The Oral-Vascular-Pulmonary Infection Route:a Pathogenic Mechanism Linking Oral Health Status to Acute and Post-Acute COVID-19

Purpose of Review: In recent years, much attention has focused on the role of poor oral health in the development or worsening of systemic diseases, including COVID-19. The mouth is an important site of cellular infection early in the disease course of COVID-19. We review how oral pathology, and specifically viral infection within the oral cavity, may mediate the disease severity and duration of COVID-19. In particular, the previously reported model of SARS-CoV-2 vascular delivery from the mouth to the lungs via the bloodstream is revisited.Recent Findings: We previously proposed that an oral-vascular-pulmonary route of infection could facilitate severe lung disease in COVID-19. This pathway could also explain the vital link between periodontitis and COVID-19 severity, including higher mortality risk. This model of pathogenesis is reconsidered in light of recent findings regarding the involvement of the mouth as a viral reservoir, and pathological processes in the blood, pulmonary vasculature, and elsewhere in the body. Oral dysbiosis in COVID-19 and the effect of oral hygiene in mitigating disease severity are discussed. The evidence for viral persistence in the mouth and intravascular viral passage from the mouth to the rest of the body via blood is also discussed in the context of post-acute COVID (long COVID).Summary: High viral load in the mouth and poor oral health status are associated with COVID-19 disease severity, increasing the risk of death. Pathophysiological links between viral activity in the mouth, oral health status, and disease outcome in the lungs and blood provide a rationale for further evaluation of the oral-vascular-systemic pathway in patients with acute COVID-19 and long COVID. The potential benefits of oral hygiene protocols and periodontal procedures in COVID-19 also warrant further investigation

The Oral-Vascular-Pulmonary Infection Route:a Pathogenic Mechanism Linking Oral Health Status to Acute and Post-Acute COVID-19

Purpose of Review: In recent years, much attention has focused on the role of poor oral health in the development or worsening of systemic diseases, including COVID-19. The mouth is an important site of cellular infection early in the disease course of COVID-19. We review how oral pathology, and specifically viral infection within the oral cavity, may mediate the disease severity and duration of COVID-19. In particular, the previously reported model of SARS-CoV-2 vascular delivery from the mouth to the lungs via the bloodstream is revisited.Recent Findings: We previously proposed that an oral-vascular-pulmonary route of infection could facilitate severe lung disease in COVID-19. This pathway could also explain the vital link between periodontitis and COVID-19 severity, including higher mortality risk. This model of pathogenesis is reconsidered in light of recent findings regarding the involvement of the mouth as a viral reservoir, and pathological processes in the blood, pulmonary vasculature, and elsewhere in the body. Oral dysbiosis in COVID-19 and the effect of oral hygiene in mitigating disease severity are discussed. The evidence for viral persistence in the mouth and intravascular viral passage from the mouth to the rest of the body via blood is also discussed in the context of post-acute COVID (long COVID).Summary: High viral load in the mouth and poor oral health status are associated with COVID-19 disease severity, increasing the risk of death. Pathophysiological links between viral activity in the mouth, oral health status, and disease outcome in the lungs and blood provide a rationale for further evaluation of the oral-vascular-systemic pathway in patients with acute COVID-19 and long COVID. The potential benefits of oral hygiene protocols and periodontal procedures in COVID-19 also warrant further investigation

Complications following correction of the planovalgus foot in cerebral palsy by arthroereisis

Pes valgus is a pathological condition which occurs in up to 25% of patients with cerebral palsy. Its correction in early age is essential to prevent progression of the deformity and to optimize the patient's function. In younger patients arthroereisis can be considered as a treatment that fills the void between orthotics and arthrodesis. We treated 15 patients (27 feet) with intra-or extra-sinus tarsi arthroereisis. Concomitant Achilles tendon lengthening was performed in 12 feet. Results were good in 19 feet and poor in 8. Even though arthoereisis presents some complications, it can be considered a useful treatment to delay or avoid a Grice subtalar arthrodesis in flexible pes valgus due to cerebral palsy.Pes valgus is a pathological condition which occurs in up to 25% of patients with cerebral palsy. Its correction in early age is essential to prevent progression of the deformity and to optimize the patient's function. In younger patients arthroereisis can be considered as a treatment that fills the void between orthotics and arthrodesis. We treated 15 patients (27 feet) with intra- or extra-sinus tarsi arthroereisis. Concomitant Achilles tendon lengthening was performed in 12 feet. Results were good in 19 feet and poor in 8. Even though arthoereisis presents some complications, it can be considered a useful treatment to delay or avoid a Grice subtalar arthrodesis in flexible pes valgus due to cerebral palsy

Hip subluxation and dislocation in cerebral palsy:outcome of bone surgery in 21 hips

The prevalence of hip subluxation and dislocation in cerebral palsy ranges between 3% and 75% in the literature. Clinical signs are rigidity, pain and instability. We assessed functionality, stability and symptoms in 20 patients preoperatively and after follow-up. A varus derotation osteotomy was performed in cases with subluxation or dislocation, while a Chiari osteotomy was performed in the presence of a con- comitant acetabular dysplasia. Results were good in 64%, fair in 22% and poor in 14% of patients treated with a varus derotation osteotomy. In patients treated with a Chiari osteo- tomy, results were good in 43% of cases, fair in 43% and poor in 14%. Subluxated or dislocated hips generally show several anomalies : their severity is directly proportional to the degree of neurological impairment. In the most severe cases, correction of just one of such anomalies might not be sufficient to guarantee good results of the surgery

Competition between Icosahedral Motifs in AgCu, AgNi, and AgCo Nanoalloys: A Combined Atomistic-DFT Study

The structures of AgCu, AgNi, and AgCo nanoalloys with icosahedral geometry have been computationally studied by a combination of atomistic and density-functional theory (DFT) calculations, for sizes up to about 1400 atoms. These nanoalloys preferentially assume core-shell chemical ordering, with Ag in the shell. These core-shell nanoparticles can have either centered or off-center cores; they can have an atomic vacancy in their central site or present different arrangements of the Ag shell. Here we compare these different icosahedral motifs and determine the factors influencing their stability by means of a local strain analysis. The calculations find that off-center cores are favorable for sufficiently large core sizes and that the central vacancy is favorable in pure Ag clusters but not in binary clusters with cores of small size. A quite good agreement between atomistic and DFT calculations is found in most cases, with some discrepancy only for pentakis-dodecahedral structures. Our results support the accuracy of the atomistic model. Spin structure and charge transfer in the nanoparticles are also analyze