COMPARISON OF THE LOW LEVEL LASER AND ACUPUNCTURE IN THE TREATMENT OF HYPOSALIVATION

Rad ne sadrži sažetak na hrvatskom jeziku.Background and objectives: Hyposalivation is a state of reduced secretion of saliva which can be caused by drugs, by radiation to the head and neck in order to treat head and neck cancers, and can occur in some systemic diseases such as Sjogren's syndrome, etc. Hyposalivation is a very annoying symptom for patients as it is constantly present, thus preventing speech, chewing and swallowing. In addition to these, there is a stronger tendency to develop caries, gingivitis and candidiasis due to lack of saliva. In the literature around the world there are various local and systemic preparations to facilitate the symptoms of dry mouth in patients, although each of them has advantages and disadvantages. The aim of this study was to compare the efficacy of acupuncture, low level laser therapy (LLLT) and water in 67 patients with hyposalivation caused by drugs. Methods: Before therapies each participant filled out a questionnaire on the quality of life in the Croatian language (OHIP-14 CRO) and the amount of saliva was measured by simple method of ejecting saliva into calibrated tubes for 5 minutes in the morning between 8 and 11 A.M. Both procedures were repeated after the completion of each therapy. Low Level Laser Therapy (GaAlAs, 830 nm wavelength; dose 1,80 J/cm2; power 35 mW, area 4 cm2, frequency 5,20 Hz, pulse 800 ms; period 1 ms) was carried out every working day in the course of 14 days and each session lasted 15 minutes on the skin area above the major salivary glands in 28 patients. In 16 participants of the control group, LLLT was conducted with laser device which was switched off. Acupuncture was performed by use of needles (0,16x10mm) inserted on the following points; Shen Man, Point Zero, Autonomic Point, Thirst Point, Salivary Gland F on both ears while the participants were sitting for 30 minutes at the acupuncturist. After the participants got press needles (0,16x1,4 mm) on one ear at the points Shen Men and Thirst Point till the next session. Second acupuncture session was one week after the first one and the remaining three every seven days. Statistical analysis was performed by use of Student t test for dependent and independent samples. Results: The results of this study have shown that acupuncture was superior in comparison to the LLLT and switched off LLLT on the basis of increased salivary flow rate and the quality of life questionnaire. LLLT increased salivary flow rate, however, there was no significant improvement in scores of the quality of life questionnaire. LLLT, when switched off, did not increase salivary flow rate nor OHIP-CRO scores significantly. Conclusion: We might conclude that salivary gland stimulation by use of acupuncture increased salivary flow rate in patients with drug-induced hyposalivation as well as improved scores of OHIPCRO. Switched on LLLT also increased salivary flow rate in these patients, however OHIP CRO scores were not signifiantly different. Switched of LLLT neither increased salivary flow rate nor improved OHIP-CRO scores

COMPARISON OF THE LOW LEVEL LASER AND ACUPUNCTURE IN THE TREATMENT OF HYPOSALIVATION

Rad ne sadrži sažetak na hrvatskom jeziku.Background and objectives: Hyposalivation is a state of reduced secretion of saliva which can be caused by drugs, by radiation to the head and neck in order to treat head and neck cancers, and can occur in some systemic diseases such as Sjogren's syndrome, etc. Hyposalivation is a very annoying symptom for patients as it is constantly present, thus preventing speech, chewing and swallowing. In addition to these, there is a stronger tendency to develop caries, gingivitis and candidiasis due to lack of saliva. In the literature around the world there are various local and systemic preparations to facilitate the symptoms of dry mouth in patients, although each of them has advantages and disadvantages. The aim of this study was to compare the efficacy of acupuncture, low level laser therapy (LLLT) and water in 67 patients with hyposalivation caused by drugs. Methods: Before therapies each participant filled out a questionnaire on the quality of life in the Croatian language (OHIP-14 CRO) and the amount of saliva was measured by simple method of ejecting saliva into calibrated tubes for 5 minutes in the morning between 8 and 11 A.M. Both procedures were repeated after the completion of each therapy. Low Level Laser Therapy (GaAlAs, 830 nm wavelength; dose 1,80 J/cm2; power 35 mW, area 4 cm2, frequency 5,20 Hz, pulse 800 ms; period 1 ms) was carried out every working day in the course of 14 days and each session lasted 15 minutes on the skin area above the major salivary glands in 28 patients. In 16 participants of the control group, LLLT was conducted with laser device which was switched off. Acupuncture was performed by use of needles (0,16x10mm) inserted on the following points; Shen Man, Point Zero, Autonomic Point, Thirst Point, Salivary Gland F on both ears while the participants were sitting for 30 minutes at the acupuncturist. After the participants got press needles (0,16x1,4 mm) on one ear at the points Shen Men and Thirst Point till the next session. Second acupuncture session was one week after the first one and the remaining three every seven days. Statistical analysis was performed by use of Student t test for dependent and independent samples. Results: The results of this study have shown that acupuncture was superior in comparison to the LLLT and switched off LLLT on the basis of increased salivary flow rate and the quality of life questionnaire. LLLT increased salivary flow rate, however, there was no significant improvement in scores of the quality of life questionnaire. LLLT, when switched off, did not increase salivary flow rate nor OHIP-CRO scores significantly. Conclusion: We might conclude that salivary gland stimulation by use of acupuncture increased salivary flow rate in patients with drug-induced hyposalivation as well as improved scores of OHIPCRO. Switched on LLLT also increased salivary flow rate in these patients, however OHIP CRO scores were not signifiantly different. Switched of LLLT neither increased salivary flow rate nor improved OHIP-CRO scores

Značaj rutinskih krvnih pretraga u bolesnika s karcinomima glave i vrata

More research suggest that parts of complete blood count might indicate disease-free and overall survival in patients with various cancers and therefore also in patients with head and neck cancer. Therefore, the aim of this paper was to review current knowledge upon signifi cance of complete blood count in head and neck cancers. PubMed was searched in the last 10 years in order to fi nd out references upon this topic and 19 articles were included. Leukocytosis and thrombocytosis negatively correlate with treatment outcome in patients with head and neck cancers, however not in all studies. High preoperative values of neutrophil and lymphocyte ratio suggest poorer disease outcome, i.e. shorter disease free period and overall survival in patients with head and neck cancer. It seems that published data provide an additional practical guidelines for evaluation of disease course in patients with head and neck cancer.Sve vise je istraživanja koja pokazuju kako elementi kompletne krvne slike mogu ukazati na period bez bolesti i ukupno preživljenje u bolesnika s raznim karcinomima. PubMed pregledom nađeno je 19 radova objavljenih zadnjih 10 godina o rutinskim laboratorijskim pretragama i karcinomima glave i vrata. Leukocitoza i trombocitoza su negativno povezane s ishodom liječenja u većini slučajeva bolesnika s orofaringealnim karcinomom, iako ne u svim istraživanjima. Visoke prijeoperacijske vrijednosti odnosa neutrofi la i limfocita ukazuju na lošiji ishod bolesti odnosno na kraći period bez bolesti i na lošije ukupno preživljenje u bolesnika s karcinomima glave i vrata. Čini se kako rezultati istraživanja omogućuju dodatne praktične vodiče u prognostici tijeka bolesti u bolesnika koji boluju od karcinoma glave i vrata