Juan Antonio Suárez-Quintanilla

The tissue renin–angiotensin system (RAS) is a regulator of oxidative and inflammatory homeostasis by balancing its pro-oxidative/pro-inflammatory axis (angiotensin II, AngII, and AngII type-1 receptor, AT1) and its anti-oxidative/anti-inflammatory axis (AngII/AT2 and ACE2/Ang1-7/Mas receptors). An RAS dysregulation contributes to diseases, including Parkinson’s disease (PD). Immune mechanisms are involved in PD. An increase in levels of pro-oxidative/pro-inflammatory autoantibodies for AT1 (AT1-AAs) and ACE2 (ACE2-AAs) has been recently observed in PD. However, it is not known whether dysregulation of autoantibodies for AT2, MasR, and the correlations among different RAS-AAs occurs in PD. In 106 controls and 117 PD patients, we used enzyme-linked immunosorbent assays to determine correlations among serum RAS-AAs, and among RAS-AAs and pro-inflammatory cytokines and 27-hydroxycholesterol. PD patients showed an increase in MasR-AAs, and a more interconnected cluster of correlations among RAS-AAs (AT1-AA, AT2-AA, MasR-AA, ACE2-AA), changes in RAS-AA networks with sex and age, and differences in networks between RAS-AAs and major PD-related pro-inflammatory cytokines and 27-hydroxycholesterol. The association between AT1-AAs and PD remained significant even after adjustment for age and other variables. This study reveals a disease-specific network of RAS autoantibodies in PD that links immune and oxidative pathways and identifies new biomarker patterns and potential therapeutic targets.

The aim of this study was to identify the most relevant dental factors and iatrogenic causes in the development of pathological changes to the sinus membrane and to analyse their possible influence on the development of odontogenic sinusitis. A descriptive, observational study was designed, with 276 patients who had been evaluated via cone beam computed tomography, analysing possible sinus thickening factors, such as apical infections, endodontic treatments, periodontitis, radicular cysts and impacted teeth, as well as iatrogenic factors caused by implant treatments or the development of oroantral communications produced during tooth extraction manoeuvres. Among the dental factors, periodontitis (47.1%), apical pathology (23.5%) and endodontic treatments (23.1%) were the predominant causes of sinus membrane thickening that most frequently produced an occupancy between 2 and 10 mm. Regarding the implant treatments, the placement of implants through the floor of the maxillary sinus was the main cause (9.8%), followed by sinus elevation techniques (6.2%). Dental extraction was the first cause of oroantral communication (5.0%), being the procedure that caused the greatest thickening of the sinus membrane. This study highlights the importance of dental treatments and iatrogenic factors in sinus pathology, and the need for diagnostic interrelations between the different specialists who address this pathology.

Background: The aim was to investigate the clinical significance of nestin immunohistochemical expression in head and neck area lesions and to study its role in patient survival and recurrence. Methods: 39 (44.3%) nasosinus, 37 (42%) major salivary gland (6 submandibular and 31 parotid) and 12 (13.6%) oral cavity lesions of paraffin-embedded samples were retrospectively included. Results: The expression was categorized into grades, negative for 55 (62.5%) cases, grade 1 in 10 cases (11.4%), grade 2 in 12 cases (13.6%), and grade 3 in 11 cases (12.5%); 100% of pleomorphic adenomas were positive for nestin with grade 3 intensity, 100% of polyps and inverted papillomas were negative (p < 0.001). The lowest estimate of disease-free-survival (DFS) was for grade 1 expression, with 50 months, confidence interval (CI): 95% 13.3–23.9 months and the highest for grade 3 expression, 167.9 months (CI: 95% 32.1–105 months; Log-Rank = 14.846, p = 0.002). ROC (receiver operating characteristic) curves revealed that the positivity for nestin (+/−) in relation to malignancy, presented a sensitivity of 50.98%, a specificity of 81.08%, with an area under the curve of 0.667 (p = 0.009). Conclusions: Nestin could be a useful marker to detect the presence of stem cells in head and neck tumors that have a role in tumor initiation and progression.

Objectives: The COVID-19 (SARS-CoV-2) pandemic is an ongoing public health challenge, also for the dentistry community. The main objective of this paper was to determine the economic and health-care impact of COVID-19 on dentists in the Autonomous Region of Galicia (Spain). Methods: This was a descriptive observational study in which the data was collected by means of a self-administered survey (from 1 April 2020 to 30 April 2020). Results: A total of 400 dentists from Galicia responded to the survey. Only 12.3% of the participants could obtain personal protective equipment (PPE) including FFP2 masks. Of the male respondents, 33.1% suffered losses >€15,000 compared to 19.4% of female respondents (OR = 3.121, p < 0.001). Economic losses seem to have contributed to the applications for economic help as 29.5% of the respondents who applied for this measure recorded losses in excess of €15,000 (p = 0.03). Patients complained more about the fact that only emergency care was available during the State of Alarm, in dental surgeries that do not work with insurance companies or franchises. Only 4 professionals tested positive, 50% of whom worked exclusively in private practice and the other 50% who practised in both private and public surgeries. Dentists who practise in the public sector saw more urgent patients per week than those practising in private surgeries (p = 0.013). Conclusions: The COVID-19 pandemic has had economic repercussions in dentistry as only urgent treatment was available during the State of Alarm. These repercussions seem to be higher in male participants, as the majority of the participants have revealed higher economic losses than females. The level of assistance has also been affected, reducing the number of treated patients, although this quantity has been different in private and public surgeries. By presenting these findings we look to highlight the role that dentists play in society in treating dental emergencies in our surgeries, and this must be recognised and addressed by the relevant authorities, who must provide PPEs as a priority to this group as well as providing special economic aid in accordance with the losses incurred by the sector.

Aim: To compare the immediate antibacterial effect of two application methods (passive immersion and active mouthwash) of two antiseptic solutions on the in situ oral biofilm. Material and Methods: A randomized observer-masked crossover study was conducted. Fifteen healthy volunteers wore a specific intraoral device for 48 h to form a biofilm in three glass disks. One of these disks was used as a baseline; another one was immersed in a solution of 0.2% Chlorhexidine (0.2% CHX), remaining the third in the device, placed in the oral cavity, during the 0.2% CHX mouthwash application. After a 2-weeks washout period, the protocol was repeated using a solution of Essential Oils (EO). Samples were analyzed for bacterial viability with the confocal laser scanning microscope after previous staining with LIVE/DEAD^® BacLight™. Results: The EO showed a better antibacterial effect compared to the 0.2% CHX after the mouthwash application (% of bacterial viability = 1.16 ± 1.00% vs. 5.08 ± 5.79%, respectively), and was more effective in all layers (p < 0.05). In the immersion, both antiseptics were significantly less effective (% of bacterial viability = 26.93 ± 13.11%, EO vs. 15.17 ± 6.14%, 0.2% CHX); in the case of EO immersion, there were no significant changes in the bacterial viability of the deepest layer in comparison with the baseline. Conclusions: The method of application conditioned the antibacterial activity of the 0.2% CHX and EO solutions on the in situ oral biofilm. The in vivo active mouthwash was more effective than the ex vivo passive immersion in both antiseptic solutions. There was more penetration of the antiseptic inside the biofilm with an active mouthwash, especially with the EO. Trial registered in clinicaltrials.gov with the number NCT02267239. URL: https://clinicaltrials.gov/ct2/show/NCT02267239.