Saliva Test Research Articles

Diagnosis of Respiratory Syncytial Virus in Adults Substantially Increases When Adding Sputum, Saliva, and Serology Testing to Nasopharyngeal Swab RT-PCR.

Nearly all existing respiratory syncytial virus (RSV) incidence estimates are based on real-time polymerase chain reaction (RT-PCR) testing of nasal or nasopharyngeal (NP) swabs. Adding testing of additional specimen types to NP swab RT-PCR increases RSV detection. However, prior studies only made pairwise comparisons and the synergistic effect of adding multiple specimen types has not been quantified. We compared RSV diagnosis by NP swab RT-PCR alone versus NP swab plus saliva, sputum, and serology. This was a prospective cohort study over two study periods (27 December 2021 to 1 April 2022 and 22 August 2022 to 11 November 2022) of patients aged ≥ 40years hospitalized for acute respiratory illness (ARI) in Louisville, KY. NP swab, saliva, and sputum specimens were collected at enrollment and PCR tested (Luminex ARIES platform). Serology specimens were obtained at acute and convalescent timepoints (enrollment and 30-60-day visit). RSV detection rate was calculated for NP swab alone and for NP swab plus all other specimen type/test. Among 1766 patients enrolled, 100% had NP swab, 99% saliva, 34% sputum, and 21% paired serology specimens. RSV was diagnosed in 56 (3.2%) patients by NP swab alone, and in 109 (6.2%) patients by NP swab plus additional specimens, corresponding to a 1.95 times higher rate [95% confidence interval (CI) 1.62, 2.34]. Limiting the comparison to the 150 subjects with all four specimen types available (i.e., NP swab, saliva, sputum, and serology), there was a 2.60-fold increase (95% CI 1.31, 5.17) compared to NP swab alone (3.3% versus 8.7%). Sensitivities by specimen type were: NP swab 51%, saliva 70%, sputum 72%, and serology 79%. Diagnosis of RSV in adults was several-fold greater when additional specimen types were added to NP swab, even with a relatively low percentage of subjects with sputum and serology results available. Hospitalized RSV ARI burden estimates in adults based solely on NP swab RT-PCR should be adjusted for underestimation.

Salivary glucose as an alternative reliable marker in diabetes mellitus: A systematic review

Introduction and Aim: Diabetes mellitus (DM) is a chronic metabolic endocrine condition characterised by elevated blood glucose levels that can be brought on by insulin resistance, insulin deficiency, or both. As a non-invasive diagnostic tool, saliva is a complex biological fluid that contains numerous enzymes, growth factors and microbial antibodies. The objective of this systematic review is to examine and analyse published studies that have estimated the levels of salivary glucose in people with type 1 diabetes. Materials and Methods: MeSH terms from the electronic search database engines such as PubMed, PubMed Central, Science Direct, Cochrane Library and Google Scholar were extensively used in this search methodology in this systematic review. The precise audit has been enlisted in the PROSPERO data set (Enrolment Number: CRD42021287015). 18 articles were retrieved all together. This systematic review included two articles after the application of the inclusion and exclusion criteria. Results: A total of 347 type 1 DM cases (174 controlled diabetics, 173 uncontrolled diabetics) and 84 controls were dissected for the appraisal of the salivary glucose levels. Using Review Manager 5.4.1, a quality assessment of the included studies produced risk of bias and applicability concern graphs. Conclusion: The emerging field of salivary diagnostics provides real-time diagnostic values for numerous diseases. The salivary and serum glucose concentrations in Type 1 diabetes were found to be statistically correlated in the studies analysed in this systematic review, thus making them a useful monitoring tool for determination of the disease’s status.

The Effects of Exam-Induced Stress on EEG Profiles and Memory Scores

Common stressors amongst postsecondary students are exam-induced anxiety and stress. The purpose of this study was to measure stress alterations in the student population around examinations and determine how they affect electroencephalogram (EEG) profiles and memory scores. Twenty university students were measured multiple times in the study. During each measurement, participants were administered a cortisol saliva test and an EEG. We hypothesized that cortisol levels, memory scores, and EEG profiles would all demonstrate changes near examinations. The brain regions of interest (ROIs) were the parahippocampal gyrus, the medial frontal gyrus, and the middle frontal gyrus. Results demonstrated that memory performance and parahippocampal activity were correlated, specifically in the 5-9 Hz frequency band. Correlations were also computed between cortisol levels, memory performance, and parahippocampal activity. The medial frontal gyrus also displayed changes in the mean (19-20 Hz) current source density (CSD) throughout the experiment. The middle frontal gyrus activation was highly variable during the different measurement time points. Essentially, when an individual's memory scores were consistent between exam and nonexam trials, there was an increase in middle frontal gyrus activation during examination periods. Lastly, the right parahippocampal gyrus was found to be the most activated one day away from examination time. These results indicate that memory scores are related to cortisol levels and examination periods, but most importantly, there are overt and predictable alterations in student EEG profiles near examinations.

Abstract A50: Distinguishing Mosaic Li Fraumeni Syndrome, Clonal Hematopoiesis and Incidental Myeloid Neoplasms in Patients with Solid Tumors with Pathogenic TP53 Mutations Identified by Germline Testing or Cell-Free Circulating DNA Sequencing

Abstract The incorporation of panel-based germline genetic testing for assessment of pathogenic or likely pathogenic variants associated with increased risk of breast, ovarian, prostatic and pancreatic cancer in NCCN guidelines and wide adoption of cell-free circulating DNA sequencing (liquid biopsy) for patients with advanced solid tumors has increased the identification of pathogenic TP53 variants in blood of patients with solid tumors. The variant allelic frequency (VAF) of the pathogenic variant is often used to help infer the compartment of origin (germline vs somatic) with near heterozygous (~50%) VAF favoring germline; however, when VAF is low (sub heterozygous) potential considerations include mosaic Li Fraumeni syndrome, clonal hematopoiesis, or incidental myeloid neoplasms, and determining the origin of the TP53 mutation can be a challenge with important surveillance and treatment implications. We describe a cohort of patients with solid tumors or hematologic malignancies in whom pathogenic or likely pathogenic TP53 variants of uncertain origin were identified by clinical genetic testing of peripheral blood, next generation sequencing (NGS) using an 81 gene hematologic malignancy-based panel, or cell-free DNA sequencing/liquid biopsy. In a subset of patients for whom solid tumor, adjacent normal tissue and/or bone marrow (BM) was available, immunohistochemistry for p53 protein was performed. Patients (n= 17) included 11 (61%) women and 7 (39%) men with a median age of 54 years (range 8-7) at initial cancer diagnosis, with 17 unique TP53 variants with a median VAF of 16% (range, 2-50%). The most common indication for referral for additional investigation of the TP53 origin was sub-heterozygous VAF on germline testing of blood (8/47%) or saliva (1/6%); TP53 variant identified in plasma when the concurrent solid tumor was TP53 wild-type (3/18%) followed by presence of a pathogenic TP53 variant in remission BM of patients with history of hematologic malignancies (4/24%). Additional germline testing of skin fibroblasts and/or BM examination was performed in in 9 (53%) and 8 (47%) patients, respectively. p53 IHC was performed on 3 BM biopsies and 2 solid tumor tissues. A multimodality/multidisciplinary interpretation of these results allowed appropriate classification of the TP53 variants in 12/18 patients (67%). These included Li Fraumeni syndrome (5/12; 42%); clonal hematopoiesis (5/12; 42%); donor-derived clonal hematopoiesis (1/12;8%) and therapy-related myelodysplastic syndrome (1/12; 8%) patients. Appropriate awareness and distinction of clonal hematopoiesis and potential myeloid neoplasms from mosaic germline TP53 in the setting of subheterozygous VAF identified on peripheral blood or bone marrow analyses can be challenging. Multimodality testing and a multidisciplinary approach for accurate interpretation is required. Immunohistochemical staining for p53 can be useful in making this distinction in a subset of patients. Citation Format: Sanam Loghavi, Yoheved Gerstein, Mark J Routbort, Keyur P Patel, Koichi Takahashi, Molly Daniels, Julie Moskowitz, Danielle E Hammond, Kelly Chien, L. Jeffrey Medeiros, Farhad Ravandi, Hagop M Kantarjian, Guillermo Garcia-Manero, Banu Arun, Joseph D Khoury, Courtney D DiNardo. Distinguishing Mosaic Li Fraumeni Syndrome, Clonal Hematopoiesis and Incidental Myeloid Neoplasms in Patients with Solid Tumors with Pathogenic TP53 Mutations Identified by Germline Testing or Cell-Free Circulating DNA Sequencing [abstract]. In: Proceedings of the AACR Special Conference: Acute Myeloid Leukemia and Myelodysplastic Syndrome; 2023 Jan 23-25; Austin, TX. Philadelphia (PA): AACR; Blood Cancer Discov 2023;4(3_Suppl):Abstract nr A50.

Latest Findings on Salivary Tumor Biomarkers

Saliva, a complex mixed biological fluid secreted by the salivary glands in the oral cavity, contains a wide variety of substances and information. With the development of saliva omics, studies have shown that saliva not only serves as a huge reservoir of biomarker, but saliva diagnostics has also become a new diagnostic technology with the advantages of non-invasiveness, easy access, and low cost. However, finding "true" saliva biomarkers is still a challenge due to the complex and changeable nature of the oral environment and the high susceptibility of biomarker content to influences. Herein, mainly focusing on potential salivary biomarkers of common tumors, including DNA, RNA, proteins, metabolites and microorganisms, we gave a systematic overview of the biomarkers that had been identified so far or the associated biomarkers. We suggested that the future development direction should be the establishment of a multidisciplinary system for developing saliva diagnosis technology, the gradual construction of a saliva diagnosis platform, and the search for more precise pre-warning tumor biomarkers.

A Review of Salivary Biomarkers in Breast Cancer

Objective: This study aimed to review the literature related to salivary biomarkers used to diagnose breast cancer or predict responses to therapy and its prognosis. Methods: Studies were eligible for inclusion if they had compared salivary diagnostics for breast cancer with the gold standard or other biomarkers. Six databases (PubMed, EMBASE, ScienceDirect, Scopus, Web of Science, and Ovid) and Google Scholar search engine searched for pertinent literature using specific search terms: breast cancer, diagnosis, prognosis saliva, and salivary biomarker. Of the 513 studies screened, 110 were selected for inclusion in this review. Different salivary biomarkers were classified and discussed. Results: Our analysis indicated that the sensitivity and specificity of salivary biomarkers, such as cerb- B2 and sialic acid in BC detection are comparable with serum values. Salivary levels of autoantibodies against MUC1, CA 15-3, and adiponectin had a better correlation with breast cancer than serum levels. Assessment of biomarkers, such as HER-2, helps develop a treatment plan and evaluates response to treatment. Conclusion: Our study confirms that salivary biomarkers are becoming increasingly important in breast cancer diagnosis and treatment planning, as well as in predicting therapeutic response and prognosis. Salivary biomarkers such as c-erb-B2 in association with traditional criteria offer the promise of use as a noninvasive screening method for breast cancer. Additional studies are warranted to determine the most sensitive and specific salivary biomarkers for this purpose.

A spitting image: molecular diagnostics applied to saliva enhance detection of Streptococcus pneumoniae and pneumococcal serotype carriage.

Despite strong historical records on the accuracy of saliva testing, oral fluids are considered poorly suited for pneumococcal carriage detection. We evaluated an approach for carriage surveillance and vaccine studies that increases the sensitivity and specificity of pneumococcus and pneumococcal serotype detection in saliva samples. Quantitative PCR (qPCR)-based methods were applied to detect pneumococcus and pneumococcal serotypes in 971 saliva samples collected from 653 toddlers and 318 adults. Results were compared with culture-based and qPCR-based detection in nasopharyngeal samples collected from children and in nasopharyngeal and oropharyngeal samples collected from adults. Optimal C q cut-offs for positivity in qPCRs were determined via receiver operating characteristic curve analysis and accuracy of different approaches was assessed using a composite reference for pneumococcal and for serotype carriage based on isolation of live pneumococcus from the person or positivity of saliva samples determined with qPCR. To evaluate the inter-laboratory reproducibility of the method, 229 culture-enriched samples were tested independently in the second center. In total, 51.5% of saliva samples from children and 31.8% of saliva samples from adults were positive for pneumococcus. Detection of pneumococcus by qPCR in culture-enriched saliva exhibited enhanced sensitivity and higher agreement with a composite reference compared to diagnostic culture of nasopharyngeal samples in children (Cohen's κ: 0.69-0.79 vs. 0.61-0.73) and in adults (κ: 0.84-0.95 vs. 0.04-0.33) and culture of oropharyngeal samples in adults (κ: 0.84-0.95 vs. -0.12-0.19). Similarly, detection of serotypes with qPCR in culture-enriched saliva exhibited enhanced sensitivity and higher agreement with a composite reference compared to nasopharyngeal culture in children (κ: 0.73-0.82 vs. 0.61-0.73) and adults (κ: 0.90-0.96 vs. 0.00-0.30) and oropharyngeal culture in adults (κ: 0.90-0.96 vs. -0.13 to 0.30). However, results of qPCRs targeting serotype 4, 5, and 17F and serogroups 9, 12, and 35 were excluded due to assays' lack of specificity. We observed excellent quantitative agreement for qPCR-based detection of pneumococcus between laboratories. After exclusion of serotype/serogroup-specific assays with insufficient specificity, moderate agreement (κ 0.68, 95% CI 0.58-0.77) was observed. Molecular testing of culture-enriched saliva samples improves the sensitivity of overall surveillance of pneumococcal carriage in children and adults, but limitations of qPCR-based approaches for pneumococcal serotypes carriage detection should be considered.

A comprehensive study into false positive rates for ‘other’ biological samples using common presumptive testing methods

The identification of biological fluids or materials in forensic samples is a key requirement in forensic science that relies on chemical and biological based tests, most of which exhibit false positivity. When reporting results from such tests, Forensic Scientists use words such as probable, possible, and likely, without always being able to provide robust support for these conclusions. In collating information about false positive rates for a number of these tests, we found limited research into the cross reactions observed from ‘other’ biological samples in commonly encountered case sample stains. By ‘other’ we mean biological fluids or materials that are not the primary target of the presumptive test being used. Here we carry out a specificity study to fill gaps in the literature for a number of the presumptive chemical, biological and immunochromatographic tests used to presumptively screen for blood, semen and saliva. The tests selected for this study are the widely used tests: Luminol, TMB/Combur3 Test® E, Kastle-Meyer (KM), RSID™ - Blood, ABAcard® HemaTrace®, Acid Phosphatase (AP), ABAcard® p30, RSID™ - Semen, Phadebas® ‘Tube’ Test, Phadebas® ‘Press’ Test, and RSID™ - Saliva tests. Specificity for each of these was tested in known samples, from volunteers, of blood, semen, saliva, urine, sweat, vaginal material, faeces and breast milk, and then false positive rates were determined.

Development of Mobile Contingency Management for Cannabis Use Reduction

Many interventions for cannabis use disorder (CUD) are associated with decreases in frequency and quantity of use but fail to increase overall rates of sustained abstinence. It is currently unknown whether reductions in use (in the absence of sustained abstinence) result in clinically significant improvements in functioning. The objective of this study was to refine a mobile contingency management approach to reduce cannabis use to ultimately evaluate whether reductions in frequency and quantity of cannabis are related to improvements in functional and mental health status. Three cohorts of participants (n = 18 total, n = 10 women) were enrolled and completed 2 weeks of ecological momentary assessment (EMA) during a baseline ad lib cannabis use period, followed by a 6-week reduction period. Participants completed EMA assessments multiple times per day and were prompted to provide videotaped saliva cannabis testing 2–3 times daily. Data from participants who were at least 80% adherent to all EMA prompts were analyzed (13 out of 18). During the ad lib phase, participants were using cannabis on 94% of the days and reported using a mean of 1.42 grams daily. The intervention was a mobile application that participants used to record cannabis use by saliva tests to bioverify abstinence and participants completed electronic diaries to report their grams used. During the 6-week intervention phase, participants reported reducing their use days to 47% of the days with a reported mean of .61 grams daily. In the last cohort, at least 50% of the heavy users were able to reduce their cannabis use by at least 50%. The effect of cannabis reduction (versus abstinence) is largely unknown. Observations suggest that it is possible to develop a mobile intervention to reduce cannabis use among heavy users, and this paradigm can be utilized in future work to evaluate whether reductions in cannabis use among heavy users will result in improvements in functional and mental health status.

한방추출물을 이용한 천연구강양치액 사용이 구강건조감과 구취에 미치는 영향

Objectives: This study was conducted to provide basic data for the development of natural gargle exhibits the effect of reducing oral dryness and halitosis by manufacturing gargle using natural oriental medicine extract.
 Methods: From June 2 to June 9, 2022, 24 subjects were divided into three groups(control group, natural gargle group, listerine group) and after using natural gargle for a week, a survey, saliva test, and halitosis test were conducted.
 Results: There was a statistically significant difference in improving the subject's objective halitosis and oral dryness for the use of natural gargle.
 Conclusions: The use of natural gargle using oriental medicine extracts is effective in improving halitosis and dryness, so it is expected to be used in the development of natural gargle that does not contain chemicals in future gargle development

Oral Cavity is the Gateway to the Body: Role of Oral Health Professionals: A Narrative Review

Background The oral cavity is the most important link between the human body and the external environment and is well-equipped to protect the body against invading pathogens. Emerging data on the bidirectional relationship between oral health and the severity of COVID-19 symptoms has prompted us to reexamine our role as the guardians of the oral cavity - the true gateway to the body. Recent studies have shown that the oral microbiome is a complex ecological system and the interactions between its residents and the host cells influence human health and disease. This narrative review elaborates on the oral-systemic connection from an oral microbiome standpoint and discusses the future role of oral health professionals.Methods A PubMed literature search using the keywords “Oral Microbiome and Diseases” and “Oral microbiome and Health” for a range of ten years between 2012-2022 was completed. Meta-Analyses, Reviews, Randomized Control Trials, Clinical Trials, and books were included in the search.Results “Oral microbiome and Diseases” yielded 6392 results and “Oral microbiome and Health” yielded 4287 results.Conclusion Oral health professionals need to be trained on the oral-systemic connection periodically to appreciate the recent advances in this field.Practical Implications A deeper understanding of the impact of existing treatment modalities on the oral microbiome could expand the role of oral health professionals in preventing and maintaining patients' overall health. Implementing point-of-care salivary diagnostics to detect salivary biomarkers for oral and non-oral diseases and conditions may be a significant leap toward this goal.

Persistence of SARS-CoV-2 in saliva: Implications for late-stage diagnosis and infectious duration.

Saliva has been a COVID-19 diagnostic specimen of interest due to its simple collection, scalability, and yield. Yet COVID-19 testing and estimates of the infectious period remain largely based on nasopharyngeal and nasal swabs. We sought to evaluate whether saliva testing captured prolonged presence of SARS-CoV-2 and potential infectiousness later in the disease course. We conducted an observational study of symptomatic COVID-19 patients at University Hospital in Newark, NJ. Paired saliva and nasal specimens from 96 patients were analyzed, including longitudinal analysis of paired observations from 28 of these patients who had multiple time-points. Saliva detected significantly more cases of COVID-19 beyond 5 days (86.1% [99/115] saliva vs 48.7% [56/115] nasal, p-value < 0.001), 9 days (79.4% [50/63] saliva vs 36.5% [23/63] nasal, p-value < 0.001) and 14 days (71.4% [20/28] saliva vs 32.1% [9/28] nasal, p-value = 0.010) of symptoms. Additionally, saliva yielded lower cycle thresholds across all time periods, indicative of higher viral loads in saliva. In the longitudinal analysis, a log-rank analysis indicated that the survival curve for saliva was significantly different from the curve for nasal swabs (p<0.001) with a median survival time for saliva of 18 days compared to 13 days for nasal swabs. We additionally performed saliva viral cultures among a similar COVID-19 patient cohort and noted patients with positive saliva viral cultures between 7 to 28 days of symptoms. Findings from this study suggest that SARS-CoV-2 RNA persists longer and in higher abundance in saliva compared to nasal swabs, with potential of prolonged propagating virus. Testing saliva may thus increase yield for detecting potentially infectious virus even beyond the first five days of symptomatic COVID-19.

Complete Blood Count and saliva parameters as an indicator for infected patients with coronavirus covid-19

Background: Coronavirus, which causes respiratory illness, has been a public health issue in recent decades. Because the clinical symptoms of infection are not always specific, it is difficult to expose all suspects to qualitative testing in order to confirm or rule out infection as a test. Methods: According to the scientific studies and investigations, seventy-three results of scientific articles and research were obtained using PubMed, Medline, Research gate and Google Scholar. The research keywords used were COVID-19, coronavirus, blood parameters, and saliva. Results: This review provides a report on the changes in the blood and saliva tests of those who are infected with the COVID-19.COVID-19 is a systemic infection that has a substantial influence on the hematological system and hemostasis, thus deviations from normal levels of laboratory tests, including the blood and saliva test show that specific testing for detecting COVID-19 infection is required. Conclusions: The blood and saliva tests aid in the clinical monitoring of the patient's health. It has advantages such as the following: it has non-invasive properties, low cost, and good stability, addition to minimum risk of infection transport.

Paroxysmal Atrial Fibrillation with Rapid Ventricular Response Following COVID-19 Nasopharyngeal Swab: A Case Report

Nasopharyngeal (NP) swab sampling is a simple procedure that has become extremely popular in the coronavirus disease 2019 (COVID-19) era, with hundreds of million specimens collected every day. However, rare but serious complications have been reported following NP swab acquisition. Here we present a case of paroxysmal atrial fibrillation associated with NP specimen collection in a healthy healthcare provider undergoing COVID-19 testing during departmental screening. This response may have been caused by an exaggerated vagal tone triggered by the trigeminocardiac reflex. Less invasive collection methods, such as saliva testing, may be warranted in predisposed individuals.

Saliva and wastewater surveillance for SARS-CoV-2 during school reopening amid COVID-19 pandemic in Thailand

ObjectivesSchool closure during the coronavirus disease 2019 (COVID-19) pandemic resulted in a negative impact on children. Serial testing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been proposed as a measure for safety school reopening. We aimed to study the usefulness of SARS-CoV-2 surveillance by saliva testing and performing wastewater surveillance for SARS-CoV-2 in a day school in a resource-limited setting. MethodsWe conducted a cluster randomized study to investigate the potential use of saliva antigen testing compared to saliva pooling for nucleic acid detection in a primary school in Thailand from December 2021 to March 2022. Wastewater surveillance in the school was also performed. ResultsA total of 484 participants attended the study. SARS-CoV-2 was detected in two participants from the tests provided by the study (one in the pool nucleic acid test arm, and another in the quantitative antigen test arm). Additional ten participants reported positive results on an additional rapid antigen test (RAT) performed by nasal swab when they had symptoms or household contact. There was no difference among arms in viral detection by intention-to-treat and per protocol analysis (p = 0.304 and 0.894, respectively). We also investigated the feasibility of wastewater surveillance to detect the virus in this setting. However, wastewater surveillance could not detect the virus. ConclusionsIn a low COVID-19 prevalence, serial saliva testing and wastewater surveillance for SARS-CoV-2 rarely detected the virus in a day school setting. Performing RAT on nasal swabs when students, teachers or staff have symptoms or household contact might be more reasonable.

CORRELATION BETWEEN FLOW, CONSISTENCY, QUANTITY, SALIVARY BUFFER CAPACITY AND BODY MASS INDEX (BMI) TO DMF-T

Background: Salivary characteristics include pH, salivary flow, consistency, composition, and saliva buffer capacity, so if changes occur, they will increase the risk of dental caries associated with the initial process and the speed of caries development. In addition to saliva, nutritional benefits can interfere with increased incidence of higher caries, reduced salivary secretion, decreased salivary buffer capacity, and qualitative changes in saliva. One of the parameters that can be used to measure nutritional status is the body mass index which also correlates with the DMF-T index. Objective: determine the correlation between flow, consistency, quantity, salivary buffer capacity, and body mass index (BMI) to the DMF-T index. Method: The group consisted of 78 respondents. Stimulated saliva samples were collected to measure salivary flow, saliva consistency, saliva quantity, and saliva buffer capacity using a saliva test buffer kit. Weight and height are measured to obtain a body mass index. Result: the average salivary flow of 1.9487, indicating a normal category because salivary flow occurs in less than 60 seconds. The average saliva quantity score was 2.6026, including normal at more than 5mL. The average buffer capacity is 2.6282, which means the standard is too high. The average BMI was 22.798, which indicated it had a normal weight and an average DMF-T level of 3.179 which belonged to the very low category. Conclusion: salivary parameters such as flow, buffer capacity, quantity, and BMI do not significantly correlate with the DMF-T index. However, one salivary parameter correlates to the DMF-T index, namely saliva viscosity.

Xerostomia in Dialysis Patients—Oral Care to Reduce Hyposalivation, Dental Biofilms and Gingivitis in Patients with Terminal Renal Insufficiency: A Randomized Clinical Study

Objectives: Dialysis patients suffer from xerostomia based on hyposalivation even in stimulated saliva testing. Therefore, the aim of this study was (i) to evaluate an optimized oral hygiene system with an oral care gel reducing oral dryness, supporting dental plaque control and reducing the number of gingivitis affected teeth; (ii) to document the efficacy in a randomized controlled trial with dental indices; and (iii) to record the individual’s oral health related quality of life. Methods: After ethical approval (EC-UWH 103/2019), 44 dialysis patients provided signed informed consent and were divided into two groups followed up for four weeks. Subjects of the verum group (A) received daily oral care gel OROFAN® based on biopolymers with a mild antibacterial and saliva stimulating action. They were compared to the control group (B) who executed routine oral hygiene with conventional dentifrice and toothbrushes. At baseline (T0), the medical report and all dental indices (sialometry, DMF/S, plaque index, periodontal index, tongue coating and denture hygiene index) were assessed. After 2 weeks and 4 weeks, T1 and T2 dry mouth frequency and all dental indices were assessed. An Oral Health Impact Profile was documented at baseline (T0) and at the end of the study (T2). Results: Twenty-two subjects were allocated to group A and to group B. At baseline, there were no statistical differences concerning renal insufficiency (years on dialysis and complications), systemic diseases and dental background (caries experience, periodontal diseases, plaque index and number of gingivitis affected teeth). All subjects exhibited hyposalivation (&lt;0.7–1.0 mL/min). The control group (B) showed no statistical differences from baseline (T0) to the end of the study (T2) in dry mouth parameters, in all dental plaque and inflammation indices and in their Oral Health Impact Profile. In contrast, the verum group (A) exhibited a highly significant (p &lt; 0.001) decrease in xerostomia frequency, in the number of gingivitis affected teeth and in their plaque index. Furthermore, their Oral Health Impact Profile improved considerably (p &lt; 0.01). Significance of Results: Terminally ill patients may gain better oral health and, consequently, an improved quality of life by rather simple oral care using long-lasting, edible anti-inflammatory oral hygiene gel and a dentist’s devotion.

Sniffer dogs performance is stable over time in detecting COVID-19 positive samples and agrees with the rapid antigen test in the field

Rapid antigen diagnostic (RAD) tests have been developed for the identification of the SARS-CoV-2 infection. However, they require nasopharyngeal or nasal swab, which is invasive, uncomfortable, and aerosolising. The use of saliva test was also proposed but has not yet been validated. Trained dogs may efficiently smell the presence of SARS-CoV-2 in biological samples of infected people, but further validation is needed both in laboratory and in field. The present study aimed to (1) assess and validate the stability over a specific time period of COVID-19 detection in humans’ armpit sweat by trained dogs thanks to a double-blind laboratory test–retest design, and (2) assess this ability when sniffing people directly. Dogs were not trained to discriminate against other infections. For all dogs (n. 3), the laboratory test on 360 samples yielded 93% sensitivity and 99% specificity, an 88% agreement with the Rt-PCR, and a moderate to strong test–retest correlation. When sniffing people directly (n. 97), dogs’ (n. 5) overall sensitivity (89%) and specificity (95%) were significantly above chance level. An almost perfect agreement with RAD results was found (kappa 0.83, SE 0.05, p = 0.001). Therefore, sniffer dogs met appropriate criteria (e.g., repeatability) and WHO's target product profiles for COVID-19 diagnostics and produced very promising results in laboratory and field settings, respectively. These findings support the idea that biodetection dogs could help reduce the spread of the virus in high-risk environments, including airports, schools, and public transport.

Septic Shock in the Course of Disseminated Tuberculosis in A COVID-19 Positive Patient with Concomitant AIDS

A 23-year-old male patient presented to the Provincial Hospital for Infectious Diseases in Warsaw, Poland in February 2022 with severe septic shock in the course of COVID-19 infection. The patient’s history and physical exam indicated a suspicion of HIV, TB, and COVID-19 triple coinfection. Numerous ulcers and phlegmon were present on the lower limbs and back with the patient complaining of difficulty walking. Laboratory tests came back positive for COVID-19, saliva tests were positive for active tuberculosis, and blood test results for the CD4 count were &lt; 200 cells/cubic millimeter confirming an AIDS diagnosis. Further testing and imaging revealed disseminated tuberculosis with involvement of bone in the left foot and thoracic spine, confirming Pott’s Disease. Treatment was started immediately for the septic shock with norepinephrine, vancomycin, meropenem, levofloxacin, and aggressive fluid resuscitation. COVID-19 treatment included oxygen mask therapy, systemic steroids and molnupiravir. Tuberculosis treatment was begun with isoniazid, rifampin, ethambutol, and pyrazinamide. Antiretroviral therapy (ART) was begun upon confirmed HIV/AIDS diagnosis using emtricitabine, tenofovir and dolutegravir. The patient was not previously on any ART and was not aware of his HIV/AIDS positive status.

Salivary Interleukin Levels in Oral Squamous Cell Carcinoma and Oral Epithelial Dysplasia: Findings from a Sri Lankan Study.

The incidence of oral squamous cell carcinoma (OSCC), and its precursor, oral epithelial dysplasia (OED), is on the rise, especially in South Asia. OSCC is the leading cancer in males in Sri Lanka, with >80% diagnosed at advanced clinical stages. Early detection is paramount to improve patient outcome, and saliva testing is a promising non-invasive tool. The aim of this study was to assess salivary interleukins (lL1β, IL6, and IL8) in OSCC, OED and disease-free controls in a Sri Lankan study cohort. A case-control study with OSCC (n = 37), OED (n = 30) patients and disease-free controls (n = 30) was conducted. Salivary lL1β, IL6, and IL8 were quantified using enzyme-linked immuno-sorbent assay. Comparisons between different diagnostic groups and potential correlations to risk factors were assessed. Salivary levels for the three tested interleukins increased from disease-free controls through OED, and were highest in OSCC samples. Furthermore, the levels of IL1β, IL6, and IL8 increased progressively with OED grade. The discrimination between patients (OSCC and OED) and controls, as assessed by AUC of receiver operating characteristic curves, was 0.9 for IL8 (p = 0.0001) and 0.8 for IL6 (p = 0.0001), while IL1β differentiated OSCC from controls (AUC 0.7, p = 0.006). No significant associations were found between salivary interleukin levels and smoking, alcohol, and betel quid risk factors. Our findings suggest that salivary IL1β, IL6, and IL8 are associated with disease severity of OED, and are potential biomarkers for predicting disease progression in OED, and the screening of OSCC.