Changes in bacterial number at different sites of oral cavity during perioperative oral care management in gastrointestinal cancer patients: preliminary study

Abstract Objective The objective of this study was to clarify differences in bacterial accumulation between gastrointestinal cancer patients who underwent severely invasive surgery and those who underwent minimally invasive surgery. Material and Methods We performed a preliminary investigation of gastrointestinal cancer patients who were treated at the Department of Surgery, Takarazuka Municipal Hospital, from 2015 to 2017 (n=71; 42 laparoscopic surgery, 29 open surgery) to determine changes in bacterial numbers at different sites of the oral cavity (tongue dorsum, gingiva of upper anterior teeth, palatoglossal arch), as well as mouth dryness and tongue coating indices. Specifically, patients received professional tooth cleaning (PTC), scaling, tongue cleaning, and self-care instruction regarding tooth brushing from a dental hygienist a day before the operation. Professional oral health care was also performed by a dental hygienist two and seven days after surgery. Oral bacteria numbers were determined using a bacterial counter with a dielectrophoretic impedance measurement method. Results The number of bacteria at all three examined sites were significantly higher in the open surgery group when compared to the laparoscopic surgery group on the second postoperative day. Relevantly, bacterial count in samples from the gingiva of the upper anterior teeth remained greater seven days after the operation in patients who underwent open surgery. Furthermore, the dry mouth index level was higher in the open surgery group when compared to the laparoscopic surgery group on postoperative days 2 and 7. Conclusions Even with regular oral health care, bacterial numbers remained high in the upper incisor tooth gingiva in gastrointestinal cancer patients who received open surgery. Additional procedures are likely needed to effectively reduce the number of bacteria in the gingival area associated with the upper anterior teeth.

Primary gastrointestinal lymphoma--a clinicopathologic study.

Gastrointestinal tract is the most common site for the development ofextra nodal lymphoma. This study was done to analyze clinical and pathological features as well as the treatment outcome of this disease. We carried out analysis of25 cases of primary gastrointestinal (GI) lymphomas during period from March 2001 to February 2003 at Gujarat Cancer & Research Institute. Out of 25 cases of primary GI lymphoma, nine cases of gastric lymphoma, nine cases of small intestinal lymphoma and seven cases of large intestinal lymphoma were identified. A male to female ratio of 2.6:1 was observed. Peak incidence was observed infirst and second decades of life (range 4-63 years). Abdominal pain and abdominal lump were the two most common presenting symptoms. Diffuse large B-cell type and Burkitt's lymphoma were the most common histologic variants, accounting for equal proportions (36% each). All the patients were treated with either surgery alone or in combination of surgery, chemotherapy and radiotherapy depending on the site, stage and histology. Anti H-pylori kit was used in early stage GI maltomas. 18 cases of GI lymphoma were evaluable, and out of these, 66.6% (11 cases) attained complete remission with a median follow up time of 12 months. The disease free survival was 50% (9 cases), and the overall survival was 72.2% (13 cases). In conclusion, although there are considerable therapeutic controversies, surgery with adjuvant chemotherapy and radiotherapy yield good survival. Clinical and histopathologic characteristics and prognosis of our cases with primary gastrointestinal lymphoma were usually similar to the cases in western countries with some differences in the incidence and histologic subtypes.

Aislamiento de Helicobacter pylori de pacientes con trastornos gastroduodenales en San Luis (Argentina) / Helicobacter pylori isolated from patients with gastrointestinal tract diseases in San Luis (Argentina)

Se investigó la presencia de Helicobacter pylori en 50 pacientes con trastornos gastroduodenales que concurrieron a dos centros de salud de la ciudad de San Luis. De cada paciente se tomaron cuatro muestras de biopsia de mucosa de antro gástrico, dos de ellas destinadas al estudio histológico y dos al análisis bacteriológico: observación al Gram, prueba de ureasa y cultivo. Helicobacter pylori se detectó en 38 (76 por ciento) de los pacientes mediante el estudio histológico y en 30 (60 por ciento) por la tinción de Gram. De estos últimos, 28 (93 por ciento) dieron positiva la prueba de ureasa coincidiendo con un número significativo de bacterias. El 80 por ciento (24/30) de las muestras positivas al Gram mostró un buen desarrollo microbiano en los medios de cultivo de Mueller-Hinton y de Skirrow indistintamente. Se recomienda la prueba de ureasa como una alternativa de diagnóstico: rápida, económica y efectiva cuando hay una cantidad suficiente de bacterias.

Helicobacter pylori infection in gastric cancer: a study of 84 cases from Asir region

Gastric cancer can be divided into three histologic types: intestinal and diffuse adenocarcinoma, and malignant lymphoma. To determine whether Helicobacter pylori was associated with either cancer type, we reviewed histologic sections from stomachs of 84 patients with the diagnosis of gastric cancer. Of 63 patients with histologic evidence of intestinal adenocarcinoma, 53 [84%] contained H. pylori in noncancerous tissue compared with six [66.7%] of nine patients with diffuse adenocarcinoma [odds ratio = 2.65; Z=1.048; P>0.05] and with eight [66.7%] of 12 patients with non-Hodgkin malignant lymphoma of the stomach [odds ratio = 2.65; Z=0.826; P>0.05]. Our findings are compared with reported data from other countries and we are not aware of similar reports from the Kingdom of Saudi Arabia