Oral microbiome and systemic antineoplastics in cancer treatment: A systematic review.

BACKGROUND: Oral mucositis is one of the most common side effects in cancer patients receiving systemic antineoplastics. However, the underlying biological mechanisms leading to this condition are still unclear. For this reason, it has been hypothesised that systemic antineoplastics may cause an imbalance on the oral microbiota that subsequently triggers oral mucosa damage. MATERIAL AND METHODS: A systematic review was performed following the PRISMA protocol and the PICO question established was: patients diagnosed with cancer, who are candidates for receiving systemic antineoplastics (P=Patients), that undergo oral microbiome determinations (I=Intervention), before and after systemic antineoplastics administration (C=Comparison), to analyse changes in the oral microbiome composition (O=Outcome). The bibliographic search was carried out in PubMed and other scientific repositories. RESULTS: Out of 166 obtained articles, only 5 met eligibility criteria. Acute myeloid leukaemia (AML) was the most frequent type of cancer (40 %) among the participants. Only one of the studies included a control group of healthy subjects. Heterogeneity in the protocols and approaches of the included studies hindered a detailed comparison of the outcomes. However, it was stated that a decrease in bacteria α diversity is often associated with oral mucositis. On the other hand, fungal diversity was not associated with oral mucositis although α diversity was lower at baseline on patients developing oral candidiasis. CONCLUSIONS: There is insufficient scientific evidence of oral microbiological changes in patients undergoing systemic antineoplastics. Further investigations ought to be carried out to identify microorganisms that might play a key role in the pathogenesis of oral mucosa damage in patients undergoing systemic antineoplastics.

Comparación de un método no invasivo de determinación del gasto cardiaco (nico) y variables hemodinámicas con técnicas invasivas de termodilución en bolos / Comparison of a not invasive method of decision of the cardiac expense (nico) and variable haemodynamic with invasive techniques of termodilución in bowling

Recientemente, un nuevo equipo ha sido desarrollado para la medición del gasto cardiaco (GC) en forma no invasiva, utilizando mecanismos de reinhalacion de CO2. Nosotros comparamos esta técnica con la medición de GC por temodilución en bolos en 23 mediciones. A diferencia de lo estándar, donde se utiliza la presión del capilar pulmonar, la presión venosa central fue utilizada para calcular parámetros derivados de los datos obtenidos del NICO. Las mediciones del GC se correlacionan parcialmente con las mediciones realizadas con termodilución y el monitoreo con NICO podría ser una buena alternativa en la medición del GC. Sin embargo, los datos obtenidos del NICO no pueden ser utilizados para los cálculos de trabajo sistólico del ventrículo izquierdo (TSVI), trabajo sistólico del ventrículo derecho (TSVD) o índices de resistencias vasculares sistémicas (IRVS)...