Search Results (954)

Background: A dilated main pancreatic duct (MPD) ≥ 5 mm can be observed in main-duct IPMNs (MD-IPMN) and chronic pancreatitis (CP); however, distinguishing between the two differently treated diseases can be difficult. Cell-free (cf) DNA in MPD fluid obtained by EUS-guided FNA might help to distinguish MD-IPMN from CP. Methods: All patients with a dilated MPD ≥ 5 mm on EUS during the period of 1 June 2017 to 30 April 2024 were prospectively analysed in this single-centre study, with EUS-guided MPD fluid aspiration performed for suspected MD-IPMN or CP in patients who were suitable for surgery. Twenty-two known gastrointestinal cancer genes, including GNAS and KRAS, were analysed by deep targeted (dt) NGS. The results were correlated with resected tissue, biopsy, and long-term follow-up. Results: A total of 164 patients with a dilated MPD were identified, of which 30 (18.3%) underwent EUS-guided FNA, with 1 patient having a minor complication (3.3%). Twenty-two patients (mean MPD diameter of 12.4 (7–31) mm) with a definitive, mostly surgically confirmed diagnosis were included in the analysis. Only a fish-mouth papilla, which was present in 3 of 12 (25%) MD-IPMNs, could reliably differentiate between the two diseases, with history, symptoms, diffuse or segmental MPD dilation, presence of calcifications on imaging, cytology, and CEA in the ductal fluid failing to achieve differentiation. However, GNAS mutations were found exclusively in 11 of the 12 (91.6%) patients with MD-IPMN (p < 0.01), whereas KRAS mutations were identified in both diseases. Conclusions: GNAS testing by dtNGS in aspirated fluid from dilated MPD obtained by EUS-guided FNA may help differentiate MD-IPMN from CP for surgical resection. Full article

Objectives: Anisakidosis is an emerging, cosmopolitan, and underdiagnosed parasitic disease caused by the accidental ingestion of third-stage anisakid larvae when consuming raw or improperly prepared seafood. Within hours to days of consuming infected raw seafood, patients may develop acute gastrointestinal symptoms including pain, nausea, vomiting, diarrhea and/or constipation, as live anisakid larvae attach to the gastric, or more rarely, the intestinal mucosa. Cases have been reported in which the nematodes succeed at migrating from the stomach upwards to the esophagus and then the oral cavity. Therefore, the purpose of the present literature review is to collect, analyze, summarize and present the relevant epidemiological, clinical, diagnostic, parasitological, therapeutic, and prognostic data concerning anisakidosis localized inside the oral cavity. Methods: An electronic search of the PubMed, Scopus, and Ovid databases was performed with them being accessed for the last time on 29 March 2025. Results: The present literature review identified 13 individual case reports of oral mucosa anisakidosis, which were published in the period 1971–2022. Conclusions: Our review aims to summarize the relevant epidemiological, clinical, diagnostic, parasitological, therapeutic, and prognostic data regarding the oral localization of anisakidosis, a helminthic infection caused by the accidental ingestion of live anisakid larvae and which manifests mainly with gastrointestinal symptoms. Its localization in the oral mucosa appears to be exceptionally rare and, in most cases, occurs with a characteristic clinical picture, defined by the onset of acute mouth or throat pain immediately after the consumption of raw seafood and by the observation of one or more larvae, either lying on or penetrating the oral mucosa. Despite its rarity, dental health professionals and other clinicians should be aware of this disease and the possibility of its intraoral localization, since environmental factors on the one hand, and the adoption of foreign dietary habits on the other, will likely make anisakidosis a much more common disease worldwide in the near future. Full article

Background/Objectives: This study aims to uncover the variables related to the success of the intervention. Methods: A retrospective study was conducted on patients who underwent joint replacement surgery utilizing a customized alloplastic system between 2018 and 2023, comprising subjects with complete records for both the planning and follow-up phases. The Student’s t-test was applied with a significance threshold of p < 0.05. Results: Forty-eight subjects were admitted for initial analysis, and 31 subjects were evaluated with a minimum follow-up of 1 year and a maximum of 7 years, with a mean age of 36.37 ± 15.53. The TMJ diagnosis was mainly with degenerative TMJ disease, followed by ankylosis and craniofacial syndromes, and an average of 2.1 ± 1.2 previous surgeries were noted. Degenerative joint disease correlated with increased pain (p < 0.0001) and a higher prevalence of prior joint surgery (p < 0.0001). Thirty-one subjects were followed up with 47 prostheses installed; 74.4% underwent complementary surgery with other facial osteotomies. Significant improvements (p < 0.0001) were observed when comparing pain levels pre- and postoperatively, with a decrease from 5.5 (±2.3) to 2.2 (±0.4). Concerning the interincisal opening, there was a significant increase (p < 0001) from 25.85 (±10.2) mm to 35.93 (±4.2) mm in mouth opening. TMJ replacement treatment is efficient and effective, demonstrating stability in follow-up assessments for up to 7 years. Conclusions: The indications for replacement are diverse and may benefit patients who have not yet progressed to end-stage TMJ disease. Full article

The livestock sector is a significant contributor to the economy and rural livelihoods, but it is exposed to high risk across the supply chain, which is detrimental and needs to be addressed for sustainable development. Therefore, this study aimed to identify the major risk mitigation strategies (RMSs) and associated factors that affect their adoption. This study conducted a comprehensive literature review to identify the eight major RMSs and prioritized them through an analytical hierarchical process (AHP). Thereafter, a multivariate probit (MVP) model was developed to identify the factors affecting the adoption of major RMSs. The primary RMSs are livestock insurance, vaccination of livestock, and advisory/extension services. Further, the multivariate probit regression analysis shows that ‘age’, ‘social category’, ‘economic status’, ‘educational level’, ‘income level’, ‘the total number of animals’, and ‘perceived risk of foot and mouth disease’ are significant factors that influence the adoption of RMSs. This study’s findings will be useful for livestock supply chain partners to mitigate the risks along the livestock supply chain. This research will also help policymakers to develop policies/plans for incorporating these RMSs by considering the influencing associated factors. Full article

Xerostomia, the subjective complaint of a dry mouth, is frequently associated with salivary flow reduction and/or salivary gland hypofunction. This condition significantly impacts an individual’s quality of life and oral health, including difficulties in speaking, chewing, and swallowing. Xerostomia may be caused by autoimmune diseases, xerogenic medications, and radiation therapy. Our objective was to identify differentially expressed proteins in the saliva of patients with medication and autoimmune disease-associated xerostomia compared to non-xerostomic control subjects. Two groups of individuals (N = 45 total) were recruited: non-xerostomic subjects (NX-group; n = 18) and xerostomic patients (XP-group; n = 27). Dried saliva spot samples were collected from major salivary glands, i.e., parotid (left and right) and submandibular glands. Proteomic analysis was performed by deep nanoLC-MS/MS. Differential protein expression in the XP-group relative to the NX-group was determined by the Mann–Whitney U-test with FDR Benjamini–Hochberg correction (p_adj < 0.05). The Search Tool for Recurring Instances of Neighboring Genes (STRING_v12.0) was used to generate interaction networks and perform pathway analysis. A total of 1407 proteins were detected. Of these, 86 from the left parotid gland, 112 from the right parotid gland, and 73 from the submandibular gland were differentially expressed proteins (DEPs). Using STRING analysis, we identified, for the first time, several neurodegenerative disease-associated networks, primarily involving the downregulation of the 20S proteasome core complex and glyoxalase proteins across salivary glands. In this study, we determined neuronal dysregulation and impaired methylglyoxal (MGO) detoxification, possibly through reduced protein expression of glyoxalase Parkinson’s Disease (PD) Protein 7 (encoded by the PARK7 gene) in major salivary glands of xerostomic patients. Indeed, impaired MGO detoxification has been previously shown to cause salivary gland dysfunction in a mouse model of type 2 diabetes. Based on other DEPs associated with neurodegenerative disorders, our results also suggest a possible deficiency in the parasympathetic nervous system innervation of salivary glands, warranting further investigation. Full article

Background: Antiphospholipid syndrome (APS) is one of the highest risk factors for obstetric complications. This article contains a case report of a patient with obstetric APS who experienced fetal loss during their first pregnancy and experienced a successful second pregnancy upon treatment with acetylsalicylic acid (ASA), low-molecular-weight heparin (LMWH), and hydroxychloroquine (HCQ). We compare placental pathology in these two pregnancies and discuss the impact of antiphospholipid antibodies and clinical management on pregnancy outcomes. We also propose methods to monitor obstetric antiphospholipid syndrome (OAPS) patients during pregnancy. Methods: A 26-year-old woman presented with a history of stillbirth at 25 weeks of pregnancy due to placental insufficiency. Before pregnancy, she experienced symptoms suggestive of autoimmune disease (thrombocytopenia, recurrent mouth aphthous ulcers, and Raynaud’s phenomenon) but had no diagnosis. Placental dysfunction correlated with the high ratio of sFlt-1/PIGF (soluble fms-like tyrosine kinase 1 and the placental growth factors index). Laboratory tests revealed the presence of antinuclear antibodies (ANAs) and triple positivity for antiphospholipid antibodies (aPLs). Results: Following the initiation of treatment for OAPS and regular monitoring consistent with current guidelines, the patient conceived and successfully delivered a healthy child. Conclusions: Adequate therapy and close monitoring during pregnancy, including clinical observation, placental biomarkers and regular ultrasonography, may help to reduce the risks and increase chances for optimal pregnancy outcomes. Additionally, pathological examination and clinical collaboration are essential components in future pregnancy counseling and should be a part of multidisciplinary management. Full article

Background: Enterovirus A71 (EV-A71) is considered as the primary causative agent of hand, foot, and mouth disease (HFMD) in young children, leading to severe neurological complications and contributing to substantial mortalities in recent HFMD outbreaks across Asia. Despite this, there is currently no effective antiviral treatment available for EV-A71. RNA interference (RNAi) is a powerful mechanism of post-transcriptional gene regulation that utilizes small interfering RNA (siRNA) to target and degrade specific RNA sequences. Objectives: The aim of this study was to design various siRNAs targeting EV-A71 genomic regions and evaluate the RNAi efficacy against a novel, previously genetically uncharacterized EV-A71 strain. Methods: A novel EV-A71 strain was first sequenced to design target-specific siRNAs. The viral titers, viral protein expression, cytopathic effects, and cell viability of EV-A71-infected HeLa cells were examined to evaluate the specific viral inhibition by the siRNAs. Results: A substantial reduction in viral titers and viral protein synthesis was observed in EV-A71-infected HeLa cells treated with specific siRNAs targeting the VP4, VP3, 2B, and 3A genes. siRNAs delayed cytopathic effects and increased cell viability of EV-A71-infected HeLa cells. Nonspecific interferon induction caused by siRNAs was not observed in this study. In contrast, replication of coxsackievirus B3, another important member of the Enterovirus genus, remained unaffected. Conclusions: Overall, the findings demonstrate that RNAi targeting genomic regions of EV-A71 VP4, VP3, 2B, or 3A could become a potential strategy for controlling EV-A71 infection, and this promising result can be integrated into future anti-EV-A71 therapy developments. Full article

Foot-and-mouth disease (FMD), bluetongue (BT), and Peste des Petits Ruminants (PPR) are major emerging and re-emerging viral infections affecting ruminants. These diseases can threaten livestock health, food security, and economic stability in low- and middle-income countries, including Algeria. However, their dynamics remain mostly unknown, limiting the implementation of effective preventive and control measures. We analyzed outbreak data reported by Algerian veterinary authorities and the WAHIS database from 2014 to 2022 for FMD; from 2006 to 2020 for BT; and from 2011 to 2022 for PPR to investigate their spatiotemporal patterns and environmental drivers. Over these periods, Algeria reported 1142 FMD outbreaks (10,409 cases; 0.16/1000 incidence), 167 BT outbreaks (602 cases; 0.018/1000), and 222 PPR outbreaks (3597 cases; 0.096/1000). Small ruminants were the most affected across all diseases, although cattle bore the highest burden of FMD. BT primarily impacted sheep, and PPR showed a higher incidence in goats. Disease peaks occurred in 2014 for FMD, 2008 for BT, and 2019 for PPR. Spatial analyses revealed distinct ecological hotspots: sub-humid and semi-arid zones for FMD and BT, and semi-arid/Saharan regions for PPR. These patterns may be influenced by species susceptibility, animal movement, trade, and climatic factors such as temperature and rainfall. The absence of consistent temporal trends and the persistence of outbreaks suggest multiple drivers, including insufficient vaccination coverage, under-reporting, viral evolution, and environmental persistence. Our findings underscore the importance of targeted species- and region-specific control strategies, including improved surveillance, cross-border coordination, and climate-informed risk mapping. Strengthening One Health frameworks will be essential to mitigate the re-emergence and spread of these diseases. Full article

Inhaled corticosteroids (ICSs) are widely used to manage chronic respiratory conditions such as asthma, chronic obstructive pulmonary disease (COPD), and human immunodeficiency virus (HIV). However, prolonged use of ICS is associated with the development of oropharyngeal candidiasis, a fungal infection primarily caused by Candida albicans, due to local immunosuppression in the oral cavity. The incidence of oropharyngeal candidiasis varies depending on geographic region, patient age, and comorbidities, with immunocompromised individuals, those with diabetes, and the elderly being particularly vulnerable. Key risk factors include high ICS doses, poor oral hygiene, and improper use of inhalers. Prevention is the cornerstone of managing oropharyngeal candidiasis associated with the chronic use of inhaled corticosteroids. Patient education on proper inhaler technique and oral hygiene is essential to reduce the risk of fungal overgrowth in the oral cavity. Additional preventive strategies include the use of spacers, mouth rinsing after inhalation, and proper denture care. In cases where these measures fail to prevent the infection, prompt detection and early intervention are crucial to prevent progression or recurrence. This narrative review aims to analyze the most effective prophylactic measures to prevent oropharyngeal candidiasis associated with the chronic use of inhaled corticosteroids, emphasizing patient education, oral hygiene, and proper use of inhalation devices. Full article

Background/Objectives: The formation of oral biofilms in periodontal pockets and around dental implants with induction of periodontitis or peri-implantitis is an increasing problem in dental health. The intelligent design of a biofilm makes the bacteria embedded in the biofilm matrix highly tolerant to antiseptic therapy, often resulting in tooth or implant loss. The question therefore arises as to which mouthwashes have eradication potential against oral biofilm. Methods: A human oral biofilm model was developed based on donated blood plasma combined with buffy coats, inoculated with oral pathogenic bacterial species found in periodontal disease (Actinomyces naeslundii, Fusobacterium nucleatum, Streptococcus mitis, and Porphyromonas gingivalis). Over a span of 7 days, we tested different mouth rinsing and antiseptic solutions (Chlorhexidine, Listerine^®, NaOCl, Octenisept^®, and Octenident^®) covering the matured biofilm with 24 h renewal. Phosphate-buffered saline (PBS) was used as a control. Bacterial growth patterns were detected via quantitative polymerase chain reaction (qPCR) after 2, 4, and 7 days of treatment. Results: While all groups showed initial bacterial reduction, the control group demonstrated strong regrowth from day 2 to 4. Listerine showed a near-significant trend toward bacterial suppression. Additionally, strain-specific efficacy was observed, with Octenisept^® being most effective against Streptococcus mitis, Octenident^® and NaOCl showing superior suppression of Actinomyces naeslundii, and Listerine^® outperforming other solutions in reducing Fusobacterium nucleatum. Donor-specific, individual variability further influenced treatment outcomes, with distinct trends in bacterial suppression and regrowth observed across donors. Conclusions: These findings underscore the complexity of biofilm-associated infections and highlight the importance of targeted therapeutic approaches for managing bacterial biofilms. In this experiment, the donor-specific outcomes of the antimicrobial effects of the solutions may indicate that genetic predisposition/tolerance to oral infections appears to play a critical role in the control of oral biofilms. Full article

Background: This study aimed to evaluate the effectiveness of a saliva-based screening method for periodontal disease among community-dwelling older adults in Japan. Methods: A total of 372 study participants (mean age: 73.1 years) with 20 or more remaining teeth were included in the study. Of the six parameters assessed by the Salivary Multi Test (SMT), this study focused on the three parameters related to periodontal disease: occult blood, leukocytes, and proteins. Periodontal tissue examinations were performed based on the Community Periodontal Index (CPI) using partial mouth recording. To evaluate screening accuracy, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each of the three markers: occult blood, leukocytes, and proteins. Receiver operating characteristic (ROC) analysis was performed for each SMT item, and area under the curve (AUC) was calculated. Logistic regression analysis was used to calculate the odds ratios for combinations of SMT markers, with the presence of periodontal pockets and gingival inflammation as the respective outcome variables. Results: Among the individual markers, occult blood showed the highest diagnostic performance for detecting both periodontal pockets and gingival inflammation. The combination of elevated occult blood and leukocyte levels yielded the highest odds ratios for both periodontal pockets and gingival inflammation. Conclusions: While several SMT markers showed associations with periodontal conditions, their utility for screening in older Japanese adults remains to be further validated. Combining markers may help improve diagnostic performance, but additional studies are warranted. Full article

Echovirus 30 (E-30), a member of the Enterovirus B species, is frequently linked to neurological illnesses such as aseptic meningitis, encephalitis, and hand, foot, and mouth disease. In this study, we present the complete-genome analysis of an Echovirus 30 strain isolated from cerebrospinal fluid (CSF) and stool samples of a pediatric encephalitis case in Kerala, India, during 2023. A comparative genomic investigation was carried out using a dataset of 111 human E-30 isolates, encompassing 116,991 mutation records. This analysis revealed six distinct non-synonymous amino acid substitutions uniquely present in the isolate PQ472410.1, which may be associated with pathogenicity and/or neurotropic behavior. To the best of our knowledge, this represents the first complete-genome sequence report of E-30 from an encephalitis case in India. These findings contribute valuable information to the understanding of E-30’s molecular epidemiology and evolution and offer vital data for enhancing surveillance and response strategies against enteroviral infections. Full article

Background: Hand, foot, and mouth disease (HFMD) typically exhibits spatiotemporal clustering. This study aimed to analyze the spatiotemporal heterogeneity of HFMD in Fujian Province, China, and to identify the associations of air pollutants and socioeconomic factors with the incidence. Methods: Daily reported HFMD case data, daily air pollutant data, and socioeconomic data in Fujian Province from 2014 to 2023 were collected for analysis. A descriptive analysis was used to describe the epidemiological trends of HFMD. Spatial autocorrelation analysis was applied to explore the spatiotemporal clustering characteristics. The associations between risk factors and HFMD incidence were evaluated using the generalized additive model (GAM). Results: HFMD incidence in Fujian has decreased since 2019, and the peak in each year occurred between May and June. Distinct high–high and low–low clustering areas were identified. The cumulative exposure–response curves for SO₂, NO₂, and CO showed a monotonically increasing trend, with relative risks (RRs) < 1 at concentrations lower than the median levels (SO₂ ≈ 4 μg/m³, NO₂ ≈ 16 μg/m³, CO ≈ 1 mg/m³). In contrast, the curves for O₃ and PM_2.5 showed a decreasing trend, with RR < 1 at concentrations above the median levels (O₃ ≈ 55 μg/m³, PM_2.5 ≈ 20 μg/m³). Among socioeconomic factors, only the proportion of the population under 15 years old was found to be associated with HFMD incidence. Conclusions: HFMD incidence in Fujian exhibited distinct spatiotemporal clustering. The incidence was associated with the concentrations of air pollutants. Targeted interventions should be implemented in high-risk areas to mitigate HFMD transmission, with particular attention given to the environmental and demographic factors. Full article

Background/Objectives: An accurate quantification of the effective antigens from different serotypes is essential for the quality control of multivalent vaccines, but it remains challenging. Herein, we developed a simple and high-throughput method using differential scanning fluorimetry (DSF) for quantifying foot-and-mouth disease virus (FMDV) antigens in monovalent and bivalent vaccines. Methods: Purified serotypes A and O FMDV were used to establish and validate the method. The DSF parameters, including the dye concentration, thermal scanning velocity, and PCR tube material, were optimized at different FMDV concentrations. The established DSF method was validated for the quantification of monovalent and A/O bivalent FMDV, and was compared with the ultracentrifugation of 86 samples from different processing stages and serotypes. Results: The DSF showed that the melting temperature (T_m) of type A (56.2 °C) was significantly higher than that of type O FMDV (50.5 °C), indicating that their T_m can be distinguished in bivalent antigens. After optimizing the DSF parameters, a strong correlation (R² > 0.998) was observed between the 146S concentration and the maximum of the first derivative of the DSF fluorescence (d(RFU)/dT) for both serotypes A and O FMDV. The method demonstrated good reproducibility (RSD < 10%) and high sensitivity (limit of detection: 0.7 μg/mL). Using a multiple linear regression analysis, the simultaneous quantification of A and O FMDV in the bivalent mixtures achieved recovery rates of 82.4–105.5%, with an RSD < 10% for most of the samples. Additionally, the DSF results correlated well with the ultracentrifugation data (Pearson ρ = 0.9789), validating its accuracy and broad applicability. Conclusions: In summary, DSF represents a simple, rapid, and high-throughput tool for the quality control of monovalent and bivalent FMDV vaccines. Full article

Gene therapy has emerged as a promising therapeutic approach across various oral diseases. This review examines current applications and future prospects of gene therapy in dentistry, focusing on five key areas: oral cancer, cancer-related pain, xerostomia (dry mouth), dental caries, and periodontal disease. Recent advances in viral and non-viral vectors have enabled more efficient gene delivery systems, with particular success in cancer pain management through µ-opioid receptor gene transfer and xerostomia treatment using aquaporin-1 gene therapy. For periodontal applications, gene therapy strategies include both immunomodulation and tissue regeneration approaches using growth factors like platelet-derived growth factor and bone morphogenetic proteins. While significant progress has been made, particularly in treating radiation-induced xerostomia and oral cancer pain, challenges remain in vector optimization and delivery methods. Clinical trials, predominantly in Phase I, indicate both the potential and current limitations of gene therapy in oral healthcare. This review synthesizes current evidence and outlines future directions for gene therapy applications in oral medicine and dentistry. Full article