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Purpose of study Proposal for an oral (or if required, parenteral) COVID-19 vaccination based upon this described technology. Investigational theory under study for the past 9 months of COVID-19 growing season. Coronavirus can attack and infect plant species. It was found that SARS-CoV-2 can infect various plant species. Others have found plants, for example tobacco as a good growth medium for Coronavirus and SARS-CoV-2. This current study has found various plants species infected with SARS-CoV-2 by rPCR. As the plants were located beside a well used hiking trail for humans, and were infected along the trail including various species with SARS-CoV-2, hypothesized that human airborne contact had caused infection in the bordering plants. Humans were observed to be coughing while walking on the trail, and were not wearing masks. The plant leaves developed small circular colonies of the virus, which became self-limited at several millimeters in diameter. All of the plants were clear of these lesions before the COVID-19 Pandemic. The plants 'immune' system produced antiviral agents, including lectins which limited the growth of the colonies and prevent death of the leaf and whole plant. The fungal cultures of the 'spots' were negative. The rPCR of all spots tested in the present series was positive for SARS-CoV-2. Hypothesis, that self-augmentation of the virus occurred by the natural culturing in plant leaves that produce antiviral agents as part of their 'immune system.' Hypothesis, a symbiotic type relationship developed between the plant using its chemical immune system, and the virus allowed to replicate in an augmented fashion to allow both the virus and the host to survive and grow. As the top candidates for the oral vaccine are nontoxic, hypothesis involves the maceration of the infected leaves, mixing with a nontoxic adjuvant and flavoring to promote assimilation and palatability, with the proposed route of entry being mastication, thus exposing the oral-nasal mucosa to the vaccine, with the probable best of immunity to usual exposure to the SARS-CoV-2 virus, that is the oral-nasal mucosal and upper airway route. As many types of animals are now infected with SARS-CoV-2, it is further hypothesized that this oral vaccine could also be mass produced to add to various animals by feedstock and oral route. Methods used Hypotheses formed through observations. Testing of observations by pPCR, viral cell culture, fungal culture, light and electron microscopy. Summary of results pPCR SARS-CoV-2 positive, cell culture 'lysis experiment' positive, EM and light microscopy positive, fungal culture negative. Conclusions TABLE OF HYPOTHESES AND STUDY RESULTS (HYPOTHETICAL, OBSERVED, PROVEN) 1. The first hypothesis that the virus is attenuated by the plant, using its innate chemical immune system. Similarly, Pasteur used chemical such as phenol to attenuate viruses for wome of the first successful vaccines. Observed. 2. Hypothesis, the plants 'immune' system produced antiviral agents, including lectins, flavonoids, and others, which limited the growth of the colonies and prevent death of the leaf and whole plant. Proven. 3. Hypothesis is that the nontoxic plants, such as Vine Maple sp.(Acer cincinatum), could be used to produce and oral plant attenuated vaccine. Hypothesis. 4. Hypothesis involves the maceration of the infected leaves, mixing with a nontoxic adjuvant and flavoring to promote assimilation and palatability, with the proposed route of entry being mastication, thus exposing the oral-nasal mucosa to the vaccine, with the probable best of immunity to usual exposure to the SARS-CoV-2 virus, that is the oral-nasal mucosa, upper airway. (Figure Presented).
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Introduction: The head and neck cancer (HNC) disease and treatment process creates highly visible disfigurement and a fundamental impact on vital functions in this anatomical region, which can lead to an emotionally traumatic illness experience. These factors make HNC patients vulnerable to significant change in quality of life (QOL). There has been little research regarding the psychosocial effects of the coronavirus disease 2019 (COVID-19) pandemic on this group, and we want to explore how their QOL has changed in this unique situation. Method(s): This is a retrospective study identifying 400 patients with newly diagnosed HNC in the time period of March 2015 to March 2021 who completed the University of Washington Quality of Life Questionnaire (UW-QOL), collected as part of routine clinical care at our institution. Patients diagnosed between March 2015 and December 2019 were classified in the pre-COVID-19 group, while those diagnosed between March 2020 and March 2021 were classified in the COVID-19 group. Only patients with newly diagnosed HNC who completed the UW-QOL were included. Patients with a diagnosis of skin, thyroid, and sinonasal cancer;those who were unwilling or unable to take part in the study;and those with recurrent HNC were excluded. Result(s): A total of 353 participants who met criteria were included. Patients diagnosed with HNC during the COVID-19 pandemic had significantly decreased scores in the chewing and speech sections of the UW-QOL (P<.01 and P<.05, respectively). More patients ranked a decreased mood as a point of concern in the COVID-19 group (29.82% vs 26.45%). There were no significant differences in global QOL scores between groups. Conclusion(s): HNC patients experienced a similar overall QOL prior to and during the COVID-19 pandemic. However, some domains of HNC-specific QOL were negatively affected during the COVID-19 pandemic. Patients had more concerns about their mood during the pandemic compared with before the pandemic. The results of this study may be used to inform patient treatment and patient education as well as to alleviate pandemic-related concerns for this vulnerable population.
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[...]we hypothesize that improving oral health could decrease the severity of COVID-19 symptoms and reduce the associated morbidity. 2.CASE PRESENTATION Medical history The patient is a 48 year-old female diagnosed with COVID 19 in August 2020, admitted to the intensive care unit (ICU) three months after the infection at 'Thing Abdulaziz" Medical City- Riyadh, Saudi Arabia due to hypoxemic respiratory failure that required lifesupporting mechanical ventilation (MV). [...]Hemoglobin A1C (HbA1c), which is the average glucose level in the blood for the past three months, was assessed three times during the ICU admission and the results were 5.9, 6.1 and 9.3, respectively. The presented radiographic and clinical figures include probing depths (PD) and attachment loss (AL) up to 8 mm (Fig. 1) [15]. [...]radiographic bone loss (RBL) was measured to be at the mid-third of the root length or beyond, both of which qualifying the diagnosis of generalized stage IV grade C periodontitis (Fig 2). In most cases, the dental treatment included masticatory function stabilization. [...]because the teeth are already periodontally involved in secondary occlusal trauma cases, their selective grinding will not solve the problem.
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Background: Impacts of primary oncology surgical procedure can impede restoration objectives. Restoring oral function, comfort and aesthetics is a challenge due to limitations in the restorative treatment options. Methodology: Literature review on the responsibilities, role of maxillofacial prosthodontist, materails and retentive aids used for prosthesis, classification of maxillofacial prostheses, recent advancements in MFP and Workflow for the fabrication of obturator prostheses in the COVID-19 pandemic scenario. Case report on the fabrication of Holllow bulb definitive obturator during pandemic crisis. A 47 years old male patient reported for post-surgical evaluation in maxillary posterior region of oral cavity. The patient had partial maxillectomysurgical procedure of squamous cell carcinoma in the palate 5 years back. To replace the gap created, the patient was using interim obturator. He had facial asymmetry and collapse. Prosthodontic rehabilitation with one piece closed hollow bulb obturator was planned & subsequently fabricated for the patient. For our case considering the feasibility & ease of manipulation, heat activated acrylic resin was used for this particular patient for rehabilitation. The method described is easy, simple, time saving & economical. Bulb portion was hollow & made of heat cure resin, so weight was less & less chances of tissue irritation. Results: With the Covid-19 infection protocol measures taken definitive obturator was given to the maxillectomy patient to restore aesthetics, function and comfort as well. After insertion of prostheses mastication, deglutition and phonetics were improved. Breathing problems were resolved and aesthetics was improved. Conclusion: A simplified technical approach for the treatment of a patient with palatal defect of and other supportive structure has been presented in Covid-19 situation following the described infection prevention protocols. The technique presented offers a method of obtaining a detailed impression of the defect and promptly provides the patient with a light weight, easyto-use and flexible tissue-tolerant obturator.
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Background: Rates of alcohol use disorder amongst women have increased markedly since the start of the Covid-19 Pandemic with some studies showing as much as a 41% increase in heavy drinking days (1). Among women with alcohol use disorder, there is a high degree of comorbidity with eating disorders (ED) with studies suggesting rates of co-occurring disease as high as 23-50%(2). However, there is little data on the assessment of transplant recipients presenting with co-occuring ED and AUD. Case: A 34-year-old woman with no known past psychiatric or substance use history presented to our hospital in acute hepatic failure (MELD Score 34) in the context of escalating alcohol use over the course of the COVID-19 Pandemic. As the patient did not respond to multiple medical therapies, evaluation for liver transplantation was initiated. The patient was assessed using the Stanford Integrated Psychosocial Assessment for Transplant (SIPAT), and found to be a high risk candidate. During the course of our evaluation, the patient demonstrated a lack of interest in eating food, refusing to eat food that required chewing, and expressed multiple consequences about the aversive consequences of eating. She described extremely restrictive eating patterns with her lowest weight being 95 lbs (BMI < 16), leading to nutritional deficiencies, peripheral neuropathy and anemia. Given the absence of excessive concern regarding appearance or body weight, a diagnosis of avoidant restrictive food intake disorder (ARFID) was made. Despite efforts to engage the patient, she demonstrated little understanding of her ED. The patient was declined for listing and medically stabilized. She was declined by all inpatient substance use programs given the extent of her ED and rejected recommendations for targeted ED treatment. She was ultimately discharged to an intensive outpatient program for AUD. Discussion: There is a paucity of information regarding liver transplantation in patients with co-occurring AUD and EDs. However, there are many unique considerations in the management of this patient population in both the pre- and post- transplant period. Existing screening methods such as the SIPAT do little to evaluate transplant risk in patients with EDs relative to other psychiatric illnesses. And while predictive risk factors for recurrence of alcohol use after transplant have been identified, little is known about the risk factors for ED relapse. It appears that the emphasis on abstinence from alcohol in the post-transplant period can be a potent trigger for ED relapse(3). Post-transplant, patients with ED have an increased risk of relapse to alcohol and poorer retention in residential treatment(4). Conclusion: Patients with co-occurring ED and AUD requiring liver transplantation are a challenging patient population with complex pre- and post-transplant considerations. References: 1. Pollard M, et al. "Changes in Adult Alcohol Use and Consequences During COVID-19 Pandemic in the US." JAMA Netw Open. 2020;3(9). 2. Bulik, Cynthia, et al. “Alcohol Use Disorder Comorbidity in Eating Disorders: A Multi-center Study.” Journal of Clinical Psychiatry. 65:7, July 2004. 3. Coffman K L, et al. Treatment of the Postoperative Alcoholic Liver Transplant Recipient With Other Addictions." Liver Transpl Surg. 1997;3:322–327. 4. Elmquist, J. et al., "Eating Disorder Symptoms and Length of Stay in Residential Treatment for Substance Use: A Brief Report." Journal of Dual Diagnosis, 11(3-4), 233–237. https://doi.org/10.1080/15504263.2015.1104480.2015.
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The aim is to determine oral manifestations in patients with COVID-19 disease and in the postcovid period. Methods: A special survey (questionnaire) was made in 424 people who had COVID-19 confirmed by RT-PCR, ELISA for specific IgM and IgG antibodies and Chest CT scan (168 people). 123 people had complaints and clinical symptoms in the oral cavity 2-6 months after the illness and they came to the University dental clinic. Laboratory tests have been performed (clinical blood test, blood immunogram, virus and fungal identification). Results: Survey results showed that 16,0% participants had asymptomatic COVID-19, 23,6% - mild and 48,1% moderate disease. 12,3% with severe COVID-19 were treated in a hospital with oxygen support. In the first 2 weeks 44,3% indicated xerostomia, dysgeusia (21,7%), muscle pain during chewing (11,3%), pain during swallowing (30,2%), burning and painful tongue (1,9%), tongue swelling (30,2%), catharal stomatitis (16,0%), gingival bleeding (22,6%), painful ulcers (aphthae) (8,5%) and signs of candidiasis - white plaque in the tongue (12,3%). After illness (3-6 months), patients indicated dry mouth (12,3%), progressing of gingivitis (20,7%) and periodontitis (11,3%). In patients who applied to the clinic we identified such diagnoses: desquamative glossitis - 16 cases, glossodynia (11), herpes labialis and recurrent herpetic gingivostomatitis (27), hairy leukoplakia (1), recurrent aphthous stomatitis (22), aphthosis Sutton (4), necrotising ulcerative gingivitis (13), oral candidiasis (14), erythema multiforme (8), Stevens-Johnson syndrome (2), oral squamous cell papillomas on the gingiva (4) and the lower lip (1). According to laboratory studies, virus reactivation (HSV, VZV, EBV, CMV, Papilloma viruces) was noted in 52 patients (42,3%), immunodeficiency in 96 people (78,0%), immunoregulation disorders (allergic and autoimmune reactions) in 24 people (19,5%). Conclusions: Lack of oral hygiene, hyposalivation, vascular compromise, stress, immunodeficiency and reactivation of persistent viral and fungal infections in patients with COVID-19 disease are risk factors for progression of periodontal and oral mucosal diseases.
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Objective: The COVID-19 pandemic has led to the rapid development of multiple safe and effective vaccines. Few neurological adverse events (AEs) associated with COVID-19 vaccines have been reported. Background: Myasthenia gravis (MG) is a chronic autoimmune disorder of the neuromuscular junction, which can involve crises of muscular weakness that can be triggered by numerous stressors including medications, infections and vaccines. Little is known about the relationship between COVID-19 vaccines and MG. Here, we present a case of new-onset generalized MG following the mRNA-based Pfizer-BioNTech COVID-19 vaccine. Design/Methods: A 46-year-old female with a past medical history of anxiety and sinus tachycardia reported drooping of her right eyelid within 48 hours of receiving her first Pfizer-BioNTech COVID-19 vaccine. Results: Over the next few weeks, she developed significant progressive fatigable extremity and bulbar muscle weakness, including ptosis, diplopia, dysarthria and fatigable mastication. Within months, she had multiple hospitalizations with unrevealing brain and spinal imaging, negative anti-AchR, anti-Musk and anti-LRP antibodies, a normal chest CT and EMG/NCS demonstrating moderate-to-severe electrical decrements in extremity and bulbar muscles. She was diagnosed with seronegative MG, and her symptoms significantly improved with Pyridostigmine treatment. She was subsequently hospitalized twice for MG crisis and received plasmapheresis, steroids and Mycophenolate with symptom stabilization. She has since tolerated a third dose of the vaccine without worsening of MG symptoms. Conclusions: Given the close temporal association, it is plausible that the vaccine unmasked subclinical MG in this patient, or less likely, induced de-novo MG. Rare COVID-19 vaccine-associated neuro-immunological cases have been observed and this case highlights the need for continued vaccine monitoring, as well as the potential to tolerate booster vaccination if the underlying neuro-immunologic condition is controlled. In addition to this case presentation and review of the relevant literature, we also present our analysis of the ongoing Vaccine AE Reporting System as it pertains to MG.
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Although misophonia is not yet included in the primary diagnostic manuals used by psychologists or psychiatrists, proposed criteria suggest that this condition is characterized by a strong negative reaction to and avoidance of certain trigger sounds. Misophonic trigger sounds are largely human-made (e.g., chewing and slurping) and evoke responses such as disgust, irritation, and/or anger that are out of proportion to the situation and cause distress and/or impairment. Currently, there is no gold standard evidence-based treatment for misophonia. As the misophonia treatment literature grows, several important questions are arising: (1) should exposure to aversive sound triggers be included in treatment for misophonia and (2) how can clinicians best assess misophonia symptoms. This case offers one example of misophonia being successfully treated with a cognitive-behavioral approach to treatment (including exposures) in an adolescent girl. This case also offers an example of how clinicians may conduct a comprehensive assessment of misophonia symptoms. Theoretically and empirically derived recommendations for including exposure in misophonia treatment are presented. Information from this case may be helpful in informing future research, as there is a paucity of evidence-based assessment and treatment protocols for misophonia.
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The purpose of this research was to develop formulations of chewing candies (CCs) in a sustainable manner by using berry by-products in combination with antimicrobial lactic acid bacteria (LAB) strains. To implement this aim, the optimal quantities of by-products from lyophilised raspberry (Rasp) and blackcurrant (Bcur) from the juice production industry were selected. Prior to use, Lactiplantibacillus plantarum LUHS135, Liquorilactobacillus uvarum LUHS245, Lacticaseibacillus paracasei LUHS244, and Pediococcus acidilactici LUHS29 strains were multiplied in a dairy industry by-product—milk permeate (MP). The antimicrobial activity of the selected ingredients (berry by-products and LAB) was evaluated. Two texture-forming agents were tested for the CC formulations: gelatin (Gl) and agar (Ag). In addition, sugar was replaced with xylitol. The most appropriate formulation of the developed CCs according to the product’s texture, colour, total phenolic compound (TPC) content, antioxidant activity, viable LAB count during storage, overall acceptability (OA), and emotions (EMs) induced in consumers was selected. It was established that the tested LAB inhibited three pathogens out of the 11 tested, while the blackcurrant by-products inhibited all 11 tested pathogens. The highest OA was shown for the CC prepared with gelatin in addition to 5 g of Rasp and 5 g of Bcur by-products. The Rasp and LUHS135 formulation showed the highest TPC content (147.16 mg 100 g−1 d.m.), antioxidant activity (88.2%), and LAB count after 24 days of storage (6.79 log10 CFU g−1). Finally, it was concluded that Gl, Rasp and Bcur by-products, and L. plantarum LUHS135 multiplied in MP are promising ingredients for preparing CCs in a sustainable manner;the best CC formula consisted of Gl, Rasp by-products, and LUHS135 and showed the highest OA (score 9.52) and induced the highest intensity of the EM ‘happy’ (0.231).
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Lymphangiomas (LG) are uncommon, rare congenital anomalies or acquired lymphatic dilations of a benign flow that can involve the skin [1, 2]. There are main groups of lymphangiomas: 1) a superficial variant, characterized by grouped vesicles (circumscriptum lymphangioma), 2) a deeper variant in the form of a cavernous lymphangioma. The prevalence of LG may be focal or diffuse. Secondary acquired LG with a rarer frequency are known [3, 4]. LG can be one of the manifestations of a symptom complex, for example, Gorham-Stout syndrome, which is characterized by progressive osteolysis [5]. The rare occurrence of LG, clinical diversity, undulating course of congenital forms, the possibility of an acquired nature of the disease causes a high risk of diagnostic errors in establishing the final diagnosis. At the Department of Dermatovenereology, Cosmetology and Additional Professional Education of Smolensk State Medical University for the period from 2018 to 2021, 5 patients (age from 5 to 17 years) with LG were observed. Of these: in four children, the disease existed from birth, in one girl it had an acquired character and developed after covid infection [4]. Gender characteristics: 4 girls (5, 6, 12 and 17 years old) and 1 boy (9 years old). All patients are urban residents. The time to establish the final diagnosis from the moment of seeking medical help ranged from 15 months to 12 (!) years, the average value being 6.5 years. The range of diagnoses of LG 'masks': herpetic infection, molluscum contagiosum, atopic dermatitis, contact dermatitis, epidermolysis bullosa. A frequent change in diagnoses was established in the same patient. Clinical case 1. The boy is 12 years old. The debut of skin lesions from birth and progression to 3 years of age, then spontaneous regression within 4 years (without signs of dermatosis). From 7 years to the present, there has been an increase in the number of rashes. Localization: the skin of the lateral surface of the trunk. Features of the rash: flesh-colored and/or reddish- purple bubbles. A pathognomonic symptom of 'frog calves' is found. The frequent autodestructive effect on the rash provokes its subsequent progression. Family history: his father is a liquidator of the atomic catastrophe in Chernobyl. Previous diagnoses: molluscum contagiosum, herpes zoster. Clinical case 2. The girl is 17 years old. The debut of the disease from birth. Lack of progression up to 5 years of age (up to 5 years of age did not apply to dermatologists). At the age of 5, she began to engage in rhythmic gymnastics (she continues to practice professionally at the present time) and noted an active increase in the number and size of the elements of the rash. She repeatedly consulted dermatologists: diagnoses of molluscum contagiosum (laser removal), herpetic infection (courses of antiherpetic therapy without effect) were assumed. The diagnosis was established 12 years after the moment of seeking medical help. Unilateral location of the rash along the inner surface of the right upper limb with transition to the axillary region;on the right lateral surface of the body, the right inguinal-femoral fold and the inner surface of the right thigh. Focuses of a rash in the form of different sizes of vesicular elements with a tendency to lymphorrhea and oozing, areas of maceration around. Single elements with a hemorrhagic component. The patient notes an increase in the inflammatory response and vesicle lymphorrhea after each workout. Dermatoscopy: yellow-pink lacunae alternating with single dark red lacunae. Histological examination: multiple dilated lymphatic vessels in the papillary and reticular dermis. Clinical case 3. Girl 6 years old. Sick from birth. The diagnosis of LG of the genitals was established at the age of 1, 5 years. Due to the localization of the rash in the external genital area, the girl's parents (at the age of 1 month) consulted an obstetrician-gynecologist, who suggested a hemangioma and referred to a dermatologist. The disease is of a family nature her grandmother (on the maternal side) and her lder brother have similar rashes on the skin of the trunk and in the mouth. The diagnosis was verified by histological examination. The pathological process is localized in the area of the labia majora and labia minora: multiple vesicular rashes with translucent contents, easily traumatized and accompanied by itching, were found. Conclusions: LG is a multidisciplinary problem, which is caused by mimicry of manifestations, varied localization and prevalence of the rash. To verify the diagnosis, the following algorithm should be followed: 1) the debut more often at birth or in the first months of life (with the exception of acquired forms of LG);2) the nature of evolution: a stable state or slow progression in the absence of traumatic factors;3) clinical features: the formation of grouped deep vesicles that resemble 'frog eggs'. The color of the bubbles is transparent or red-purple due to the hemorrhagic component. LG lesions may have hemangioma components. It should be remembered about the frequent localization of LG on the mucous membrane of the cheeks, tongue and floor of the oral cavity, which can manifest itself as bleeding from the elements of the rash when chewing or when providing dental care;4) biopsy reveals dilated lymphatic vessels in the upper layers of the dermis.
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Introduction: Head and neck cancer (HNC) is a heterogeneous group of subsites, with differing natural histories. Its management is complex and it may have a long-term effect on patients’ quality of life (QOL). The purpose of this survey was to assess patients’ preferences using a validated 12 point ‘Priority Assessment Tool’ developed by Sharp et al [1]. Materials and Methods: Sixty consecutive HNC patients being treated with radiotherapy at our centre were approached. Patients were asked to rank their priorities from 1 to 12 (1 = very important, 12 = least important). Results: 45 patients (75%) completed the survey. The most important, overwhelming priority for the cohort as a whole, was ‘being cured of my cancer’ which was first priority in 73% patients and within first three priorities for 96% of patients. Similarly, ‘living as long as possible’ was within the first three priorities for 67% of patients although for 13% patients, living longer was, surprisingly the least priority. For more than two third of patients (69%), ‘having no pain’ was within the first four important priorities. There is next, a group of six QOL priorities (voice, speech, chewing, swallowing, taste/smell, moist mouth), which have a much wider range and vary considerably in importance to individual patients, being very important to some and much less important to others. There then remains a group of three priorities that have a relatively low importance to patients, not absolutely, but in relation to their other priorities, with ‘keeping appearance unchanged’, being the lowest priority chosen by 40% patients. The other two least priorities were ‘returning to activities as soon as possible’ and ‘having a normal amount of energy’. Conclusions: Our survey has shown that most HNC patients markedly prioritise survival over function and other QOL measures. Having such information is crucial, to being able to make a valid decision with regard to the treatment options and the trade-offs between increased probability of cure or extending survival and loss of function, and late morbidity. This makes shared decision-making even more important in the present COVID-19 era, so that added information about the risks of infection and potential changes in risk benefit ratio may alter patients’ priorities and preferred outcomes.
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The authors aimed to give a quick reference guide for humanity about the new threat even after the COVID-19 health battle i.e., the Black fungus also baptized as Mucormycosis infection. After recovering from COVID-19, patients with diabetes mellitus and patients who have undergone steroidal treatment are more prone to black fungus infection. This review gives quick information about various types of Mucormycosis infections, risk factors, symptoms, treatment, and prevention of black fungus. The things that can be and cannot be done to eradicate the black fungus. Any sign of black nasal mucosa/sputum, fever, headache, hazy/blurred/double vision with eye pain, loss of one side sensation on face and loss in the sensation while chewing, etc., then it should not be neglected and immediately intimated to the health professionals and get treated. If black fungus is unidentified early stages and untreated in time, the patients may lose their facial/neck parts as a part of cleaning surgery. The study concludes that by maintaining hygienic conditions, health checkups, and doctors' advice one can fight and eradicate the black fungus.