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Objective Combining pharmacologic agents with mechanical ripening achieves the shortest labor duration, yet there is no clear evidence on route of drug administration in obese individuals. The use of buccal misoprostol has shown greater patient acceptance but remains understudied. Our objective was to evaluate the difference in time to delivery of buccal compared with vaginal misoprostol in combination with a Foley catheter (FC) for induction of labor (IOL) in the obese population. Study Design This was a secondary analysis of a randomized controlled trial comparing identical dosages (25 μg) of buccal and vaginal misoprostol in combination with a FC. The parent trial was an institutional review board-approved, randomized clinical trial conducted from June 2019 through January 2020. Labor management was standardized among participants. Women undergoing IOL at ≥37 weeks with a singleton gestation and cervical dilation ≤2 cm were included. Body mass index (BMI, kg/m 2) was stratified. The primary outcome was time to delivery. Results A total of 215 participants were included. Demographic characteristics were similar between the three groups. Vaginal drug administration achieved a faster median time to delivery than the buccal route among patients with a body mass index greater than or equal to 30 kg/m 2 (vaginal misoprostol–FC: 21.3 hours vs. buccal misoprostol–FC: 25.2 hours, p = 0.006). There was no difference in the cesarean delivery rate between the two groups. Furthermore, patients with a BMI greater than or equal to 30 kg/m 2 receiving vaginal misoprostol delivered 1.2 times faster than women who received buccal misoprostol after censoring for cesarean delivery and adjusting for parity (hazard ratio: 1.2, 95% confidence interval: 1.1–1.7). There were no significant differences in maternal and neonatal outcomes. Conclusion We found that vaginal misoprostol was superior to buccal misoprostol when combined with a FC among individuals with a BMI greater than or equal to 30 kg/m 2. Vaginal misoprostol should be the preferred route of drug administration for term IOL in this population. Key Points Vaginal misoprostol was superior to buccal route among patients with obesity. There was no difference in the cesarean delivery rate between the two groups. Vaginal misoprostol should be the preferred route of administration among patients with obesity. [ABSTRACT FROM AUTHOR]

Objectives: To describe the clinicopathologic presentation of buccal squamous cell carcinoma and identify risks factors for recurrence and overall survival. Methods: This is a retrospective case–control study of patients with oral cavity squamous cell carcinoma (OCSCC) treated at a single tertiary care center between 2010 and 2022. All patients with buccal subsite OCSCC treated during this time frame were included and paired with a randomly selected age and gender matched patient with non‐buccal OCSCC. Relevant data was collected via chart review. Results: Seventy‐seven patients with buccal SCC were matched with 77 non‐buccal OCSCC controls. The median follow‐up time was 27 months (IQR 14–61). Median age was 67 years (IQR 57–75) and 53% of the cohort was female. Twenty (26%) buccal SCC patients experienced a recurrence versus 19 (25%) in the controls. Age ≥65‐years‐old increased odds of all‐cause mortality in the buccal SCC group, but not in the control group. Perineural invasion and positive margins increased odds of recurrence in the buccal group only. Overall survival and progression‐free survival did not differ between the groups, despite a greater number of T2 buccal tumors and T1 non‐buccal tumors. Conclusions: Buccal SCC presents at a higher T stage than other oral cavity SCC subsite and may exhibit variance in the pathologic risk factors that predict poor outcomes versus non‐buccal OCSCC. Despite these relatively minor differences, however, oncologic outcomes between these groups were similar. [ABSTRACT FROM AUTHOR]

Benzodiazepines are the recommended first-line treatment of acute seizures. We wished to compare the efficacy, side effects, and satisfaction after midazolam administration by the buccal, intranasal, or intramuscular route in the treatment of acute seizures in children at homes and in emergency room (ER). A prospective, randomized, controlled trial was performed in children aged one month to 17 years with acute seizures lasting longer than five minutes. The primary end point was seizure cessation within 10 minutes of drug administration and no seizure recurrence within 30 minutes. In the home group, 67 patients received midazolam via buccal route, 60 via intranasal route, and 69 via intramuscular route, whereas in the ER group, 37 patients received buccal, 34 received intranasal, and 34 received intramuscular midazolam. The primary end point was achieved in 94.2% and 85.3% after intramuscular midazolam in the home and ER groups, respectively. The intranasal midazolam was successful in stopping seizures in 93.3% in the home group and 88.2% in the ER group. The buccal route was effective in 91% in the home group and 78.4% in the ER group. There were no significant differences in efficacy between all groups (P = 0.763 and P = 0.509) among the home and ER groups, respectively. There were no significant cardiorespiratory events in all groups. Intramuscular, intranasal, and buccal doses of midazolam resolved most seizures in prehospital and emergency settings. Our results indicate that there is no statistically significant difference detected between different routes of midazolam. Intranasal route showed the highest satisfaction rate among caregivers. [ABSTRACT FROM AUTHOR]

Over the years, research regarding the Zika virus has been steadily increasing. Early immunization for ZIKV is a priority for preventing complications such as microencephaly and Guillain–Barré syndrome (GBS). Unlike traditional vaccination approaches, oral dissolving films (ODFs) or mucoadhesive film technology is an emerging, exciting concept that can be used in the field of pharmaceuticals for vaccine design and formulation development. This attractive and novel method can help patients who suffer from dysphagia as a complication of a disease or syndrome. In this study, we investigated a microparticulate Zika vaccine administered via the buccal route with the help of thin films or oral dissolving films (ODFs) with a prime dose and two booster doses two weeks apart. In vitro, the ODFs displayed excellent physiochemical properties, indicating that the films were good carriers for vaccine microparticles and biocompatible with the buccal mucosa. In vivo results revealed robust humoral (IgG, subtypes IgG1 and IgG2a) and T-cell responses (CD4+/CD8+) for ZIKV-specific immunity. Both the Zika MP vaccine and the adjuvanted Zika MP vaccine affected memory (CD45R/CD27) and intracellular cytokine (TNF-α and IL-6) expression. In this study, ZIKV vaccination via the buccal route with the aid of ODFs demonstrated great promise for the development of pain-free vaccines for infectious diseases. [ABSTRACT FROM AUTHOR]

Epigenetic aging clocks are computational models that predict age using DNA methylation information. Initially, first-generation clocks were developed to make predictions using CpGs that change with age. Over time, next-generation clocks were created using CpGs that relate to both age and health. Since existing next-generation clocks were constructed in blood, we sought to develop a next-generation clock optimized for prediction in cheek swabs, which are non-invasive and easy to collect. To do this, we collected MethylationEPIC data as well as lifestyle and health information from 8045 diverse adults. Using a novel simulated annealing approach that allowed us to incorporate lifestyle and health factors into training as well as a combination of CpG filtering, CpG clustering, and clock ensembling, we constructed CheekAge, an epigenetic aging clock that has a strong correlation with age, displays high test–retest reproducibility across replicates, and significantly associates with a plethora of lifestyle and health factors, such as BMI, smoking status, and alcohol intake. We validated CheekAge in an internal dataset and multiple publicly available datasets, including samples from patients with progeria or meningioma. In addition to exploring the underlying biology of the data and clock, we provide a free online tool that allows users to mine our methylomic data and predict epigenetic age. [ABSTRACT FROM AUTHOR]

Objectives: The project intends to create and evaluate oral fast-dissolving Ondansetron (ODN) films and explore how different plasticizers and polymers affect ondansetron release at varied doses. Materials and Methods: The solvent casting method was used to make the films. Complex formation and compatibility were evaluated using spectral and calorimetric methods to confirm. Utilising the core composite design, which included 13 different Ondansetron Fast-Dissolving Oral Films (OFDOFs) formulas, the produced Ondansetron Fast-Dissolving Oral Films (OFDOFs) were optimised. Using the Design Expert-v.11 software, the impacts of three variables, including HPMC K4M (X1), Carbopol 934 P (X2), and propylene glycol levels (X3), on two responses, Folding Endurance (FE) and Swelling Index (SI), were examined. Numerical optimisation increased the FE (Y1) and maximised the SI (Y2). Results: The statistical analysis findings showed that X1 greatly enhances Y1 and Y2. While X2 and X3 significantly prejudiced the responses optimistically. It was found that the best films were created at the midpoint concentration of both X1 and X2. Moreover, as X3 levels increased, the elasticity and FE also improved, in addition to the film's quality. Conclusion: The study concludes that the prepared buccal films of ODN exhibited great mechanical and physical qualities in addition to their other physicochemical assets. This dosage form is expected to offer a bioavailability benefit over conventional dosage forms due to its rapid onset of action and anticipated partial avoidance of pre-systemic metabolism. [ABSTRACT FROM AUTHOR]

Hydrogels are hydrophilic, three-dimensional, cross-linked polymers that absorb significant amounts of biological fluids or water. Hydrogels possess several favorable properties, including flexibility, stimulus-responsiveness, versatility, and structural composition. They can be categorized according to their sources, synthesis route, response to stimulus, and application. Controlling the cross-link density matrix and the hydrogels' attraction to water while they're swelling makes it easy to change their porous structure, which makes them ideal for drug delivery. Hydrogel in drug delivery can be achieved by various routes involving injectable, oral, buccal, vaginal, ocular, and transdermal administration routes. The hydrogel market is expected to grow from its 2019 valuation of USD 22.1 billion to USD 31.4 billion by 2027. Commercial hydrogels are helpful for various drug delivery applications, such as transdermal patches with controlled release characteristics, stimuli-responsive hydrogels for oral administration, and localized delivery via parenteral means. Here, we are mainly focused on the commercial hydrogel products used for drug delivery based on the described route of administration. [ABSTRACT FROM AUTHOR]

Background & Objective: The purpose of this study was to compare the effectiveness of Buccal, Vaginal, and Sublingual misoprostol for induction of labor in term pregnancy. Materials & Methods: The research was done as an RCT from 2017 to 2018. About 300 participants were randomly allocated to obtain 50 µg Buccal, 25 µg Vaginal, and 50 µg Sublingual misoprostol in Kosar Hospital, Qazvin, Iran. The maternal and fetal complications, Bishop score hour 1, and hour 6 were observed. Results: There were no differences between fetal complications (P>0.05) and maternal complications (P>0.05) among the three groups. Bishop score hour 1 (P = 0.146), Bishop Score hour 6 (P = 0.704), and total dose (P = 0.15) also were no differences among these groups. Our study found a difference between the three groups (P = 0.015) in achieving standard vaginal delivery within 24 hours, as Buccal, Sublingual and Vaginal groups were performed respectively. The use of Oxytocin in the Buccal group was higher than that of other groups (P = 0.022). Conclusion: This study found that there is no difference in terms of fetal complications and maternal complications in the three groups, but there was a significant difference in Oxytocin use and vaginal delivery within 24 h from the start of induction. [ABSTRACT FROM AUTHOR]

Feces of animals that forage on nectar and fruit, including many species of bats, often contain DNA that is low in quality and quantity. We developed an approach based on DNA from feces gathered passively to generate microsatellite data for individual lesser long-nosed bats (Leptonycteris yerbabuenae), which are important pollinators for columnar cacti and agave across much of Mexico and in the southwestern U.S. We collected feces from roosts near the U.S-Mexico border and developed a two-step amplification approach to characterize five highly polymorphic microsatellite loci from fecal DNA. Addition of a multiplex PCR step improved amplification success and conserved DNA extracts with a minimal increase in cost. In our initial screening of 433 samples, five focal loci distinguished individuals reliably, with a probability of identity (i.e., the probability of two unrelated individuals having the same microsatellite profile by chance) of 7.5E-09. Repeated analyses revealed a genotyping error rate < 2%. We explore the benefits and limits of our approach for population studies of lesser long-nosed bats and other nectivorous and frugivorous species that provide key ecosystem services and are often of conservation concern. [ABSTRACT FROM AUTHOR]

This study compared SARS-CoV-2 RNA loads at different anatomical sites, and the impact of self-swabbing and food intake. Adult symptomatic patients with SARS-CoV-2 or non-SARS-CoV-2 respiratory tract infection were included between 2021 and 2022. Patients performed a nasal and buccal swab before a professionally collected nasopharyngeal/oropharyngeal swab (NOPS). Buccal swabs were collected fasting and after breakfast in a subgroup of patients. SARS-CoV-2 RNA loads were determined by nucleic acid testing. Swabbing convenience was evaluated using a survey. The median age of 199 patients was 54 years (interquartile range 38–68); 42% were female and 52% tested positive for SARS-CoV-2. The majority of patients (70%) were hospitalized. The mean SARS-CoV-2 RNA load was 6.6 log10 copies/mL (standard deviation (SD), ±1.5), 5.6 log10 copies/mL (SD ± 1.9), and 3.4 log10 copies/mL (SD ± 1.9) in the professionally collected NOPS, and self-collected nasal and buccal swabs, respectively (p < 0.0001). Sensitivity was 96.1% (95% CI 90.4–98.9) and 75.3% (95% CI 63.9–81.8) for the nasal and buccal swabs, respectively. After food intake, SARS-CoV-2 RNA load decreased (p = 0.0006). Buccal swabbing was the preferred sampling procedure for the patients. In conclusion, NOPS yielded the highest SARS-CoV-2 RNA loads. Nasal self-swabbing emerged as a reliable alternative in contrast to buccal swabs. If buccal swabs are used, they should be performed before food intake. [ABSTRACT FROM AUTHOR]

Squamous cell carcinoma of the buccal mucosa has an aggressive nature. If cancers originating from the buccal mucosa invade adjacent anatomical structures, surgical tumor resection becomes more challenging. The present case describes the surgical management of a 65-year-old woman with persistent ulceration of the mucosal membrane due to tobacco chewing habit for the past 30 years and a mouth-opening limitation of 10 mm. Radiological investigations revealed a buccal mucosa tumor that had invaded the retroantral space upward with involvement of the anterior border of the masseter muscle by the lateral part of the tumor. In this report, we present the surgical approach to access the masticator space behind the maxillary sinus. [ABSTRACT FROM AUTHOR]

Over the years, research regarding the Zika virus has been steadily increasing. Early immunization for ZIKV is a priority for preventing complications such as microencephaly and Guillain–Barré syndrome (GBS). Unlike traditional vaccination approaches, oral dissolving films (ODFs) or mucoadhesive film technology is an emerging, exciting concept that can be used in the field of pharmaceuticals for vaccine design and formulation development. This attractive and novel method can help patients who suffer from dysphagia as a complication of a disease or syndrome. In this study, we investigated a microparticulate Zika vaccine administered via the buccal route with the help of thin films or oral dissolving films (ODFs) with a prime dose and two booster doses two weeks apart. In vitro, the ODFs displayed excellent physiochemical properties, indicating that the films were good carriers for vaccine microparticles and biocompatible with the buccal mucosa. In vivo results revealed robust humoral (IgG, subtypes IgG1 and IgG2a) and T-cell responses (CD4+/CD8+) for ZIKV-specific immunity. Both the Zika MP vaccine and the adjuvanted Zika MP vaccine affected memory (CD45R/CD27) and intracellular cytokine (TNF-α and IL-6) expression. In this study, ZIKV vaccination via the buccal route with the aid of ODFs demonstrated great promise for the development of pain-free vaccines for infectious diseases.

The most popular and convenient route for the drug administration is oral route with some merits, demerits, and limitations with some paediatric and geriatrics patients as they face difficulty to take solid dosage forms like capsules or compressed tablets that results in improper dosing due to vomit or removal of drug from buccal cavity. Oral fast dissolving films are a good alternate to overcome these difficulties and to deliver the drugs with any these age groups. Fast dissolving oral films are capable of delivering the drug locally and systemically by absorption through buccal mucosa, sublingual route, and oesophagus and finally form the stomach. Oral fast dissolving films offers a convenient way of dosing medication, not only for special groups of the population like paediatric, geriatric, confined to bed patients, patients with mental problems, but also to the general population. The present article review is focused on composition, preparation methods, evaluation and advancements of orally fast dissolving oral films.

Hydrogels are hydrophilic, three-dimensional, cross-linked polymers that absorb significant amounts of biological fluids or water. Hydrogels possess several favorable properties, including flexibility, stimulus-responsiveness, versatility, and structural composition. They can be categorized according to their sources, synthesis route, response to stimulus, and application. Controlling the cross-link density matrix and the hydrogels’ attraction to water while they’re swelling makes it easy to change their porous structure, which makes them ideal for drug delivery. Hydrogel in drug delivery can be achieved by various routes involving injectable, oral, buccal, vaginal, ocular, and transdermal administration routes. The hydrogel market is expected to grow from its 2019 valuation of USD 22.1 billion to USD 31.4 billion by 2027. Commercial hydrogels are helpful for various drug delivery applications, such as transdermal patches with controlled release characteristics, stimuli-responsive hydrogels for oral administration, and localized delivery via parenteral means. Here, we are mainly focused on the commercial hydrogel products used for drug delivery based on the described route of administration.

Developing mucoadhesive buccal films loaded with metoclopramide for the treatment of migraine-associated vomiting. Buccal films were prepared using the solvent casting method. Several tests were conducted, including measurement of film weight, thickness, drug content, moisture uptake, swelling index, and DSC analysis. The bioadhesion properties were also assessed. Furthermore, in vitro release profiles and in human bioavailability were studied. The developed films were transparent, homogeneous, and easy to remove. Film weight and thickness increased with higher drug content. The drug entrapment exceeded 90%. Film weight increased with moisture uptake, and DSC analysis indicated the absence of drug crystallinity. Bioadhesion properties and swelling index decreased with increasing drug content. In vitro release demonstrated that drug release depended on the drug-polymer ratio. The in vivo study showed significant improvements in Tmax (from 1.21 ± 0.33 to 0.50 ± 0.0) and Cmax (from 45.29 ± 14.66 to 63.27 ± 24.85) compared to conventional tablets. The prepared mucoadhesive buccal films exhibited the desired characteristics and demonstrated enhanced drug absorption, evidenced by the significantly reduced Tmax and increased Cmax compared to conventional tablets. The results indicate the successful achievement of the study objectives in selecting and designing an effective pharmaceutical dosage form. as cm2 [ABSTRACT FROM AUTHOR]

Abstract Epithelial cells are known to produce mediators which can influence the behaviour of neighbouring immune cells. Although the oral mucosa has gained increased interest as a route to induce allergy desensitisation and mucosal pathogen immunisation in dogs, there is only limited knowledge on the factors which impact mediator secretion by canine oral epithelial cells. The study’s objective was to enlarge the knowledge on the stimuli that can influence the secretion of some pro- and anti-inflammatory cytokines and the chemokine CXCL8 by canine buccal epithelial cells. To investigate this, buccal epithelial cells were isolated from a biopsy of a dog and immortalised by lentiviral transduction of the SV40 large T antigen. The cells were stained with a CD49f and cytokeratin 3 antibody to confirm their epithelial origin. Cells were incubated with allergen extracts, Toll-like receptor ligands (TLRL), recombinant cytokines and vitamin A and D metabolites. Subsequently, the secretion of the cytokines interleukin (IL)-4, IL-6, IL-10, IL-17A, IFN-γ, TGF-β1 and the chemokine CXCL8 was assayed by ELISA. Immortalised canine buccal epithelial cells stained positive for CD49f but not for cytokeratin 3. The cells produced detectable amounts of CXCL8 and TGF-β1. A Dermatophagoides farinae extract, an Alternaria alternata extract, Pam3CSK4, heat-killed Listeria monocytogenes, FSL-1, flagellin and canine recombinant IL-17A significantly increased CXCL8 secretion, while the vitamin D metabolite calcitriol significantly suppressed the production of this chemokine. This study showed that certain allergens, TLRL, IL-17A and calcitriol modulate CXCL8 secretion in a cell line of canine buccal epithelial cells.

BACKGROUND Genomic medicine has great potential for diagnoses, disease prediction, and targeted treatment. Buccal swabs are a suitable non-invasive method for neonates to obtain DNA samples. Due to Indonesia's geographical conditions, samples require a prolonged time to reach the genetic laboratory. This study aimed to compare the DNA quality of buccal swabs in neonates between immediate and after-storage extraction. METHODS This study was part of a study about the profile of human milk oligosaccharide and FUT2 genotype in Indonesian mother-infant dyads consisting of 20 neonates. 1 swab stick for each participant was taken using a standardized buccal swabbing protocol and divided into 2 isovolume aliquots, which were grouped into the immediate (extraction was performed within 3 days after sampling) and storage groups (extraction was performed on the 14th day after storage in 4°C). DNA yield and purity A260/280 ratio were measured by spectrophotometry. The PCR amplification and Sanger sequencing were performed to validate the DNA isolate quality for downstream application. RESULTS The DNA yield for the immediate group was similar compared with the storage group (9.50 [4.89] versus 9.10 [5.05] µg), p = 0.659, as well as DNA purity A260/280 (1.58 [0.24] versus 1.56 [0.28]), p = 0.785. PCR and sequencing of FUT2 results also showed similar quality between both groups. CONCLUSIONS The similar DNA quality and sequencing results between immediate and storage extraction confirmed that buccal swabs could be stored for 2 weeks, allowing ample time for sample shipping from remote areas to the laboratory. [ABSTRACT FROM AUTHOR]

Pleomorphic adenoma is a benign salivary gland tumor that is frequently seen in the parotid gland. It is very rare in minor salivary glands. The case we present is a case of pleomorphic adenoma originating from the buccal minor salivary gland, which is very rare in this localization. Keywords: Pleomorphic adenoma; Minor salivary gland; Buccal; Salivary gland tumors.

We report on remains of the buccal apparatus and possible associated structures for the Late Cretaceous ammonite Maorites seymourianus from the López de Bertodano Formation (Antarctic Peninsula). This is the first description of these structures for the family Kossmaticeratidae. Further, we discuss the most likely taphonomic processes taking place that allowed this exceptional preservation. Reflectance Transformation Imaging (RTI) technique was employed in this work to better document the faint structures. We briefly provide a review of this method and its potential importance for paleontological studies because it seems that this powerful technique has been largely overlooked by paleontologists.

This study focuses on developing and evaluating mucoadhesive buccal tablets containing Torsemide, utilizing HPMC K-100, Xanthan Gum, and chitosan polymers at varying concentrations. Physicochemical parameters were wellmaintained according to Indian Pharmacopeia standards. Swelling indices ranged from 201.75% to 241.85% over 8 hours, with suitable tablet pH (6.8-6.9) for buccal administration. Mucoadhesive strengths (18.00-27.33 g) varied with polymer concentration. Batch 6 displayed sustained Torsemide release (73.73% at 8 h), supported by optimized swelling index and mucoadhesive strength. Formulation F6, combining Xanthan Gum and Chitosan, emerged as optimal. Dissolution followed zero-order kinetics, fitting the Korsmeyer-Peppas model, indicating a diffusion-based, non-Fickian mechanism. No Torsemide-excipient interactions were observed through Fourier Transform Infrared Spectroscopy. This study successfully designed controlled-release mucoadhesive buccal tablets, influenced by polymer behavior and concentration, advancing drug delivery systems. [ABSTRACT FROM AUTHOR]

Copyright of Al-Mustansiriyah Journal for Pharmaceutical Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Environmental exposures to chemicals can disrupt gene expression, and the effects could be mediated by methylation. This investigation focused on methylation of genes associated with exposure to metals. Mother–child pairs from three locations in Montana were recruited, and buccal cells were collected for genome-wide methylation assay. Four pairs were from Butte, where there is mining and a Superfund site, four pairs were from Anaconda with a Superfund site, and four pairs were from Missoula with neither a mine nor a Superfund site. Principal component analysis, linear mixed models, hierarchical clustering and heatmap, and gene set enrichment analysis were used to visualize the profiles, identify the top associated methylation loci, and investigate the involved pathways. Distinctly higher or lower methylation in samples from Butte were found at the top differentially methylated loci. The 200 genes harboring the most hypermethylated loci were significantly enriched in genes involved in actin cytoskeleton regulation, ABC transporters, leukocyte transendothelial migration, focal adhesion, and adherens junction, which plays a role in pathogenesis of disease, including autism spectrum disorders. This study lays a foundation for inquiry about genetic changes associated with environmental exposure to metals for people living in proximity to Superfund and open pit mining. [ABSTRACT FROM AUTHOR]

Abstract Background The microbiome could trigger inflammation leading to epigenetic changes and is involved in the pathophysiology of eye diseases; however, its effect on uveitic glaucoma (UG) has not been fully investigated. This study analysed the differences in eyelid and buccal microbiomes in patients with UG using next-generation sequencing. Methods The eyelid and buccal specimens of 34 UG and 25 control patients were collected. The taxonomic composition of the microbiome was obtained via 16S ribosomal DNA sequencing. Diversity and differential gene expression analyses (DEG) determined taxon differences between the microbiomes of UG and control groups. Results In both the eyelid and buccal microbiomes, alpha-diversity was lower in UG patients than controls, while beta-diversity in patients with UG was higher than in controls. DEG analysis of the eyelid microbiome revealed various taxa differences, including enrichment of Paenibacillus and Dermacoccus (p-value, 1.31e−6 and 1.55e−7, respectively) and depletion of Morganella and Lactococcus (p-value, 6.26e−12 and 2.55e−6, respectively) in patients with UG. In the buccal microbiome, taxa such as Lactococcus was significantly depleted (p-value, 1.31e−17), whereas Faecalibacterium was enriched in patients with UG (p-value, 6.12e−8). Conclusions The eyelid and buccal microbiomes in patients with UG differ from controls, which raises concerns surrounding environmental influences on the pathogenesis of UG. The reduced Lactococcus in the eyelid and buccal area suggest that microbiota dysbiosis is associated with UG.

Saliva and buccal samples are popular for epigenome wide association studies (EWAS) due to their ease of collection compared and their ability to sample a different cell lineage compared to blood. As these samples contain a mix of white blood cells and buccal epithelial cells that can vary within a population, this cellular heterogeneity may confound EWAS. This has been addressed by including cellular heterogeneity obtained through cytology at the time of collection or by using cellular deconvolution algorithms built on epigenetic data from specific cell types. However, to our knowledge, the two methods have not yet been compared. Here we show that the two methods are highly correlated in saliva and buccal samples (R = 0.84, P

Abstract Background Breast carcinoma is a common tumor in women, but it rarely metastasizes to the oral region. Furthermore, metastases to the oral region occur mainly to the maxillary and mandibular bone and rarely to soft tissue. Case presentation We describe a case of breast cancer metastasis to the buccal area. Examination of the right buccal mass of a 66-year-old Japanese woman was suggestive of breast cancer metastasis, and a breast lump was detected. Since receiving hormone-based treatment, the patient has survived more than 5 years and is now in remission. Conclusions An oral metastatic lesion may be the first sign of breast carcinoma; oral surgeons should be aware of this possibility.

Gastrointestinal tract metagenomic sequencing has unveiled rumen microbiota influences on animal production and efficiency; however, ability to analyze the rumen non-invasively, amply, and cost-effectively is restricted, as specialized equipment is required to obtain ruminal samples. This study aimed to employ buccal swabs as a substitute for rumen sampling by exploiting rumination. Ruminal fluid contents and buccal swabs were collected from registered Angus bulls (n = 541) produced by five commercial feed testing centers located in Georgia, Iowa, and Montana. DNA was extracted and the 16S rRNA gene was sequenced to determine differences and similarities in microbial composition between the two sample types. Sequencing data were analyzed for taxonomic classification, and calculation of alpha and beta diversity indices. Microbial evenness (Pielou’s index), richness (number of amplicon sequence variants), and diversity (Shannon index) were all significantly greater (P < 0.01) in the rumen, indicating distinct differences in alpha diversity between sample type. Beta diversity analysis (unweighted UniFrac distances) revealed the taxonomic profile of each sample type was also explicitly different (P < 0.01). Both sample types were dominated by genera that are common members of each environment: Streptococcus in oral, and Prevotella in ruminal samples, and only three of the 30 most abundant genera for each sample type were shared in both environments. At the species level, only 33.1% out of 4,323 total microbial species occurred in both rumen and oral environments. Collectively, these results suggest substantial differences between oral and ruminal compartments, indicating that using the oral microbiome as a substitute for the rumen microbiome may not be a feasible strategy. Further research should be conducted to control for factors that could impact oral to rumen reflection, such as time since last feeding, rumination patterns, and water intake. [ABSTRACT FROM AUTHOR]

Introduction: Dermoid and epidermoid cysts commonly termed as “Dermoids” are known to be developmental benign swellings that possibly occur as a result of traumatic implantation of epithelium or entrapment of epithelial remnants during embryonic fusion. The occurrence is rare (about 7%) in the head-and-neck region and they represent

Epigenome-wide association studies (EWAS) assessing the link between DNA methylation (DNAm) and phenotypes related to structural brain measures, cognitive function, and neurodegenerative diseases are becoming increasingly more popular. Due to the inaccessibility of brain tissue in humans, several studies use peripheral tissues such as blood, buccal swabs, and saliva as surrogates. To aid the functional interpretation of EWAS findings in such settings, there is a need to assess the correlation of DNAm variability across tissues in the same individuals. In this study, we performed a correlation analysis between DNAm data of a total of n = 120 matched post-mortem buccal and prefrontal cortex samples. We identified nearly 25,000 (3% of approximately 730,000) cytosine-phosphate-guanine (CpG) sites showing significant (false discovery rate q < 0.05) correlations between buccal and PFC samples. Correlated CpG sites showed a preponderance to being located in promoter regions and showed a significant enrichment of being determined by genetic factors, i.e. methylation quantitative trait loci (mQTL), based on buccal and dorsolateral prefrontal cortex mQTL databases. Our novel buccal–brain DNAm correlation map will provide a valuable resource for future EWAS using buccal samples for studying DNAm effects on phenotypes relating to the brain. All correlation results are made freely available to the public online. [ABSTRACT FROM AUTHOR]

To determine the rate of positivity of immunofluorescence studies in buccal biopsies in patients with cicatrizing conjunctivitis undergoing workup for ocular mucous membrane pemphigoid (MMP)/ocular cicatricial pemphigoid (OCP). Retrospective cohort review. Forty-one patients with cicatrizing conjunctivitis undergoing workup for OCP. A retrospective chart review of direct immunofluorescence (DIF) studies in buccal mucosal biopsies was performed. The primary outcome measure was the rate of positivity of direct and indirect immunofluorescence studies on buccal mucosal biopsies. Twenty-two patients (54%) had a positive buccal mucosal biopsy; 64% of patients (14/22) demonstrated +DIF on initial biopsy and an additional 36% of patients (8/22) on the second biopsy. Eighteen patients underwent conjunctival biopsy. In the 6 patients with a negative conjunctival biopsy, 4 (67%) had a positive buccal biopsy. Buccal mucosal immunofluorescence studies may be positive in patients with OCP even in the absence of extraocular disease. Buccal mucosal biopsy may be considered as an alternative to or attempted before conjunctival biopsy for the diagnosis of OCP, particularly in patients in whom conjunctival biopsy may be difficult or imminently visually threatening. [ABSTRACT FROM AUTHOR]

Epithelial cells are known to produce mediators which can influence the behaviour of neighbouring immune cells. Although the oral mucosa has gained increased interest as a route to induce allergy desensitisation and mucosal pathogen immunisation in dogs, there is only limited knowledge on the factors which impact mediator secretion by canine oral epithelial cells. The study's objective was to enlarge the knowledge on the stimuli that can influence the secretion of some pro- and anti-inflammatory cytokines and the chemokine CXCL8 by canine buccal epithelial cells. To investigate this, buccal epithelial cells were isolated from a biopsy of a dog and immortalised by lentiviral transduction of the SV40 large T antigen. The cells were stained with a CD49f and cytokeratin 3 antibody to confirm their epithelial origin. Cells were incubated with allergen extracts, Toll-like receptor ligands (TLRL), recombinant cytokines and vitamin A and D metabolites. Subsequently, the secretion of the cytokines interleukin (IL)-4, IL-6, IL-10, IL-17A, IFN-γ, TGF-β1 and the chemokine CXCL8 was assayed by ELISA. Immortalised canine buccal epithelial cells stained positive for CD49f but not for cytokeratin 3. The cells produced detectable amounts of CXCL8 and TGF-β1. A Dermatophagoides farinae extract, an Alternaria alternata extract, Pam3CSK4, heat-killed Listeria monocytogenes, FSL-1, flagellin and canine recombinant IL-17A significantly increased CXCL8 secretion, while the vitamin D metabolite calcitriol significantly suppressed the production of this chemokine. This study showed that certain allergens, TLRL, IL-17A and calcitriol modulate CXCL8 secretion in a cell line of canine buccal epithelial cells. [ABSTRACT FROM AUTHOR]

Introduction: Dermoid and epidermoid cysts commonly termed as "Dermoids" are known to be developmental benign swellings that possibly occur as a result of traumatic implantation of epithelium or entrapment of epithelial remnants during embryonic fusion. The occurrence is rare (about 7%) in the head-and-neck region and they represent <1.6% of all cysts of the oral cavity. Patients and Methods: A retrospective study was done on 12 histopathologically proven cases of epidermoid and dermoid cysts of the maxillofacial region that were treated in Shyam Shah Medical College, Rewa, Madhya Pradesh, India, from January 2013 to December 2019. The cases were evaluated for clinical presentation, demographic characteristics, and treatment performed. Results: Out of a total of 12 cases that were included in this study, 10 cases were diagnosed as epidermoid and 2 cases as true dermoid cysts. The mean age of occurrence was 31.66 ± 9.97 years. Male predominance was seen with a male-to-female ratio of 1.4:1. The floor of the mouth was the most commonly involved site in ten (83.34%) cases. Sublingual cysts were seen in five (41.67%) cases, combined sublingual--submandibular involvement in three (25%) cases, and midline floor of the mouth cyst in two (16.67%) cases. All the cases were treated by surgical enucleation, and no recurrence or malignant transformation was reported in any case at a minimum follow-up of 2 years. Conclusion: Based on the findings of this retrospective study, it is suggested that these lesions are very rare in the maxillofacial region and pose a diagnostic challenge. However, fine-needle aspiration cytology, ultrasound imaging, computerized tomography, and magnetic resonance imaging techniques can be relied upon for precise treatment planning. Surgical enucleation of these lesions is the preferred treatment modality. [ABSTRACT FROM AUTHOR]

Although the treatment of epilepsy primarily focuses on prevention, recurrent seizures are unfortunately an ongoing reality, particularly in people with epilepsy who live with chronic refractory seizures. Rescue medications are agents which can be administered in urgent/emergent seizure episodes such as seizure clusters or prolonged seizures with the goal of terminating seizure activity, preventing morbidity, and decreasing the risk of further seizures. This review first discusses clinical opportunities for rescue medications, with particular attention focused on seizure clusters and prolonged seizures, including their epidemiology, risk factors, and associated morbidity. Current rescue medications, their indications, efficacy, and adverse effects are discussed. We then discuss rescue medications and formulations which are currently under development, concentrating on practical aspects relevant for clinical care. Rescue medications should be considered for all people with epilepsy with ongoing seizures. Recent rescue medications including intranasal formulations provide considerable advantages. New rescue medications are being developed which may expand opportunities for effective treatment. In the future, combining rescue medications with seizure detection and seizure prediction technologies should further expand opportunities for use and should reduce the morbidity of seizures and provide increased comfort, control, and quality of life for people living with epilepsy. [ABSTRACT FROM AUTHOR]

Objectives: This study analyzes and compares dental microwear textures on occlusal and buccal surfaces from the same tooth to determine if using these surfaces in tandem can provide complementary data for dietary reconstructions. Materials and methods: Cova de la Guineu is a Late Neolithic‐Chalcolithic burial cave located in Font‐Rubí (Barcelona, Spain). The study sample consisted of 69 individuals represented by the lower left second molar. However, only 27 individuals had well‐preserved surfaces. Dental Microwear Texture Analysis was performed on both surfaces using a Sensofar® S Neox white‐light confocal profilometer following standard procedures. Toothfrax® software was used to quantify surface complexity and anisotropy. Results: The bootstrap resampling analysis shows significant differences in complexity and anisotropy between surfaces. There is no correlation between surfaces for complexity or anisotropy. The occlusal surfaces exhibit high complexities and low anisotropies, which are similar to values observed in Late Neolithic farming groups from Belgium. Discussion: The combination of occlusal and buccal microwear signatures provided important inferences regarding the studied sample. First, occlusal complexity and anisotropy values indicate an abrasive dietary regime. Second, we propose that the higher anisotropy values found on buccal surfaces, compared to those on the occlusal ones, are attributed to the specific mechanisms of microwear formation for each surface. Finally, combining both surfaces may increase the number of samples suitable for analysis. Further studies, with greater intergroup sampling, will help to understand how buccal microwear reflects or complements DMTA signatures on the occlusal surfaces. [ABSTRACT FROM AUTHOR]

Background: The microbiome could trigger inflammation leading to epigenetic changes and is involved in the pathophysiology of eye diseases; however, its effect on uveitic glaucoma (UG) has not been fully investigated. This study analysed the differences in eyelid and buccal microbiomes in patients with UG using next-generation sequencing.Methods: The eyelid and buccal specimens of 34 UG and 25 control patients were collected. The taxonomic composition of the microbiome was obtained via 16S ribosomal DNA sequencing. Diversity and differential gene expression analyses (DEG) determined taxon differences between the microbiomes of UG and control groups.Results: In both the eyelid and buccal microbiomes, alpha-diversity was lower in UG patients than controls, while beta-diversity in patients with UG was higher than in controls. DEG analysis of the eyelid microbiome revealed various taxa differences, including enrichment of Paenibacillus and Dermacoccus (p-value, 1.31e-6 and 1.55e-7, respectively) and depletion of Morganella and Lactococcus (p-value, 6.26e-12 and 2.55e-6, respectively) in patients with UG. In the buccal microbiome, taxa such as Lactococcus was significantly depleted (p-value, 1.31e-17), whereas Faecalibacterium was enriched in patients with UG (p-value, 6.12e-8).Conclusions: The eyelid and buccal microbiomes in patients with UG differ from controls, which raises concerns surrounding environmental influences on the pathogenesis of UG. The reduced Lactococcus in the eyelid and buccal area suggest that microbiota dysbiosis is associated with UG. [ABSTRACT FROM AUTHOR]

The development of pediatric-specific dose forms is particularly difficult due to a variety of factors relating to pediatric population differences from adult populations. The buccal dosage form is considered a good alternative to oral dosage form if the latter cannot be used in pediatric patients. Both oral and buccal dosage formulations uphold great application qualities for pediatric patients. This review sheds light on both oral and buccal, as they are the most convenient dosage forms for pediatrics. The use of adult drugs to treat children is a legislation concern, as it may result in incorrect dose, safety, and efficacy. The Best Pharmaceuticals for Children Act (BPCA) and the Pediatric Research Equity Act (PREA) are two key pieces of legislation that encourage and regulate pediatric medication research. Both contribute to a well-balanced approach to emphasizing critical safety and efficacy warnings for the of medications within pediatric populations. These contributions are what enable companies to continue making significant investments in pediatric drug developments. Despite the importance of investigating medicines for children, there is still a demand for pediatric-specific formulations and dosage forms. Many formulations and dosage forms can be designed, among which the buccal drug delivery seems a good modality for pediatric-friendly dosage forms. The main issues associated with these pediatric dosage forms development, particularly clinical and physiological factors, are discussed in this review. In addition, formulation developments and regulatory expectations are highlighted. In turn, suggestions are made to potentially improve future pediatric formulation development. [ABSTRACT FROM AUTHOR]

Background: Breast carcinoma is a common tumor in women, but it rarely metastasizes to the oral region. Furthermore, metastases to the oral region occur mainly to the maxillary and mandibular bone and rarely to soft tissue.Case Presentation: We describe a case of breast cancer metastasis to the buccal area. Examination of the right buccal mass of a 66-year-old Japanese woman was suggestive of breast cancer metastasis, and a breast lump was detected. Since receiving hormone-based treatment, the patient has survived more than 5 years and is now in remission.Conclusions: An oral metastatic lesion may be the first sign of breast carcinoma; oral surgeons should be aware of this possibility. [ABSTRACT FROM AUTHOR]

Saliva and buccal samples are popular for epigenome wide association studies (EWAS) due to their ease of collection compared and their ability to sample a different cell lineage compared to blood. As these samples contain a mix of white blood cells and buccal epithelial cells that can vary within a population, this cellular heterogeneity may confound EWAS. This has been addressed by including cellular heterogeneity obtained through cytology at the time of collection or by using cellular deconvolution algorithms built on epigenetic data from specific cell types. However, to our knowledge, the two methods have not yet been compared. Here we show that the two methods are highly correlated in saliva and buccal samples (R = 0.84, P < 0.0001) by comparing data generated from cytological staining and Infinium MethylationEPIC arrays and the EpiDISH deconvolution algorithm from buccal and saliva samples collected from twenty adults. In addition, by using an expanded dataset from both sample types, we confirmed our previous finding that age has strong, non-linear negative correlation with epithelial cell proportion in both sample types. However, children and adults showed a large within-population variation in cellular heterogeneity. Our results validate the use of the EpiDISH algorithm in estimating the effect of cellular heterogeneity in EWAS and showed DNA methylation generally underestimates the epithelial cell content obtained from cytology. [ABSTRACT FROM AUTHOR]

Background: Repaglinide (REP) is an antihyperglycemic drug having low bioavailability due to its extensive first-pass metabolism. The present study aimed to develop and pharmacokinetic investigte the thiolated chitosan (TC) based buccal tablets of REP for improved bioavailability. Methods: TC was prepared by conjugation of L-cysteine with chitosan. The amount of free thiol groups present in TC was determined by UV-spectrophotometry using Ellman’s reagent. TC based REP buccal tablets were prepared by two layers co-compression method and characterized for in vitro and ex vivo parameters. The in vivo performance of prepared REP buccal tablets was assessed by the pharmacokinetic study in New Zealand white rabbits. Results: The prepared TC resulted in 87%w/w yield with 52.3±3.2 μM free thiol functional groups per 10 mg of TC. The prepared formulations have good flow nature and compressibility, acceptable thickness (2.02 to 2.1 mm), weight (60.11 to 61.06 mg), surface pH (6.59 to 6.81) and drug content (98.92 to 101.08 %w/w). The presence of TC significantly improved the mucoadhesion strength, sustained the in vitro release and enhanced the ex vivo permeation of REP buccal tablets. The shelf life of REP buccal tablets was found to be 15.07 months in accelerated storage conditions. The prepared REP buccal tablets (V5) have area under the curve (712.22±15.91 ng/mL/h) and mean residence time (4.66±0.25 h) was 1.89 and 1.83 folds higher than oral bolus respectively. Conclusion: TC based REP buccal tablets are capable of controlled transbuccal release of REP for a prolonged time and have better bioavailability than oral bolus.

Objective Through a pain study of buccal gingival mucosa sensitivity of the mandible, the corresponding sensitive area of pain was determined, which provided the basis for reducing the pain and discomfort of oral diagnosis and treatment. Methods 400 patients with mandibular tooth extraction in the outpatient department of stomatology were selected. During tooth extraction, articaine epinephrine injection was used for infiltration anesthesia. The injection needle size was 0.3 mm × 21 mm, and the injection site was about 5 mm away from the buccal gingival margin. The pain degree of the patients was recorded. The data were statistically analyzed using the modified International pain classification method. Results Among the 400 patients who underwent mandible extraction, 75% (300 patients) graded their pain from painless to moderate, and 25% (100 patients) reported moderate to severe and severe pain. Of those in the moderate to severe and severe groups, 50% and 42% reported pain in the central and lateral incisors, respectively, and 38% were in the canine group. When comparing the moderate to severe and the severe groups, 16% and 10% were in the bicuspid group, 16% and 12% and 16% were in the molar group, respectively . There were significant differences in the pain sensitivity of different teeth positions (χ2=54.203, P < 0.001). The proportion of moderate to severe and severe pain in the anterior teeth group was higher than it was in the posterior teeth group (χ2=55.555, P < 0.001). There were significant differences in the pain sensitivity of different ages (χ2=96.501, P=0.000), and there was a positive correlation between pain and age (r=0.465, P < 0.001). The proportion of women with at least a moderate degree of pain was higher than that of men (χ2=12.298, P=0.031). Conclusion The sensitivity of the buccal gingival mucosa to pain is different in different positions of the mandible. The sensitivity of the anterior gingiva is higher than that of the posterior gingiva. Age is positively correlated with the degree of pain. Further, compared with men, women are more sensitive to pain.