Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 469
Filter
1.
São Paulo; s.n; 20240222. 152 p.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1531900

ABSTRACT

Introdução: Mucosite oral é um efeito colateral dos tratamentos oncológicos, caracterizado por lesões orais que vão de eritema a úlceras que podem causar dor intensa e restrição de dieta. É conhecida como condição limitante e de grande impacto na qualidade de vida (QV). Objetivo: Elaborar um novo instrumento para avaliar a QV relacionada à mucosite oral. Material e método: Pesquisa através de métodos mistos, iniciando com entrevistas qualitativas analisadas pelo método de Bardin e método Reinert, com o programa IRAMUTEQ, seguido do método Delphi com quatro rodas de entrevistas e discussões com especialistas. A primeira versão do instrumento passou por um pré-teste com 10 pacientes, com análise quantitativa e qualitativa, seguido de outra rodada de especialistas. Resultados: O material das entrevistas qualitativas apontou os termos dor e alimentação como centrais na experiência de mucosite oral, além de fornecerem várias palavras-chave para definição dos constructos. Baseado nesse material e na literatura, 4 especialistas formularam 34 perguntas enviadas para outros 10 especialistas de diferentes regiões e instituições brasileiras que analisaram a clareza, ortografia e necessidade de cada pergunta para o questionário. As alterações pertinentes foram realizadas, revisadas e novamente discutidas. A primeira versão foi apresentada a 10 pacientes que não participaram das entrevistas qualitativas e responderam o grau de entendimento e necessidade de cada pergunta. A análise final do pré-teste reformulou alguns tempos verbais e palavras de difícil compreensão, dando forma a versão final do instrumento. Discussão: Embora existam bons instrumentos para mensurar QV e mucosite oral, apresentamos novas questões sobre impactos financeiros, interrupção de tratamento, alteração de saliva, perda de peso relacionada diretamente com a mucosite oral e aspectos psicossociais. Conclusão: Foi elaborado um novo instrumento para mensurar os impactos mucosite oral em pacientes oncológicos.


Subject(s)
Quality of Life , Stomatitis , Surveys and Questionnaires , Dental Instruments
2.
Braz. dent. sci ; 27(1): 1-18, 2024. ilus, tab
Article in English | LILACS, BBO | ID: biblio-1554280

ABSTRACT

Objective: To identify and analyze plant extracts used in Brazil for the treatment of oral ulcers and oral mucositis. Material and Methods: A systematic review was registered in PROSPERO (CRD 42018102184) and performed following the PRISMA protocol. The databases searched were PubMed, Web of Science, Scopus, Lilacs, Scielo, the Brazilian Dentistry Library. Manual searches were also performed. Results: Initially, 440 studies were found, of which 392 were excluded after reading the titles and abstracts. A total of 29 articles were read in full and 11 studies were excluded, resulting in 18 articles included in the systematic review. Nine plant species were identified in five clinical trials and 13 in vivo studies, with Chamomila recutita being the most used (33.3% of the studies). Chamomila recutita showed more promising results for analgesic, anti-inflammatory, and healing properties. Calotropis procera latex significantly decreased (p<0.05) inflammatory mediators, such as TNF-α and IL-1ß in oral mucositis induced in rats. Eupatorium laevigatum showed anti-inflammatory activity and analgesic action on oral ulcers. Carapa guianensis Aubl. reduced the severity and painful symptoms of oral mucositis and exhibited better results compared to the use of low power laser. Curcuma longa L accelerated re-epithelialization and resolution of inflammatory processes. Spondias mombin reduced oxidative stress and inflammation caused by oral mucositis and helped on healing it. Extracts of Aloe barbadensis Miller or Aloe vera showed anti-inflammatory action but did not help in the healing process of oral ulcers. Copaifera reticulata Ducke oil did not induce improvement in the healing process, nor did it show an anti-inflammatory effect. Malva sylvestrisdid not show an anti-inflammatory action on oral lesions in humans or rats. The assessment of methodological heterogeneity showed the impossibility of performing a meta-analysis. Risk of bias varied from low to high. Conclusion: The plant species most used and with the best results for the treatment of oral ulcerations and oral mucositis was Chamomilla recutita. Spondias mombin L., Curcuma longa L., Carapa guianensis Aubl and Calotropis procera showed good results in the treatment of oral mucositis, while Eupatorium laevigatum was efficient in the treatment of ulcers of traumatic origin. Malva sylvestris, Copaifera reticulata Ducke, and Aloe barbadensis Miller did not exhibit significant results (AU)


Objetivo: Identificar e analisar extratos vegetais utilizados no Brasil para o tratamento de úlceras orais e mucosite oral. Material e Métodos: Uma revisão sistemática foi registrada no PROSPERO (CRD 42018102184) e realizada seguindo o protocolo PRISMA. As bases de dados pesquisadas foram PubMed, Web of Science, Scopus, Lilacs, Scielo, Biblioteca Brasileira de Odontologia. Buscas manuais também foram realizadas. Resultados: Inicialmente, foram encontrados 440 estudos, dos quais 392 foram excluídos após a leitura dos títulos e resumos. Um total de 29 artigos oram lidos na íntegra e 11 estudos foram excluídos, resultando em 18 artigos incluídos na revisão sistemática. Nove espécies vegetais foram identificadas em cinco ensaios clínicos e 13 estudos in vivo, sendo a Chamomila recutita a mais utilizada (33,3% dos estudos). A Chamomila recutita apresentou resultados mais promissores quanto às propriedades analgésicas, anti-inflamatórias e cicatrizantes. O látex de Calotropis procera diminuiu significativamente (p<0,05) os mediadores inflamatórios, como TNF-α e IL-1ß, na mucosite oral induzida em ratos. Eupatorium laevigatumapresentou atividade anti-inflamatória e ação analgésica em úlceras orais. Carapa guianensis Aubl. reduziu a gravidade e os sintomas dolorosos da mucosite oral e apresentou melhores resultados em comparação com o uso do laser de baixa potência. Curcuma longa L. acelerou a reepitelização e resolução de processos inflamatórios. Spondias mombinreduziu o estresse oxidativo e a inflamação causadas pela mucosite oral e ajudou na sua cicatrização. Extratos de Aloe barbadensis Miller ou Aloe vera apresentaram ação anti-inflamatória, mas não auxiliaram no processo de cicatrização de úlceras orais. O óleo de Copaifera reticulata Ducke não induziu melhora no processo cicatricial, nem apresentou efeito anti-inflamatório. Malva sylvestris não apresentou ação anti-inflamatória em lesões orais em humanos ou ratos. A avaliação da heterogeneidade metodológica mostrou a impossibilidade de realizar uma meta-análise. O risco de viés variou de baixo a alto. Conclusão: A espécie vegetal mais utilizada e com melhores resultados para o tratamento de ulcerações orais e mucosite oral foi a Chamomilla recutita. Spondias mombin L., Curcuma longa L., Carapa guianensis Aubl e Calotropis procera apresentaram bons resultados no tratamento da mucosite oral, enquanto Eupatorium laevigatum foi eficiente no tratamento de úlceras de origem traumática. Malva sylvestris, Copaifera reticulata Duckee Aloe barbadensis Miller não apresentaram resultados significativos(AU)


Subject(s)
Plants, Medicinal , Stomatitis , Plant Extracts , Oral Ulcer , Mucositis , Phytotherapy
3.
Article in English | LILACS, BBO | ID: biblio-1535002

ABSTRACT

ABSTRACT Objective: To measure the costs of preventive and therapeutic protocols of Photobiomodulation (PBM) for oral mucositis (OM) and their budgetary impact on Brazil's Ministry of Health (BMH). Material and Methods: A partial economic analysis was performed to estimate the costs using a bottom-up approach from a social perspective. Monetary values were assigned in Brazilian reais (BRL). The costs of the preventive protocol were calculated for five, 30, and 33 consecutive PBM sessions, depending on the antineoplastic treatment instituted. The costs of the therapeutic protocol were calculated for 5 or 10 sessions. The annual financial and budgetary impact was calculated considering the groups of oncologic patients with a higher risk of development of OM, such as those with head and neck and hematological cancer and pediatric patients. Results: The cost of a PBM session was estimated at BRL 23.75. The financial impact of providing one preventive protocol per year for all oncologic patients would be BRL 14,282,680.00, 0.030% of the estimated budget for hospital and outpatient care of the BMH in 2022. The financial and budgetary impacts of providing one treatment for OM for all patients in one year would be BRL 2,225,630.31 (0.005%, most optimistic scenario) and BRL 4,451,355.63 (0.009%, most pessimistic scenario). Conclusion: The budgetary impact of implementing PBM protocols in the Brazilian Healthcare System is small, even in a pessimistic scenario.


Subject(s)
Stomatitis/etiology , Oncology Service, Hospital , Models, Economic , Low-Level Light Therapy/instrumentation , Unified Health System , Brazil/epidemiology , Oral Health
4.
Rev. Odontol. Araçatuba (Impr.) ; 44(3): 46-54, set.-dez. 2023. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1553135

ABSTRACT

Sabe-se que para o combate de células cancerígenas, é imprescindível a submissão de pacientes oncológicos a tratamentos antineoplásicos, sessões de quimioterapia e radioterapia são as terapêuticas mais utilizadas em pacientes neoplásicos, sendo capazes de originar inúmeras reações adversas, como a mucosite oral, que é considerada um dos principais efeitos adversos do tratamento com quimioterapia e radioterapia. A laserterapia vem sendo considerada um grande aliado na prevenção e tratamento da mucosite, visto que de forma preventiva retarda o aparecimento desta condição, e de forma terapêutica proporciona alívio da dor, além de reduzir a gravidade da mucosite oral. Dessa forma, a presente revisão de literatura teve por objetivo denotar os benefícios da laserterapia de baixa intensidade na prevenção e tratamento da mucosite oral induzida por tratamentos antineoplásicos. Para a confecção deste trabalho, foram pesquisados artigos científicos publicados entre 2012 e 2022, nas bases de dados PubMed, Portal BVS, Scielo e google acadêmico, nos idiomas inglês e português. Como resultado foram encontrados 59 trabalhos, onde após leitura dos títulos e resumos, e do tipo de estudo, foram excluídos 32 artigos. Sendo 27 selecionados para leitura integral do texto, onde dentre eles somente 19 se encaixaram nos critérios de inclusão e foram utilizados neste trabalho. Portanto, conclui-se que a literatura mostra que embora haja bastante discussão, a maior parte dos estudos mostram evidências que a laserterapia de baixa intensidade possui muitos benefícios na prevenção e no tratamento da mucosite oral devido sua capacidade moduladora nos eventos metabólicos por meio de processos fotofísicos e bioquímicos(AU)


It is known that in order to fight cancer cells, it is essential to submit cancer patients to antineoplastic treatments, chemotherapy and radiotherapy sessions are the most used therapies in cancer patients, being capable of causing numerous adverse reactions, such as oral mucositis, which is considered one of the main adverse effects of chemotherapy and radiotherapy treatment. Laser therapy has been considered a great ally in the prevention and treatment of mucositis, since in a preventive way it delays the onset of this condition, and in a therapeutic way it provides pain relief, in addition to reducing the severity of oral mucositis. Thus, the present literature review aims to denote the benefits of low-level laser therapy in the prevention and treatment of oral mucositis induced by antineoplastic treatments. For the preparation of this work, scientific articles published between 2012 and 2022 were searched in PubMed, Portal BVS, Scielo and academic google databases, in English and Portuguese. As a result, 59 studies were found, where after reading the titles and abstracts, and the type of study, 32 articles were excluded. 27 were selected for full text reading, among which only 19 met the inclusion criteria and were used in this work. Therefore, it is concluded that the literature shows that, although there is a lot of discussion, most studies show evidence that low-level laser therapy has many benefits in the prevention and treatment of oral mucositis due to its modulating capacity in metabolic events through processes photophysical and biochemical(AU)


Subject(s)
Stomatitis/prevention & control , Stomatitis/therapy , Mucositis
5.
Rev. Ciênc. Méd. Biol. (Impr.) ; 22(1): 123-130, jun 22, 2023. ilus
Article in Portuguese | LILACS | ID: biblio-1444237

ABSTRACT

ntrodução: a própolis é um produto natural que apresenta inúmeras propriedades terapêuticas, dentre elas a ação cicatrizante e anti-inflamatória. Diversos estudos têm sugerido o seu emprego no manejo da mucosite oral (MO) e de lesões ulceradas em mucosa bucal. A MO é uma inflamação da mucosa oral, resultante do tratamento quimio e/ou radioterápico. Já as lesões ulceradas caracterizam-se como um distúrbio ulcerativo inflamatório doloroso. Objetivo: discutir a ação da própolis sobre a prevenção e cicatrização de lesões de origem não infecciosa que acometem a cavidade oral. Metodologia: trata-se de uma revisão integrativa da literatura em que foram utilizadas as bases de dados LILACS, PubMed, SciELO e Cochrane, por meio do cruzamento dos descritores em português: "própolis", "úlceras orais" e "mucosite oral"; e em inglês: "propolis", "oral ulcer" e "mucositis". Os seguintes critérios de inclusão foram estabelecidos: ensaios clínicos e revisões sistemáticas, na íntegra, escritos em inglês ou português, entre 2005 e 2018, que utilizaram a própolis de forma tópica ou sistêmica. Resultados: foram incluídos um total de 10 estudos, onde 2 abordaram o uso da própolis em úlceras orais e 8 tiveram como foco a aplicação deste agente no manejo da MO. Quanto ao desfecho, a aplicação da própolis na mucosite se mostrou eficaz em 7 dos 8 estudos. Já se tratando de úlceras orais, a administração deste agente foi efetiva nos 2 estudos. Conclusão: os estudos analisados demostraram que a própolis apresenta propriedades capazes de favorecer a prevenção e cicatrização de lesões de MO e úlceras orais.


Introduction: propolis is a natural product that has numerous therapeutic properties, including healing and anti-inflammatory action. Several studies have suggested its use in the management of oral mucositis (OM) and ulcerated lesions in the oral mucosa. OM is an inflammation of the oral mucosa resulting from chemotherapy and/or radiotherapy. Whereas ulcerated lesions are characterized as a painful inflammatory ulcerative disorder. Objective: to discuss the action of propolis on the prevention and healing of non-infectious lesions that affect the oral cavity. Methodology: this is an integrative literature review in which LILACS, PubMed, SciELO and Cochrane databases were used, by crossing descriptors in Portuguese: "própolis", "úlceras orais" and "mucosite oral"; and in English: "propolis", "oral ulcer" and "mucositis". The following inclusion criteria were established: clinical trials and systematic reviews, in full, written in English or Portuguese, between 2005 and 2018, which used propolis topically or systemically. Results: a total of 10 studies were included, where 2 addressed the use of propolis in oral ulcers and 8 focused on the application of this agent in the management of OM. As for the outcome, the application of propolis in mucositis proved to be effective in 7 of the 8 studies. As for oral ulcers, the administration of this agent was effective in both studies. Conclusion: the analysed studies demonstrated that propolis has properties capable of help the prevention and healing of OM lesions and oral ulcers.


Subject(s)
Humans , Male , Female , Propolis , Oral Ulcer , Stomatitis
6.
Natal; s.n; 03 mar. 2023. 56 p. ilus, tab, graf.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1532227

ABSTRACT

A via hippo é uma via de transdução de sinal altamente conservada que está implicada no desenvolvimento, homeostase e regeneração celular/tecidual. A YAP tem papel fundamental na via hippo uma vez que junto com a TAZ ativam fatores de transcrição que levam ao crescimento, diferenciação e migração celular. O mecanismo de fosforilação da YAP/TAZ pela LATS1/LATS2 cria um sítio de ligação para manter a YAP no citoplasma (fosforilada) impedindo suas funções a nível nuclear. Diante das importantes funções desta via no reparo e crescimento tecidual, esta pesquisa avaliou se a via hippo exerceu influência na resposta ao tratamento da MO através da expressão das proteínas YAP e LATS2 em mucosite oral (MO) quimicamente induzida pelo 5- fluoracil (5-FU), em modelo murino, tratada com própolis (P), geleia real (GR) ou laser (L) comparadas ao grupo controle (C), sem tratamento. Foram utilizadas amostras de ratos machos wistar divididos nos seguintes grupos: C, P, GR e L (intraoral 6 J/cm2 ) separados em três tempos experimentais: dias 08, 10 e 14. O perfil de imunomarcação foi feito por escores padronizados entre 0 a 3 levando em consideração a marcação nuclear e/ou citoplasmática. Na análise de imunomarcação da YAP, no dia 08, o grupo controle obteve os escore 0 e 1 na maioria das amostras, já nos dias 10 e 14 a maior parte das amostras obteve os escore 2 e 3. Nos grupos experimentais (L, GR e P), o escore 2 prevaleceu em todos os tempos experimentais. Para LATS2 houve prevalência do escore 2 tanto no grupo controle quanto nos grupos teste em todos os tempos experimentais. Em relação a análise estatística da imunoexpressão da proteína YAP, verificou-se diferença estatítica significativa (p= 0,020), apenas no dia 08 entre o grupo controle comparado aos grupos experimentais (L, GR e P). Já para LATS2 nenhuma diferença estatística foi encontrada. Na avaliação estatística dos diferentes tempos experimentais dentro um mesmo grupo, só foi encontrada diferença estatística significativa no grupo laser e apenas para LATS2 (p=0,025). Adicionalmente foi realizada a correlação de spearman, entre YAP e LATS2 para todos os grupos, porém não houve associação estatística significativa. A maior imunoexpressão de YAP e LATS2 (escores 2 e 3) observada nos grupos experimentais, indica que a via hippo é ativada e parece influenciar o processo de reparo nas mucosites orais quimioinduzidas e tratadas pelos diferentes métodos (AU).


The hippo pathway is a highly conserved signal transduction pathway that is implicated in cell/tissue development, homeostasis and regeneration. YAP plays a key role in the hippo pathway since, together with TAZ, they activate transcription factors that lead to cell growth, differentiation and migration. The YAP/TAZ phosphorylation mechanism by LATS1/LATS2 creates a binding site to keep YAP in the cytoplasm (phosphorylated) preventing its functions at the nuclear level. Given the important functions of this pathway in tissue repair and growth, this research evaluated whether the hippo pathway exerted influence on the response to OM treatment through the expression of YAP and LATS2 proteins in oral mucositis (OM) chemically induced by 5-fluororacil (5- FU), in a murine model, treated with propolis (P), royal jelly (GR) or laser (L) compared to the control group (C), without treatment. Samples of male Wistar rats divided into the following groups were used: C, P, GR and L (intraoral 6 J/cm2) separated into three experimental times: days 08, 10 and 14. The immunostaining profile was performed by standardized scores between 0 to 3 taking into account nuclear and/or cytoplasmic labeling. In the YAP immunostaining analysis, on day 08, the control group obtained scores 0 and 1 in most samples, while on days 10 and 14 most samples obtained scores 2 and 3. In the experimental groups (L, GR and P), score 2 prevailed at all experimental times. For LATS2 there was a prevalence of score 2 both in the control group and in the test groups at all experimental times, showing a very heterogeneous expression. Regarding the statistical analysis of YAP protein immunoexpression, there was a statistically significant difference (p= 0.020), only on day 08 between the control group compared to the experimental groups (L, GR and P). As for LATS2, no statistical difference was found. In the statistical evaluation of the different experimental times within the same group, a statistically significant difference was only found in the laser group and only for LATS2 (p=0.025). Additionally, the Spearman correlation was performed between YAP and LATS2 for all groups, but there was no statistically significant association. The greater immunoexpression of YAP and LATS2 (scores 2 and 3) observed in the experimental groups indicates that the hippo pathway is activated and seems to influence the repair process in chemoinduced oral mucositis treated by different methods (AU).


Subject(s)
Animals , Rats , Stomatitis/metabolism , Stomatitis/therapy , Phytotherapeutic Drugs , Hippo Signaling Pathway , Propolis/therapeutic use , Statistics, Nonparametric , Low-Level Light Therapy/methods
7.
Chinese Journal of Internal Medicine ; (12): 819-825, 2023.
Article in Chinese | WPRIM | ID: wpr-985992

ABSTRACT

Objective: To explore the stem cell collection rate and efficacy and safety of patients aged 70 and below with newly diagnosed multiple myeloma (MM) treated with the VRD (bortezomib, lenalidomide and dexamethasone) regimen followed by autologous stem cell transplantation (ASCT). Methods: Retrospective case series study. The clinical data of 123 patients with newly diagnosed MM from August 1, 2018, to June 30, 2020, at the First Affiliated Hospital of Soochow University and Suzhou Hopes Hematology Hospital, who were eligible for VRD regimen sequential ASCT, were collected. The clinical characteristics, efficacy after induction therapy, mobilization regimen of autologous stem cells, autologous stem cell collection rate, and side effects and efficacy of ASCT were retrospectively analyzed. Results: Of the 123 patients, 67 were males. The median patient age was 56 (range: 31-70) years. Patients with IgG, IgA, IgD, and light-chain types accounted for 47.2% (58/123), 23.6% (29/123), 3.2% (4/123), and 26.0% (32/123) of patients, respectively. In addition, 25.2% (31/123) of patients had renal insufficiency (creatinine clearance rate<40 ml/min). Patients with Revised-International Staging System (R-ISS) Ⅲ accounted for 18.2% (22/121) of patients. After induction therapy, the rates of partial response and above, very-good partial response (VGPR) and above, and complete response (CR)+stringent CR were 82.1% (101/123), 75.6% (93/123), and 45.5% (56/123), respectively. Overall, 90.3% (84/93) of patients were mobilized with cyclophosphamide+granulocyte colony-stimulating factor (G-CSF) and 8 patients with G-CSF or G-CSF+plerixafor due to creatinine clearance rate<30 ml/min and one of them was mobilized with DECP (cisplatin, etoposide, cyclophosphamide and dexamethasone)+G-CSF for progressive disease. The rate of autologous stem cell collection (CD34+cells≥2×106/kg) after four courses of VRD regimen was 89.1% (82/92), and the rate of collection (CD34+cells≥5×106/kg) was 56.5% (52/92). Seventy-seven patients treated with the VRD regimen sequential ASCT. All patients had grade 4 neutropenia and thrombocytopenia. Among the nonhematologic adverse events during ASCT, the highest incidence was observed for gastrointestinal reactions (76.6%, 59/77), followed by oral mucositis (46.8%, 36/77), elevated aminotransferases (44.2%, 34/77), fever (37.7%, 29/77), infection (16.9%, 13/77) and heart-related adverse events (11.7%, 9/77). Among the adverse events, grade 3 adverse events included nausea (6.5%, 5/77), oral mucositis (5.2%, 4/77), vomiting (3.9%, 3/77), infection (2.6%, 2/77), elevated blood pressure after infusion (2.6%, 2/77), elevated alanine transaminase (1.3%, 1/77), and perianal mucositis (1.3%, 1/77); there were no grade 4 or above nonhematologic adverse events. The proportion of patients who achieved VGPR and above after VRD sequential ASCT was 100% (75/75), and the proportion of patients who were minimal residual disease-negative (<10-4 level) was 82.7% (62/75). Conclusion: In patients aged 70 and below with newly diagnosed MM treated with VRD induction therapy, the collection rate of autologous stem cells was good, and good efficacy and tolerability were noted after follow-up ASCT.


Subject(s)
Male , Humans , Female , Multiple Myeloma/diagnosis , Hematopoietic Stem Cell Transplantation/adverse effects , Retrospective Studies , Creatinine , Hematopoietic Stem Cell Mobilization , Transplantation, Autologous , Dexamethasone/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Heterocyclic Compounds/therapeutic use , Bortezomib/therapeutic use , Cyclophosphamide/therapeutic use , Stomatitis/etiology
8.
Journal of Experimental Hematology ; (6): 274-279, 2023.
Article in Chinese | WPRIM | ID: wpr-971136

ABSTRACT

OBJECTIVE@#To analyze the distribution and drug resistance of pathogens in oral mucositis associated with chemotherapy in hospitalized patients with malignant hematopathy, so as to provide scientific evidences for rational selection of antibiotics and infection prevention and control.@*METHODS@#From July 2020 to June 2022, 167 patients with malignant hematopathy were treated with chemical drugs in the Department of Hematology, Hainan Hospital, and secretions from oral mucosal infected wounds were collected. VITEK2 COMPECT automatic microbial identification system (BioMerieux, France) and bacterial susceptibility card (BioMerieux) were used for bacterial identification and drug susceptibility tests.@*RESULTS@#A total of 352 strains of pathogens were isolated from 167 patients, among which 220 strains of Gram-positive bacteria, 118 strains of Gram-negative bacteria and 14 strains of fungi, accounted for 62.50%, 33.52% and 3.98%, respectively. The Gram-positive bacteria was mainly Staphylococcus and Streptococcus, while Gram-negative bacteria was mainly Klebsiella and Proteus. The resistance of main Gram-positive bacteria to vancomycin, ciprofloxacin and gentamicin was low, and the resistance to penicillin, cefuroxime, ampicillin, cefotaxime, erythromycin and levofloxacin was high. The main Gram-negative bacteria had low resistance to gentamicin, imipenem and penicillin, but high resistance to levofloxacin, cefotaxime, cefuroxime, ampicillin and vancomycin. The clinical data of oral mucositis patients with oral ulcer (severe) and without oral ulcer (mild) were compared, and it was found that there were statistically significant differences in poor oral hygiene, diabetes, sleep duration less than 8 hours per night between two groups (P<0.05).@*CONCLUSION@#Gram-positive bacteria is the main pathogen of oral mucositis in patients with malignant hematopathy after chemotherapy. It is sensitive to glycopeptide antibiotics and aminoglycosides antibiotics. Poor oral hygiene, diabetes and sleep duration less than 8 hours per night are risk factors for oral mucositis with oral ulcer (severe).


Subject(s)
Humans , Vancomycin/therapeutic use , Cefuroxime , Levofloxacin , Oral Ulcer/drug therapy , Drug Resistance, Bacterial , Anti-Bacterial Agents/adverse effects , Ampicillin , Penicillins , Cefotaxime , Gram-Positive Bacteria , Gram-Negative Bacteria , Gentamicins , Stomatitis/drug therapy
9.
Braz. j. oral sci ; 22: e238998, Jan.-Dec. 2023. tab
Article in English | LILACS, BBO | ID: biblio-1509519

ABSTRACT

Allogeneic hematopoietic stem cell transplantation (HSCT) is a treatment for many diseases; however, it can induce complications such as Oral Mucositis (OM) and Graft-versus- Host Disease (GVHD). The neutrophil-lymphocyte ratio (NLR) is a peripheral biomarker of systemic inflammation and an independent prognostic factor for several inflammatory diseases. Aim: This study aimed to evaluate the association of NLR with OM and GVHD in patients undergoing allogeneic HSCT. Methods: Patients who underwent allogeneic HSCT at the Bone Marrow Transplant Service of the Hospital de Clínicas Complex of the Federal University of Paraná were included in the study. Socio-demographic data and blood counts were collected from patients' medical records. The NLR was calculated and associated with OM and GVHD. Results: 45 patients were included in the study. Although NLR was higher in patients with OM and oral GVHD, no statistical difference was observed, and no relationship between OM and GVHD with NLR could be stated. Conclusion: Although both OM and GVHD are associated with an inflammatory response as well as the immune system, it was not associated with NLR. Further investigation considering other variables related to HSCT might find possible associations, as it could favor patient management and prevention


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Stomatitis , Lymphocytes , Hematopoietic Stem Cell Transplantation , Graft vs Host Disease , Neutrophils
10.
Belo Horizonte; s.n; 2023. 156 p. ilus, tab.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1511273

ABSTRACT

O presente estudo é fundamentado em três objetivos: 1. sintetizar informações sobre ansiedade/depressão de indivíduos em regimes antineoplásicos que desenvolveram mucosite oral por meio de uma revisão sistemática da literatura; 2. avaliar o perfil de citocinas inflamatórias e a formação de redes extracelulares de neutrófilos em amostras de saliva de pacientes em quimioterapia e suas associações com mucosite oral; e 3. investigar ansiedade/depressão e qualidade de vida e associações com mucosite oral quimioinduzida. No primeiro estudo, buscas eletrônicas foram realizadas em cinco bases de dados, complementadas por escrutínio manual e pesquisas na literatura cinzenta. Oito estudos observacionais foram incluídos e a amostra analisada foi de 954 indivíduos. Sete instrumentos diferentes foram aplicados para mensurar ansiedade e/ou depressão. Associações de ansiedade e/ou depressão com a gravidade da mucosite oral foram observadas em 75,0% dos estudos. Os outros dois estudos foram análises longitudinais prospectivas com indivíduos adultos com diagnóstico de doenças hematolinfóides e em tratamento quimioterápico e/ou condicionamento para transplante de células-tronco hematopoiéticas no Hospital das Clínicas da Universidade Federal de Minas Gerais. Os níveis de citocinas inflamatórias (IL-1, IL-6, IL-8, TNF-α e TGF-ß1) e a formação de redes extracelulares de neutrófilos foram analisados por ELISA e identificação do complexo mieloperoxidase-DNA, respectivamente. As coletas de saliva foram realizadas em quatro momentos: dias D0, D3, D10 e D15. Dos 60 pacientes avaliados, 26 (43,3%) desenvolveram algum grau de mucosite oral. Os níveis de concentração de citocinas revelaram diferenças entre indivíduos com e sem mucosite oral. Concentrações significativamente maiores de IL-6 e TNF-α e menores concentrações de TGF-ß1 foram identificadas naqueles que desenvolveram mucosite oral. Houve uma diminuição na formação das redes extracelulares de neutrófilos entre aqueles que tiveram mucosite oral. Entretanto, não foram identificadas diferenças estatísticas entre as concentrações de citocinas e a formação de redes extracelulares de neutrófilos com variáveis clínicas e gravidade da mucosite oral. No terceiro estudo, os instrumentos Hospital Anxiety and Depression Scale, World Health Organization Quality of Life-BREF e Oral Health Impact Profile (versão abreviada ­ OHIP-14) foram aplicados a 37 pacientes nos dias D0 e D15. Aproximadamente 38% (n=14) dos indivíduos desenvolveram mucosite oral e obtiveram escores mais altos de ansiedade/depressão no início da análise. A mucosite oral teve um impacto negativo na qualidade de vida relacionada à saúde bucal, particularmente nas dimensões limitação funcional, dor física e incapacidade física. Em conjunto, os dados deste estudo contribuem para medidas preventivas e redução de comorbidades em pacientes com mucosite oral induzida por esquemas quimioterápicos. As citocinas inflamatórias participam do desenvolvimento da mucosite oral e podem ser úteis como biomarcadores na predição e monitoramento. Ademais, sintomas de ansiedade e depressão estão associados à mucosite oral que, por sua vez, afetam a saúde geral e a qualidade de vida relacionada à saúde bucal.


The present study is based on three purposes: 1. to synthesize by means of a systematic literature review information about anxiety/depression in individuals undergoing antineoplastic therapy who developed oral mucositis; 2. to evaluate the profile of inflammatory cytokines and neutrophil extracellular trap formation in salivary samples from patients undergoing chemotherapy and its associations with oral mucositis; and 3. to investigate anxiety/depression and quality of life and their associations with chemotherapy-induced oral mucositis. In the first study, electronic searches were conducted on five databases, complemented by manual scrutiny and grey literature searches in three other databases. Eight observational studies conducted on 954 individuals were included. Seven different instruments were applied to measure anxiety and/or depression. Associations of anxiety and/or depression with the severity of oral mucositis were observed in 75.0% of the studies. The other two studies were prospective longitudinal analyses of adult individuals diagnosed with hematolymphoid diseases and undergoing chemotherapy treatment and/or conditioning for hematopoietic stem-cell transplantation at the Hospital das Clínicas of Universidade Federal de Minas Gerais. The levels of inflammatory cytokines (IL-1, IL-6, IL-8, TNF-α, and TGF-ß1) and neutrophil extracellular trap formation were analyzed by ELISA and by the identification of the myeloperoxidase-DNA complex, respectively. Saliva sampling was performed at four time-points, i.e. days D0, D3, D10, and D15. Of the 60 patients evaluated, 26 (43.3%) developed some degree of oral mucositis. Cytokine concentration levels revealed differences between individuals with and without oral mucositis. Significantly higher concentrations of IL-6 and TNF-α and lower concentrations of TGF-ß1 were identified in those who developed oral mucositis. There was a decrease in neutrophil extracellular trap formation among those who experienced oral mucositis. However, no statistical differences were identified between cytokine concentrations or neutrophil extracellular trap formation and clinical variables or severity of oral mucositis. In the third study, the Hospital Anxiety and Depression Scale, World Health Organization Quality of Life-BREF and Oral Health Impact Profile (short-form ­ OHIP-14) were the instruments applied to 37 patients on days D0 and D15. Nearly 38% (n=14) of individuals developed oral mucositis and had higher anxiety/depression scores at baseline. Oral mucositis had a negative impact on quality of life related to oral health, particularly functional limitation, physical pain, and physical disability. Taken together, the data from this study contribute to the application of preventive measures and the reduction of comorbidities in patients with chemotherapy-induced oral mucositis. Inflammatory cytokines participate in the development of oral mucositis and may be useful as biomarkers in prediction and monitoring. Moreover, anxiety and depressive symptoms are associated with oral mucositis, affecting, in turn, overall health and oral health-related quality of life


Subject(s)
Anxiety , Stomatitis , Depression , Neoplasms , Antineoplastic Agents
11.
Article in Portuguese | LILACS | ID: biblio-1511497

ABSTRACT

O Neuroblastoma (NB) é uma neoplasia do sistema nervoso simpático, e o segundo tumor sólido maligno extracraniano mais comum da infância. Na terapia antineoplásica, complicações orais podem ser observadas, dentre elas a mucosite oral (MO). Trata-se de uma inflamação aguda da mucosa, proveniente da toxicidade dos quimioterápicos. Este relato de caso enfatiza o manejo da MO, bem como sua influência na condição sistêmica e qualidade de vida. Paciente do sexo feminino, nove anos, apresentou recidiva de NB metastático, após tratamento de primeira linha. Admitida na unidade hospitalar para tratamento oncológico na enfermaria de pediatria oncológica, queixando-se de dor intensa em cavidade bucal e orofaringe, associada a pancitopenia severa febril. Ao exame físico apresentava disfagia e déficit ponderal grave, que debilitava a deglutição da própria saliva. O exame intraoral revelou lesões de MO grau 3, segundo a Organização Mundial de Saúde (OMS), em lábios, gengiva anterior e orofaringe. O tratamento consistiu em remoção de debris local, higiene da cavidade bucal com clorexidina 0,12% e utilizando haste flexível de algodão estéril tipo "Swab", visando controle microbiano local, diariamente. Além disso, foi aplicado no leito eritematoso e hemorrágico fotobiomodulação (660 nm, 50 mW, 2 J/cm2, 90 segundos) pontualmente nas áreas do leito da lesão e em varredura na região de orofaringe (sessões intercaladas). Foi prescrito acetato de racealfatocoferol (vitamina E) para ação antioxidante e hidratação dos lábios. Concomitante a mucosite, a paciente apresentou pancitopenia febril severa, sendo necessário uso de cefepima 150 mg/kg/dia, com coleta prévia de hemoculturas, fator estimulador de colônias de granulócitos, Fluconazol, hidratação e suporte nutricional. As hemoculturas foram negativas. As consequências da mucosite contribuíram para desnutrição e piora da qualidade de vida. Conclui-se que a intervenção odontológica em interdisciplinaridade, possibilitou o restabelecimento físico e emocional, possibilitando melhor uma qualidade de vida da paciente (AU).


Neuroblastoma (NB) is a neoplasia of the sympathetic nervous system and the second most common extracranial malignant solid tumor in childhood. In antineoplastic therapy, oral complications can be observed in antineoplastic therapy, among them oral mucositis (OM). It is an acute mucosa inflammation resulting from the toxicity of chemotherapy drugs. This case report emphasizes the management of OM and its influence on the systemic condition and quality of life. A female patient, nine years old, presented a recurrence of metastatic NB after first-line treatment. She was admitted to the hospital unit for oncological therapy in the pediatric oncology ward, complaining of severe pain in the oral cavity and oropharynx associated with severe febrile pancytopenia. On physical examination, she presented dysphagia and severe weight deficit, which weakened the swallowing of her saliva. According to the World Health Organization (WHO), the intraoral exam revealed third-grade OM lesions on the lips, anterior gum, and oropharynx. Treatment consisted of removing local debris, cleaning the oral cavity with 0.12% chlorhexidine, and using a flexible, sterile cotton swab, aiming for daily local microbial control. In addition, photobiomodulation (660 nm, 50 mW, 2 J/cm2, 90 seconds) was applied to the erythematous and hemorrhagic bed, punctually in the areas of the lesion and sweeps in the oropharynx region (interspersed sessions). Racealphatocopherol acetate (vitamin E) was prescribed for antioxidant action and lip hydration. Concomitant with mucositis, the patient had severe febrile pancytopenia, requiring cefepime 150 mg/kg/day, with previous collection of blood cultures, granulocyte colony-stimulating factor, fluconazole, hydration, and nutritional support. Blood cultures were negative. The consequences of mucositis contributed to malnutrition and worsened quality of life. It is concluded that the interdisciplinary dental intervention enabled physical and emotional restoration, enabling a better quality of life for the patient (AU).


Subject(s)
Humans , Female , Child , Oral Hygiene , Stomatitis/drug therapy , Vitamin E , Low-Level Light Therapy , Antineoplastic Agents/adverse effects
12.
Article in English | LILACS, BBO | ID: biblio-1529126

ABSTRACT

ABSTRACT Objective: To report nine cases of pediatric patients with Acute Lymphoid Leukemia (ALL) or Acute Myeloid Leukemia who developed severe oral mucositis (SOM) at the first week of chemotherapy. Material and Methods: The cases were selected from a sample of 105 children followed for 10 consecutive weeks. Hematological and personal data were obtained from the patient's medical records. The oral cavity was examined weekly using the modified Oral Assessment Guide. Results: More of the patients were male (55.6%), had black/brown skin (55.6%), with ALL (66.7%), and the mean age was 5.55. Two patients had values below normal for leukocytes, platelets, and creatinine over the follow-up. However, all patients showed changes in the normality of hematological data in most weeks. The most used chemotherapeutic agents were aracytin, etoposide, and methotrexate, known for their high stomatotoxic potential. Patients had 2 to 6 (mean of 4) episodes of SOM and 4 to 7 (mean of 5.5) episodes of OM. One patient at week 7, one patient at week 5, and one patient at weeks 2 and 10 did not have OM. Saliva (84 times) and lips (44 times) were the most affected items. Conclusion: The patients showed oscillations in the severity of oral mucositis and hematological parameters over the follow-up. All patients were exposed to stomatotoxic drugs during the initial phase of cancer treatment.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Stomatitis/pathology , Leukemia, Myeloid, Acute/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Hematologic Diseases/drug therapy , Medical Records/statistics & numerical data , Risk Factors
13.
Braz. j. oral sci ; 22: e237697, Jan.-Dec. 2023. ilus
Article in English | LILACS, BBO | ID: biblio-1425466

ABSTRACT

Aim: To assess oral microbial status in patients with acute lymphoblastic leukemia (ALL) undergoing high-dose chemotherapy and to unravel possible associations between nosocomial pathogens and the establishment of chemotherapy-induced oral mucositis (CIOM). Methods: Oral mucosa, saliva, and peripheral blood samples were collected from 46 ALL subjects one day prior to chemotherapy (D0) and 2 weeks after treatment initiation (D14). Clinical intraoral inspection was performed by a single practitioner, with mucositis classification performed according to the WHO oral toxicity scale. Blood components were quantified by automatic flow cytometry, while oral Staphylococcus aureus and Pseudomonas aeruginosa were detected by Polymerase Chain Reaction with species-specific primers. Associations among bacteria and clinical findings were determined by Fisher's Exact test, longitudinal bacterial changes by paired Macnemar, and correlations among blood parameters and mucositis status or bacteria via Mann-Whitney. Results: S. aureus displayed higher detection rates at D14 (p < 0.05) and was positively associated with mucositis, adoption of a non-solid diet (all p < 0.001), nausea and fever (all p < 0.05). Conversely, P. aeruginosa did not correlate to CIOM clinical parameters. At the systemic standpoint, lower hemoglobin levels associated with CIOM and fever events (all p < 0.01). Conclusion: The study evidences S. aureus as a potential pathogen in ALL-CIOM, reaffirming microbial control as an important preventive measure during high-dose immunosuppressive therapy. The weight of non-white-blood-cell parameters should be validated as novel CIOM biomarkers in prospective research


Subject(s)
Humans , Male , Female , Middle Aged , Stomatitis , Bacteria , Polymerase Chain Reaction , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Antineoplastic Agents , Drug Therapy
14.
Arq. ciências saúde UNIPAR ; 26(3): 927-948, set-dez. 2022.
Article in Portuguese | LILACS | ID: biblio-1399509

ABSTRACT

Cuidados paliativos são um conjunto de procedimentos ofertados ao paciente por uma equipe multidisciplinar com objetivo de garantir bem-estar, autonomia,conforto e alívio de sintomas decorrentes de doença ou tratamento quando a cura é impossibilitada. O câncer representa uma das doenças que possuem chances de evoluir o paciente ao estágio terminal, momento em que cuidados paliativos são indicados e necessários. Dentro da equipe responsável, o cirurgião-dentista atua na prevenção, diagnóstico e tratamento de lesões expressas no sistema estomatognático que se manifestam estimuladas pelo câncer ou pelos tratamentos utilizados. O objetivo desta pesquisa é destacar a função do odontólogo dentro da equipe multidisciplinar paliativista para pacientes oncológicos. Trata-se de uma revisão bibliográfica sistemáticada literatura. Foram feitas buscas nas plataformas Biblioteca Virtual em Saúde (BVS) e Scientific Electronic Library Online (SciELO) e após aplicação dos critérios de inclusão e exclusão foram selecionados 14 artigos. A literatura evidencia que alterações orais estão relacionadas com o curso da neoplasia ou seu tratamento; as lesões mais descritas foram: mucosite, xerostomia, candidíase, cárie, periodontite e osteorradionecrose. Isso faz com que o paciente sofra limitações em realizar atividades básicas, alterando negativamente a sua qualidade de vida. A complexidade da manifestação oral pode interromper o tratamento antineoplásico. As medidas de enfrentamento mais empregadas para a saúde bucal do paciente oncológico são a laserterapia, bochechos com clorexidina 0,12%, instrução de higiene oral, uso de anti-inflamatórios, analgésicos e antifúngicos. A atuação do odontólogo na equipe multidisciplinar oncológica paliativista é indispensável para o controle das manifestações orais.


Palliative care comprises a set of procedures offered by a multidisciplinary team to patients who cannot be cured, aiming to restore and ensure well-being, autonomy, independence, comfort and relief from symptoms resulting from illness or treatments. Cancer commonly leads the patient to the terminal stage, and at this stage palliative care is indicated and necessary. Composing the multidisciplinary team, the dentist works in the prevention, diagnosis and treatment of injuries that arise in the stomatognathic system, which manifest themselves due to cancer or its treatments. The objective of this research was to highlight the work of the dentist in the multidisciplinary team of palliative care for cancer patients. This is a systematic bibliographic review of the literature, with an integrative character. Study searches were performed in the Virtual Health Library (VHL) and Scientific Electronic Library Online (SciELO). After applying the inclusion and exclusion criteria, 14 articles were selected. Results showed that oral alterations are completely related to the development of the neoplasm or its treatment; the most described lesions were: mucositis, xerostomia, candidiasis, osteoradionecrosis, radiation caries and periodontitis. These injuries make the patient suffer limitations to perform basic activities, such as eating or communicating, negatively altering their quality of life. The complexity of the oral manifestation can determine the interruption of the anticancer treatment. The most used coping measures for the oral healthof cancer patients are: low- potency laser therapy, mouthwash with 0.12% chlorhexidine, instructionin oral hygiene and use of anti-inflammatory, analgesic and antifungal drugs. The role of dentists in the multidisciplinary palliative oncology team is essential for the control of oral lesions.


Los cuidados paliativos son un conjunto de procedimientos ofrecidos al paciente por un equipo multidisciplinar con el objetivo de garantizar el bienestar, la autonomía, el confort y el alivio de los síntomas derivados de la enfermedad o del tratamiento cuando la curación es imposible. El cáncer representa una de las enfermedades que tienen posibilidades de evolucionar al paciente hasta la fase terminal, momento en el que los cuidados paliativos son indicados y necesarios. Dentro del equipo responsable, el cirujano dentista actúa en la prevención, diagnóstico y tratamiento de las lesiones expresadas en el sistema estomatognático que se manifiestan estimuladas por el cáncer o por los tratamientos utilizados. El objetivo de esta investigación es destacar la función del odontólogo dentro del equipo paliativo multidisciplinar para pacientes oncológicos. Se trata de una revisión bibliográfica sistemática. Se realizaron búsquedas en las plataformas Virtual Health Library (BVS) y Scientific Electronic Library Online (SciELO) y tras aplicar los criterios de inclusión y exclusión, se seleccionaron 14 artículos. La literatura muestra que las alteraciones orales están relacionadas con el curso del cáncer o su tratamiento; las lesiones más comúnmente descritas fueron: mucositis, xerostomía, candidiasis, caries, periodontitis y osteorradionecrosis. Esto hace que el paciente sufra limitaciones para realizar actividades básicas, alterando negativamente su calidad de vida. La complejidad de la manifestación oral puede interrumpir el tratamiento antineoplásico. Las medidas de afrontamiento más utilizadas para la salud bucodental de los pacientes con cáncer son la terapia láser, los enjuagues bucales con clorhexidina al 0,12%, las instrucciones de higiene bucodental y el uso de fármacos antiinflamatorios, analgésicos y antifúngicos. La actuación del odontólogo en el equipo multidisciplinar de oncología paliativa es fundamental para el control de las manifestaciones orales.


Subject(s)
Palliative Care , Dentists , Medical Oncology/instrumentation , Patient Care Team/organization & administration , Radiotherapy/instrumentation , Stomatitis/complications , Stomatitis/diagnosis , Stomatognathic System , Mouth Neoplasms/diagnosis , Mouth Neoplasms/drug therapy , Mouth Neoplasms/radiotherapy , Oral Medicine/instrumentation , Drug Therapy/instrumentation
15.
Acta odontol. Colomb. (En linea) ; 12(2): 115-125, Jul-Dec. 2022. ilus, ilus, ilus, ilus, ilus, ilus
Article in Spanish | LILACS | ID: biblio-1397423

ABSTRACT

Introducción: la disostosis cleidocraneal (CCD) es una enfermedad genética rara que compromete el desarrollo óseo normal, causada por la alteración en el gen RUNX2 del cromosoma 6p (brazo corto). Sus consecuencias incluyen alteraciones óseas por anomalías en la osificación intramembranosa que, a su vez, conllevan a modificaciones en el desarrollo de huesos craneales, claviculares, a múltiples efectos sobre el número, erupción y recambio dental, y a dificultades funcionales, además de cambios en la conducta psicosocial por el deterioro en la calidad de vida. Objetivo: describir el manejo integral de una paciente con disostosis cleidocraneal, a través de la revisión de caso clínico y el reporte de hallazgos en su mejoramiento, como consecuencia de tratamientos quirúrgicos, rehabilitación y el apoyo interdisciplinario, aspecto de gran importancia para este tipo de pacientes. Caso clínico: paciente femenina de 31 años con diagnóstico de CCD que asistió a la Unidad Estomatológica de la Universidad de Cartagena ­ Colombia, y fue remitida desde Genética por presentar inconformidad funcional y dolor leve durante la masticación de los alimentos por movilidad dental severa en dientes antero-inferiores; además, manifestó permanencia de órganos dentarios deciduos, la cual fue tratada en fases. Al tratamiento se le dio un enfoque multidisciplinar, lo que mejoró, de forma sustancial, la autopercepción e interrelación de la paciente en la sociedad.


Background: Cleidocranial dysostosis (CCD) is a rare genetic disease that compromises normal bone development, caused by the alteration in the RUNX2 gene of chromosome 6p (short arm), which causes bone alterations due to abnormalities in intramembranous ossification that leads to alterations in the development of cranial and clavicular bones and multiple efects on the number, eruption and dental turnover, which leads to functional difculties, in addition to behavior and alterations in psychosocial behavior and the deterioration of their quality of life, Objective: To describe the comprehensive management of a patient with cranial Cleido dysostosis, through a clinical case review, reporting among the fndings the improvement of the patient through surgical treatments, rehabilitation and interdisciplinary support, of great importance for this type of patient. Clinical case: A 31-year-old female patient with a diagnosis of CCD, who attended the Stomatology Unit of the University of Cartagena - Colombia, referred by the treating geneticist, due to functional discomfort and mild pain during chewing food due to severe dental mobility. in anterior-inferior teeth, also showing permanence of deciduous dental organs, which was treated in phases in which a multidisciplinary approach was given to its management, which substantially improved its self-perception and its interrelation in society.


Subject(s)
Humans , Female , Adult , Cleidocranial Dysplasia , Oral Medicine , Stomatitis , Mouth, Edentulous
16.
São Paulo; s.n; 20220720. 96 p.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1379708

ABSTRACT

A qualidade de vida em saúde é um tema com enfoque na percepção do paciente e tem sido mais utilizada para ajudar, entre outros fatores, na tomada de decisão clínica. Ela pode ser afetada por diversos fatores e um deles são os efeitos colaterais de tratamentos oncológicos. A mucosite oral é uma inflamação da cavidade oral que pode se apresentar de formas mais leves ou mais severas e traz consequências para o cotidiano das pessoas que por ela são afetadas, como a dificuldade em falar e comer. Buscando entender melhor como essa doença afeta a vida dos pacientes, o instrumento Oral mucositis quality of life (OMQoL) foi criado, e esse estudo tem o objetivo de avaliar as propriedades psicométricas e subescalas desse instrumento para validá-lo. Foram entrevistados 102 pacientes em 2 hospitais diferentes (Hospital Israelita Albert Einstein, na cidade de São Paulo, SP e Hospital Napoleão Laureano, em João Pessoa, PB), a amostra incluiu pacientes maiores de 18 anos em tratamento oncológico. Foi utilizado além do OMQoL, um questionário sociodemográfico para caracterização da amostra. Para avaliar as propriedades psicométricas do instrumento foi realizada uma análise fatorial confirmatória. A amostra era pareada e com dados seguindo a curva de normalidade. A análisse da relação entre o grau de mucosite oral e os diferentes grupos dos hospitais demonstraram diferenças estatisticamente significantes (p<0,001), mas o mesmo não aconteceu com idade (p=0,179) e sexo (p=0,486). Foi realizada análise fatorial confirmatória que mostrou que o instrumento tem boas propriedades, caso seja excluído uma das perguntas do mesmo. Propomos um instrumento reduzido, com propriedades ainda melhores e com menos perguntas. O instrumento Oral Mucositis Quality of Life é válido para ser utilizado na população brasileira, assim como a sua versão reduzida proposta por esse estudo.


Subject(s)
Quality of Life , Stomatitis , Surveys and Questionnaires , Validation Study , Neoplasms
17.
Rev. odontopediatr. latinoam ; 12(1): 212240, 2022. graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1417077

ABSTRACT

La erupción dentaria tiene inicio en las primeras fases de la odontogénesis y termina cuando el diente alcanza su posición funcional en el plano oclusal. La erupción de dientes primarios y la manifestación de los síntomas en niños, es un tema de amplio debate en la literatura. El objetivo del estudio es determinar si se presentan signos y síntomas durante la erupción de los dientes primarios según lo informado por padres y tutores de niños de 6 meses a 3 años. Los datos fueron recolectados a través de un cuestionario dirigido a 50 padres y cuidadores que acompañaban a niños de 6 meses a 3 años para el cuidado odontológico Plataforma Brasil. Hubo signos y síntomas que se describieron como irritabilidad, fiebre, diarrea, encías inflamadas, prurito gingival, salivación excesiva, insomnio, pérdida de apetito, dolor, llanto, estomatitis y sin síntomas reportados. Se puede concluir que la irritabilidad, la fiebre y la diarrea fueron los signos y síntomas más referidos por los padres y tutores.


A irrupção dentária tem início nos primórdios da odontogênese com a fase pré-irruptiva e termina quando o dente atinge a sua posição funcional no plano oclusal. A associação entre irrupção de dentes decíduos e a manifestação de sintomas em crianças é tema de amplo debate na literatura. O objetivo do estudo é determinar se há ocorrência de sinais e sintomas durante a irrupção de dentes decíduos segundo o relato dos pais e responsáveis de crianças de 6 meses a 3 anos de idade. Dados foram coletados através de questionário direcionado a 50 pais e cuidadores que acompanhavam crianças de 6 meses a 3 anos de idade para atendimento odontológico, os dados foram coletados mediante autorização em Termo de Consentimento Livre e Esclarecido e o estudo foi aprovado pelo comitê de ética da Plataforma Brasil. Verificou-se ocorrência de sinais e sintoma que foram descritos como irritabilidade, febre, diarreia, gengiva inchada, coceira gengival, salivação excessiva, insônia, perda de apetite, dor, choro, estomatite e nenhuma sintomatologia relatada. Pode-se concluir que a irritabilidade, febre e diarréia foram os sinais e sintomas mais relatados pelos pais e responsáreis


The dental eruption starts in the early odontogenesis with the pre-irruptive phase and ends when the tooth reaches its functional position in the occlusal plane. The eruption of primary teeth and the manifestation of symptoms in children is the subject of a wide debate in the literature. The purpose of the study is to determine whether signs and symptoms occur during the eruption of deciduous teeth according to the reports of parents and guardians of children aged 6 months to 3 years. Data were collected through a questionnaire directed to 50 parents and caregivers who accompanied children from 6 months to 3 years of age for dental care. Brazil Platform. There were signs and symptoms that were described as irritability, fever, diarrhea, swollen gums, gingival itching, excessive salivation, insomnia, loss of appetite, pain, crying, stomatitis and no reported symptoms. It can be concluded that irritability, fever and diarrhea were the signs and symptoms most reported by parents and guardians


Subject(s)
Infant , Child, Preschool , Tooth, Deciduous , Tooth Eruption , Dental Occlusion , Signs and Symptoms , Stomatitis , Dental Care , Informed Consent , Odontogenesis
18.
Braz. J. Pharm. Sci. (Online) ; 58: e20114, 2022. tab, graf
Article in English | LILACS | ID: biblio-1403742

ABSTRACT

Abstract Curcumin, contained at Turmeric (Curcumalonga), can exert many beneficial pleiotropic activities in the gastrointestinal tract. This study evaluated the antioxidant and anti-inflammatory activity of C. longa on 5-fluorouracil (5-FU)-induced oral mucositis (OM) in hamsters. Phytochemical analysis of crude C. longa extract (CLE) was performed to detect the presence of curcumin by TLC and HPLC. Golden Syrian hamsters were orally pre-treated with CLE (5, 50, or 100mg/kg). Cheek pouch samples were subjected to macroscopic and histopathological evaluation. ELISA was performed to quantify the inflammatory cytokines IL-1ß and TNF-α. Superoxide dismutase (SOD), glutathione (GSH) and malondialdehyde (MDA) levels were assessed by ultraviolet-visible spectroscopy analysis. Behavior analysis was conducted by the open field test. Curcumin content in the CLE was 0.55%m/m ± 0.0161 (2.84%). The group treated with 5mg/kg CLE showed healing evidence with macroscopic absence of ulceration (p<0.05) and microscopic aspect of re-epithelialization, discrete inflammatory infiltrate and absence of edema. Treatment with 5mg/kg CLE significantly increased GSH levels, and reduced MDA levels and SOD activity (p˂0.05), and decreased IL-1ß (p˂0.05) and TNF-α (p˂0.01) levels. A significant reduction in walking distance, ambulation, speed, and rearing was observed for motor activity. Curcumin reduced oxidative stress, inflammation, and motor activity in hamsters with 5-FU-induced OM.


Subject(s)
Animals , Male , Rats , Stomatitis/pathology , Curcumin/analysis , Curcuma/classification , Chromatography, High Pressure Liquid/methods , Phytochemicals/agonists , Fluorouracil/administration & dosage , Inflammation/complications , Antioxidants/classification
19.
São Paulo; s.n; 2022. 91 p. tab, ilus.
Thesis in Portuguese | LILACS, Inca | ID: biblio-1414233

ABSTRACT

A mucosite oral (MO) é uma reação inflamatória da mucosa orofaríngea ao tratamento quimioterápico (e/ou radioterápico), sendo uma das complicações mais frequentes e que pode afetar significativamente a qualidade de vida (QdV) de pacientes durante o tratamento oncológico. Existem diversos questionários que têm o objetivo de avaliar QdV, sendo o Oral Mucositis Quality of Life (OMQoL) e o Patient-Reported Oral Mucositis Symptom Scale (PROMS) instrumentos desenvolvidos especificamente para pacientes com MO. O objetivo deste trabalho foi traduzir, adaptar e validar os instrumentos OMQoL e PROMS para o português do Brasil, e avaliar a QdV de pacientes com MO. Ambos os questionários passaram pelos processos de tradução do inglês para o português, retrotradução e adaptação cultural, obtendo-se uma versão inicial em português dos questionários, com a qual foi realizado um primeiro teste-piloto com 40 pacientes, após o qual foram realizadas adaptações chegando-se à versão pré-final, aplicada em um segundo teste-piloto a outros 40 pacientes, chegando-se às versões finais dos questionários, as quais foram aplicadas a outros 58 pacientes, com o objetivo de estabelecer o coeficiente alfa de Cronbach, e após o intervalo de 48 horas, estes mesmos pacientes responderam novamente os questionários (teste-reteste), a fim de se calcular o coeficiente de correlação intraclasse. Os questionários OMQoL e PROMS obtiveram, respectivamente, alfa de Cronbach de valor classificado como "alto" (0,75 < α ≤ 0,90) e "muito alto" (α > 0,90), e confiabilidade do testereteste "muito alta" (0,912) e "alta" (0,796), respectivamente. O OMQoL demonstrou apropriada construção como questionário e adequada coesão entre os itens do mesmo, com reprodutibilidade e confiabilidade para avaliar satisfatoriamente os quesitos a que se propõe analisar. Já no que se refere ao questionário PROMS, infere-se que há menor coesão entre os itens, apresentando redundâncias e um desequilíbrio no número de questões entre os diferentes domínios do questionário. A avaliação da QdV de pacientes com MO foi realizada através da aplicação de 4 questionários (OMQoL, PROMS, OHIP-14 e EORTC QLQ-C30) a um total de 122 pacientes (61 no Grupo Mucosite e 61 no Grupo Controle). Foi demonstrado que a MO exerce impacto negativo na QdV dos pacientes, sobretudo entre aqueles com graus de MO mais intensa.


Oral mucositis (OM) is an inflammatory reaction of the oropharyngeal mucosa to chemotherapy (and/or radiotherapy), being one of the most frequent complications that can significantly affect the quality of life (QoL) of patients during cancer treatment. There are several questionnaires that aim to assess QoL, the Oral Mucositis Quality of Life (OMQoL) and the Patient-Reported Oral Mucositis Symptom Scale (PROMS) being instruments developed specifically for patients with OM. The aim of this study was to translate, adapt and validate the instruments OMQoL and PROMS into Brazilian Portuguese, and to assess the QoL of patients with OM. Both questionnaires went through the processes of translation from English to Portuguese, backtranslation and cultural adaptation, obtaining an initial version in Portuguese of the questionnaires, with which a first pilot test was carried out with 40 patients, after which adaptations were made, resulting in the pre-final version, applied on a second pilot test to other 40 patients, resulting in the final versions of the questionnaires, which were applied to other 58 patients, with the aim of establishing Cronbach's alpha coefficient, and after a 48-hour period, these same patients answered the questionnaires again (test-retest) in order to calculate the intraclass correlation coefficient. The OMQoL and PROMS questionnaires obtained, respectively, Cronbach's alpha value classified as "high" (0.75 < α ≤ 0.90) and "very high" (α > 0.90), and reliability of test-retest "very high" (0.912) and "high" (0.796), respectively. The OMQoL demonstrated proper construction as a questionnaire and adequate cohesion between its items, with reproducibility and reliability to satisfactorily assess the items it intends to analyze. Regarding the PROMS questionnaire, it is inferred that there is less cohesion between the items, presenting redundancies and an imbalance in the number of questions between the different domains of the questionnaire. The assessment of QoL of patients with OM was performed through the application of 4 questionnaires (OMQoL, PROMS, OHIP-14 and EORTC QLQ-C30) to a total of 122 patients (61 in the Mucositis Group and 61 in the Control Group). OM has been shown to have a negative impact on patients' QoL, especially among those with more intense OM degrees. There was no significant association between chemotherapy protocol and QoL. The Mucositis group had a lower QoL in all four instruments used, compared to the results of the Control group.


Subject(s)
Quality of Life , Stomatitis , Surveys and Questionnaires , Cross-Cultural Comparison , Validation Study , Head and Neck Neoplasms
20.
Braz. dent. sci ; 25(4): 1-11, 2022. tab, ilus
Article in English | LILACS, BBO | ID: biblio-1396322

ABSTRACT

Objective: In this study, patients undergoing neck and head radiotherapy (RT) with or with no chemotherapy were contrasted to the low-level laser therapy (LLLT) efficacy against benzydamine hydrochloride in treating and preventing oral mucositis (OM) (CHT). Material and Methods: This study included 90 individuals with neck and head cancer who were undergoing radiotherapy (RT) individually or in mixture with chemotherapy (CHT), varying in age from 18 to 80 years. Three equal groups were randomly formulated: Group, I patients were using oral care only, Group II patients were using benzydamine hydrochloride mouth rinse, and Group III patients were medicated by using low-level laser therapy. The National Institute of Cancer-Common Toxicity Criteria (NIC-CTC) and the World Health Organization (WHO) were used to rate the severity of OM, and the pain was validated utilizing a visual analog scale (VAS). The salivary level of tumor necrotic factor-α (TNF- α) was assayed. Results: As per WHO and NIC, the grade of oral mucositis at the end of cancer treatment was less in the LLLT group than in the other two groups. The alteration in TNF- α level was not significant. The laser group is more liable to have less salivary levels of the pro-inflammatory cytokines TNF- α . Conclusion: The incidence of oral mucositis severity has seemed to be reduced due to the prophylactic use of benzydamine hydrochloride and laser therapy protocols. However, laser therapy was more efficient in controlling the shape and progression of OM (AU)


Objetivo: Neste estudo, pacientes submetidos à radioterapia (RT) da cabeça e pescoço com ou sem quimioterapia foram avaliados quanto à eficácia da terapia com laser de baixa potência (LLLT) versus o cloridrato de benzidamina no tratamento e prevenção da mucosite oral (MO) (CHT). Material e Métodos: Este estudo incluiu 90 indivíduos com câncer de cabeça e pescoço submetidos à radioterapia (RT) individualmente ou em combinação com quimioterapia (QT), com idade variando de 18 a 80 anos. Três grupos iguais foram aleatoriamente formulados: os pacientes do Grupo I usaram apenas higiene bucal, os pacientes do Grupo II usaram bochechos com cloridrato de benzidamina e os pacientes do Grupo III foram medicados com terapia a laser de baixa intensidade. Foram utilizados os critérios do National Institute of Cancer-Common Toxicity Criteria (NIC-CTC) e da Organização Mundial da Saúde (OMS) para classificar a gravidade da OM, e a dor foi validada utilizando uma escala visual analógica (VAS). O nível salivar de fator necrótico tumoral-α (TNF-α) foi ensaiado. Resultados: De acordo com a OMS e NIC, o grau de mucosite oral ao final do tratamento do câncer foi menor no grupo LLLT do que nos outros dois grupos. A alteração no nível de TNF-α não foi significativa. O grupo com tratamento a laser apresentou menores níveis de citocinas pró-inflamatórias TNF-α na saliva. Conclusão: A gravidade da mucosite oral parece ser reduzida devido ao uso profilático de cloridrato de benzidamina e protocolos de laserterapia. No entanto, a laserterapia foi mais eficiente em controlar a forma e a progressão da MO. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Radiotherapy , Stomatitis , Benzydamine , Drug Therapy , Laser Therapy
SELECTION OF CITATIONS
SEARCH DETAIL