The forgotten oral microbial transplantation for improving the outcomes of COVID-19

Ever since the uncovering of the severe discrepancy of COVID-19 manifestations, irrespective of viral load, scientists have raced to locate and manage factors contributing to the genesis of a critical state. Recent evidence delineates the role of oral dysbiosis in the development of low-grade inflammation, characterized by the increase of inflammatory cytokines common to those fundamental to the development of severe COVID. Furthermore, high periodontopathic bacteria were recorded in severe acute respiratory syndrome in COVID patients, as well as its common provoking comorbidities such as diabetes and hypertension. This can be explained by the immigration and elimination of oral bacteria into the airways, which, in the context of an injured lung, allows for their preferential overgrowth familiar to that, causing the progression to advanced lung diseases. This is why we indicate the promising usage of oral microbiome transplantation as a treatment of oral microbial dysbiosis, not only associated with the worst outcomes of COVID-19 but also in other disorders of low-grade inflammation.

Ultrastructural features on the oral cavity floor (tongue, sublingual caruncle) of the Egyptian water buffalo (Bubalus bubalis): gross, histology and scanning electron microscope

The present work was focused on the morphological characters of the lingual caruncles, and tongue with its papillae of Egyptian water buffalo (Bubalus bubalis) using the gross, light, and scanning electron microscope. The ventral surface of the sublingual caruncle carried a small opening of the duct of both monostoamtic and mandibular salivary gland. The lingual mucosa of dorsal, lateral border, some extent to ventral surface of apex had lingual papillae (filiform, fungiform), while the lingual mucosa of body especially at torus linguae had conical papillae, but circumvallate papillae observed at the caudal part of body and root. The dorsal surface of apex and body carried numerous long thread-like with blunt apex caudally directed filiform papillae that covered with keratinized scales without secondary papillae. The degree of keratinization classified filiform papillae into rostral part of high keratinization and caudal less keratinization. Conical papillary surface carried exfoliated epithelium with longitudinal groove on its rostral surface and had CT core does not reach the level surface of epithelium and carried secondary papillae. Fungiform papillae scattered among filiform papillae on the dorsal and ventral surface of apex and its convex surface had exfoliated keratinized epithelium. Circumvallate papillae surrounded by circular deep groove that bordered by vallum that carried small secondary papillae that ended into the primary groove. Taste buds of circumvallate papillae opened in the lateral lining epithelium facing the groove. Von Ebner's glands were observed in CT under papillae especially toward the groove and their ducts open into the base of the groove.

Acute dental periapical abscess and new-onset atrial fibrillation: A nationwide, population-based cohort study

Funding Acknowledgements

Type of funding sources: None.

Background

There are limited data on whether there is an association between hospitalisation with dental periapical abscess and new-onset atrial fibrillation (AF) which is independent of main cardiovascular risk factors.

Purpose

To investigate whether there is an association between hospitalisation with dental periapical abscess and new-onset AF.

Methods

A retrospective cohort study from a national database of patients hospitalised in 2013 (3.4 million patients) with at least five years of follow up, unless deceased. International Classification of Diseases (ICD) codes were used to compare the risk of developing new-onset AF for adults with and without dental periapical abscesses using univariate and multivariable analysis and hazard ratios (HR).

Results

In total, 4,693 patients classified as having dental periapical abscess, 435 (9.27%) developed AF, compared to 326,241 (10.69%) without dental periapical abscess over a mean follow-up of 4.8 ± 1.7 years.  Multivariable analysis indicated that dental periapical abscess acted as an independent predictor for new onset AF (p < 0.01).

Conclusions

An increased risk of new onset AF was identified for individuals hospitalised with dental periapical abscess. Careful follow up of patients with severe, acute dental periapical infections are needed for incident AF, as well as investigations of possible mechanisms linking these conditions.

Predictors of new-onset AF during FU Univariate analysis Multivariate analysis HR, 95%CI P HR, 95%CI P Age, years 1.077 (1.076-1.077) <0.0001 1.076 (1.075-1.076) <0.0001 Gender (male) 1.640 (1.629-1.651) <0.0001 1.0498 (1.487-1.509) <0.0001 Hypertension 2.849 (2.829-2.869) <0.0001 1.114 (1.487-1.509) <0.0001 Diabetes mellitus 1.951 (1.935-1.968) <0.0001 1.106 (1.096-1.116) <0.0001 Heart failure 3.893 (3.857-3.930) <0.0001 1.434 (1.416-1.452) <0.0001 Ischaemic stroke 2.289 (2.23902.340) <0.0001 1.140 (1.114-1.165) <0.0001 smoker 0.903 (0.891-0.917) <0.0001 1.052 (1.036-1.069) <0.0001 Liver disease 1.141 (1.119-1.164) <0.0001 1.082 (1.059-1.105) <0.0001 Previous myocardial infarction 2.128 (2.082-2.176) <0.0001 0.903 (0.880-0.926) <0.0001 Inflammatory disease 1.036 (1.020-1.052) <0.0001 0.978 (0.964-0.994) 0.005 Cognitive impairment 2.368 (2.326-2.410) <0.0001 0.821 (0.807-0.836) <0.0001 Illicit drug use 0.288 (0.263-0.317) <0.0001 0.940 (0.855-1032) 0.19 Dental periapical abscess 0.855 (0.778- 0.939) 0.001 1.107 (1.008-1.216) 0.03 At least 5 years of follow-up (mean follow-up 4.8 ± 1.7 years).

Abstract Figure. Flow Chart of the study patients

953 Role of Routine Preoperative Echocardiograms in Adolescent Idiopathic Scoliosis Patients undergoing Deformity Correction Surgery

Introduction

Patients with Adolescent Idiopathic Scoliosis (AIS) are often noted to have routine preoperative Echocardiograms (ECHO). The prevalence of ECHO abnormalities and their impact on perioperative outcome is not clear, especially balancing against its costs. The study aims at identifying the significance of routine preoperative ECHO for AIS patients.

Methodology

Clinical records of 295 adolescent AIS patients, >10years age (mean 15.64years), who underwent primary posterior corrective surgery in a tertiary spinal centre, between 2015-2020, were reviewed. Patients with revision surgery, anterior correction, syndromic/neuromuscular scoliosis and/or pre-existent known cardiac comorbidities were excluded.

Results

139(47%) patients had preoperative ECHO. 21(15%) patients showed echocardiographic abnormalities (11 trivial valvular abnormalities, 5 mild root dilatation, 3 mild pericardial effusion and 2 septal defects). None of these patients showed any clinical symptoms/signs or required Cardiology assessment; and none had perioperative cardiovascular complications. Conversely, four(1.36%) patients demonstrated auscultatory murmurs on preoperative clinical assessment. None reported any perioperative complication. The average known cost of an echocardiogram was noted to be £363.

Conclusions

Routine preoperative Echocardiogram for all AIS patients is not recommended or deemed cost-effective. Positive clinical assessment finding could be used as a screening tool for performing ECHO in AIS patients.

Review of potential risk groups for coronavirus disease 2019 (COVID-19)

The current pandemic of coronavirus disease 19 (COVID-19) is a global issue caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Studies have revealed that this virus results in poorer consequences and a higher rate of mortality in older adults and those with comorbidities such as cardiovascular disease, hypertension, diabetes and prolonged respiratory illness. In this review, we discuss in detail the potential groups at risk of COVID-19 and outline future recommendations to mitigate community transmission of COVID-19. The rate of COVID-19 was high in healthcare workers, smokers, older adults, travellers and pregnant women. Furthermore, patients with severe medical complications such as heart disease, hypertension, respiratory illness, diabetes mellitus and cancer are at higher risk of disease severity and mortality. Therefore, special effort and devotion are needed to diminish the threat of SARS-CoV-2 infection. Proper vaccination, use of sanitizers for handwashing and complete lockdown are recommended to mitigate the chain of COVID-19 transmission.

Silencing of the phosphofructokinase gene impairs glycolysis and causes abnormal locomotion in the subterranean termite Reticulitermes chinensis Snyder

Phosphofructokinase (PFK) is a rate-limiting enzyme in glycolysis, but its linkage with locomotion in termites is not well understood, despite the demonstrated involvement of this gene in the locomotion of different animals. Here, we investigated the effect of the pfk gene on locomotion in the subterranean termite Reticulitermes chinensis Snyder through RNA interference and the use of an Ethovision XT tracking system. The knockdown of pfk resulted in significantly decreased expression of the pfk gene in different castes of termites. The pfk-silenced workers displayed higher levels of glucose but lower levels of nicotinamide adenine dinucleotide (NADH) and adenosine triphosphate (ATP) production and decreased activity of the PFK enzyme. Furthermore, abnormal locomotion (decreased distance travelled, velocity and acceleration but increased turn angle, angular velocity and meander) was observed in different castes of pfk-silenced termites. We found caste-specific locomotion among workers, soldiers and dealates. Additionally, soldiers and dealates showed higher velocity in the inner zone than in the wall zone, which is considered an effective behaviour to avoid predation. These findings reveal the close linkage between the pfk gene and locomotion in termites, which helps us to better understand the regulatory mechanism and caste specificity of social behaviours in social insects.

Morphology of the lips, cheeks, and the hard palate of the Egyptian water buffalo (Bubalus bubalis): a focus on histological, histochemical, and ultrastructural aspects

BACKGROUND

The available data is scanty about Egyptian water buffalo lips, cheeks, and palate.

AIMS

The current investigation was focused on describing the morphology of the lip, cheek, and palate.

METHODS

Our study included the gross, light, and electron microscopic examinations of ten heads of the Egyptian water buffalos.

RESULTS

The nasolabial plate surface carried numerous scales of keratinized epithelium. Internal labial surface and labial mucocutaneous junctions were covered with stratified squamous keratinized epithelium. Two types of hair follicles in the dermis included ordinary and cavernous types characterized by cavernous space. The conical papillae on the internal aspect of the oral commissure were projected from the mucous membrane. Seromucous glands were occasionally observed under the oral mucous membrane of the commissure and gave positive PAS and AB. Conical papillae density on the inner cheek surface had some variations: the rostral part had large papillae, while the dorsal part had numerous papillae than the ventral part, the caudal part had a smaller number of papillae, while the middle part was devoid of papillae. Parotid duct opening in the buccal vestibule was without papillae. Conical papillae had two surfaces; the rostral surface was highly keratinized than the caudal one. The buccal gland was a compound tubuloacinar mixed (mucoserous) gland and mucus acini only reacted to PAS and AB. The oral surface of palatine rugae was covered with highly keratinized epithelium than the aboral surface. Palatine glands showed PAS and AB positive.

CONCLUSION

The result describes the relationship between the available food particles, environmental conditions and the lip, cheek, and palate appearance, and structure.

Impact of copeptin, miRNA-499 and miRNA-208 as new biomarkers for early detection of acute coronary syndrome

Introduction

Acute coronary syndrome (ACS) is a leading cause of mortality and morbidity worldwide. Despite being the gold standard biomarkers, cTn and CK-MB have a major drawback as they are less sensitive in the first 3 hours of the onset of symptom. So, there is still a need for novel biomarkers, which can reliably rule in or rule out this disease immediately on admission.

Aim of the work

To evaluate the role of copeptin, miRNA-499 and miRNA-208 as novel biomarkers for early detection of unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) Patients and Methods: A total of 65 patients presenting within 4 h of onset of chest pain suggestive of ACS were enrolled in the study. They included 23 UA, 42 NSTEMI. Also 25 apparently healthy controls were included. Blood samples (first set within the first 3 hours and second set at 6 hours) were taken for estimation of copeptin by ELISA and miRNA-499 and miRNA-208 expression levels by real time PCR.

Results

Copeptin, miRNA-499 and miRNA-208 expression levels were significantly increased in UA and NSTEMI patients compared to controls (P<0.001 each). Also these biomarkers were significantly increased in NSTEMT compared to UA (P<0.001 each). They also significantly elevated in UA and NSTEMI patient in the first 3 hours who had negative cardiac troponin (p<0.001 each). ROC curve analysis revealed that the area under curve (AUC) for prediction of ACS was 0.96 for copeptin, 0.97 for miRNA-499 and 0.0.97 for miRNA-208. Interestingly, combining copeptin with miRNA-499 and miRNA-210 significantly improved the diagnostic value by increasing the AUC to 0.98, P<0.001. The sensitivity and specificity within the first 3 hours were 90%, 86% for copeptin, 95%, 94% for miRNA-499 and 93%, 98% for miRNA-208. The sensitivity and specificity were 81% and 86% for cardiac troponin within 6 hours. There was a positive correlation between copeptin and miRNA-499 and miRNA-208 (r=0.75, P<0.001 and r=0.76, P<0.001 respectively) Also, there was a positive correlation between these biomarkers and cTn (r=0.7. P<0.001, r=0.64, P<0.001 and r=0.68, P<0.001 respectively).

Conclusions

Copeptin, miRNA-499 and miRNA-208 expression might be novel biomarkers as they are associated with UA and NSTEMI presented in the first 3 hours of onset of pain. The combination of copeptin and miRNA with cTn accelerate the diagnosis of ACS and avoiding the gray zone of cTn. Copeptin and miRNAs representing a potential aid in early diagnosis as they have different pathogenesis and site of liberation.

Funding Acknowledgement

Type of funding source: None

Are outcomes of surgery for retina detachments from giant tears worse than from other holes and tears in this era of small gauge vitrectomy and perflorocarbon use in Sub-Saharan Africa?

Aims

To report a comparison of clinical features, visual and anatomic outcomes between patients with retinal detachments from giant retinal tears (GRTs) and those from other types of holes and tears undergoing retina reattachment surgery in the same institution within the same time period in sub-Saharan Africa.

Materials and Methods

A retrospective noncomparative case series of patients undergoing primary retina detachment (RD) repair for rhegmatogenous retina detachment (RRD) at Eye Foundation Hospital Retina Institute between January 2014 and December 2018 was done.

Results

A total of 275 eyes of 275 patients met the inclusion criteria. Ages ranged from 7 to 87 years. And 81 (29.4%) eyes had giant tears were categorized as group A and 194 (70.6%) eyes had other types of tears were categorized as group B. At presentation Visual acuity in 66 eyes (79.6%) in the group A was worse than 3/60, compared to 117 eyes (60.3%) in group B. Primary anatomic success was achieved in 73 eyes (92.4%) in-group A and 157 eyes (86.7%) in group B. Final anatomic success was achieved in 75 eyes (94.9%) in group A and 164 eyes (93.2%) in group B. Good visual outcomes were achieved in 48 eyes (59.3%) in group A and 126 eyes (65.6%) in group B.

Conclusion

Good anatomic and visual outcomes can be achieved after surgery for RRD secondary to giant tears in a sub-Saharan Africa setting in this era of small gauge vitrectomy and perflourocarbon use, these outcomes are comparable to those from surgery for RRD secondary to other types of holes and tears.

Environmental effects on the oxygen consumption rate in juvenile Epinephelus fuscoguttatus (Forsskal, 1775)

This study was designed to optimize the culture conditions of juvenile Epinephelus fuscoguttatus (Forsskål, 1775) under laboratory conditions. To this effect, the rate of oxygen consumption was monitored as an index of stress under different temperature, salinity, pH, photoperiod, and urea concentrations. The result obtained after 12 h of exposure suggests the preference of the juvenile E. fuscoguttatus to a temperature range of 15-25 °C and salinity of 30 ppt. Based on this study, temperature was found to be the most lethal as 100% mortality was observed after 6 h in fish exposure to temperatures above the optimal (≥ 30 °C). However, the oxygen consumption rate was similar under the different pH, photoperiod, and urea concentration tested. It was concluded that water temperature was most critical in terms of respiration physiology of the juvenile E. fuscoguttatus given the range and levels of environmental factors tested in this study.