Mucositis en pacientes portadores de cáncer de cabeza y cuello sometidos a radioquimioterapia

The objective of present study was to classify oral mucositis according to the Common Toxicity Criterion (CTC) international parameters in head and neck tumor patients simultaneously treated with radio and chemotherapy, and characterize a patient profile in our area, observing the individuals' habits, tumor characteristics, treatment protocol and acute reaction intensity. Fifty patients undergoing simultaneous 66 to 70 Gy megavoltage radiotherapy and cisplatin/carboplatin chemotherapy were evaluated in this study. Weekly evaluations of the degree of mucositis were perfoemed according to CTC, a four-degree ordinal scale; 36% of all patients and 100% of those with diabetes discontinued treatment due to mucositis, showing that this pathology contributes to the severity of mucositis.El trabajo objetivó clasificar el grado de Mucositis oral de acuerdo a parámetros internacionales del CTC en pacientes portadores de tumores de cabeza y cuello sometidos a radioterapia y quimioterapia concomitantes, y caracterizar un perfil de pacientes en nuestro medio, verificando hábitos de los individuos, características del tumor, protocolo de tratamiento e intensidad de esta reacción aguda. Fueron evaluados 50 pacientes sometidos a radioterapia en megavoltaje con dosis entre 66 y 70 G y quimioterapia con cisplatino o carboplatino concomitante. Se evaluó semanalmente el grado de Mucositis según el Common Toxicity Criterio - CTC, una escala ordinal que presenta cuatro grados. Se observó interrupción del tratamiento por Mucositis en 36% del total de pacientes y en 100% de los pacientes diabéticos, lo que nos permite verificar que dicha patología potencia la gravedad de la mucositis.O objetivo do presente trabalho é classificar o grau de mucosite oral de acordo com os parâmetros internacionais do Common Toxicity Criterion (CTC) em pacientes portadores de tumor de cabeça e pescoço submetidos à radioterapia e quimioterapia concomitantes, e caracterizar um perfil dos pacientes em nosso meio, verificando os hábitos dos indivíduos, as características do tumor, o protocolo de tratamento e a intensidade desta reação aguda. Neste estudo foram avaliados 50 pacientes, submetidos à radioterapia em megavoltagem com doses entre 66 a 70 Gy e quimioterapia com cisplatina ou carboplatina concomitante. Semanalmente foi avaliado o grau de mucosite de acordo com o CTC, uma escala ordinal que apresenta 4 graus. Observou-se interrupção do tratamento por mucosite em 36% do total de pacientes e em 100% dos pacientes diabéticos, o que nos permitiu verificar que esta patologia contribui para a gravidade da mucosite.Universidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Departamento de Oncologia Programa de Pós-Graduação em RadioterapiaUniversidade Federal de São Paulo (UNIFESP) Departamento de Oncologia Setor de RadioterapiaUniversidade Federal de São Paulo (UNIFESP) Departamento de Oncologia Laboratório de Radioterapia ExperimentalUNIFESP, Depto. de Oncologia Programa de Pós-Graduação em RadioterapiaUNIFESP, Depto. de Oncologia Setor de RadioterapiaUNIFESP, Depto. de Oncologia Laboratório de Radioterapia ExperimentalSciEL

Validity and reliability of the Italian version of the Oral Assessment Guide

Mucositis is a frequent side-effect of chemotherapy and radiotherapy. Assessment of oral cavity is important to detect alterations in the mouth and plan appropriate interventions. A reliable tool can help to have a better assessment of mucositis and a major knowledge about this phenomenon. Since no valid and reliable tool for the assessment of mucositis is still available in Italy, the aim of this study was to establish the validity and reliability of the Italian version of the Oral Assessment Guide (OAG). A panel of health care experts established the content validity of the tool both for the items and the descriptors. To establish the reliability of the tool, a sample of 14 inpatients with haematological diseases were recruited. Couples of dental hygienists separately performed 60 pairs of assessments (for a total of 120 assessments) on the sample. The Italian version of OAG was found to have an acceptable Content Validity Index (CVI) for items and related descriptors ranging between 0.67 and 1. Cronbach’s alpha was 0.84, agreement of assessment ranged between 0.87 and 0.65 with Cohen’s Kappa coefficient ranging from good to very good. This study showed that the Italian version of the OAG has good psychometric properties of validity and reliability to assess mucositis in patients undergoing chemotherapy. This tool will have a great importance to carry out future research in Italy aimed to improve the patient's outcomes particularly in terms of functional ability and quality of life

Efficacy of a Solution Composed by Verbascoside, Polyvinylpyrrolidone (PVP) and Sodium Hyaluronate in the Treatment of Chemotherapy-induced Oral Mucositis in Children With Acute Lymphoblastic Leukemia

Summary: The aim of this study was to assess the efficacy of a solution composed by verbascoside, polyvinylpyrrolidone, and sodium hyaluronate (Mucosyte) in the treatment of chemotherapy- induced oral mucositi (OM). Patients between 5 and 18 years receiving chemotherapy for acute lymphoblastic leukemia and with OM grade 1 or 2 were randomized in group A (treated with Mucosyte, 3 mouthwashes/d per 8d) and group B (treated with placebo, ie, an inert water-based solution, 3 mouthwashes/d per 8 d). The OM scoring was performed at day 1 (diagnosis of OM- T0), after 3 days of treatment (T1), and at day 8 (T2). Pain was evaluated through the visual analog scale with the same timing of OM measurement. A total of 56 patients were included (28 patients per group). Group A experienced a statistically significant decline of OM at T2 (P=0.0038); a statistically significant difference in pain reduction between 2 groups both at T1 and at T2 (P < 0.005) was observed. The use of Mucosyte mouthwashes in children with chemotherapy-induced OM may be recommended as supportive therapy

Stato dell'arte sul mantenimento implantare; nuovi approcci

L’implantologia orale osteointegrata negli ultimi 25 anni, ha rinnovato rdicalmente la pratica odontoiatrica nel campo delle riabilitazioni protesiche. Gli impianti dentali offrono nuove possibilità di trattamento per le edentulie , sia nel caso delle sostituzioni di un dente singolo sia nei casi di edentulia parziale che totale, rappresentando oggi una valida alternativa alla protesi fissa tradizionale. Inoltre nelle edentulie totali la riabilitazione con protesi implantare rappresenta una valida alternativa per protesi più stabili con valida integrazione funzionale. Un’attenta selezione dei pazienti, una programmazione del trattamento riabilitativo implantoprotesico con procedure chirurgiche corrette e protesicamente guidate, l’introduzione alle procedure di rigenerazione ossea, e le tecniche chirurgiche atte al rialzo di seno, permettono l’inserimento di impianti con sempre maggiori garanzie di successo anche in pazienti con volumi ossei considerati prima inadeguati. Recenti studi a lungo termine hanno enfatizzato le alte percentuali di successo raggiunte dalle tecniche di osteointegrazione implantare; si riportano percentuali di successo dell’80/90% a 5-10 aa nel mascellare superiore, percentuali del 92% per il mascellare e del 94% per la mandibola a 5 anni, e del 78% nel mascellare e 86% nella mandibola a 15 anni. Le percentuali di successo prima citate però , sono frutto di studi presenti in letteratura ove non risultano chiari e soprattutto univoci i criteri utilizzati per la valuatzione dello stato di salute sia da un punto di vista biologico che funzionale nonché estetico degli impianti. Inoltre, anche per quanto riguarda le due principali cause di fallimento implantare, fallimento di tipo meccanico e ditipo biologico , solo negli ultimi anni stiamo riuscendo ad avere un quadro abbastanza chiaro. Lo scopo di questo elaborato è, entro i limiti del possibile , di enunciare e descrivere quello che fino ad oggi sappiamo sulle patologie di tipo infiammatorio che colpiscono gli impianti , la mucosite perimplantare e la perimplantite. Quali sono le cause e i fattori di rischio, i criteri utilizzati per la loro diagnosi e soprattutto i metodi di trattamento per queste due patologie sia di tipo non chirurgico (in particolare) siadi tipo chirurgico. Infine viene presentato uno studio dove vari superfici in titanio sono stati trattati con diverse metodiche non chirurgiche con conseguente valutazione dei risultati

Expression of salivary biomarkers in patients with oral mucositis: evaluation by SELDI-TOF/MS

OBJECTIVE: This study aims to evaluate changes in proteomic salivary profile of patients with oral mucositis after adjuvant cancer treatments. MATERIALS AND METHODS: Samples were collected from patients after adjuvant cancer therapies, and were analyzed by means of SELDI/TOF. Patients were sepa- rated in two groups: patients affected by mucositis (MUCOSITIS) and patient without mucositis (NO MUCOSITIS). All patients were divided in function of the anticancer treatment: patients who had radiother- apy (MUCOSITIS RADIO), had not radiotherapy (MUCOSITIS NO RADIO), had chemotherapy (MUCO- SITIS CHEMO), and those who had not chemotherapy (MUCOSITIS NO CHEMO). Statistical evaluation PCA (Principal Component Analysis) was conducted with the software BIO-RAD Data ManagerTM (Version 3.5). RESULTS: We found the increased peaks of 3443, 3487, and 4135 m/z in MUCOSITIS group, while 6237 m/z was reduced. These same peaks would the same modifica- tions in MUCOSITIS RADIO, while in MUCOSITIS CHEMIO are increased 3443 and 6237 m/z but 3487, 4135 m/z are reduced. These data were confirmed by the PCA. CONCLUSION: Anticancer therapy influenced the level expression of many salivary biomarkers in mucositis with a good significance. Therefore, 3443, 3487, 4135, and 6237 m/z are good biomarker candidates of oral mucositis

What's new for the clinician? - Excerpts from and summaries of recently published papers

The effects of a hydrogen peroxide mouthrinse on the intraoral viral load of SARS-CoV-2 - The effect of adjuvant oral irrigation on self-administered oral care in the management of peri-implant mucositi

Corso di formazione in "Medicina, Individuo, Società". Atti 2009

Il volume raccoglie gli atti del corso di formazione celebrato in Accademia delle Scienze Mediche di Palermo, dove sono state trattate tematiche di "Etica e Management in Sanità"

Nutraceutical Analysis of Marticaria recutita (Chamomile) Dried Leaves and Flower Powder and Comparison between Them

Chamomile is known as German Chamomile (Marticaria recutita) and Roman Chamomile (Chamaemelum nobile) a very famous daisy plant. The work mainly focuses on the nutraceuticals potential of Chamomile leaf and flower of this plant. The nutrient contains of the leaf and flower power was determined by various methods. The phytochemicals screening of the leaf and flower aqueous extract was performed by the different procedure. Leaf of this plant is rich in carbohydrate, protein, fat and also rich in vitamin C, iron, zinc and calcium. Whereas flower is rich in moisture and fiber as compared to leaf. The aqueous extract of leaf of Chamomile showed the presence of steroids, terpenoids, flavonoids, tannins and saponins and flower were lacked in alkaloids, saponins, gelatin and phenolic compounds. The results record that leaf and flowers powder contains different types of nutrients and phytochmicals in it. Chamomile is rich in different bioactive compounds, antioxidant and phytochemicals; carries many pharmacological and traditional properties. Leaves, flowers and stems of Chamomile are used as anti-oxidant, analgesic, anti-viral, anti-inflammatory, anti-septic, anti-diabetic, anti-proliferative, anti-bacterial activities and many more diseases. This paper put a light on nutrient content and phytochemical properties of Chamomile leaf and flower