Differences between the oral changes presented by patients with solid and hematologic tumors during the chemotherapeutic treatment

Abstract Objective: This study sought to identify the differences between the oral changes presented by patients with solid and hematologic tumors during chemotherapeutic treatment. Methodology: This is an observational, prospective and quantitative study using direct documentation by follow-up of 105 patients from 0 to 18 years using the modified Oral Assessment Guide (OAG). Of the 105 patients analyzed, 57 (54.3%) were boys with 7.3 years (±5.2) mean age. Hematologic neoplasms accounted for 51.4% of all cases. Results: Voice, lips, tongue, and saliva changes were not significantly different (p>0.05) between patients with solid or hematologic tumors and during the follow-up. From the 6th until the 10th week of chemotherapeutic treatment alterations in swallowing function, in the mucous membrane (buccal mucosa and palate), in the labial mucosa, and in the gingiva occurred and were distributed differently between the two tumors groups (p<0.05). The main alterations were observed in patients with hematologic tumors. Conclusion: It was concluded that the oral changes during the chemotherapeutic treatment occurred especially in swallowing function, in the mucous membrane, in the labial mucosa and in the gingiva, and these alterations were found mainly in patients with hematologic tumors.

Bedside assessment of swallowing in elderly subjects using psychotropic drugs / Avaliação funcional da deglutição do idoso em uso de medicação psicotrópica

Neuroleptic drugs are used in several mental disorders, but are suspected of causing oropharyngeal dysphagia, mainly in the elderly. AIM: To study the effect of neuroleptic agents on swallowing of institutionalized older people. MATERIAL AND METHOD: A cross sectional study of swallowing in 47 subjects that either used or did not use neuroleptic drugs. Bedside swallowing tests with foods of four different consistencies were carried out. RESULTS: There was no significant difference between the two groups. Users of neuroleptic medications showed a higher percentage of multiple swallowing while non-users had a higher percentage of oral food escape. CONCLUSIONS: Neuroleptic agents alone do not affect the mechanism of swallowing in the elderly; nonetheless. Further studies with a larger number of individuals and specific swallowing tests are needed.

Drogas neurolépticas são utilizadas em diversas doenças mentais e suspeita-se que causem disfagia orofaríngea, principalmente em usuários idosos. OBJETIVO: Observar o efeito dos neurolépticos sobre a deglutição de idosos institucionalizados. Forma de Estudo: Descritivo transversal de série de casos. MATERIAL E MÉTODOS: A deglutição de 47 idosos moradores de casa de repouso, usuários e não usuários de drogas neurolépticas foi avaliada por meio do teste clínico funcional da deglutição usando quatro consistências de alimentos. RESULTADOS: Não houve diferença significativa entre os dois grupos. Os usuários de neurolépticos mostraram porcentagem maior de deglutições múltiplas, enquanto os não usuários apresentaram porcentagem maior de escape oral. CONCLUSÃO: Medicações neurolépticas, isoladamente, não afetam o mecanismo da deglutição do idoso. Entretanto, novos estudos, com número maior de indivíduos e que usem avaliação específica da deglutição, são necessários.

Drogas, disfagia e nutriçäo / Drugs, dysphagia and nutrition

After reviewing this article you should be able to:understand the term " dysphagia" and its clinical manifestations; understand the different components of the swallowing system; understand how different agents interact with the components of a swallowing system; be able to identify those most at risk of dysphagia and what drugs may contribute to, or exacerbate their dysphagia