Radiation recall phenomenon after administration of the mRNA-1273 SARS-CoV-2 vaccine

Several types of SARS-CoV-2 vaccine have been developed. However, the relationship between SARS-CoV-2 vaccine and radiation therapy (RT) is unclear. Recently, there have been some reports of radiation recall phenomenon (RRP) caused by a SARS-CoV-2 vaccine. We report a case of RRP after administration of the mRNA-1273 SARS-CoV-2 vaccine. A 51-year-old female was diagnosed with breast cancer (cT4N1M0, cStage IIIB) and underwent breast total mastectomy with axillary lymph node dissection after neoadjuvant chemotherapy. After mastectomy, the patient received RT with 50 Gy in 25 fractions. An acute side effect of grade 2 dermatitis according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. occurred after RT. The patient had not started any new systemic medication after RT; however, the patient received the mRNA-1273 SARS-CoV-2 vaccine (Moderna) 1 month after the end of the initial RT. Seven days after vaccination, the patient had a skin reaction with burning sensation and redness. This skin reaction was induced in an area corresponding to the irradiation field of the chest wall. There was no skin reaction in areas other than that described. The reaction was cured within 1 week with topical hydrocortisone. This report is an interesting case report with a RPP after administration of the mRNA-1273 SARS-CoV-2 vaccine.

Total Oral Rehabilitation with Dental Implants in an Elderly Patient with Concomitant Diseases: a Case Report

We report a case of restoration of the masticatory and phonetic functions of a senior patient with comorbidities who receives systemic medication and lacks sufficient bone volume for implant placement in the accurate position. X-ray shows severe asymmetric atrophy of the mandible, especially on the right sight, which affects the location of the mandibular canal. This greatly limits and complicates the restoration of the masticatory and phonetic functions with conventional prostheses. Adequate management of medication and long-term disease control of the patient allow safe surgery for tooth extraction and placement of intraosseous implants in the jaw bones.

Uniformity and Efficacy of Dry Powders Delivered to the Lungs of a Mycobacterial-Surrogate Rat Model of Tuberculosis

Purpose Pulmonary administration of dry drug powder is a considered promising strategy in the treatment of various lung diseases such as tuberculosis and is more effective than systemic medication. However, in the pre-clinical study phase, there is a lack of devices for effective delivery of dry powders to the lungs of small rodents. In this study, an administration device which utilizes Venturi effect to deliver dry powders to the lungs homogeneously was developed. Methods A Venturi-effect administration device which synchronizes with breathes by use of a ventilator and aerosolizes the dry powders was created. Pulmonary distribution of inhalable dry powders prepared by spray-drying poly(lactic-co-glycolic) acid and an antituberculosis agent rifampicin and anti-tuberculosis effect of the powders on mycobacteria infected rats by administration with the Venturi-effect administration device and a conventional insufflation device were evaluated. Results Homogeneous distribution of the dry powders in the lung was achieved by the Venturi-effect administration device due to efficient and recurring aerosolization of loaded dry powders while synchronizing with breathes. Amount of rifampicin delivered to the lungs by the Venturi-effect administration device was three times higher than that by a conventional insufflation device, demonstrating three times greater antimycobacterial activity. Conclusions The Venturi-effect administration device aerosolized inhalable antituberculosis dry powders efficiently, achieved uniform pulmonary distribution, and aided the dry powders to exert antituberculosis activity on lung-residing mycobacteria.

Severe COVID-19 in inflammatory bowel disease patients in a population-based setting

Objective Data on the course of severe COVID-19 in inflammatory bowel disease (IBD) patients remains limited. We aimed to determine the incidence rate and clinical course of severe COVID-19 in the heavily affected South-Limburg region in the Netherlands. Methods All COVID-19 patients admitted to the only two hospitals covering the whole South-Limburg region between February 27, 2020 and January 4, 2021 were included. Incidence rates for hospitalization due to COVID-19 were determined for the IBD (n = 4980) and general population (n = 597,184) in South-Limburg. Results During a follow-up of 4254 and 510,120 person-years, 20 IBD patients (0.40%; 11 ulcerative colitis (UC), 9 Crohn’s disease (CD)) and 1425 (0.24%) patients from the general population were hospitalized due to proven COVID-19 corresponding to an incidence rate of 4.7 (95% Confidence interval (CI) 3.0–7.1) and 2.8 (95% CI 2.6–2.9) per 1000 patient years, respectively (Incidence rate ratio: 1.68, 95% CI 1.08–2.62, p = 0.019). Median age (IBD: 63.0 (IQR 58.0–75.8) years vs. general population: 72.0 (IQR 62.0–80.0) years, p = 0.10) and mean BMI (IBD: 24.4 (SD 3.3) kg/m2 vs. general population 24.1 (SD 4.9) kg/m2, p = 0.79) at admission were comparable in both populations. As for course of severe COVID-19, similar rates of ICU admission (IBD: 12.5% vs. general population: 15.7%, p = 1.00), mechanical ventilation (6.3% vs. 11.2%, p = 1.00) and death were observed (6.3% vs. 21.8%, p = 0.22). Conclusion We found a statistically significant higher rate of hospitalization due to COVID-19 in IBD patients in a population-based setting in a heavily impacted Dutch region. This finding reflects previous research that showed IBD patients using systemic medication were at an increased risk of serious infection. However, although at an increased risk of hospitalization, clinical course of severe COVID-19 was comparable to hospitalized patients without IBD.

Dopamine-loaded nanoparticle systems circumvent the blood–brain barrier restoring motor function in mouse model for Parkinson’s Disease

Parkinson's disease (PD) is a progressive and chronic neurodegenerative disease of the central nervous system. Early treatment for PD is efficient; however, long-term systemic medication commonly leads to deleterious side-effects. Strategies that enable more selective drug delivery to the brain using smaller dosages, while crossing the complex brain-blood barrier (BBB), are highly desirable to ensure treatment efficacy and decrease/avoid unwanted outcomes. Our goal was to design and test the neurotherapeutic potential of a forefront nanoparticle-based technology composed of albumin/PLGA nanosystems loaded with dopamine (ALNP-DA) in 6-OHDA PD mice model. ALNP-DA effectively crossed the BBB, replenishing dopamine at the nigrostriatal pathway, resulting in significant motor symptom improvement when compared to Lesioned and L-DOPA groups. Notably, ALNP-DA (20 mg/animal dose) additionally up-regulated and restored motor coordination, balance, and sensorimotor performance to non-lesioned (Sham) animal level. Overall, ALNPs represent an innovative, non-invasive nano-therapeutical strategy for PD, considering its efficacy to circumvent the BBB and ultimately deliver the drug of interest to the brain.

Effectiveness of Velscope and Vizilite Plus Systems in Diagnostics of Oral Lesions

Aim: To compare the level of diagnostic coincidence between classical (standard) method and VELscope and ViziLite Plus systems in the diagnosis of different oral lesions. Material and methods: 184 oral lesions were examined using classical method, VELscope and ViziLite Plus systems, and after that underwent a pathohistological examination for diagnosis proof. The percentage of diagnostic coincidence for various types of lesions was analyzed for the three methods compared. Results: The results demonstrated the highest coincidence rate for lesions diagnosed with VELscope – 35 (83.3%), followed by those with classical method – 80 (80.8%), and those with the application of ViziLite – 33 (76.7%). In premalignant and malignant lesions, the highest percentage of diagnostic coincidence was reported using the classical method – 14 (93.3%), for non-malignant lesions using VELscope – 28 (84.8%), for inflammatory and reactive lesions using VELscope – 14 (82.4%) and for lesions associated with general disease and systemic medication again using VELscope – 11 (91.7%). Conclusion: Non-invasive methods, tested in the study, have different diagnostic properties when differentiating particular clinical types of lesions. They are highly sensitive to changes in the oral mucosa but the final diagnosis must always be proved with biopsy.

Uveitis for the non-ophthalmologist

The uveitides are a heterogeneous group of diseases characterized by inflammation inside the eye. The uveitides are classified as infectious or non-infectious. The non-infectious uveitides, which are presumed to be immune mediated, can be further divided into those that are associated with a known systemic disease and those that are eye limited,—ie, not associated with a systemic disease. The ophthalmologist identifies the specific uveitic entity by medical history, clinical examination, and ocular imaging, as well as supplemental laboratory testing, if indicated. Treatment of the infectious uveitides is tailored to the particular infectious organism and may include regional and/or systemic medication. First line treatment for non-infectious uveitides is corticosteroids that can be administered topically, as regional injections or surgical implants, or systemically. Systemic immunosuppressive therapy is used in patients with severe disease who cannot tolerate corticosteroids, require chronic corticosteroids at >7.5 mg/day prednisone, or in whom the disease is known to respond better to immunosuppression. Management of many of these diseases is optimized by coordination between the ophthalmologist and rheumatologist or internist.

Etiology, Clinical Manifestation and Natural Treatments of Psoriasis from the Perspective of Persian Medicine

Psoriasis is an inflammatory and autoimmune disease with unknown etiology. This is a chronic, recurrent, distressing and costly disease, which has a great impact on the quality of life of individuals. Its treatment varies from topical to systemic medication and sometimes with a great deal of side effects. Probably, changing nutritional habits, life style modification and applying preventive measures may reduce the high amount use of chemical drugs and the costs of the disease. This study investigates etiology, clinical manifestation and natural treatments of psoriasis from the perspective of Persian Medicine by which prevention and nutritional recommendations and some treatments can be introduced. Searching selected sources of Persian Medicine including the Canon of Medicine, Zakhirah -E- Kharazm Shahi, Kamel alsanaat, Sharh al-asbab va al-alamat, Tebbe-Akbari, Moalejate Aghili, Exir-e-Azam, three diseases named “Ghooba”, “Barase Asvad” and “Saafe-Yabes” were found to be similar to psoriasis in their manifestations. Therefore, study of their specific treatments in the levels of lifestyle management more importantly nutrition and herbal therapy could be noteworthy for the future studies.

Vascular Anomalies of the Oro-Maxillofacial Region

Vascular anomalies is a diverse group of disorders involving the vasculature (arteries,veins and lymphatics). These lesions in the head and neck can present since birth or later in life causing functional, cosmetic and bleeding problems. They can sometimes co-exist with a wide array of other pathologies and components of various syndromes. The different types, classifications, clinical features, imaging characteristics, treatment options and complications will be discussed in detail, with accordance to guidelines and principles in current literature. The author has designed a widely accepted anatomical classification for surgical management of these complex lesions, which is discussed in depth. Tailoring therapy depending on the anomaly is the key to successful treatment. Hemangiomas tend to proliferate and then involute , hence treated with systemic medication or alternate therapy for residual lesions. Vascular Malformations essentially would require aggressive management with surgery or embolisation and surgery. The concept of ‘corset suturing’ is explained and described, which is thought to be the ideal management for large venous malformations.