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.

Study of Mycobacterium tuberculosis drug resistance in the region of Galicia, Spain.

FRAMEWORK: Galicia, a region in north-east Spain with its own government and health system and a population of 2 695 880. OBJECTIVE: To study the epidemiology of resistant tuberculosis (TB). DESIGN: A prospective, descriptive, and observational study of all Mycobacterium tuberculosis isolates processed by each of the laboratories in Galicia that perform mycobacterial cultures. The study followed the methodology recommended by the World Health Organization and the International Union Against Tuberculosis and Lung Disease, and included isolates processed between 1 November 2001 and 1 June 2002. FINDINGS: Of 400 strains analysed, 360 corresponded to previously untreated cases and 40 to previously treated cases. Of the previously untreated cases, 88.3% contained strains susceptible to isoniazid, rifampicin, streptomycin and ethambutol, while 4.4% were resistant to isoniazid. The rate of susceptibility to the four drugs was 77.5% in the previously treated cases. Multidrug-resistant TB was detected in 1.4% of the previously untreated cases and in 7.5% of the previously treated cases. CONCLUSION: Although Galicia has a high incidence of TB (49.4 cases per 100 000 population in 2001), the resistance levels detected by the study do not currently pose a serious problem for the region.

[Current treatment of tuberculosis]. / Tratamiento actual de la tuberculosis.

Tuberculosis (TB) is a growing national and international health concern today. A revision of pharmacological treatment of TB is done in this issue. Regimens for TB disease and latent TB treatment are described. Common adverse reactions and drug interactions of first and second-line antituberculosis drug are summarized in tables. Management strategies to improve treatment adherence and TB control, treat special situations like immunodeficiences, pregnancy, hepatic and renal impairment and multidrug resistant TB are presented. In a next future the prospects for using more effective and shorter new treatments to fight against this disease are not very promising.

[Empyema caused by Pasteurella multocida]. / Empiema por Pasteurella multocida.

A new case of pneumonia and empyema by Pasteurella multocida diagnosed by culture of pleural fluid is reported. It is also reviewed the most common ways of infection, the characteristics of the rare pulmonary diseases, the risks factors and the treatment.