Comparison of oral candidiasis characteristics in head-and-neck cancer patients before and during radiotherapy.

Background: Patients undergoing head-and-neck radiotherapy are susceptible to Candida colonization and infection. This study aimed to identify oral Candida species type (ST), colony count (CC), and oropharyngeal candidiasis (OPC) in head-and-neck cancer patients, undergoing radiotherapy, before and 2 weeks after radiation. Materials and Methods: In this quasi-experimental study, head-and-neck cancer patients undergoing radiotherapy (up to 6000 cGy) were recruited. Samples were taken before and 2 weeks after radiation therapy (RT). CC was assigned using Sabouraud dextrose agar culture medium and morphological studies were performed to confirm OPC. For identification, polymerase chain reaction-restriction fragment length polymorphism was performed. Data were analyzed using Chi-square-test and kappa coefficient. P < 0.05 was considered statistically significant. Results: Twenty-one of 33 patients were Candida positive. The detected fungal species included Candida albicans (60%), Candida tropicalis (22%), Candida glabrata (9%), and other species (9%). Following RT, OPC and CC changed significantly (P = 0.003 and P = 0.001, respectively), whereas ST did not significantly change (P = 0.081). Two new species (Candida krusei and Candida parapsilosis) were detected after the intervention. The OPC, CC, and ST changes after RT were not significantly related to malignancy site or radiation dose (P > 0.05). Conclusion: The present study showed that OPC, CC, and ST were not related to the malignancy site. Following RT, OPC and CC changed significantly, while ST showed no significant change. The radiation dose and malignancy site had no effects on the OPC, CC, or ST alterations following RT.

The salivary alpha-amylase concentration in patients with rheumatoid arthritis: A case-control study.

Background: Rheumatoid arthritis (RA) is one of the most common chronic inflammatory diseases. Previous studies have reported an association between stress and salivary alpha-amylase. The aim of this study was to investigate the concentration of salivary alpha-amylase in patients with RA (by elimination of stress factor). Materials and Methods: In this case-control study, we enrolled 50 patients with RA and 48 healthy patients as the control group. The perceived stress scale questionnaire was used to evaluate scores of stress in both case and control groups, and then the participants with high scores of stress were excluded from the study. Moreover, the alpha-amylase activity kit was used for the assessment of the levels of salivary alpha-amylase. In all analyses, the significance level was considered to be < 0.05. Finally, the obtained data were analyzed by SPSS22. Results: Our results indicated a high score of stress in the case group (19.42 ± 5.83 units) compared with the control group (18.02 ± 6.07 units) which was not statistically significant (P < 0.248). Moreover, we demonstrated a high salivary alpha-amylase concentration in the case group (340.65 ± 38.04 units) compared to the control group (302.62 ± 58.72 units), which was statistically significant (P < 0.001). The sensitivity and specificity of this method, at >312 alpha-amylase concentrations, were 80% and 46%, respectively. Conclusion: In general, we indicated that the alpha-amylase concentration in patients with RA is higher than the healthy controls, and can be used as a codiagnostic factor.

Relationship between oral cancer stage and elapsed time from the onset of signs and symptoms to diagnosis and treatment.

BACKGROUND: Oral cancer includes a variety of diagnoses of malignancies that manifest in the oral tissues. Prognosis and treatment depend on the site of involvement, the time of diagnosis, and the stage of the tumor. Early diagnosis of oral mucosal lesions facilitates the early detection of cancer, which is a key step for treatment. The purpose of this study was to investigate the relationship between delayed referral of patients with oral cancer and disease progression at the time of diagnosis. MATERIALS AND METHODS: In this cross-sectional study, data were collected from 108 patients with a definitive diagnosis of oral cancer by a standardized questionnaire. Data were analyzed by descriptive statistics, including mean, standard deviation, frequency, frequency percentage, and inferential statistics, including logistic regression analysis. P<0.05 was considered to be statistically significant. RESULTS: The mean time of referral to a therapist was 17.73 ± 22.80 weeks, with 53 (49.1%) patients having a delay of more than 10 weeks. Age, education level, smoking, disease stage, N class, M class, and type of cancer were not significantly associated with the incidence of delay (P>0.05). Patients whose first signs were significant bleeding and/or unrecovered ulceration showed a significant reduction in the delay time (OR = 0.024 and P = 0.038). CONCLUSION: There was no significant relationship between the disease progression in oral cancer and the time elapsed from the onset of symptoms to diagnosis and treatment. Hence, it seems necessary to take appropriate measures to enhance public awareness of oral cancer and its symptoms.

Comparative Study of the Effect of Licorice Muco-adhesive Film on Radiotherapy Induced Oral Mucositis, A Randomized Controlled Clinical Trial.

BACKGROUND: Oral mucositis is a common complication induced by radiation in head and neck cancer patients. OM can cause pain, dysphagia, dehydration and impaired quality of life. The main objective of this study was to assess the effectiveness of licorice mucoadhesive film on symptoms of head and neck radiotherapy-induced mucositis. METHODS: sixty head and neck cancer patients who have been scheduled to undergo radiotherapy were randomly assigned to receive radiotherapy plus licorice mucoadhesive film (30) or radiotherapy plus placebo mucoadhesive film. In this double blinded randomized clinical trial, oral mucositis was estimated by world health organization scales, a quantitative scale, and symptoms were evaluated by visual analog scale. RESULTS: The results showed a meaningful difference in pain score between two groups in third and fourth weeks (P-value <0.05). Also, there was a significant difference in scale of mucositis between the two groups in weeks 3 and 4 (P-value <0.05). However, there were no meaningful differences with regard to pain and scale of mucositis in weeks 0, 1, 2. (P-value>0.05). CONCLUSION: This study showed that licorice mucoadhesive film can be effective in decreasing pain and level of radiation-induced mucositis and it could be administered as an alternative agent in OM management. Key words: Oral mucositis, Radiotherapy, Licorice, Mucoadhesive film, Placebo.

A novel formulation for radiotherapy-induced oral mucositis: Triamcinolone acetonide mucoadhesive film.

BACKGROUND: The main purpose of this study was to evaluate the effectiveness of triamcinolone acetonide (TA) mucoadhesive films versus placebo as a preventive and therapeutic intervention of oral mucositis (OM) induced by radiotherapy for head-and-neck cancer (HNC) patients. MATERIALS AND METHODS: In this double-blind, randomized case-controlled clinical trial, 60 HNC patients were randomized to receive TA mucoadhesive films (n = 30) or placebo mucoadhesive films (n = 30) taken four times daily. Mucositis severity was assessed during the course of radiation therapy using the World Health Organization scales, and pain scores were assessed using visual analog scale. Repeated measures ANOVA was used for data analysis. RESULTS: Mean ± standard deviation age of the TA group was 58.53 ± 8.89 years and 60% were male, whereas in the placebo group, it was 56.46 ± 9.36 years and 56.7% were male (P > 0.05). The mean value of pain score was significantly reduced in the TA group (5.36 ± 1.29 vs. 2.20 ± 2.02) compared with the placebo group (5.34 ± 0.78 vs. 4.69 ± 0.77) during 4 weeks (P < 0.001); repeated measures ANOVA analysis showed that the mean value of grade mucositis was significantly reduced in the TA group (2.40 ± 0.49 vs. 0.96 ± 0.81) compared with the placebo group (2.36 ± 0.80 vs. 1.86 ± 0.93) during 4 weeks (P < 0.001). CONCLUSION: TA film could be considered as an effective approach for reducing the mucositis grading and pain score in the patients with OM.

Prevalence of oral mucosal status in resident and non-resident nursing home in Isfahan city, Iran: a comparative cross-sectional study / Prevalência da condição da mucosa oral em idosos residente em casas de repouso ou não residente, na cidade de Isfahan, Irã: um estudo transversal comparativo

Objective: The aim of this study was to evaluate the oral mucosal status of residents nursing home and non-resident in Isfahan, Iran and compare them with each other. Material and Methods: This was a cross-sectional study comparing 281 elderly in two groups: 141 resident and 140 non-residents nursing homes in Isfahan, Iran. The selection of nursing home and all of elderly was randomly. The nonresidents elderly were randomly selected from the public places adjacent to the nursing home. Persons were examining and the relevant information recorded in a checklists. Data were analyzed by SPSS version 24 using t-test, chi square, MannWhitney, Fisher exact test. (α =0/05). Results: The sample of the case was 281 people, including 135 males (48%) and 146 females (52%). Of all the subjects 153 patients (54.4%) had at least one oral lesion, 78 (55.3%) in resident nursing home and 75 (53.6%) in non-resident. There was no significant difference between two groups based on Chi-Square test (P>0/05). In this study, 25 different types of lesions were recorded, the most common lesion in all participants was epulis fissuratum (12.1%). Conclusion: The results showed that the prevalence of mucosal lesions is high in the elderly living in the centers and in the non-resident. Therefore, maintaining dentures is necessary to prevent and control lesions. (AU)

Objetivos: O objetivo deste estudo foi avaliar a condição da mucosa oral de residentes em casas de repouso e não residentes em Isfahan, Irã, e compará-los entre si. Material e Métodos: Estudo transversal que comparou 281 idosos em dois grupos: 141 casas de repouso residentes e 140 não residentes em em casas de repouso na cidade de Isfahan, Irã. A seleção da casa de repouso de idosos e todos os idosos envolvidos foi aleatória. Os idosos não residentes foram selecionados aleatoriamente nos locais públicos adjacentes ao lar de idosos. As pessoas foram examinadas e as informações relevantes registradas. Os dados foram analisados pelo SPSS versão 24, utilizando o teste t, Qui-quadrado, Mann-Whitney, teste exato de Fisher (α = 0/05). Resultados: A amostra do estudo constou de 281 pessoas, incluindo 135 homens (48%) e 146 mulheres (52%). Do total geral, 153 pacientes (54,4%) apresentaram pelo menos uma lesão oral, sendo 78 (55,3%) em idosos residentes na casa de repouso e 75 (53,6%) em idosos não-residentes. Não houve diferença significativa entre os dois grupos com base no teste do Quiquadrado (p>0.05). Neste estudo, foram registrados 25 tipos diferentes de lesões, sendo que a lesão mais comum em todos os participantes foi a epulis fissuratum (12,1%). Conclusão: Os resultados mostraram que a prevalência de lesões nas mucosas é alta nos idosos residentes nas casas de repouso e também em não residentes. Portanto, a manutenção da prótese é necessária para prevenir e controlar as lesões. (AU)

Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy-induced oral mucositis: A randomized double-blinded clinical trial.

AIM: Mucositis is a major complication of irradiation in head and neck tumors, the addition of chemotherapy to irradiation may enhance this dose-limiting problem. Licorice is a strong demulcent that had been effectively used in treatment of peptic ulcer. The main purpose of this study was to compare the therapeutic safety and efficacy of triamcinolone acetonide (T) and licorice (L) mucoadhesive films on oral mucositis in terms of pain control and/or ulcer treatment. METHODS: The study was a double-blind, randomized prospective trial of two types of mucoadhesive films in the management of oral mucositis that occurred during head and neck cancer radiotherapy. Oral mucositis was assessed using a quantitative scale (World Health Organization scales) and symptoms were assessed using visual analog scale. Sixty patients were enrolled in the study: 30 patients in the triamcinolone and 30 in the licorice group. RESULTS: With respect to visual analog scores, repeated observations in consecutive weeks showed a meaningful difference (P-value < 0.05), suggesting the efficacy of both T and L in reducing pain during radiotherapy. Comparison of the pain scores between two groups by independent sample t-test, however, demonstrated no meaningful difference in any consecutive week. CONCLUSIONS: We concluded that both triamcinolone and licorice mucoadhesive films are effective in the management of oral mucositis during radiotherapy. Furthermore, comparison of the pain scores between two groups demonstrated no meaningful difference, although an overall trend to reduced oral discomfort was seen in the licorice group.