The impact of medication-related osteonecrosis of the jaws on the quality of life in cancer patients

To evaluate the impact of oral health on the quality of life (QOL) of individuals undergoing cancer treatment at the time of diagnosis of medication-related osteonecrosis of the jaw (MRONJ). The present cross-sectional study analyzed patients with MRONJ from 2013 to 2019. The collected data included demographic data, base disease, medications associated with MRONJ, route of administration and time of use, signs, symptoms, and tomographic features of acute MRONJ, staging according to American Association of Oral and maxillofacial Surgeons position paper 2014 (AAOMS), type of dental treatment performed, outcome, and the responses to the Oral Health Impact Profile questionnaire (OHIP-14). Statistical analysis was performed using the Tukey test to study the association between oral condition and the QOL. A p-value of less than 0.05 was considered statistically significant. The sample consisted of 16 medical records of patients with MRONJ. Psychological discomfort showed alarmingly significant results (p< 0.001) with strong negative impact on the QOL of the patients. Functional limitation was the least affected dimension (p = 0.747). The other dimensions did not show statistically significant results. MRONJ compromises oral health and negatively impacts the QOL, especially with respect to the psychological discomfort (worry and stress). The OHIP-14 questionnaire proved to be an effective tool in the assessment of this impact

Os exames de imagem mais frequentemente solicitados no tratamento do quisto ósseo aneurismático e a sua relação com o resultado: uma atualização

El objetivo de este estudio fue revisar cuáles son los exámenes de imagen más requeridos, sus características y si la elección principal es suficiente para el manejo de la lesión. Se realizaron búsquedas en las bases de datos PubMed, Web of Science y Scopus. Los artículos incluidos eran informes de casos o series de casos de quistes óseos aneurismáticos en la mandíbula o el maxilar que tenían toda la información sobre el caso, desde el diagnóstico hasta el seguimiento. Los 32 artículos incluidos mostraron que el primer examen de imagen requerido es el examen radiográfico panorámico de los casos, y solo unos pocos eligen la tomografía computarizada como primera opción. El tratamiento elegido suele ser el curetaje, y 9 casos presentaron recidivas, aunque 17 no informaron del seguimiento. Los exámenes de imagen 2D fueron el tipo más requerido a la hora de diagnosticar un quiste óseo aneurismático, pero los exámenes 3D fueron necesarios en muchos casos para una mejor evaluación y para proporcionar más detalles. &nbsp; &nbsp;This study aimed to review the most required imaging tests, their characteristics, and whether the primary choice is sufficient for lesion management. PubMed, Web of Science, and Scopus databases were searched. The included articles were case reports or series of aneurysmal bone cysts in the mandible or maxilla that had all the information about the case, from diagnosis to follow-up. The 32 included articles showed that the first imaging test required is a panoramic radiographic examination of the cases, with only a few choosing computed tomography as the first option. The treatment of choice is usually curettage, and 9 cases had recurrences, although 17 did not report follow-up. 2D imaging examinations were the most required type when diagnosing an aneurysmal bone cyst, but 3D examinations were necessary in many cases for better evaluation and to provide more details. &nbsp;O objetivo deste estudo foi analisar quais os exames imagiológicos mais frequentemente solicitados, as suas características e se a escolha principal é suficiente para a gestão da lesão. Foram pesquisadas as bases de dados PubMed, Web of Science e Scopus. Os artigos incluídos eram relatos de casos ou séries de casos de cistos ósseos aneurismáticos na mandíbula ou maxila que continham todas as informações sobre o caso, desde o diagnóstico até o acompanhamento. Os 32 artigos incluídos mostraram que o primeiro exame de imagem solicitado é o exame radiográfico panorâmico dos casos, sendo que apenas alguns escolheram a tomografia computadorizada como primeira opção. O tratamento de escolha é geralmente a curetagem, e 9 casos tiveram recidivas, embora 17 não tenham relatado o acompanhamento. Os exames de imagem 2D foram os mais solicitados para o diagnóstico de cisto ósseo aneurismático, mas os exames 3D foram necessários em muitos casos para uma melhor avaliação e para fornecer mais detalhes

Epidemiological study with oral antiseptic Phtalox® and the relationship with the clinical condition of individuals who present COVID-19 diagnosis

O presente ensaio comunitário quase-experimental, prospectivo e longitudinal tem como objetivo verificar a ação do antisséptico bucal contendo derivado de ftalocianina (ADF) ajustado por fatores sociodemográficos da população participante de um município a partir do diagnóstico confirmado para COVID-19 e tempo de uso da solução; analisar a sobrevida da população em risco e confirmada com diagnóstico de COVID-19 a partir da primeira semana de distribuição do antisséptico bucal; e verificar a redução de risco de COVID-19 em três momentos distintos. A pesquisa foi realizada em um município no interior do Estado de São Paulo contendo 1.251 habitantes. Foram incluídos todos os residentes da zona urbana e rural com até 5 km de distância da cidade, com mais de 10 anos, e excluídos os indivíduos que declararam contraindicações ao uso de antissépticos bucais por razões médicas ou incapacidade de gargarejar e cuspir. A pesquisadora e sua assistente de pesquisa foram a todas as residências dos indivíduos seguindo os critérios de biossegurança e preencheram um questionário estruturado dividido em duas partes: (I) Dados sociodemográficos e (II) Perguntas específicas relacionadas à COVID-19. Posteriormente, os indivíduos receberam dois frascos contendo 600mL de ADF e foram instruídos a utilizar 3mL da solução, alternando entre bochecho/gargarejo durante 1 minuto, de 3 a 5 vezes ao dia, por um período de dois meses. Para comparar as estimativas de redução de risco da doença, foi selecionada uma população controle de outro município demograficamente semelhante, que não recebeu a intervenção com ADF. No município estudado, os indivíduos foram acompanhados por um período de 4 e 6 meses através do sistema eletrônico do Centro de Saúde Municipal e Sistema Estatal de Análise de Dados. Foram realizados testes estatísticos de Regressão Linear Múltipla, Análise de Regressão de Cox e de Risco Relativo (RR). Com um total de 995 indivíduos participantes, o estudo evidenciou os seguintes dados sociodemográficos: indivíduos com grau de instrução ensino médio incompleto, 98/995 (p<0,002), utilizaram o ADF 66,30 vezes mais em relação ao nível superior, e a sobrevida apresentou resultado expressivo em relação ao tempo de uso da solução; cada dia a mais do uso dos ADF pelos indivíduos diminuía as chances de positivar para COVID- 19 em 14,1%. Em diferentes momentos de avaliação, o risco de doença entre as duas populações não diferiu significativamente (p=NS), enquanto na comparação do município teste com o controle, o risco da doença encontrou-se 54% menor no município teste. O grau de instrução dos indivíduos foi o dado sociodemográfico que apresentou resultado expressivo quanto ao tempo de uso da solução ADF e o fator de proteção foi de 14,1% em relação ao tempo de uso diário, sugerindo que a utilização deste antisséptico estudado pode reduzir a incidência de COVID-19 a nível populacional.The present quasi-experimental, prospective, longitudinal community trial aims to verify the action of oral antiseptic containing phthalocyanine derivative (APD) adjusted by sociodemographic factors of the participant population of a municipality from the confirmed diagnosis for COVID-19 and time of use of the solution; to analyze the survival of the population at risk and confirmed with diagnosis of COVID-19 from the first week of distribution of the oral antiseptic; and to verify the reduction of risk of COVID-19 in three distinct moments. The research was conducted in a municipality in the interior of the state of São Paulo containing 1,251 inhabitants. All residents of urban and rural areas up to 5 km away from the city, older than 10 years, were included, and individuals who declared contraindications to the use of oral antiseptics for medical reasons or inability to gargle and spit were excluded. The researcher and her research assistant went to all the individuals\' homes following the biosafety criteria and filled out a structured questionnaire divided into two parts: (I) Sociodemographic data and (II) Specific questions related to COVID-19. Subsequently, the subjects received two bottles containing 600mL of APD and were instructed to use 3mL of the solution, alternating between mouthwash/gargle for 1 minute, 3 to 5 times a day, for a period of two months. To compare the estimates of disease risk reduction, a control population from another demographically similar municipality that did not receive the APD intervention was selected. In the municipality studied, individuals were followed up for a period of 4 and 6 months through the electronic system of the Municipal Health Center and State Data Analysis System. Statistical tests of Multiple Linear Regression, Cox Regression Analysis and Relative Risk (RR) were performed. With a total of 995 participating individuals, the study showed the following sociodemographic data: individuals with incomplete high school education, 98/995 (p<0.002), used the APD 66.30 times more often than those with higher education, and survival showed a significant result in relation to the time of use of the solution; each additional day of APD use by individuals decreased the chances of being positive for COVID-19 by 14.1%. At different times of assessment, the risk of disease between the two populations did not differ significantly (p=NS), while comparing the test city with the control city, the risk of disease was 54% lower in the test city. The level of education of the individuals was the sociodemographic data that presented a significant result regarding the time of use of the APD solution and the protection factor was 14.1% in relation to the time of daily use, suggesting that the use of this antiseptic studied can reduce the incidence of COVID-19 at the population level

Assessment of depression, stress, anxiety and oral health-related quality of life in individuals with sjögren’s syndrome: case control pilot study.

Objective: Sjögren’s syndrome (SS) is a chronic auto-immune inflammatory systemic disease, in which the infiltration of mo-nonuclear cells in the exocrine glands leads to physiological and morphological changes. This pilot case-control study aims to describe the profile, evaluate the oral condition, quality of life (QoL) and psychological condition, through complete clinical examination, OHIP-14 and DASS-21 questionnaires. Materials and Methods: The study was conducted with seven individuals with a final diagnosis of SS (case group [CG]), and seven individuals with symptoms of dry mouth (control group [GCO]), consulting at the institution from January to November 2021. participants were selected by free demand and those previously seen at the institution with a diagnosis of SS between 19 and 70 years of age. The questionnaire OHIP-14 was applied to assess the patient’s quality of life, where seven dimensions are assessed, subdivided into 14 questions through the Lickert scale (0 to 4) assigned by the individual and which quantifies the impact of oral health on QoL. The questionnaire DASS-21 assessed the psychological condition of the patient, which presents seven questions for each emotional state (depression, anxiety, and stress), totaling 21 questions. The general clinical condition, evolution of SS, oral clinical condition, and the profile of this population were related to QoL factors and psychological conditions, using these assessment instruments. Results: There was no statistically significant difference between the groups regarding stimulated salivary flow. The only symptom with a statistically significant difference in the CG was difficulty in phonation (p< 0.001). The dimensions related to functional limitation and physical pain showed the most expressive results (p=0.004) (p=0.025), showing a strong negative impact on the QoL of the CG individuals, and the dimension related to disability was the least affected (p=0.684). The analysis of depression, anxiety, and stress did not show statistically significant results between the groups; however, in the CG, 5 (71.42%) individuals showed a severe degree of depression, anxiety, and stress. Conclusions: Individuals in the case group showed some changes, with a strong negative impact on QoL compared to the control group

Use of phthalocyanine-derived mouthwash as a protective factor for COVID-19: a community trial

Aim: In a population profile corrected for sociodemographic factors, the aim of this study was to examine sociodemographic the protective effect of a phthalocyanine-derived mouthwash (APD) before infection with SARS-CoV-2, in addition to analyzing the survival of the at-risk population and the confirmed diagnosis of COVID-19. Methods: For individuals from the Uru municipality, a structured questionnaire consisting of two parts was completed before the distribution of APD. Subsequently, subjects received two bottles containing 600 mL of APD and were instructed to rinse/gargle with 3 mL of the solution o 5 times per day for 1 min for 2 months. Data were obtained from the electronic system of the municipal health center, organized in a spreadsheet, and analyzed using multiple linear regression and Cox regression analysis. Results: The study included 995 participants with the following sociodemographic data: 98/995 individuals (p<0.002) who did not complete high school used the APD 66.30 times more than did individuals with higher education. The results in terms of survival were meaningful in relation to the duration of APD use. The protective factor for COVI9 was 14.1%. Conclusion: Daily use of a solution containing phthalocyanine derivatives provided a higher protection factor against COVID-19 infection, predominantly in individuals without a school-completion certificate