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Dental Disease, Inflammation, Cardiovascular Disease, Nutrition and Nutritional Supplements
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
Douglas G. Thompson, Gregori M. Kurtzman, Chelsea Q. Watkins
Saliva consists of the fluid excreted from the major and minor salivary glands, containing proteins, enzymes and buffers that are designed to provide protection, buffering, digestion and aid in swallowing. Saliva also contains a serum exudate known as gingival crevicular fluid. In inflamed tissues, this serum exudate serves as a protective mechanism to cleanse the “pocket” of the bacteria and debris that reside within the sites. Gingival crevicular fluid contains bacteria, yeast, viruses, serum, white blood cells, inflammatory mediators and matrix metalloproteinases. Thus, saliva is an excellent source for bacterial and human cell DNA. Both kinds of DNA can be extracted and analyzed through a laboratory process called polymerase chain reaction (PCR). In molecular biology, PCR is a technique for detection and elongation of DNA strands, an indispensable technique for duplicating DNA so that it can be analyzed for the identification of hereditary diseases, as well as the detection and diagnosis of infectious disease. DNA-PCR also permits identification of mycobacteria, anaerobic bacteria or viruses from the saliva sample sent for testing. Several unique salivary tests are now available to dentists that are reliable, affordable and easy – requiring only minutes to collect. These tests evaluate bacteria, yeast, viruses and genetic variations in genes that express inflammatory mediators. Within 4–5 days of receipt of the sample, a comprehensive interpretation of the periodontal pathogens detected and their concentrations present in the saliva are sent to the clinician.
Aids and Hepatitis
Published in T.M. Craft, P.M. Upton, Key Topics In Anaesthesia, 2021
Staff. High risk body fluids are blood, amniotic fluid, vaginal secretions, semen, breast milk, CSF, peritoneal, pleural, pericardial and synovial fluid. Saliva in association with dentistry, and unfixed organs and tissues also are classified as high risk and may transmit the virus. It is presently considered unethical to test all patients for evidence of HIV infection prior to surgery. ‘Universal precautions’ which assume that all patients maybe infected are recommended. Identical precautions are taken with other bloodborne infective agents, e.g. hepatitis B, and their success suggests that they are likely to be equally effective against the less infective HIV virus. Other precautions include the use of gloves when there is any risk of contact with infective body fluids, the wearing of masks and protective glasses when infective fluids may become airborne and gowns if there is any chance of being splashed. If contact with body fluids occurs the affected part should be washed immediately. Open or exudative wounds should be covered and contact with potentially infective fluids avoided. To reduce the risk of needle stick injuries, needles are immediately disposed of in a suitable container. They are not resheathed, or passed from one person to another. The risk of seroconversion following a needle stick injury is 0.3%. Post-exposure prophylaxis with zidovudine, lamivudine and indinavir is given as soon as possible (within 1-2 hours) after exposure and continued for 4 weeks.
The Precision Medicine Approach in Oncology
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
Saliva is a clinically important fluid as it filters from the blood, thus reflecting systemic physiological conditions. It contains genetic materials such as DNAs and RNAs (e.g., mRNA and micro-RNA), proteins and other small-molecule metabolic compounds that could potentially be used as biomarkers. Compared to biomarkers in blood, salivary biomarkers have obvious advantages including the noninvasive nature of sampling which would facilitate frequent screening. However, early studies showed that conventional tumor biomarkers such as cancer squamous cell carcinoma (SCC) antigen and Cyfra 21-1 measured in either blood or saliva are not clinically accurate enough, especially in the early stages of the disease. For example, in one study, only 10.9% cases of early disease (i.e., Stages I and II) and 46% of advanced-stage disease (i.e., Stages III and IV) were detected as positive based on SCC level (SCC-antigen >2.0 ng/ml).
Saliva diagnostics: emerging techniques and biomarkers for salivaomics in cancer detection
Published in Expert Review of Molecular Diagnostics, 2022
Jieren Liu, Dongna Huang, Yuanzhe Cai, Zhihua Cao, Zhiyu Liu, Shuo Zhang, Lin Zhao, Xin Wang, Yuchuan Wang, Feijuan Huang, Zhengzhi Wu
This article reviewed the applications of multi-omics approach in the etiologic research on cancer diseases, representative research in the past three years, opportunities and challenges for salivary cancer diagnosis. To be useful in a clinical setting, biomarkers should accurately reflect the presence of disease in a repeatable manner and be able to be collected using non-invasive methods that do not require preparation. Saliva diagnosis has these characteristics, saliva contains rich biomarkers, can be used to detect oral diseases and other systemic diseases. Omics studies contribute to the identification of salivary components and characterization, including proteome, transcriptome, metabolome, and microbiome. Although salivary biomarkers have been recognized in the detection of human cancers, as the studies on oral cancer, pancreatic cancer, lung cancer, breast cancer, gastric cancer are reviewed in this report, the mechanism between distal tumors and oral cavity remains unclear, undermining the scientific credibility of salivary in clinical applications. Based on the non-invasive cancer biomarkers, many detection techniques, the biosensors and products used for saliva biomarker detection have been developed and are summarized.
Bioidentical hormones
Published in Climacteric, 2021
F. Z. Stanczyk, H. Matharu, S. A. Winer
Saliva is a complex fluid which is mostly produced by the parotid, submandibular, and sublingual salivary glands, with a small contribution from the buccal glands that line the mouth13. In addition, saliva contains variable amounts of gingival crevicular fluid, which leaks from the tooth–gum margin, or blood from oral abrasions or lesions. Steroid hormones can enter saliva by a variety of mechanisms but for most steroids the most common route is rapid passive diffusion through the acinar cells, which drain into the salivary ducts13. The acini are surrounded by blood capillaries that enable the passage of substances from the circulation into the salivary glands. In passive diffusion, lipid-soluble substances such as progesterone and E2 cross the cell membranes of capillaries and acini rapidly. It is only the non-protein-bound steroids that enter the acini; steroids bound to sex hormone-binding globulin (SHBG), corticosteroid-binding globulin (CBG) and albumin are too large to enter acinar cells.
Effects of hemodialysis treatment on saliva flow rate and saliva composition during in-center maintenance dialysis: a cross-sectional study
Published in Renal Failure, 2021
I-Chen Yu, Chieh-Yu Liu, Ji-Tseng Fang
Saliva comprises numerous substances. In addition to water and mucin, saliva contains blood urea nitrogen (BUN), creatinine (Cr), and various electrolytes. Relevant research has indicated that the concentrations of biochemical substances in saliva and blood are equally correlated to each other [6]. The saliva secretion volume under normal physiological functioning should be approximately 0.5–1 L/day [7]. A survey conducted in Taiwan indicated that the unstimulated saliva flow rate of hemodialysis patients is approximately 0.06–0.07 mL/min [8]; approximately 66.4% of such patients have experienced dry mouth [9]. Ship et al. determined that unstimulated saliva flow rate below 0.1–0.2 mL/min indicates salivary gland hypofunction (SGH) [10]. Using salivary scintigraphy, Kao et al. found hemodialysis patients who experienced dry mouth had decreased salivary gland functioning [11]. A possible reason underlying the occurrence of dry mouth in dialysis patients is metabolic wastes, such as high concentration BUN and Cr, damaging the salivary gland; this in turn affects the saliva secretion function of the gland and causes the sensation of mouth dryness.