Quality of life in patients with early-stage extra-nodal NK/T cell lymphoma of nasal type after definitive radiation therapy / 中华放射肿瘤学杂志

Objective:To investigate the quality of life in patients with early-stage extra-nodal NK/T cell lymphoma of nasal type (ENKTL) arising from the upper aerodigestive tract, who had remained progression-free survival (PFS) for over 3 months after definitive intensity-modulated radiation therapy (IMRT), and to analyze the factors related to main adverse symptoms.Methods:276 patients who received IMRT from March, 2012 to June, 2021 were included. There were 201 males and 75 females with a median age of 41.5 years (range: 13-81 years) upon diagnosis. Consistent target delineation schemes and similar dose gradients were adopted for IMRT, with a median prescribed dose of 54.6 Gy/26F. Cross-sectional investigation was performed with a modified EORTC QLQ-H&N35 questionnaire, the incidence and severity of adverse symptoms, severity of disease and their influencing factors at each time-point during their survival were statistically analyzed.Results:The median age of patients at the investigation was 46.2 years, and the median PFS after IMRT was 47.2 months (range: 3.1-115.7 months). The most common adverse symptoms included nasal symptoms (incidence rate 63.8%), dry mouth (50%), tooth diseases (47.1%), smell and taste alteration, and sexual apathy, etc. Most symptoms were mild (the average standardized score was 5.50, the full score of 100 indicating the most severe), and could be relieved remarkably over survival time, but some symptoms, such as tooth diseases and sexual apathy, were more obvious and recurred for several years. Age and anti-PD-1 immune therapy influenced the symptom scores, and tooth diseases were closely correlated with dry mouth. Conclusion:The quality of life in patients with early-stage ENKTL after definitive IMRT is high, and the most significant symptoms include nasal symptoms, tooth diseases, and sexual apathy, etc. , which need to be mitigated with more studies.

Research progress on oral characterization of Corona Virus Disease 2019 / 口腔疾病防治

@#Corona Virus Disease 2019 (Corona Virus Disease 2019,COVID-19) has become a public health emergency that has attracted global attention because of its large-scale outbreak resulting in numerous human infections and deaths. COVID-19 is a highly contagious respiratory disease caused by novel coronavirus 2019-nCoV. Due to a large number of infections and fast transmission speed, it's significant to diagnose the infected people quickly and detect the asymptomatic infected people as soon as possible. At present, the preliminary screening is judged by the clinical manifestations of the patients, mainly involving the respiratory system, but recent studies have found that the patients infected with COVID-19 have unique oral manifestations, such as taste disturbance, xerostomia, halitosis, inflammation of salivary glands, necrotizing periodontal disease and some of them are earlier than typical symptoms such as dry cough, fever, etc. Paying attention to the oral manifestations of patients can further improve the COVID-19 screening procedure. At present, symptomatic treatment is mainly used for these oral symptoms.

Prevalence of xerostomia and its association with systemic diseases and medications in the elderly: a cross-sectional study

ABSTRACT BACKGROUND: Dry mouth syndrome or xerostomia is defined as decreased salivary flow or hypofunction of salivary glands. Its origins are multicausal and might be the result of a change in the salivary glands or a systemic imbalance. OBJECTIVE: To ascertain the prevalence of self-reported xerostomia and to identify associated factors. DESIGN AND SETTING: Cross-sectional study on the entire population of 293 elderly people over 60 years of age living in a Brazilian municipality. METHODS: Data were gathered from a questionnaire that asked about demographic data, chronic diseases and use of continuous medications, and which used the Xerostomia Inventory (XI) to evaluate dry mouth sensation. Our analysis consisted of multivariate regression and estimation of odds ratios (OR) and their respective 95% confidence intervals (CI) in binary logistic regression models. RESULTS: The prevalence of self-reported xerostomia was 19.1%. Elderly people with diabetes had higher odds of having self-reported xerostomia (OR: 3.59; 95% CI: 1.48-8.68; P < 0.001) as did those who had chronic diseases and used continuous medication (OR: 2.3; 95% CI: 1.19-4.67; P = 0.009). Elderly people who used continuous medication for the gastrointestinal tract were more likely to have xerostomia (OR: 2.14; 95% CI: 1.03-1.44; P = 0.030). CONCLUSIONS: Elderly people with diabetes and chronic diseases who were using continuous medication were more likely to have dry mouth. Use of continuous medications for the gastrointestinal tract led to a greater chance of having self-reported xerostomia.

Oral manifestation in pre-renal transplant patients in Tertiary Care Hospital in Punjab

The incidence of renal failure is known to be increasing globally. Kidney transplant are considered the most efficient renal replacement therapy for a significant number of patients with end- stage renal disease. Renal failure can give rise to a large spectrum of oral manifestations, affecting overall health of patients with renal disease. End-stage renal disease (ESRD) patients have a plethora of oral findings. The aim of this study was to study oral symptoms and lesions in pre-renal transplant patients. This prospective study was conducted over a 6-month period. A total of 80 individuals (40 pre renal transplant patients and 40 controls) were recruited. Each patient was interviewed individually using questionnaire about oral symptoms. Each patient was examined for oral lesions and documented. For Caries DMFT and for Gingivitis CPITN index was used. In both study and control group majority were males and majority were in age group 21-30 years. In study group knowledge of importance of oral hygiene was more. The most common symptoms were dry mouth (20%), altered taste (52.5%) and bleeding gums (42.5%). Study group showed significantly more oral changes than those in the control group. DMFT index was positive in 60% of study and 80% control group. CPITN index was equally positive (92.5%) in both study and control group. Mucosal pallor, suburral tongue, leukoplakia and hyperplastic gingivitis was seen in 27.5%, 10%, 10% and 2.5% respectively in the study group. Prevalence of oral lesions is significantly higher in renal patients. The potential source of active infective lesions in medically compromised patients with ESRD must be treated before transplant.

Observation on therapeutic effect of needle-knife for dry mouth and eyes symptoms of primary Sjögren's syndrome / 中国针灸

OBJECTIVE@#To compare the clinical efficacy of needle-knife and hydroxychloroquine sulfate in the treatment of dry mouth and eyes symptoms of primary Sjögren's syndrome.@*METHODS@#A total of 60 patients with primary Sjögren's syndrome were randomly divided into an observation group and a control group, 30 cases in each group. In the observation group, needle-knife was used in the range of 2 cm and 2-3 cm below the occipital protuberance, the left and right lateral bone edges of the C spinous process, between and within the range of 1.5-3 cm beside the C and C spinous processes, points between the left and right mandibular angle and the mastoid, the treatment was given 1 time a week for 8 times. The hydroxychloroquine sulfate was applied 0.2 g each time, 2 times daily, 4 weeks as a course and a total of 2 courses in the control group. The changes of salivary flow rate, tear volume, serum immunoglobulin IgG, IgA, IgM contents and Chinese medicine symptom score were observed before and after treatment in the two groups, and the efficacy was evaluated.@*RESULTS@#The total effective rate in the observation group was 86.7% (26/30), which was better than 70.0% (21/30) in the control group (0.05).@*CONCLUSION@#Needle-knife is superior to hydroxychloroquine sulfate in improving dry mouth and eyes symptoms and reducing serum IgG content in patients with primary Sjögren's syndrome.

Xylitol stimulates saliva secretion via muscarinic receptor signaling pathway

Xylitol is well-known to have an anti-caries effect by inhibiting the replication of cariogenic bacteria. In addition, xylitol enhances saliva secretion. However, the precise molecular mechanism of xylitol on saliva secretion is yet to be elucidated. Thus, in this study, we aimed to investigate the stimulatory effect of xylitol on saliva secretion and to further evaluate the involvement of xylitol in muscarinic type 3 receptor (M3R) signaling. For determining these effects, we measured the saliva flow rate following xylitol treatment in healthy individuals and patients with dry mouth. We further tested the effects of xylitol on M3R signaling in human salivary gland (HSG) cells using real-time quantitative reverse-transcriptase polymerase chain reaction, immunoblotting, and immunostaining. Xylitol candy significantly increased the salivary flow rate and intracellular calcium release in HSG cells via the M3R signaling pathway. In addition, the expressions of M3R and aquaporin 5 were induced by xylitol treatment. Lastly, we investigated the distribution of M3R and aquaporin 5 in HSG cells. Xylitol was found to activate M3R, thereby inducing increases in Ca²⁺ concentration. Stimulation of the muscarinic receptor induced by xylitol activated the internalization of M3R and subsequent trafficking of aquaporin 5. Taken together, these findings suggest a molecular mechanism for secretory effects of xylitol on salivary epithelial cells.

Boca Seca em Idosos: Proposta de um Novo Substituto Salivar à Base de Própolis / Dry mouth in elderly people: proposal of a new salivary substitute based on propolis

Introdução: O idoso tem tendência à secura da cavidade oral, a qual está ligada à atrofia da mucosa oral e das glândulas salivares. Objetivo: O presente estudo objetiva, por meio de uma revisão de literatura, estudar a xerostomia e os substitutos artificiais atualmente utilizados para a saliva. Revisão de literatura: Os benefícios na área da saúde das propriedades farmacológicas com produtos apícolas estão sendo estudados devido à sua eficiência, para o crescente desenvolvimento de nutracêuticos e alimentos funcionais. Própolis e seus extratos têm inúmeras aplicações no tratamento de várias doenças devido ao seu efeito antisséptico, anti-inflamatório, antioxidante, antibacteriano, antifúngico, antiúlcera, anticancerígeno, e propriedades imunomoduladoras. No campo odontológico tem atraído a atenção, reduzindo a inflamação resultante de procedimentos cirúrgicos e como agente antimicrobiano no controle da placa bacteriana. Considerações finais: Os sintomas da boca seca (xerostomia e hipossialia) incluem: distúrbios do paladar, mau hálito, intolerância a prótese dentária, com um risco aumentado para infecções, incluindo candidíase e lesões nas mucosas, doença periodontal, desmineralização dos dentes, susceptibilidade a cárie dentária e perda dentária, principalmente nos idosos. Por isso a importância em estudar um novo substituto salivar (APIS saliva) a base de própolis, para amenizar e substituir a falta de saliva na cavidade oral.

Introduction: The elderly tends to dry the oral cavity, and it is linked to the atrophy of the oral mucosa and salivary glands. Objective: This study aims, through a literature review, to study xerostomia and the artificial substitutes currently used for saliva. Literature review: The health benefits of pharmacological properties with bee products are being studied because of their efficiencies, for the growing development of nutraceuticals and functional foods. Propolis and its extracts have numerous applications in the treatment of various diseases due to their antiseptic, antiinflammatory, antioxidant, antibacterial, antifungal, anti-ulcer, anticancer, and immunomodulatory properties. In the dental field has attracted attention, reducing inflammation resulting from surgical procedures and as an antimicrobial agent in plaque control. Final considerations: Dry mouth symptoms (xerostomia and hyposialia) include taste disturbances, bad breath, intolerance to dental prostheses, increased risk of infection, including candidiasis and mucosal lesions, periodontal disease, tooth demineralization, tooth decay susceptibility and dental loss, especially in the elderly. Therefore, the importance in studying a new salivary substitute (APIS saliva) based on propolis, to soften and replace the lack of saliva in the oral cavity.

Xerostomía en pacientes con fibromialgia: Estudio epidemiológico / Xerostomia in fibromyalgia patients: Epidemiologic study

Introducción: Dentro de los fenómenos clínicos estudiados asociados a la Fibromialgia (FM) se ha descrito el Síndrome Sicca, cuyo término engloba xeroftalmia, xerostomía, xerodermia y xerovagina. El objetivo de este estudio fue estimar la frecuencia de xerostomía en pacientes con diagnóstico de fibromialgia y describir las características clínicas de dichos pacientes. Material y métodos: Se incluyeron pacientes con diagnóstico de FM según criterios ACR 1990 y 2010, en quienes se evalúo la presencia de xerostomía mediante las preguntas correspondientes al dominio de los criterios clasificatorios 2002 ACR-EULAR de Sjögren y se realizó sialometría no estimulada para medición de flujo salival. Resultados: Se reclutaron 50 pacientes, el 100% fueron mujeres. La media de edad fue 47 años (DS+-8,5), siendo la media tiempo de evolución de la FM de 6 años (DS+-4,5). En total 29 pacientes (51%) refirieron xerostomía y de este grupo sólo 4 sialometrías fueron positivas. El tabaquismo fue más prevalente en las pacientes con FM que no referían xerostomía con respecto a las que sí referían xerostomía (31,8 % vs 6,9%, p 0,02), sin encontrarse diferencias estadísticamente significativas en las características clínicas evaluadas. Conclusión: La prevalencia de xerostomía fue del 51%. No se demostró una disminución del flujo salival objetiva en la mayoría de los pacientes con FM.

Introduction: The aim of this study was to determinate the frecuency of xerostomia in patients with diagnosis of Fibromyalgia (FM) and describe their clinical characteristics. Material and methods: Patients were included according 1990 and 2010 ACR Classification criteria. All of them were evaluated for xerostomia and a sialometry was performed in order to determinate the decrease of salival flow. Results: Fifty patients were recruited during the study. The 100% of them were women. The mean age was 47 years old (DS+-8.5), while the mean time of evolution of FM was 6 years (SD +-4.5). Twenty nine patients reported xerostomia of which 4 presented positive sialometry. Smoking was more prevalent in patients with FM who did not report xerostomia with respect of those who reported xerostomia (31.8% vs 6.9%, p 0.02). Conclusion: The frequency of xerostomia was 51%. No statistically significant associations were found in patients who reported xerostomia. A decrease in objective salivary flow was not demonstrated in patients with FM.

How common is dry mouth? systematic review and meta-regression analysis of prevalence estimates

Abstract The aim of this paper is to systematically review the literature to estimate the overall prevalence of xerostomia/hyposalivation in epidemiological studies. An electronic search was carried out up to February 2018 with no language restrictions. A total of 5760 titles were screened and just twenty-nine papers were included in review and the meta-analysis after a two independently reviewers applied the selection criteria. Data were extracted from PubMed and Web of Science databases. Eligibility criteria included original investigations from observational population-based studies that reported the prevalence of xerostomia or data that allowed the calculation of prevalence of xerostomia and/or hyposalivation. Studies conducted in samples with specific health conditions, literature reviews, case reports and anthropological studies, as conferences or comments were excluded. Sample size, geographic location of the study, study design, age of the studied population, diagnosis methods, and evaluation criteria used to determine xerostomia e/or hyposalivation were extracted for meta-analysis and meta-regression. Multivariate meta-regression analysis was performed to explore heterogeneity among studies. The overall estimated prevalence of dry mouth was 22.0% (95%CI 17.0-26.0%). Higher prevalence of xerostomia was observed in studies conducted only with elderly people. Despite diverse approaches to the condition's measurement, just over one in four people suffer from xerostomia, with higher rates observed among older people. Moreover, the measurement methods used currently may over- or underestimate xerostomia. These findings highlight the need for further work on existing and new clinical measure and will be useful to determine which one is more reliable in clinical and epidemiological perspectives.

Resumo O objetivo do estudo é revisar sistematicamente a literatura afim de estimar a prevalência global de xerostomia/hiposalivação em estudos epidemiológicos. Uma busca eletrônica foi conduzida até Fevereiro de 2018 sem restrições de linguagem. Um total de 5760 títulos foram inicialmente identificados e somente vinte e nove artigos foram incluídos na revisão e meta-análise após dois revisores independentes aplicarem os critérios de seleção. Os artigos foram extraídos das bases de dados PubMed/Medline e Web of Science. Os critérios de elegibilidade incluíram investigações originais de estudos observacionais de base populacional os quais reportaram a prevalência de xerostomia ou dados que permitissem o cálculo da prevalência de xerostomia e/ou hiposalivação. Estudos realizados em populações com condições de saúde específicas, revisões de literatura, relato de casos e estudos antropológicos, assim como, conferências ou comentários foram excluídos. Tamanho amostral, localização geográfica aonde foi realizado o estudo, desenho do estudo, idade da população estudada, métodos de diagnóstico e o critério de avaliação para determiner xerostomia e/ou hiposalivação foram extraídos para a meta-análise e metaregressão. Análise de meta-regressão multípla foi realizada para explorar a heterogeneidade entre os estudos. A prevalência global estimada de boca seca foi de 22.0% (95%IC 17.0-26.0%). Uma maior prevalência de xerostomia foi observada em estudos realizados exclusivamente em populações idosas. Apesar de diferentes abordagens utilizadas para mensurar as condições de interesse, cerca de uma em quatro pessoas é acometida por xerostomia, com taxas mais elevadas sendo observadas na população idosa. Além disso, os métodos de mensuração podem ter super- ou subestimado os valores de xerostomia. Os achados do presente estudo salientam a necessidade de mais estudos acerca das existentes e novas formas de avaliação clínica, os quais serão úteis para determinar qual é a mais confiável para as perspectivas clínicas e epidemiológicas.

Síndrome de Boca Ardiente en pacientes atendidos en el Hospital Clínico Quirúrgico Docente "Freyre de Andrade", 2009-2014 / Burning Mouth Syndrome in patients treated in "Freyre de Andrade"Clinical Surgical Teaching Hospital, 2009-2014

Introducción: El Síndrome de Boca Ardiente, constituye un trastorno sensitivo-doloroso de la cavidad bucal, caracterizado por síntomas crónicos de ardor o dolor en presencia de una mucosa bucal clínicamente normal, capaz de conducir a importantes alteraciones psicosociales. Objetivo: Caracterizar epidemiológica y clínicamente a los pacientes con Síndrome de Boca Ardiente atendidos en el Hospital Clínico Quirúrgico Docente Freyre de Andrade en el período de 2008 a 2014. Material y Métodos: Estudio descriptivo y transversal, en 36 pacientes con Síndrome de Boca Ardiente desde febrero de 2009 hasta junio de 2014. Se estudiaron las variables: edad, sexo, síntomas y su localización, factores de riesgo sistémicos y locales y subtipo clínico. Resultados: El 77,8 por ciento de los afectados eran del sexo femenino y 22,2 por ciento del masculino; mientras que 72,2 por ciento pertenecían al grupo de 60 años y más. El 66,6 por ciento mantenía tratamiento con medicamentos xerostomizantes y 27,8 por ciento de los pacientes presentó factores protésicos como factor de riesgo local; 13,8 por ciento presentaba síntomas difusos en la cavidad bucal; en 44,4 por ciento la lengua fue el lugar referido y la mucosa del carrillo en 25 por ciento; mientras 66,7 por ciento perteneció al subtipo II. Conclusiones: En los pacientes con Síndrome de Boca Ardiente estudiados predomina el sexo femenino y el grupo de 60 años y más; los factores de riesgo de mayor frecuencia son los medicamentos xerostomizantes, la posmenopausia y los trastornos psicológicos. El síntoma ardor bucal es el más referido, la lengua la más afectada y la mayoría de los pacientes pertenecen al subtipo II(AU)

Introduction: Burning Mouth Syndrome is a sensitive-painful disorder of the oral cavity, characterized by chronic symptoms of burning or pain in the presence of a clinically normal oral mucosa, capable of leading to important psychosocial changes. Objective: To characterize, from the epidemiological point of view, the patients with Burning Mouth Syndrome treated in "Freyre de Andrade" Clinical Surgical Teaching Hospital from 2008 to 2014. Material and Methods: A cross-sectional descriptive study was conducted in 36 patients with Burning Mouth Syndrome from February 2009 to June 2014. The following variables were studied: age; sex; symptoms and their localization; and systemic and local risk factors, as well as clinical subtype. Results: The 77,8 percent of people affected were female and the 22,2 percent were male, whereas the 72,2 percent belonged to the group of 60 years and over. The 66,6 percent followed treatment with xerostomizing drugs; the 27,8 percent of patients presented factors related to prosthetic use as a local risk factor; the 13,8 percent presented diffuse symptoms in the oral cavity; the 44,4 percent of patients reported symptoms in the tongue, and the 25 percent presented symptoms in the mucosa of the cheek; whereas the 66,7 percent belonged to the subtype II. Conclusions: Burning Mouth Syndrome predominates in the female sex and the group of 60 years and over in the patients studied. The most frequent risk factors are the xerostomizing drugs, menopause, and psychological disorders. Burning mouth is the most referred symptom, the tongue is the most affected site, and most of the patients belong to subtype II(AU)