Capecitabine-induced oral mucosal hyperpigmentation associated with hand-foot syndrome - A literature review

Abstract Background Capecitabine (Xeloda®) is a cytotoxic, antimetabolite chemotherapeutic agent. Its most common adverse events are diarrhea, hand-foot syndrome (HFS), hyperbilirubinemia, hyperpigmentation, fatigue, abdominal pain, and other gastrointestinal effects. HFS or palmar-plantar erythrodysesthesia (PPE) is an adverse reaction resulting from therapy with chemotherapeutic agents, classified into three degrees. Hyperpigmentation, as an adverse effect of capecitabine, can occur in different locations and with different patterns. The skin, nails and oral mucosal membrane can be affected. Objective The objective of this study was to report and discuss oral hyperpigmentation associated with HFS caused by the use of capecitabine, which is still poorly described in the literature. Methodology A literature review was carried out using the online databases PubMed, Scielo, BVS, Lilacs, Medline, BBO and Google Scholar, associating the descriptors "Capecitabine", "Pigmentation Disorders", "Oral mucosa", "Cancer" and "Hand-Foot Syndrome", which were related and used to exemplify, discuss and report the exposed clinical case. Results This case report corroborates the literature regarding the incidence in females and black skin persons like this patient who was affected by HFS when undergoing antineoplastic therapy with capecitabine and presented hyperpigmentation of the hands, feet and oral mucosa. On the oral mucosa, the hyperpigmented spots were diffuse, showing a blackish color and irregular edges. Their pathophysiology remains unknown. Study limitations Few articles citing capecitabine-associated pigmentation. Conclusions It is hoped that this study may contribute to the identification and correct diagnosis of hyperpigmentation in the oral cavity, as well as call attention to the adverse effects related to capecitabine.

Satisfação dos usuários atendidos na Clínica Integral de Odontologia da Universidade Federal de Pernambuco e fatores associados / Patients satisfaction in Dental School Clinics of the Federal University of Pernambuco and associated factors

Objetivo: avaliar a satisfação dos usuários atendidos nas clínicas integrais do curso de Odontologia da Universidade Federal de Pernambuco e a associação com fatores relacionados ao paciente, ao acesso e ao atendimento. Método: trata-se de um estudo descritivo, quantitativo, de corte transversal, partindo de uma amostra de conveniência, realizado com 81 pacientes adultos, de ambos os sexos. Foi aplicado um questionário semiestruturado com questões do Questionário de Avaliação dos Serviços de Saúde Bucal (QASSAB), uma questão de ansiedade ao tratamento odontológico (Dental Anxiety Question modificada) e dados individuais do paciente, como sexo, idade, escolaridade, local de residência e procedimentos realizados. Resultados: os resultados demonstraram que os usuários consideraram a obtenção de uma vaga como razoável ou fácil (75,3%), e o tempo na fila de espera como razoável ou curto (66,7%). A maioria dos participantes respondeu que o motivo da procura por atendimento na clínica era o fato de não ter dinheiro para pagar o tratamento particular, e 40,7% dos pacientes manifestaram algum sinal de ansiedade. Houve uma avaliação positiva do ambiente físico do serviço por parte dos usuários, para a maioria das variáveis pesquisadas. No entanto, apenas a variável organização foi significativamente associada com a satisfação dos usuários. Conclusão: de forma geral, os resultados encontrados nesta pesquisa indicam um bom nível de satisfação, porém, tornam-se necessárias reavaliações periódicas para obtenção de informações importantes que possibilitem melhorias na estrutura e no atendimento das clínicas.(AU)

Objective: to evaluate patient satisfaction at the Dental School Clinics at the Federal University of Pernambuco, Brazil, and the association with factors related to the patient, access and care. Method: this is a descriptive, quantitative, cross-sectional study, based on a convenience sample, conducted with 81 adult patients, of both sexes. A semi-structured questionnaire was applied with questions from the Oral Health Services Assessment Questionnaire (QASSAB), a question of anxiety to dental treatment (modified Dental Anxiety Question) and individual patient data, such as sex, age, education, place of residence and procedures performed. Results: the results showed that users considered obtaining a place as reasonable or easy (75.3%) and the time in the queue as reasonable or short (66.7%), most participants answered that the reason why they chose theservice was the fact that they did not have the money to pay for private treatment and 40.7% of the patients showed some sign of anxiety. There was a positive evaluation of the physical stucture of the service by users, for most of the variables surveyed. However, only the organization variable was significantly associated with user satisfaction. Conclusion: in general, the results found in this research indicate a good level of satisfaction, however, periodic reassessments are necessary to obtain important information that will allow improvements in the structure and care of clinics.(AU)