element disorders such as oculopharyngeal muscular dystrophy (OPMD) are treated using antioxidants. However, even elevated ingestion of these trace elements such as copper could lead to oral submucosa disorder and the advancement of diversified oral diseases and conditions. Trace element enzymes play a very vital role in a variety of biological and chemical events. In redox operations, some trace elements are complicated. Oral potentially malignant fibrosis has a profound influence on the body and early oral symptoms are frequently used to diagnose such disorders. The objective is to elaborate on the role and significance of various trace elements in oral submucous fibrosis.

Taste Changes and Salivary Flow Rate Disparities in Premenopausal and Postmenopausal Women: Exploring the Zinc Connection.

Menopause triggers hormonal changes that can manifest in oral symptoms like dysgeusia, xerostomia, and burning sensations, substantially impacting daily life, including chewing, swallowing, and taste perception. Menopausal women are particularly susceptible to nutritional fluctuations, including variations in zinc levels, which are believed to be linked to taste perception. Taste alterations can render food unappetizing, leading to malnutrition and diminished quality of life. The study aims to assess taste alterations, salivary flow rate, and zinc levels in premenopausal and postmenopausal women, investigating the correlation between these factors. This research involved 30 premenopausal and 30 postmenopausal women randomly selected from outpatients at the Department of Oral Medicine and Radiology, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, India. Saliva samples were collected, unstimulated salivary flow rates were measured, taste perception was evaluated using a whole mouth threshold taste test, and serum zinc levels were assessed. The study revealed that a significantly higher percentage of postmenopausal women could not identify sucrose taste at concentrations 1 (76.7%, p = 0.017) and concentrations 2 (56.7%, p = 0.007) compared to premenopausal women (43.3%, 20%, respectively). A statistically significant number of postmenopausal women also couldn't identify the bitter taste at concentration 1 (43.3%, p=0.047) compared to premenopausal women. No significant difference in taste perception of salt and sour was observed between both groups at all tested concentrations. In both groups, mean taste perception rankings were similar, with salt being most perceived, followed by sour bitter, and at least with sucrose. Salivary flow rates and zinc levels did not significantly differ between premenopausal and postmenopausal women. The correlation between zinc levels and taste perception was weak and non-significant, indicating that zinc levels were not significant predictors of taste perception in either group. Postmenopausal women exhibited reduced perceptions of sucrose and quinine hydrochloride, potentially impacting eating habits, while taste perception of sodium chloride and citric acid remained relatively consistent. Salivary flow rates and zinc levels were within the normal range for postmenopausal women up to 60 years of age included in the study. The study demonstrated that zinc levels did not significantly influence perception among postmenopausal women, suggesting that taste impairment is a multifactorial phenomenon.

Effect of aligners on patients’ oral health-related quality of life and anxiety: a prospective pilot study

BackgroundThis prospective study explored the impact of aligners on the oral health-related quality of life and anxiety of patients during the first month of orthodontic treatment and the first month of the retention phase.MethodsA total of 23 male and female patients (median age 25 y) treated with clear aligners were included. The OHRQoL questionnaire was used at certain time points during treatment (T1: placement of the first aligner; T2: after one day of use; T3: after seven days; T4: after one month; and T5: after one month in the retention phase). The State-Trait Anxiety Inventory (STAI) was also self-administered to assess state and trait anxiety (Y1 and Y2 subscales, respectively) at the T1, T4 and T5 time points. A population average generalized estimating equations logistic regression model was fit to assess the effect of time on the responses, and the Wald test was used to examine the overall effect of time.ResultsOverall time was a significant predictor for most of the questions. However, time was marginally significant for the OHRQoL questions evaluating oral symptoms such as bad taste/smell, sores, and food accumulation. Tooth discolouration did not differ between time points. The general activity disturbance was significantly lower in the retention phase. Higher depression and anxiety scores were reported at the initial appointment and decreased thereafter.ConclusionsCAT has a negative impact on quality of life and psychological status during the initial days of treatment. These impairments ameliorate at later treatment stages.

Evaluation of the Oral Health Education Programme for Nurses using an Oral Lesion Simulator.

This study aimed to investigate the usefulness of a newly developed oral simulator for nursing students' oral assessment education on oral diseases and symptoms. The participants were first-year students (n=105) at a nursing school in Japan. Ten identical oral simulators with angular cheilitis, missing teeth, dental caries, calculus, periodontitis, hypoglossal induration, food debris, and crust formation were created by a team of dentists. After a 45-minute lecture programme for oral assessment performance with the Oral Health Assessment Tool (OHAT), the ability test with the simulators and the OHAT as well as test feedback were conducted in a 30-minute practical programme. To evaluate the effectiveness of the programmes, questionnaires and ability tests with slides of oral images were conducted at baseline and after the programme. Ninety-nine students (94.3%) participated in this study. The results of the ability test with the simulators and the OHAT in the practical programme showed that the correct answer rates of assessing tongue, gingiva, present teeth, and oral pain were less than 40%. Their levels of confidence, perception, and oral assessment performance were statistically significantly higher after the programmes than they were at baseline. Their level of confidence in assessing the need for dental referral had the largest increase in scores compared to the lowest scores at baseline in the nine post-programme assessment categories. This study identified several problems with nursing students' oral assessment skills and improvements of their oral assessment confidence, perceptions and performance.

Frequency of Oral Lesions, Olfactory, and Gustatory Disorders and Xerostomia in Patients with COVID-19.

COVID-19, a respiratory illness with a global impact on millions, has recently been linked to manifestations affecting various bodily systems, including the oral cavity. Studies highlight oral issues, like ulcers, blisters, and white patches, alongside olfactory and gustatory dysfunction, influencing an individual's quality of life. In this context, our study aimed to assess the frequency of oral lesions, olfactory and gustatory disorders, and xerostomia resulting from COVID-19. An observational study was conducted with 414 patients to evaluate the frequency of oral symptoms resulting from COVID-19. Patients were diagnosed with mild symptoms and evaluated through clinical examination of the oral cavity and a questionnaire to assess functional alterations. The findings showed that 139 out of 414 patients presented clinical manifestations, with oral lesions being the most prevalent (19.1%), followed by gustatory disorders (18.1%), xerostomia (14.2%), and olfactory dysfunction (14%). The most prevalent oral lesions were ulcerations (n = 51), candidiasis (n = 8), and erythema or red plaques (n = 7). Unfortunately, 50 (12.1%) patients died during this study. Therefore, oral lesions, olfactory and gustatory dysfunctions, and xerostomia are common symptoms associated with COVID-19.

Comparing the effectiveness of two educational methods for oral health management in COVID-19 pandemic among dental professionals.

AIM. The aim of this study was to train dentists on the different oral hygiene measures to be followed by COVID-19 patients via Webinar and Information Education Communication (IEC) Materials and compare the effectiveness of both. METHODOLOGY. A total of 100 dental professionals were included by non-probability convenience sampling. Webinar and IEC Materials on oral hygiene measures, oral symptoms, and management strategies during COVID-19 were created and training was conducted for all dental professionals who registered themselves. An online version of the self-administered questionnaire (English) was created on the official Edantseva website and circulated to all the registered participants to obtain the pre and post-training data. RESULTS. Out of the total 80 participants in the Webinar group, 47 were females and 33 were males. Comparing the mean total scores obtained by the participants in the webinar and IEC groups in the pre and post-test showed that there is a significant difference in the scores obtained by the participants in the two groups in the pre and post-test (p<0.01). CONCLUSION. Educating dentists via IEC Materials was effective in improving their knowledge regarding oral health management during the COVID-19 pandemic. IEC materials being handy and referable at any time was found to be more effective.

Sustained remission induced by 2 years of treatment with benralizumab in patients with severe eosinophilic asthma and nasal polyposis

AbstractBackground and ObjectiveSeveral randomized controlled trials (RCTs) have shown that benralizumab is characterized by a good profile of efficacy and safety, thereby being potentially able to elicit clinical remission on‐treatment of severe eosinophilic asthma (SEA). The main goal of this multicentre observational study was to verify the effectiveness of benralizumab in inducing a sustained remission on‐treatment of SEA in patients with or without comorbid chronic rhinosinusitis with nasal polyps (CRSwNP).MethodsThroughout 2 years of treatment with benralizumab, a four‐component evaluation of sustained remission of SEA was performed, including the assessment of SEA exacerbations, use of oral corticosteroids (OCSs), symptom control and lung function.ResultsThe present study recruited 164 patients suffering from SEA. After 24 months of add‐on biological therapy with benralizumab, 69 (42.1%) achieved the important target of sustained remission on‐treatment (exacerbation rate = 0, OCS dose = 0, pre‐bronchodilator FEV1 ≥80% pred., ACT score ≥ 20). During the same period, a persistent improvement of CRSwNP (SNOT‐22 &lt; 30, NP recurrence = 0) was observed in 33 (40.2%) out of 82 subjects with concomitant NP. The latter comorbidity and post‐bronchodilator reversibility of airflow limitation were two independent predictors of sustained remission on‐treatment (OR = 2.32, p &lt; 0.05 and OR = 5.59, p &lt; 0.01, respectively).ConclusionTaken together, the results of this real‐life clinical investigation indicate that benralizumab can induce a sustained remission on‐treatment of SEA, especially in those patients with comorbid CRSwNP and reversible airflow limitation.image

RESEARCH OF MANIFESTATION OF THE ORAL MUCOSA IN COVID-19

The oral cavity is one of the main gates for coronavirus (SARS-CoV-2); the oral cavity also suffers greatly from this infection, because it is one of the most vulnerable places. In addition, since the salivary glands can serve as a reservoir for viruses and support their release into the external environment, it was concluded that saliva, as a component of oral fluid, can play an important role in the spread of coronavirus infection. This is mainly due to the ACE-2 receptor, which have a high level of expression in the keratinized surface epithelial cells of the oral mucosa, especially in the epithelial cells of the dorsal part of the tongue, tonsils, vocal cords, salivary glands and sinuses, due to which the virus replicates in and causes both oral lesions and oral symptoms mouth After entering the cell, the virus delays the response of the immune system, allowing the infection to progress, and it becomes much more difficult to fight it. Accordingly, due to the relatively high level of COVID-19-associated complications, timely diagnosis of clinical forms, including high-risk patients with prognosis their clinical course and the selection of drug treatment appropriate to the severity of the clinical course remain quite complex and controversial issues. It was emphasized that in some cases oral symptoms may be the initial or only sign of disease, and dentists should take this into account when performing a thorough clinical examination of the oral cavity.

Can systematic dental examinations or treatments in addition to routine multidisciplinary treatment in a palliative care unit (PCU) improve the quality of life (QoL) and symptom burden (SB) of patients (Pt) receiving palliative care (PC)?

e23163 Background: Pt with advanced cancer who require PC often experience not only common symptoms such as pain, shortness of breath, or nausea, but also oral health and dental problems. In many PC teams, and even in dedicated PCUs, the inclusion of dentists in the Pt care team is rare, resulting in a lack of routine dental screening or treatment. Objectives:To investigate the extent to which Pt admitted to a PCU suffer from oral health or dental problems and to explore the impact of incorporating dentists into inpatient PC, with a focus on improving QoL and reducing SB. Methods: In this monocentric study, data were collected in one PCU over a period of eight months. At admission, T0, Pt underwent both a dental examination and interviews using established questionnaires, the EORTC QLQ-C30 (core, general) and OH 15 (oral health). One week later, at T1, Pt underwent a follow-up examination and interview. The QLQ-C30 is a widely accepted instrument developed to assess health-related QoL in cancer Pt. Results: A total of n = 103 Pt (48.5% women) were enrolled. The median time since the last dental visit was 1 year. The dental status at T0 was worse (Table 1). At T1, statistically and clinically significant changes in oral QoL and SB were observed. Notable changes were observed in OH-QoL score (mean 60.60 vs. 88.40, p &lt; 0.001), sticky saliva (mean 38.10 vs. 11.28, p &lt; 0.001), sensitivity to food and drink (mean 35.25 vs. 8.16, p &lt; 0.001), sore mouth (mean 23.87 vs. 4.98, p &gt; 0.001), and poorly fitting dentures (mean 38.63 vs. 8.07, p &lt; 0.001). Improvements in xerostomia, candidiasis and mucositis were also observed. A confidential survey was administered to both Pt and palliative care staff to assess their satisfaction with the addition of systematic dental care to routine multidisciplinary PC. 97% of respondents indicated a high level of satisfaction with this treatment program. Conclusions: The study underscores the powerful contribution of integrating a dentist into the PC, e.g. in a PCU, resulting in a notable reduction in oral symptom burden. This contributes to improved care status, alleviation of distressing symptoms and ultimately an improvement in QoL. The results strongly support the consideration of dental support (e.g. routine dental screening) as an integral part of PC. [Table: see text]

Association of Oral Health and Periodontal Disease with Hypertension: A Cross-Sectional Study

Objectives: The association of orodental and cardiovascular health has been an area of extensive research for many years. As per American Heart Association hypertension 2017 guidelines, good periodontal health is associated with better systolic blood pressure control. However, there have been conflicting results for hypertension and dental correlation in a few other studies. Moreover, there are no recognized oral manifestations, seen in patients with hypertension. Indian data on this subject are scarce. Therefore, the present study was contemplated to determine the frequency and nature of oral manifestations in hypertensive patients as compared to normotensive patients. Materials and Methods: In this observational cross-sectional study, participants were divided into two groups. Group A included 40 hypertensive subjects and group B included 40 healthy normotensive volunteers. Oral symptoms such as dry mouth, altered taste sensation, mouth odor, and bleeding from gums were noted. An oral examination was performed to check periodontal pockets, lichenoid reactions, and gingival hyperplasia. Russell’s Periodontal Index was used to estimate gingival and periodontal health. Results: The mean age of patients in the hypertensive group was higher than normotensive groups (53.8 ± 11 vs. 42.45 ± 12, P = 0.001). Oral symptoms in the form of dry mouth, halitosis, and altered taste were reported in 60%, 52.5%, and 42.5% of hypertensive patients which were significantly higher as compared to the control group. Bleeding gums, lichenoid reactions, and gingival enlargement were also significantly higher in hypertensive than normotensive groups. The mean value of Russell’s index was 1.09 ± 0.41 in group A which was significantly different from group B (0.05 ± 0.10). Gingival hyperplasia and gum bleeding were predominantly found in patients on calcium channel blockers, whereas lichenoid reactions were significantly present in patients on angiotensin receptor blockers. Hyposalivation was reported with all four classes of antihypertensive drugs, predominantly diuretics. Conclusion: The orodental involvement in hypertensive subjects has a wide spectrum from mildly symptomatic halitosis and dryness of mouth to severe bleeding gums, lichenoid lesions, irreversible bone loss, and periodontitis that may require dental visits and interventions. The documented mucosal changes can also be attributed to antihypertensive drugs. Regular dental examinations should be made part of routine screening programs of hypertensive patients to protect them from various oral complications and subsequent inflammation-mediated changes in vasculature endothelium.

Oral health in systemic sclerosis: A scoping review

Background: Limited research on oral health in systematic sclerosis poses a significant challenge for people with systematic sclerosis and health care professionals. We conducted a scoping review to map existing research on oral health–related quality of life in systematic sclerosis across domains including (1) oral manifestations or symptoms, (2) functional consequences, (3) psychosocial aspects, (4) associated patient factors and (5) self-care and management considerations. Methods: We searched MEDLINE, EMBASE, SCOPUS and CINAHL databases to 10 March 2023 for studies on oral health in people with systematic sclerosis. Study data were mapped into pre-specified domains of oral health–related quality of life, subtopics and types of research and reported in tabular form. Results: Of 1460 unique studies reviewed, 91 were eligible and included in the scoping review; of these, 69 (76%) were published as full-text versions, 72 (79%) were from Europe or North America, and 63 (69%) included ⩽50 participants. Only 1 study had &gt;200 participants (N = 382). By domains, 85 (93%) studies reported aspects of oral manifestations or symptoms, with the most common subtopics being oral opening and mandibular function, sicca, periodontitis and soft tissue changes and pathology; 36 (40%) studies provided information on associated patient factors, 23 (25%) on self-care and management, 19 (21%) on psychosocial aspects and 6 (7%) on functional consequences. No studies related to interventions included &gt;50 participants. Conclusion: Most studies on oral health in systematic sclerosis report on manifestations or symptoms, and there are relatively few studies on other important domains. Most studies have been conducted with small samples. Updated systematic reviews should evaluate the quality of existing evidence in domains where enough studies have been done. Large, well-conducted primary studies are needed to address knowledge gaps across domains, including studies that test approaches for supporting oral self-care, improving routine professional care and addressing major disability-causing manifestations.

Manifestations and Treatment of Hypovitaminosis in Oral Diseases: A Systematic Review.

This review's objective is to examine the findings from various studies on oral signs and symptoms related to vitamin deficiency. In October 2023, two electronic databases (Scopus and PubMed) were searched for published scientific articles following PRISMA principles. Articles eligible for inclusion in this review had to be published in English between 2017 and 2023, be original studies, and involve human subjects. Fifteen studies were included in this review: three examining oral symptoms of vitamin B12 deficiency; one assessing vitamin B complex and vitamin E for recurrent oral ulcers; one investigating serum vitamin D levels in recurrent aphthous stomatitis patients; three exploring hypovitaminosis effects on dental caries; two measuring blood serum vitamin D levels; one evaluating vitamin B12 hypovitaminosis; three investigating hypovitaminosis as indicative of gingival disease; one focusing on vitamin deficiencies and enamel developmental abnormalities; one assessing vitamin deficiencies in oral cancer patients; one examining vitamin K as an oral anticoagulant and its role in perioperative hemorrhage; and one evaluating vitamin effects on burning mouth syndrome. Despite some limitations, evidence suggests a correlation between vitamin deficiencies and oral symptoms. This systematic review was registered in the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) database (202430039).

Measurement of some immunological Indicators in patients with recurrent oral lichen planus and some viral infections

Oral lichen planus(OLP) usually appears in the form of skin lesions with multiple oral symptoms. Research indicates that it may be an autoimmune disease and is believed to be related to some viral infections. aims to determine the level of some immune indicators in patients with OLP and some types of viral infections associated with it. The research also aimed to determine the level of these indicators in patients who suffered from recurrence of the infection. Methods: ELISA technology was used to determine the level of immune indicators, Results the percentage of patients infected with OLP was 48.9%, while those infected with OLP+HCV, OLP+HBsV, and OLP+HSV-1 were 9.4%, 6.2%, and 5.2%, respectively. Some immune indicators are in higher concentrations in females than in males. While there was variation in the levels of some other measured indicators, as they appeared in higher concentrations in patients infected with OLP+HBsV than in other groups, followed by the group of patients infected with OLP+HCV. In the group of patients with OLP, the infection was recurrent at a rate of 93.6%, while the non-recurrence rate was 6.4%. The immune indicators S-IgA, IgG, and C3 each appeared in higher concentrations in non-recurring disease cases, while the rest of the immune indicators appeared in higher concentrations in recurrent cases, and they varied. The levels of these immune indicators in other disease groups under study among those who have recurrence than in the other group. Conclusion: Some immunological indicators are increase in OLP patients and also, in HBsV infections and the disease may be recurrent in same family.

Contemporary Insights Into HIV Esophagitis: Pathogenesis, Therapeutic Strategies, and Prognostic Outcomes.

Opportunistic infections caused by various bacteria, viruses, fungi, or parasites can cause esophagitis.The fungus Candida albicans is often believed to be the thief behind this disorder.This condition's distinctive signs include the process of inflammation and the development of esophageal ulcers.The underlying immunodeficiency condition in HIV/AIDS patients, especially those in the late stages of the disease, may lead to severe illness or even death if the lowered immune system can no longer combat common infections.These individuals are, therefore, more at risk of contracting diseases like Candidiasis since they already have weakened immune systems. Furthermore, bacteria and mycobacteria can cause esophagitis in the same way that viruses can.Tobacco use, alcohol drinking, and nutritional deficiency are three additional problems that can lead to an HIV esophagitis infection.Complaints of inability to swallow, suffocating feeling or discomfort behind the breastbone, and painful swallowing are the primary symptoms of the patients.White plaques or ulcers observed in the esophagus during an endoscopy can be biopsied for further examination. The presence of C. albicans hyphae and inflammatory infiltrates in these samples confirms the diagnosis of HIV-associated esophagitis. Treatment involves the use of antifungal medications and addressing any underlying causes of esophagitis, which is linked to AIDS. For superficial to moderate infections, fluconazole is typically used first. If the disease is severe or recurs after treatment, intravenous amphotericin B may be necessary. Patients with recurring oral symptoms of HIV esophagitis might also need to take antifungal drugs as a preventative measure.

New light on an old syndrome: Role of Api g 7 in mugwort pollen–related celery allergy

BackgroundCelery root is known to cause severe allergic reactions in patients sensitized to mugwort pollen. ObjectiveTo study clinically well-characterized patients with celery allergy by IgE testing with a comprehensive panel of celery allergens to disentangle the molecular basis of the “celery-mugwort-syndrome”. MethodsPatients with suspected food allergy to celery underwent a standardized interview. Main inclusion criteria were a positive food challenge with celery or an unambiguous case history of severe anaphylaxis. IgE to celery allergens (rApi g 1.01, rApi g 1.02, rApi g 2, rApi g 4, nApi g 5, rApi g 6, rApi g 7), and to mugwort allergens (rArt v 1, rArt v 3, rArt v 4) were determined by ImmunoCAP. IgE levels ≥ 0.35kUA/L were regarded positive. ResultsSeventy-nine patients with allergy to celery were included. Thirty patients suffered from mild oral or rhino-conjunctival symptoms and 49 from systemic reactions. Sixty-eight % had IgE to celery extract, 80% to birch pollen and 77% to mugwort pollen. A combination of Api g 1.01, 1.02, 4, 5, and 7 increased diagnostic sensitivity for celery allergy to 92%. The LTPs Api g 2 and Api g 6 were not relevant in our celery allergic population. IgE to Api g 7, detected in 52% of patients, correlated closely (r=0.86) to Art v 1 from mugwort pollen. Eleven out of 12 patients with monosensitization to Api g 7 were IgE negative to celery extract. The odds ratio for developing a severe anaphylactic reaction rather than only mild oral symptoms was about 6 times greater (odds ratio 5.87; 95% CI 1.08-32.0, p=0.0410) for Api g 7 sensitized versus Api g 7 non-sensitized subjects. ConclusionThere is an urgent need for routine diagnostic tests to assess sensitization to Api g 7 not only to increase test sensitivity, but also to identify celery allergic patients at risk of a severe allergic reaction to celery.