The incidence of severe oral mucositis and its occurrence sites in pediatric oncologic patients

Childhood cancer is one of the main causes of child mortality and its treatment has debilitating effects on the oral cavity. Several oral mucositis (SOM) is one of the most common and may cause undesirable symptoms such as pain and risk of systemic infection. This was a longitudinal, retrospective, and observational study determining the incidence of severe oral mucositis (SOM) and its occurrence sites in pediatric oncologic patients, in João Pessoa, Brazil, between 2013 and 2018. Data from 56 patients aged 1 to 18 years were collected from their medical records and through an oral mucosa examination, from the 1st to 5th week of chemotherapy treatment (CT) using the modified Oral Assessment Guide, by previously calibrated examiners (Kappa index > 0.7). The data were analyzed by the Chi-square test, and Odds Ratios were calculated. Most patients were females (54.5%), aged 8.8 years (± 4.8), with hematologic tumors (73.2%), predominantly Acute Lymphoid Leukemia (50.0%). An increase in the occurrence of SOM was observed throughout the CT (P = 0.05), ranging from 12.5% in the 1st to 35.7% in the 5th CT week. In the 1st CT week, there was a predominance of alterations in the lips (5.5%) and saliva (5.5%), while in the 5th, the jugal / palate mucosa (21.4%) remained the most affected site by SOM. Differences in the severity of SOM in the jugal / palate mucosa (P = 0.01) and labial mucosa (P = 0.04) were observed over time. In the 5th CT week, the likelihood of developing SOM was 13.3-fold higher (95% CI: 1.5 - 105.6) in patients with hematologic tumors. The incidence of SOM was higher in the 5th CT week, most commonly affecting the jugal / palate mucosa, and patients with hematologic tumors were more prone to develop SOM

Characterization of childhood cancer in Brazil from the hospital-based cancer registries, 2000-2016 / Caracterização do câncer infantojuvenil no Brasil a partir dos Registros Hospitalares de Câncer (RHC), 2000-2016

Objective: To characterize childhood cancer in Brazil, based on the national and regional investigation of hospital-based cancer registrie, from 2000 to 2016. Methods: Observational, retrospective and secondary-based study, with a sample of 71,925 records containing information of children and adolescents (0 to 19 years old). Results: Childhood cancer was more frequent in males (54.3%), among children aged 0 to 4 years (31.1%), with brown skin color (40.4%), and residents of the region Northeast (59.7%). Leukemias, myeloproliferative diseases and myelodysplastic diseases (28.8%) were the most relevant pathologies. There was a predominance of solid tumors (58.5) and chemotherapy was the most commonly administered therapy at the beginning of treatment (48.7%). It was noticed that 78.6% of the individuals started the treatment within 60 days after diagnostic confirmation. Conclusion: It was possible to know the demographic, clinical and care profile of children and adolescents with cancer in Brazil, and by region.Objetivo: Caracterizar el cáncer infantil en Brasil, con base en la investigación nacional y regional de registros hospitalarios de cáncer (RHC), de 2000 a 2016. Métodos: Estudio observacional, retrospectivo y secundario, con una muestra de 71,925 registros que contienen información de niños. y adolescentes (0 a 19 años). Resultados: El cáncer infantil fue más frecuente en hombres (54,3%), entre niños de 0 a 4 años (31,1%), con piel morena (40,4%) y residentes de la región Nordeste (59,7%). Las leucemias, las enfermedades mieloproliferativas y las enfermedades mielodisplásicas (28,8%) fueron las patologías más relevantes. Hubo predominio de los tumores sólidos (58,5) y la quimioterapia fue la terapia más administrada al inicio del tratamiento (48,7%). Se observó que el 78,6% de los individuos inició el tratamiento dentro de los 60 días posteriores a la confirmación del diagnóstico. Conclusión: fue posible conocer el perfil demográfico, clínico y de atención de niños y adolescentes con cáncer en Brasil y por región.Objetivo: caracterizar o câncer infantojuvenil no Brasil, a partir da investigação nacional e regional dos registros hospitalares de câncer (RHC), no período de 2000 a 2016. Métodos: estudo observacional, retrospectivo e de base secundária, com amostra de 71.925 registros contendo informações de crianças e adolescentes (0 a 19 anos). Resultados: o câncer infantojuvenil foi mais frequente no sexo masculino (54,3%), entre crianças de 0 e 4 anos de idade (31,1%), com cor de pele parda (40,4%), e residentes da região Nordeste (59,7%). As leucemias, doenças mieloproliferativas e doenças mielodisplásicas (28,8%) foram as patologias mais relevantes. Houve predominância dos tumores sólidos (58,5) e a quimioterapia foi a terapêutica mais administrada no início do tratamento (48,7%). Percebeu-se que 78,6% dos indivíduos iniciaram o tratamento até 60 dias após comprovação diagnóstica. Conclusão: foi possível conhecer o perfil demográfico, clínico e assistencial das crianças e adolescentes com câncer no Brasil, e por regiões.

Impact of COVID-19 on Oral Healthcare for Oncopediatric Patients: The Setting in a Reference Hospital in Northeast Brazil

Objective: To describe the impact of the COVID-19 pandemic on dental care provided to pediatric cancer patients assisted in a referral hospital. Material and Methods: This is an observational, retrospective study based on secondary data extracted from worksheets of dental procedures for patients aged between 0 and 19 years assisted in the pediatric oncology sector of a hospital in João Pessoa, PB, Brazil. Dental procedures performed by the interdisciplinary team of researchers from August 2018 to February 2020 (19 months prior to the pandemic) and from April 2020 to October 2021 (19 months during the pandemic) were totaled and compared. A descriptive analysis of the data was performed. Results: There was a reduction of 80.2% in dental interventions implemented in the sector during the pandemic, with the number of procedures decreasing from 6,210 (the period before the pandemic) to 1,229 (during the pandemic). Most procedures in both periods were performed for patients assisted in beds, for whom there was a reduction of care provided for 81.2% from 5,275 to 994 procedures. Dental procedures in the outpatient clinic decreased by 74.9%, from 935 to 235. Conclusion: The COVID-19 pandemic negatively impacted dental care provided to pediatric oncology patients by restricting dental procedures to emergency demands, compromising performance prevention and health promotion actions

A mucosite oral grave em pacientes pediátricos oncológicos: um estudo com análise de sobrevivência

Severe oral mucositis is an adverse event commonly presented by children undergoing oncologic treatment. The objective of this study was to investigate the occurrence of severe oral mucositis and the associated factors in pediatric patients with hematological tumors and solid tumors submitted to oncological treatment, attended at a reference hospital in the city of João Pessoa / PB by means of survival analysis. This was a longitudinal, descriptive, observational, inductive study in order to explain the time of onset of severe oral mucositis in pediatric patients submitted to cancer treatment. The study was carried out at the Hospital Napoleão Laureano, located in the city of João Pessoa / PB, in the pediatric ward, from 2013 to 2017, with a target population of 0-19 years old pediatric patients submitted to an oncological treatment regimen, attended in the pediatrics sector of said hospital, with a sample of 142 participants. The data were collected from a form with information regarding the sociodemographic aspects related to the patient's health condition and the modified OAG (Oral Assessment Guide). A descriptive and inferential analysis was performed using the Kaplan-Meier method and the semi-parametric Cox model. The results show that the median time to onset of severe oral mucositis in patients with haematological and solid tumors was 35.3 and 77.1 days, respectively. The Cox model revealed that changes in the number of leukocytes, platelets and chemotherapy of the natural product class are risk factors for the appearance of oral mucositis in patients with haematological tumors and, for patients with solid tumors, non-pardos, presence of metastasis, changes in creatinine levels, combination of surgery, chemotherapy and radiotherapy, and the administration of chemotherapeutic agents of the miscellaneous group were related to the occurrence of this condition. It is concluded that the time of onset of severe oral mucositis varied for both groups and those for patients with hematologic tumors, blood changes and chemotherapy were considered risk factors for its occurrence; for patients with solid tumors, the individual's own characteristics related to treatment and disease appeared as a risk condition for the occurrence of severe oral mucositis.NenhumaA mucosite oral grave é um evento adverso comumente apresentado por crianças realizando tratamento oncológico. O objetivo deste trabalho é investigar a ocorrência de mucosite oral grave e os fatores associados em pacientes pediátricos com tumores hematológicos e sólidos, submetidos a tratamento oncológico, assistidos em um hospital de referência na cidade de João Pessoa/PB por meio da análise de sobrevivência. Tratou-se de um estudo longitudinal, descritivo, observacional, indutivo, a fim de explicar o tempo de aparecimento da mucosite oral grave em pacientes pediátricos submetidos ao tratamento oncológico. O estudo foi realizado no Hospital Napoleão Laureano, localizado na cidade de João Pessoa/PB, na ala pediátrica, no período de 2013 a 2017, tendo como população alvo os pacientes pediátricos, de 0-19 anos, submetidos a regime de tratamento oncológico, atendidos no setor de pediatria do referido hospital, contando com uma amostra de 142 participantes. Os dados foram coletados a partir de um formulário com informações referentes aos aspectos sociodemográficos, relacionados à condição de saúde do paciente e o OAG modificado (Oral Assessment Guide). Foi realizada a análise descritiva e inferencial utilizando a técnica da análise de sobrevida, com aplicação do método de Kaplan-Meier e do modelo semiparamétrico de Cox. Os resultados apresentam que o tempo mediano para aparecimento da mucosite oral grave em pacientes com tumores hematológicos e sólidos foi de 35,3 e 77,1 dias, respectivamente. O modelo de Cox revelou que as alterações no número de leucócitos, de plaquetas e a administração do quimioterápico da classe de produtos naturais são fatores de risco para o aparecimento da mucosite oral em pacientes com tumores hematológicos e, para os pacientes com tumores sólidos, as variáveis sexo feminino, não pardos, ocorrência de metástase, alterações dos níveis de creatinina, combinação de cirurgia, quimioterapia e radioterapia e a administração de quimioterápicos do grupo miscelânea foram relacionadas a ocorrência dessa condição. Conclui-se que o tempo de aparecimento da mucosite oral grave variou para os dois grupos e os para os pacientes com tumores hematológicos as alterações sanguíneas e o quimioterápico foram considerados fatores de risco para sua ocorrência; já para os pacientes com tumores sólidos as características próprias do indivíduo, relacionadas ao tratamento e à doença apareceram como condição de risco para a ocorrência da mucosite oral grave

Impactos da Pandemia da Covid-19 na Qualidade de Vida no Trabalho dos Gestores do IFPB, campus João Pessoa, em Atividades Home Office

O objetivo do estudo foi analisar os impactos da pandemia da covid-19 na Qualidade de Vida no Trabalho (QVT) dos gestores do Instituto Federal de Educação, Ciência e Tecnologia da Paraíba (IFPB), campus João Pessoa, em atividades home office. Tratou-se de estudo de caso aplicado, exploratório-descritivo, com amostra (n=39) não probabilística, selecionada por acessibilidade e conveniência. Os dados foram coletados por meio de envio de questionário eletrônico, tratados e analisados por meio da estatística descritiva. Houve predominância do sexo masculino (53,8%), com faixa etária entre 30 e 39 anos (43,6%), doutores (33%) e com função gratificada (61,5%). As percepções dos gestores – quanto aos aspectos organizacionais, ambientais e comportamentais na QVT em home office no contexto pandêmico – foram positivas em sua maioria, porém que exigem a melhoria no cotidiano organizacional

Severe Oral Mucositis in Pediatric Cancer Patients: Survival Analysis and Predictive Factors

This paper investigates the occurrence of severe oral mucositis and associated factors in blood and solid cancer pediatric patients subjected to cancer treatment, using a survival analysis. A longitudinal, descriptive, observational and inductive study of 142 pediatric patients aged from 0 to 19 years was conducted from 2013 to 2017. Data were collected using a form to record the sociodemographic characteristics and health-related aspects of patients and the modified Oral Assessment Guide (OAG). Survival analysis was performed using the Kaplan–Meier method and Cox semiparametric model. The median times to occurrence of severe oral mucositis were 35.3 and 77.1 days for patients with hematologic malignancies and solid tumors, respectively. The Cox model showed that white cell changes and platelet counts as well as the use of natural chemotherapeutic agents are risk factors for the occurrence of oral mucositis among patients with hematologic malignancies. Nonetheless, among patients with solid tumors, the occurrence of oral mucositis was associated with female sex, mixed ethnicity, the presence of metastasis, abnormal creatinine levels, a combination of chemotherapy, radiotherapy, and surgery, and the administration of chemotherapeutic agents included in the miscellaneous group. The time to occurrence of severe oral mucositis and its associated factors varied according to cancer type

Factors associated with oral biofilm in ICU patients with infectious diseases

<div><p>Abstract Introduction Hospitalization may cause a decline in oral health and affect the entire body. The intensive care unit (ICU) may be a favorable environment for oral biofilm to accumulate in critically ill patients. Objective To identify factors associated with oral biofilm in ICU patients in a hospital for infectious diseases. Method This was a retrospective, descriptive and inferential study with a quantitative approach. Data were collected from 178 medical records of patients from January 2012 to July 2015. Biofilm presence was assessed according to the Greene and Vermillion index. Potential influential factors were analyzed by logistic regression. Result Among ICU patients, 69.1% were men, 60.7% had acquired immune deficiency (AIDS), 66.3% were ward patients, 50.6% were intubated, and 50.0% were sedated. The oral elements of the patients were mostly normal. The following characteristics were significantly associated with oral biofilm: changes in the lips, gums, cheeks, and palates and bleeding. Patients from the ward had a lower risk of biofilm. Conclusion Increased oral biofilm accumulation was observed in patients with oral changes, and patient origin was associated with the presence of biofilm.</p></div

Impact of Saliva and Cariogenic Microbiota on the Chemotherapy-Induced Oral Mucositis in Oncopediatric Patients: A Preliminary Longitudinal Study

This study aims to evaluate the salivary parameters and cariogenic microbiota of pediatric oncological patients and their correlation with severe oral mucositis (SOM). A preliminary longitudinal study included patients in the age range from 4 to 18 years (n = 26), with diagnosis of primary cancer, who were followed up before and after time intervals of two, five, and ten weeks of induction chemotherapy. Oral mucosa examinations were performed by means of the modified Oral Assessment Guide (OAG) by calibrated examiners (κ > 0.70). Saliva analysis (unstimulated saliva flow (USF), clinical saliva viscosity (CSV), and pH) and microbiological (total Streptococcus (TS) and Streptococcus of the mutans group (SMG)) tests were performed using unstimulated saliva. The data were analyzed by the Wilcoxon and Spearman Correlation tests (α = 5%). The patients were predominantly of the female sex (n = 15; 57.7%), adolescents (n = 15; 57.7%), and patients with hematological tumors (n = 21; 80.8%). SOM was more frequent in the tenth week (n = 7; 28.6%). The values of USF, CSV, pH, TS, and SMG were not changed by the institution of chemotherapy (p>0.05). These values were correlated with SOM and the time, TS and SMG, and CSV and SMG. The salivary and microbiological parameters investigated did not influence the severity of oral mucositis in the pediatric patients oncological.

Factors Contributing to the Duration of Chemotherapy-Induced Severe Oral Mucositis in Oncopediatric Patients

This study analyzes the factors contributing to the duration of severe oral mucositis in oncopediatric patients. A longitudinal study was conducted in the pediatric department of a cancer referral hospital between 2013 and 2017. Seventy-three patients diagnosed with cancer undergoing chemotherapy protocols were analyzed. Oral evaluations were performed using the Modified Oral Assessment Guide criteria, and the data were collected from the patients&rsquo; records. The Kaplan-Meier method was used to estimate survival curves. Most patients were males (52.1%), of mixed race (&ldquo;pardo&rdquo;) (49.3%), with a mean age of 7.56 years (&plusmn;5.34). There was a predominance of patients diagnosed with solid tumors (52.1%), with no metastasis (86.3%), using natural product chemotherapeutics (56.2%), who had not undergone a bone marrow transplant (97.3%); amputation was observed in 35.6% of patients, while death rates were as high as 8.2%. The survival analysis estimated a mean time of 30.6 days until complete remission of severe oral mucositis. The regression analysis showed that patients over 10 years old had a median mucositis duration 1.4 times greater than those at the age of 10 years or younger. Patients without metastasis had a median mucositis duration 1.7 times greater than those with metastasis (p-value &le; 0.10). Increasing age and the absence of metastasis were conditions that prolonged the duration of severe oral mucositis