Could saliva play a role in controlling the Covid-19 pandemic?

The pneumonia outbreak observed in Wuhan, China, in December 2019 evolved into a general multi-system infection. This is attributed to a virus, from coronaviruses, the SARS-CoV-2 or 2019-nCoV the increased transmissibility of which lead to a spread across the world and the subsequent declaration of a pandemic. Saliva and in particular saliva droplets of different density play a significant role in the Covid-19 infection spread and contamination of the general population, leading to the development of severe acute respiratory syndrome in affected patients.

Pharmacies for pain and trauma in ancient Greece.

PURPOSE: To summarize pharmacies for pain and trauma in ancient Greece, to present several pharmaceutical/therapeutical methods reported in myths and ancient texts, and to theorize on the medical explanation upon which these pharmacies were used. METHOD: A thorough literature search was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize the pharmacies and pain practices used for trauma in ancient Greece. RESULTS: Archeological findings and historical texts have revealed that humans have always suffered from diseases and trauma that were initially managed and healed by priests and magicians. In early Greek antiquity, the term pharmacy was related to herbal inquiries, with the occupants called charmers and pharmacists. Additionally, apart from therapeutic methods, ancient Greeks acknowledged the importance of pain therapy and had invented certain remedies for both acute and chronic pain management. With observations and obtaining experience, they used plants, herbs, metals and soil as a therapeutic method, regardless of the cultural level of the population. They achieved sedation and central and peripheral analgesia with opium and cold, as well as relaxation of smooth muscle fibers and limiting secretions with atropina. CONCLUSION: History showed a lot of experience obtained from empirical testing of pain treatment in ancient people. Experience and reasoning constructed an explanatory account of diseases, therapies and health and have provided for the epistemology of medicine.

New alkylresorcinols from a lipophilic extract of Urginea indica L. bulbs showing experimental trauma healing activity.

Several alkylresorcinols presenting the substitution pattern of structures I (3-methyl ether of 5-alkyl-2-methylresorcinol) and II (1,3-dimethyl ether of 5-alkylresorcinol), were isolated from the dichloromethane extract of the air-dried bulbs of Urginea indica L. Compounds of structure I with 15, 17 and 20 carbon atoms in the alkyl chain as well as compounds of structure II with 20, 22, 24 carbon atoms in the alkyl chain are new. The structures of the new compounds were elucidated on the basis of their NMR and MS data. The exact number of homologues in each series I and II and the exact length of the side chain were found using GC-MS analysis. The dichloromethane extract of the bulbs was evaluated for its trauma healing properties after local application and a statistically significant tendency to trauma remodeling was observed in comparison to control groups.

Conservative treatment of bisphosphonate-related osteonecrosis of the jaw in multiple myeloma patients.

The use of intravenous bisphosphonates (pamidronate or zoledronic acid) is the cornerstone for the management of multiple myeloma-(MM-) related bone disease. However, osteonecrosis of the jaw (ONJ) is a rare, but sometimes difficult to manage, adverse effect of bisphosphonates therapy. A retrospective review of all MM patients who were treated with bisphosphonates in our department, from 2003 to 2013, and developed ONJ was performed. According to inclusion criteria, 38 patients were studied. All these patients were treated as conservatively as possible according to the American Association of Oral and Maxillofacial Surgeons criteria. Patients were managed with observation, oral antibacterial mouth rinse with chlorhexidine, oral antibiotics, pain control with analgesics, nonsurgical sequestrectomy with or without simultaneous administration of antibiotics, or major surgery with or without antibiotics. Healing of the lesions was achieved in 23 (60%) patients who were treated with conservative measures; the median time to healing was 12 months (95% CI: 4-21). The number of bisphosphonates infusions influenced the time to healing: the median time to healing for patients who received <16 infusions was 7 months and for those with >16 infusions was it 14 months (P = 0.017). We conclude that a primarily nonsurgical approach appears to be a successful management strategy for bisphosphonate-related ONJ.

Morphological changes of parotid gland in experimental hyperlipidemia.

Objective. The aim of this study was to investigate the role of hyperlipidemia in the microstructure of parotid gland and its possible amelioration through statin treatment on Wistar rats. Methods. Forty Wistar rats (111.06 ± 3.36 g) were divided into 4 groups (A1, A2 controls, B1, B2 experimental). Groups A1 and A2 consumed normal cereal rodents diet during the experimental hyperlipidemic mixture. The A2 and B2 were treated with simvastatin (Zocor) 40 mg/kg/daily p.o. for 3 months. Results. Total cholesterol, triglycerides, high density lipoproteins, and low density lipoproteins were increased in groups B1 and B2 while the parotid weight was decreased. The histological findings demonstrated changes in the parotid gland morphology of the B1 and B2, such as the presence of chronic inflammation, fibrosis, lipocytes, and foci of lymphocytic infiltration. Conclusions. The influence of statin tended to predominate over the chronic inflammation while the lipocytes were decreased and remodelling of the parotid's structure occurred.

Morphine administration at reperfusion fails to improve postischaemic cardiac function but limits myocardial injury probably via heat-shock protein 27 phosphorylation.

BACKGROUND AND OBJECTIVES: We explored the effects of morphine administration during reperfusion period after an index ischaemia as well as potential molecular mechanisms underlying this response. This is of important clinical value, as morphine is used routinely in cardiovascular anaesthesia and in the emergency management of cardiac infarction. METHODS: Male Wistar rat hearts, mounted on constant flow isolated Langendorff preparation, were subjected to stabilization, 30 min of zero-flow global ischaemia and 45 min of reperfusion (CONT; n = 10). Morphine (10(-6) mol l(-1)) was administered only at reperfusion (MORPH; n = 10). Postischaemic recoveries of left ventricular developed pressure were expressed as percentage of the initial value. At the end of the experimental protocol, lactate dehydrogenase release in the perfusate was measured and the left ventricle was isolated and used for determination of oxidized actin, mitogen-activated protein kinase activation and heat-shock protein 27 phosphorylation. RESULTS: Left ventricular developed pressure percentage did not differ between groups, whereas lactate dehydrogenase release was significantly reduced in MORPH compared with CONT hearts. Left ventricular developed pressure percentage was negatively correlated with lactate dehydrogenase release in CONT hearts (r = -0.8, P = 0.006), whereas in MORPH hearts no correlation was found (r = -0.2, P = 0.57). Phosphorylated p38 mitogen-activated protein kinase, c-jun N-terminal protein kinases, extracellular signal-regulated kinases and Akt at 45 min of reperfusion were similar between groups. However, a 1.5-fold increase in phospho-heat-shock protein 27 was found in MORPH hearts compared with CONT hearts (P < 0.05). Additionally, the ratio of oxidized actin to total actin was found to be 1.9-fold more in MORPH compared with CONT hearts (P < 0.05). CONCLUSION: Morphine administration at reperfusion does not affect cardiac function but limits the extent of myocardial injury, possibly through increased heat-shock protein 27 phosphorylation.

Diabetes increases both N-ras and ets-1 expression during rat oral oncogenesis resulting in enhanced cell proliferation and metastatic potential.

BACKGROUND: The expression of N-ras and ets-1 proteins was investigated in an experimental model of chemically-induced carcinogenesis in normal and diabetic (type I) Sprague-Dawley rats. MATERIALS AND METHODS: Tissue sections ranging from normal mucosa to moderately-differentiated oral squamous cell carcinoma were studied using monoclonal antibodies against N-ras and ets-1 proteins. RESULTS: In diabetic rats, N-ras expression increased with tumor advancement, while in normal rats N-ras was not detected in initial stages of oral oncogenesis and increased only in well-differentiated OSCC. The same pattern of elevated ets-1 expression was observed both in diabetic and normal rats, but in cancerous stages this expression was higher in diabetic than in normal rats. CONCLUSION: It seems that diabetes may contribute to increased cell proliferation due to N-ras constitutive activation, as well as to enhanced invasion and metastatic potential by increasing ets-1 levels.

Association of matrix metalloproteinase-1 (-1607 1G/2G) polymorphism with increased risk for oral squamous cell carcinoma.

BACKGROUND: The purpose of this study was to investigate the possible relation of matrix metalloproteinase-1 (MMP-1) to increased risk for oral cancer, in light of recently found contribution of angiogenesis and thrombosis-related factors to the development of malignancies. MATERIALS AND METHODS: The 1G/2G polymorphism in the MMP-1 gene, which influences its expression, was examined in 156 patients with oral squamous cell carcinoma and 141 healthy controls of comparable ethnicity (Greeks and Germans), gender and age. RESULTS: In comparison to controls, the detected 2G allele frequency was significantly lower in the patient group and in subgroups with early cancer stages, with positive family history of thrombophilia, with tobacco abuse and without alcohol abuse (p < 0.05). These findings were mainly due to a significant decrease in 2G/2G homozygotes despite a small increase in 1G/2G heterozygotes in the above groups. CONCLUSION: These findings suggest a significant involvement of the MMP-1 -1607 1G/2G polymorphism in the increasing risk for oral cancer in the 1G allele European carriers.

Perioperative thyroid hormone kinetics in patients undergoing major oral and maxillofacial operations.

PURPOSE: The aim of this study was to investigate the perioperative response of serum thyroid hormones in patients who underwent extensive maxillofacial operations with desflurane (0.2 to 1.5 MAC) and remifentanil (0.05 to 0.3 microg/kg/min) anesthesia. MATERIALS AND METHODS: Serum thyroxine, total and free triiodothyronine, thyroid-stimulating hormone, interleukin-1beta and 6, TNF-alpha, free fatty acids, S100B protein, CRP, as well as amyloid A protein were measured in 13 patients subjected to extensive oral and maxillofacial operations. Samples were collected before anesthesia induction, at the end, and 6, 12, 24, and 72 hours after the end of surgery. Patients during the study fasted, and at the postoperative period received Ringer's saline or with 5% dextrose alternatively, at the rate of 0.5 to 1.5 mL/kg/hr. RESULTS: Thyroid hormones concentrations showed a significant decrease over time whereas their values recovered to the baseline 72 hours after surgery. Interleukin 1beta, 6, S100B protein, CRP, serum amyloid A protein, and free fatty acids showed a significant increase 6, 12, and 24 hours after the end of the operation as related to the basal value. No significant clinical complications were recorded over the study. CONCLUSION: Patients undergoing extensive oral and maxillofacial surgery exhibit marked decrease in serum thyroid hormones. Stress response, anesthesia, and perioperative fasting may be decisive factors eliciting this response. These metabolic derangements do not deteriorate the clinical outcome and subsequently may be an adaptive response for energy preservation in various organs.

FGFR-2 and -3 play an important role in initial stages of oral oncogenesis.

BACKGROUND: FGFR-2 and FGFR-3 (fibroblast growth factor receptors) have been shown to play an important role in several processes including carcinogenesis. This study was designed to determine gradual FGFR-2 and FGFR-3 expression in sequential stages of oral carcinogenesis in an experimental animal system of Syrian golden hamsters. MATERIALS AND METHODS: Tissue sections ranging from normal mucosa to squamous cell carcinoma were studied using monoclonal antibodies against FGFR-2 and FGFR-3 proteins. RESULTS: A significant elevation was revealed in both FGFR-2 and FGFR-3 expression during the stages of dysplasia and early invasion, while in the later stages of oral carcinogenesis the expression of both FGFR-2 and FGFR-3 decreased although not significantly. CONCLUSION: Our findings indicate that FGFR-2 and FGFR-3 seem to play an important role in the initial stages of oral cancer progression.

Occipital neuralgia secondary to respiratory tract infection.

Occipital neuralgia is an extracranial pain that may be confused with other headaches. It can be attributed to multiple causes. The authors report the case of a 55-year-old woman suffering from right occipital neuralgia secondary to respiratory tract infection that began 6 days before the pain started. The patient suffered from a sharp and burning pain with paroxysms in the right occipital region and at the top of the right ear. Sensation was decreased in the affected area, and hypersensitivity to touch and cold water was also noted. Tinel's sign was present, and local anesthetic block produced pain relief. The combination of gabapentin and amitriptyline did not provide significant pain relief but led to marked adverse effects. Carbamazepine (300 mg/d) was required for pain control. A month later the patient appeared totally pain-free. The treatment was continued for 3 months, and the patient remained pain-free over a subsequent follow-up period of more than 6 months. Thus, in the case of occipital pain, a careful assessment of symptoms and a thorough history are necessary to obtain the correct diagnosis and to choose the appropriate treatment plan.

Effect of various stress models on lidocaine pharmacokinetic properties in the mandible after masseter injection.

PURPOSE: The aim of this study was to investigate the role of stress (trauma, cold swimming, and adjuvant rheumatoid arthritis) on lidocaine concentrations as well as lidocaine's protein binding in the mandible. MATERIALS AND METHODS: Forty male Wistar rats were used. The animals were divided into four groups. Group A served as control. Group B underwent mandible osteotomy. Group C was submitted to cold swimming stress. Group D was subjected to experimental arthritis. Additionally, all the groups received 5 doses of lidocaine, 1 dose of lidocaine (3 mg/kg) intramuscularly every 2 hours. Two hours after the last dose, the animals were killed. Lidocaine concentrations were estimated in plasma. Furthermore, the mandible was isolated, and both lidocaine concentrations and lidocaine protein binding were assessed. RESULTS: In groups under stress, lidocaine concentrations in serum showed a marked elevation. In addition, these animals demonstrated a significant decrease in the percent of lidocaine binding in the mandible. CONCLUSIONS: Stress can modify local anesthetics pharmacokinetic properties, resulting in alterations both in their concentration in serum and their protein binding in mandibular bone.

Mepivacaine alters vascular responsiveness to vasoconstrictors in aortic rings from normal and aortic-banded rats.

The present study investigated the effects of mepivacaine on the response of rat aorta to vasoconstrictors in normal and aortic-banded animals. Cardiac hypertrophy was induced in Wistar rats by aortic banding, while sham-operated animals served as controls. Isolated aortic rings with or without endothelium were contracted with potassium chloride and phenylephrine in the presence of mepivacaine (10(-3) M). Maximal tension was measured at the highest concentration of potassium chloride and phenylephrine. Maximal response to potassium chloride was reduced in the presence of mepivacaine both in normal and aortic-banded rings. As regards the vascular reactivity to phenylephrine, aortic rings with intact endothelium from aortic-banded rats have shown increased response as compared to normal. After mepivacaine administration this difference between normal and aortic-banded rats was abolished. In conclusion, in a model of cardiac hypertrophy such as that of aortic-banding, increased response to alpha1-adrenergic stimulation is observed, which is blunted by mepivacaine administration.

Effects of propranolol or paracetamol on lidocaine concentrations in serum and tissues.

PURPOSE: The goal of this study was to determine the interaction of lidocaine after paracetamol or propranolol administration. MATERIALS AND METHODS: Group A rats received a mixture of cold lidocaine and (14)C lidocaine into the masseter muscle. Group B rats received lidocaine and paracetamol 7.5 mg/kg orally, whereas group C received lidocaine intramuscularly and propranolol 1.5 mg/kg orally. Five consecutive doses were administered. The levels of these drugs were estimated in serum and the total concentration and the percent protein binding of lidocaine in tissues (liver and mandible) were determined. The rats were killed 2 hours after the last dose. RESULTS: The results suggest that lidocaine concentrations in serum were significantly increased after either paracetamol or propranolol administration. Additionally, the combined therapy of propranolol and lidocaine resulted in a significant decrease in the total concentration and the percent protein binding of lidocaine in tissues. CONCLUSIONS: The coadministration of lidocaine with paracetamol or propranolol interferes with the metabolic profile, resulting in pharmacokinetic interactions that may be significant for the determination of the correct dose of lidocaine in clinical applications.