A Community Study of SARS-CoV-2 Detection by RT-PCR in Saliva: A Reliable and Effective Method

Efficient, wide-scale testing for SARS-CoV-2 is crucial for monitoring the incidence of the infection in the community. The gold standard for COVID-19 diagnosis is the molecular analysis of epithelial secretions from the upper respiratory system captured by nasopharyngeal (NP) or oropharyngeal swabs. Given the ease of collection, saliva has been proposed as a possible substitute to support testing at the population level. Here, we used a novel saliva collection device designed to favour the safe and correct acquisition of the sample, as well as the processivity of the downstream molecular analysis. We tested 1003 nasopharyngeal swabs and paired saliva samples self-collected by individuals recruited at a public drive-through testing facility. An overall moderate concordance (68%) between the two tests was found, with evidence that neither system can diagnose the infection in 100% of the cases. While the two methods performed equally well in symptomatic individuals, their discordance was mainly restricted to samples from convalescent subjects. The saliva test was at least as effective as NP swabs in asymptomatic individuals recruited for contact tracing. Our study describes a testing strategy of self-collected saliva samples, which is reliable for wide-scale COVID-19 screening in the community and is particularly effective for contact tracing.     

Effect of the intra-alveolar administration of dexamethasone on swelling,trismus, and pain after impacted lower third molar extraction: a randomized,double-blind clinical trial

Background To evaluate the efficacy of intra-alveolar administration of dexamethasone 4 mg in the control of edema, trismus, and pain resulting from the extraction of impacted lower third molars and the drug permeability through the oral mucosa by in silico prediction.Material and Methods The randomized, double-blind, split-mouth clinical trial included patients who had both impacted lower third molars in equivalent positions. Hemiarches were divided into control side when dexamethasone was administered orally and experimental side when dexamethasone was administered using the intra-alveolar route. Patients were evaluated considering edema, trismus, and pain. The permeability of dexamethasone through the oral mucosa was assessed by in silico prediction. Student’s t-test was selected for comparative analysis of edema and trismus, and the chi-square test analyzed the distribution of postoperative pain between the sides.Results There were no significant differences between the routes of administration in measuring symptoms between the pre and postoperative times (p>0.05). In silico prediction suggested that dexamethasone molecular characteristics facilitate intra-alveolar administration.Conclusions Intra-alveolar administration had similar efficacy to oral administration in controlling symptoms of post-surgical inflammation of impacted lower third molars. Key words:Molar, third, tooth, impacted, oral surgical procedures, dexamethasone.     

Miocardiopatia hipocalcémica

The association between hypocalcemia and heart failure is rare. There are few reported cases in the literature of this association, which is termed hypocalcemic cardiomyopathy.We report the case of a 61-year-old woman with no relevant medical history, admitted for progressively worsening exertional dyspnea, orthopnea and edema of the lower limbs for a previous month. Physical examination showed diffuse muscle spasms, with no signs of latent tetany.Further investigation revealed ionized calcium 0.54 mmol/l (normal 1.12-1.30), phosphorus 9.8 mg/dl, parathyroid hormone <2.5 pg/ml and CK >3000 U/l, with normal thyroid function. The electrocardiogram showed long QT interval and a pattern of left ventricular overload, and myocardial biomarkers were negative. The echocardiogram revealed regional wall motion abnormalities, coronary angiography was normal and a cranial CT scan detected calcification of basal ganglia and white matter.She started diuretic and calcium replacement therapy which resulted in complete clinical recovery, with no need for heart failure therapy after normalization of serum calcium.     

Comparative in vitro activities of six new fluoroquinolones and other oral antimicrobial agents against Campylobacter pylori.

The in vitro susceptibilities of 56 clinical isolates of Campylobacter pylori to six new fluoroquinolones and other oral antimicrobial agents were determined by an agar dilution technique. Ciprofloxacin was the most active of the fluoroquinolones (MIC for 90% of strains tested [MIC90], 0.05 microgram/ml). Other fluoroquinolones had variable activities, although most isolates were moderately susceptible to fleroxacin (MIC90, 4 micrograms/ml) and lomefloxacin (MIC90, 4 micrograms/ml).     

Exhaled air temperature in asthmatic children: a mathematical evaluation

Recently, the exhaled breath temperature has been proposed as a potential marker for the evaluation of airway inflammation in asthma. The purpose of this study was to verify the ability to distinguish asthmatics from normal controls by a dedicated detailed mathematical evaluation of the exhaled air curve. Analysis was performed in the different phases of the curve of exhaled temperature, i.e. the rate of temperature increase (Δ e ° T ) and the mean plateau value. Principal components analysis (PCA) and artificial neural networks (ANNs) were used for the evaluation of the data in 90 asthmatic children and in 33 healthy age-matched controls. Both PCA and ANNs showed that a separation between patients and controls can be obtained only by the evaluation of the plateau phase of the curve, which better reflects the periphery of the airway.     

Food avoidances at puberty and menstruation in Tamilnad

One thousand and two hundred women of 54 castes and 55 tribal women in Tamilnad (South India) were interviewed during a period of six months on food avoidances during puberty and subsequent menstruation.

Avoidances referred to different types of food, but the most significant were those of animal origin. This practice could be explained by the concept of purity and pollution. Even non‐vegetarians held animal foods to be impure and, as women during menstruation are considered impure also, they should abstain from consuming them to prevent the pollution increasing.

Eggs, though coming under the impure category, were nevertheless eaten at puberty, because of their reputed “strengthening” effect on the girl's body for future pregnancies.

Avoidances during ordinary menstruation were much rarer than at puberty indicating a decreased concern with habituation.