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Ribeiro AB, Pizziolo PG, Clemente LM, Aguiar HC, Poker BDC, Silva AAME, Makrakis LR, Fifolato MA, Souza GC, Oliveira VDC, Watanabe E, Lovato da Silva CH. Strategies for Preventing and Treating Oral Mucosal Infections Associated with Removable Dentures: A Scoping Review. Antibiotics (Basel) 2024; 13:273. [PMID: 38534708 DOI: 10.3390/antibiotics13030273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/01/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
Oral infections occur due to contact between biofilm rich in Candida albicans formed on the inner surface of complete dentures and the mucosa. This study investigated historical advances in the prevention and treatment of oral mucosal infection and identified gaps in the literature. Bibliographic research was conducted, looking at PubMed, Embase, Web of Science, and Scopus, where 935 articles were found. After removing duplicates and excluding articles by reading the title and abstract, 131 articles were selected for full reading and 104 articles were included. Another 38 articles were added from the gray literature. This review followed the PRISMA-ScR guidelines. The historical period described ranges from 1969 to 2023, in which, during the 21st century, in vitro and in vivo studies became more common and, from 2010 to 2023, the number of randomized controlled trials increased. Among the various approaches tested are the incorporation of antimicrobial products into prosthetic materials, the improvement of oral and denture hygiene protocols, the development of synthetic and natural products for the chemical control of microorganisms, and intervention with local or systemic antimicrobial agents. Studies report good results with brushing combined with sodium hypochlorite, and new disinfectant solutions and products incorporated into prosthetic materials are promising.
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Affiliation(s)
- Adriana Barbosa Ribeiro
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Pillar Gonçalves Pizziolo
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Lorena Mosconi Clemente
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Helena Cristina Aguiar
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Beatriz de Camargo Poker
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Arthur Augusto Martins E Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Laís Ranieri Makrakis
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Marco Aurelio Fifolato
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Giulia Cristina Souza
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Viviane de Cássia Oliveira
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Evandro Watanabe
- Department of Restorative Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
| | - Cláudia Helena Lovato da Silva
- Department of Dental Materials and Prosthesis, Ribeirão Preto School of Dentistry, University of São Paulo, Café Avenue S/N, Ribeirão Preto 14040-904, SP, Brazil
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Aseri AA. Clinical and Radiographic Outcomes of Adjunctive Phototherapy Versus Antibiotic Therapy Against Peri-Implant Diseases: A Systematic Review and Meta-Analysis. Photobiomodul Photomed Laser Surg 2024; 42:189-199. [PMID: 38512322 DOI: 10.1089/photob.2023.0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Background: Peri-implantitis, an inflammatory condition in implant tissues, requires bacterial eradication and implant surface decontamination, with aPDT as a helpful surgical adjunct. Objective:This project was designed to investigate the effect of antibiotic therapy versus aPDT, as adjuncts to conventional mechanical debridement (MD), on the peri-implant clinical and/or radiographic parameters among patients with peri-implant diseases. Methods: A comprehensive search was conducted across electronic databases, including PubMed, Scopus, and Web of Science, up to and including April 2023, without any restriction on the language and year of publication, focusing the following research question: "Does adjunctive aPDT improve the peri-implant clinical and/or radiographic parameters in treating peri-implant diseases compared to antibiotic therapy?" Statistical analysis was performed on peri-implant clinical [plaque index (PI), probing depth (PD), and bleeding on probing (BOP)] and radiographic parameters [marginal bone loss (MBL)]. The study included six randomized controlled trials and one clinical (nonrandomized) study. Results: The systematic review findings indicate that the application of aPDT as an adjunct to MD is equally effective as adjunctive antibiotic therapy in improving peri-implant clinical parameters and radiographic parameters in patients with peri-implant diseases. Only two studies were classified as having a low risk of bias (RoB), two were assessed as having an unclear RoB, and the remaining three studies were determined to have a high RoB. However, the meta-analysis results revealed no statistically significant difference in peri-implant PI, PD, and MBL scores between patients treated with adjunct aPDT or adjunct antibiotic therapy. Notably, there was a statistically significant difference favoring adjunct aPDT in peri-implant BOP values compared to the control group. Conclusions: Despite the limited number of included studies and the significant heterogeneity among them, the findings suggest that aPDT yields comparable peri-implant clinical and radiographic outcomes to adjunctive antibiotic therapy, as adjuncts to MD, for the potential treatment of peri-implant diseases.
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Affiliation(s)
- Abdulrahman A Aseri
- Department of Preventive Dental Sciences, College of Dentistry, Najran University, Najran, Kingdom of Saudi Arabia
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Garutti M, Noto C, Pastò B, Cucciniello L, Alajmo M, Casirati A, Pedrazzoli P, Caccialanza R, Puglisi F. Nutritional Management of Oncological Symptoms: A Comprehensive Review. Nutrients 2023; 15:5068. [PMID: 38140327 PMCID: PMC10745914 DOI: 10.3390/nu15245068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/06/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Throughout their experience of illness and during the course of treatment, a substantial proportion of cancer patients are prone to develop nutritional and/or metabolic disturbances. Additionally, cancer patients often encounter long-term side effects from therapies, which may lead to impaired digestion, nutrient absorption or bowel motility. Therefore, the preservation and maintenance of an optimal and balanced nutritional status are pivotal to achieving a better prognosis, increasing the tolerance and adherence to cancer therapies and improving the overall quality of life. In this context, personalized nutritional programs are essential for addressing conditions predisposing to weight loss, feeding difficulties, digestion problems and intestinal irregularity, with the goal of promoting adequate nutrient absorption and minimizing the detrimental effects of treatment regimens. The focus of this research is to examine the most common clinical conditions and metabolic changes that cancer patients may experience, including stomatitis, xerostomia, diarrhea, nausea, vomiting, dysphagia, sub-occlusion, dysgeusia, dysosmia, anorexia, and cachexia. Furthermore, we present a pragmatic example of a multidisciplinary workflow that incorporates customized recipes tailored to individual clinical scenarios, all while maintaining the hedonic value of the meals.
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Affiliation(s)
- Mattia Garutti
- CRO Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy
| | - Claudia Noto
- CRO Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy
- Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Brenno Pastò
- CRO Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy
- Department of Medicine, University of Udine, 33100 Udine, Italy
| | - Linda Cucciniello
- CRO Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy
- Department of Medicine, University of Udine, 33100 Udine, Italy
| | | | - Amanda Casirati
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Paolo Pedrazzoli
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
- Medical Oncology Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
| | - Fabio Puglisi
- CRO Aviano, National Cancer Institute, IRCCS, 33081 Aviano, Italy
- Department of Medicine, University of Udine, 33100 Udine, Italy
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Terry D, Eads AV. Alogliptin Induced Stomatitis: An Adverse Drug Event Case Report. J Pharm Pract 2023; 36:1516-1518. [PMID: 35702931 DOI: 10.1177/08971900221108721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Dipeptidyl peptidase (DPP)-4 inhibitors are commonly used agents to treat type 2 diabetes mellitus (T2DM). Although generally well tolerated, stomatitis has been previously reported as an adverse event with sitagliptin and linagliptin. Stomatitis with alogliptin has not been reported in post-marketing data to date. Objective: To report a case of suspected drug-induced stomatitis in a patient who received alogliptin for T2DM which resolved upon discontinuation of the offending agent. Summary: A 60-year-old male with T2DM began treatment with a DPP-4 inhibitor, alogliptin. After 4 doses of alogliptin, the patient reported inflammation and irritation along the lateral borders of his tongue, along with open fissures and oral ulcerations on the dorsal surface of the mucosa. He was subsequently diagnosed with stomatitis. Patient discontinued alogliptin and reported improvement in symptoms within 48 hours. Lesions re-epithelialized within 4 weeks after cessation of alogliptin. The Naranjo Algorithm was used to assess causality. The total score was 7, which when interpreted, implicates alogliptin as a "probable" cause of the reaction. Conclusion: A causality assessment determined alogliptin was a "probable" cause of stomatitis experienced by this patient. This adverse effect has not been reported with alogliptin to the authors' knowledge.
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Affiliation(s)
- Danielle Terry
- Veterans Health Care System of the Ozarks, Fayetteville, AR, USA
| | - Andrea V Eads
- Veterans Health Care System of the Ozarks, Fayetteville, AR, USA
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DeVore A, Newsome MS, Davis LS. Oral ulcerations in an immunosuppressed pediatric patient. JAAD Case Rep 2023; 42:4-6. [PMID: 37961080 PMCID: PMC10630751 DOI: 10.1016/j.jdcr.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023] Open
Affiliation(s)
- Ansley DeVore
- Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | | | - Loretta S. Davis
- Department of Dermatology, Medical College of Georgia, Augusta, Georgia
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Anderson JG, Rojas CA, Scarsella E, Entrolezo Z, Jospin G, Hoffman SL, Force J, MacLellan RH, Peak M, Shope BH, Tsugawa AJ, Ganz HH. The Oral Microbiome across Oral Sites in Cats with Chronic Gingivo stomatitis, Periodontal Disease, and Tooth Resorption Compared with Healthy Cats. Animals (Basel) 2023; 13:3544. [PMID: 38003162 PMCID: PMC10668797 DOI: 10.3390/ani13223544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/01/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Feline chronic gingivostomatitis (FCGS) is a chronic mucosal and gingival inflammatory disease in which pathogenesis remains unclear. Interactions between the host inflammatory process, the host immune response, and the oral microbiome are implicated in this pathogenesis. To begin to understand this disease and the impact of the microbiome to host inflammatory disease states, we collected sterile noninvasive plaque biofilm samples from ten distinct sites within the oral cavity in cats with stomatitis (n = 12), healthy cats (n = 9), and cats with tooth resorption or periodontitis (n = 11). Analysis of full-length 16S rRNA gene sequences indicated that the microbiomes of cats with FCGS presented marked dysbiosis at multiple oral sites. Additionally, microbiome beta diversity varied with oral condition, indicating that stomatitis, periodontitis, and/or tooth resorption influence the microbiome differently. Lastly, we found that the microbiomes of swabs taken from the oral cavity were comparable to those taken from plaque using endodontic paper points, validating this as another sampling method. Collectively, our work furthers our understanding of the dysbiosis and composition of bacteria in the oral microbiome in FCGS, with hopes of contributing to the prevention, diagnosis, and treatment of this challenging condition in felines.
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Affiliation(s)
- Jamie G. Anderson
- Department of Oral Medicine, Penn Dental Medicine, Philadelphia, PA 19104, USA
| | - Connie A. Rojas
- AnimalBiome, Oakland, CA 94609, USA; (C.A.R.); (E.S.); (Z.E.); (G.J.); (H.H.G.)
| | - Elisa Scarsella
- AnimalBiome, Oakland, CA 94609, USA; (C.A.R.); (E.S.); (Z.E.); (G.J.); (H.H.G.)
| | - Zhandra Entrolezo
- AnimalBiome, Oakland, CA 94609, USA; (C.A.R.); (E.S.); (Z.E.); (G.J.); (H.H.G.)
| | - Guillaume Jospin
- AnimalBiome, Oakland, CA 94609, USA; (C.A.R.); (E.S.); (Z.E.); (G.J.); (H.H.G.)
| | | | - Judy Force
- Dentistry for Animals, Aptos, CA 95003, USA
| | - Roxane H. MacLellan
- VCA Highlands Ranch Animal Specialty and Emergency Center, Highlands Ranch, CO 80126, USA;
| | - Mike Peak
- The Pet Dentist, Inc., Tampa, FL 33544, USA;
| | | | | | - Holly H. Ganz
- AnimalBiome, Oakland, CA 94609, USA; (C.A.R.); (E.S.); (Z.E.); (G.J.); (H.H.G.)
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Jahanroshan N, Dalir‐Naghadeh B, Lotfollahzadeh S, Abdollahi M, Azarmi S, Moosakhani F. Bluetongue outbreak in a sheep flock from Iran. Vet Med Sci 2023; 9:2791-2795. [PMID: 37776265 PMCID: PMC10650254 DOI: 10.1002/vms3.1288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/21/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023] Open
Abstract
Bluetongue virus (BTV) is an arthropodborne Orbivirus that belongs to the Reoviridae family. Bluetongue is one of the most important diseases of sheep. A flock of 300 Lacon sheep just arrived from France, located in the countryside of Qazvin city, Iran, was examined, in August 2022. In history taking and clinical examination, submandibular oedema (216/300, 72%), fever (216/300, 72%), inappetence (216/300, 72%), stomatitis (216/300, 72%), nasal discharge (90/300, 30%) and lameness (30/300, 10%) were recorded. Foot-and-mouth disease, bluetongue (BT), contagious ecthyma and peste des petits ruminants were the most important differential diagnosis with reference to clinical signs. Tongue scraping samples from four clinically affected sheep were sent to the laboratory for PCR tests and, in all of them, BTV was detected. The affected flock had a history of vaccination with an attenuated live vaccine in the previous 4 months. The morbidity rate, mortality rate and case fatality rate were 72% (216/300), 7% (21/300) and 9.7% (21/216), respectively. This report is the first documented clinical form of BT in sheep from Iran.
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Affiliation(s)
- Navid Jahanroshan
- Department of TheriogenologyFaculty of Veterinary MedicineUniversity of TehranTehranIran
- Private Veterinary PractitionerTehranIran
| | - Bahram Dalir‐Naghadeh
- Department of Internal Medicine and Clinical PathologyFaculty of Veterinary MedicineUrmia UniversityUrmiaIran
| | - Samad Lotfollahzadeh
- Department of Internal MedicineFaculty of Veterinary MedicineUniversity of TehranTehranIran
| | - Mostafa Abdollahi
- Department of Clinical SciencesFaculty of Veterinary MedicineSemnan UniversitySemnanIran
| | - Sareh Azarmi
- Reproduction BiotechnologyFaculty of Veterinary MedicineUniversity of TehranTehranIran
| | - Farhad Moosakhani
- Department of Microbiology and ImmunologyFaculty of Veterinary MedicineIslamic Azad UniversityKarajIran
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Ramírez-Carmona W, Fernandes GLP, Díaz-Fabregat B, Oliveira EC, do Prado RL, Pessan JP, Monteiro DR. Effectiveness of fluconazole as antifungal prophylaxis in cancer patients undergoing chemotherapy, radiotherapy, or immunotherapy: systematic review and meta-analysis. APMIS 2023; 131:668-684. [PMID: 37199283 DOI: 10.1111/apm.13324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 05/19/2023]
Abstract
This review assessed the effectiveness of fluconazole as antifungal prophylaxis on the incidence of oral fungal diseases in patients undergoing cancer treatment. The secondary outcomes evaluated were the adverse effects, discontinuation of cancer therapy due to oral fungal infection, mortality by a fungal infection, and the mean duration of antifungal prophylaxis. Twelve databases and records were searched. The RoB 2 and ROBINS I tools were used to assess the risk of bias. The relative risk (RR), risk difference, and standard mean difference (SMD) were applied with 95% confidence intervals (CI). The certainty of the evidence was determined by GRADE. Twenty-four studies were included in this systematic review. In randomized controlled trials pooling, fluconazole was a protective factor for the primary outcome (RR = 0.30; CI: 0.16, 0.55; p < 0.01, vs placebo). Compared to other antifungals, fluconazole was only more effective than the subgroup of amphotericin B and nystatin (alone or in combination) (RR = 0.19; CI: 0.09, 0.43; p < 0.01). Fluconazole was also a protective factor in non-randomized trials pooling (RR = 0.19; CI: 0.05, 0.78; p = 0.02, vs untreated). The results showed no significant differences for the secondary outcomes. The certainty of the evidence was low and very low. In conclusion, prophylactic antifungals are necessary during cancer treatment, and fluconazole was shown to be more effective in reducing oral fungal diseases only compared with the subgroup assessing amphotericin B and nystatin, administered alone or in combination.
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Affiliation(s)
- Wilmer Ramírez-Carmona
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (Unesp), Araçatuba/São Paulo, Brazil
| | - Gabriela Leal Peres Fernandes
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (Unesp), Araçatuba/São Paulo, Brazil
| | - Beatriz Díaz-Fabregat
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (Unesp), Araçatuba/São Paulo, Brazil
| | - Evelyn Carmo Oliveira
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (Unesp), Araçatuba/São Paulo, Brazil
| | - Rosana Leal do Prado
- School of Dentistry, Presidente Prudente, University of Western São Paulo (UNOESTE), Presidente Prudente/São Paulo, Brazil
| | - Juliano Pelim Pessan
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (Unesp), Araçatuba/São Paulo, Brazil
| | - Douglas Roberto Monteiro
- Department of Preventive and Restorative Dentistry, School of Dentistry, Araçatuba, São Paulo State University (Unesp), Araçatuba/São Paulo, Brazil
- School of Dentistry, Presidente Prudente, University of Western São Paulo (UNOESTE), Presidente Prudente/São Paulo, Brazil
- Postgraduate Program in Health Sciences, University of Western São Paulo (UNOESTE), Presidente Prudente/São Paulo, Brazil
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Cotomacio CC, Yshikawa BK, Calarga CC, Arana-Chavez VE, Simões A. Red, infrared, and simultaneous laser-wavelengths irradiation effects on 5-fluorouracil-induced oral mucositis in hamsters. J Biophotonics 2023; 16:e202300156. [PMID: 37420314 DOI: 10.1002/jbio.202300156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/09/2023]
Abstract
The association of more than one wavelength for photobiomodulation therapy (PBMT) to treat oral mucositis (OM) is unusual in the literature. Thus, this study aims to compare the simultaneous irradiation effects with their isolated application to treat OM. In order of that, 48 male Syrian hamsters were divided into 4 groups: Chemotherapy (Ch), which received only a OM induction protocol (5-fluorouracil chemotherapy and superficial oral mucosa scratches); red laser (RL), which received the OM induction and a PBMT protocol at 660 nm; infrared laser (IRL), which received the OM induction, and a PBMT protocol at 808 nm; and the RL + IRL group, which received the simultaneous application, of 660 and 808 nm wavelengths. Clinical (OM grade classification), histological (light microscopy analysis with H&E and collagen staining), immunohistochemical (TNF-α expression), and biochemical (TNF-α and hydroxyproline concentration) analyzes were performed after 7 and 10 days. Mainly on the 10th day, the RL and IRL groups showed lower OM grades and faster microscopic repair process, with greater expression of collagen fibers and lower TNF-α levels, besides the higher hydroxyproline concentrations, mainly in comparison with the Ch group. In conclusion, in this study, the simultaneous protocol did not present superior results than the isolated irradiations.
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Affiliation(s)
- Claudia C Cotomacio
- School of Dentistry, Paulista University (UNIP), São Paulo, SP, Brazil
- Department of Dentistry, Pediatric Oncology Institute/Support Group for Children and Adolescents with Cancer (GRAACC), São Paulo, Brazil
| | - Bianca K Yshikawa
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (FOUSP), São Paulo, SP, Brazil
| | - Caio C Calarga
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (FOUSP), São Paulo, SP, Brazil
| | - Victor E Arana-Chavez
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (FOUSP), São Paulo, SP, Brazil
| | - Alyne Simões
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo (FOUSP), São Paulo, SP, Brazil
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Vieira Nascimento M, Costa FWG, de Oliveira Filho OV, Silva PGDB, de Freitas Pontes KM. Management of Cancer Therapy-Induced Oral Mucositis Using Photobiomodulation Therapy: An Overview of Systematic Reviews. Photobiomodul Photomed Laser Surg 2023; 41:513-538. [PMID: 37788454 DOI: 10.1089/photob.2023.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
Objective: To systematically summarize the evidence for photobiomodulation therapy (PBMT) in the prevention and treatment of oral mucositis (OM) in patients undergoing cancer treatment. An electronic search was conducted in 8 databases and grey literature. Background: PBMT is recommended for the management of OM resulting from cancer treatment, with several systematic reviews (SRs) being published in recent years on this topic. Methods: Only SRs with outcomes from clinical trials were included, with no language or year restriction. The AMSTAR 2 tool was used to assess the methodological quality of the SRs. Results: Five thousand eight hundred fifty-six references were found, and 16 were selected for this review. OM prevention and treatment were favorable for PBMT in most studies, with a significant reduction in OM severity. Most studies obtained moderate confidence. Conclusions: PBMT represents an effective strategy in the management of OM, and this evidence is supported by studies with acceptable methodological quality.
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Affiliation(s)
| | | | - Osias Vieira de Oliveira Filho
- Graduate Program in Dentistry, Federal University of Ceará, Fortaleza, Brazil
- College of Dentistry, Christus University, Fortaleza, Brazil
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Moata H, Hali F, Zafad S, Jouhadi H, Chiheb S. Recalcitrant Paraneoplastic Pemphigus Associated With Prostate Adenocarcinoma: Spectacular Evolution Under Androgen Deprivation. Cureus 2023; 15:e43585. [PMID: 37719500 PMCID: PMC10503779 DOI: 10.7759/cureus.43585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
Paraneoplastic pemphigus (PNP) is a rare, autoimmune, blistering condition defined by severe stomatitis, polymorphous cutaneous eruptions, and underlying neoplasms. PNP associated with solid cancer is extremely rare. An association with prostate adenocarcinoma remains exceptional. We describe a 69-year-old patient with recalcitrant PNP associated with prostate adenocarcinoma showing spectacular response immediately after associating hormonotherapy with conventional immunosuppressive drugs.
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Affiliation(s)
- Hajar Moata
- Department of Dermatology and Venerology, Ibn Rochd University Hospital, Casablanca, MAR
| | - Fouzia Hali
- Department of Dermatology and Venerology, Ibn Rochd University Hospital, Casablanca, MAR
| | - Safia Zafad
- Department of Oncology and Radiotherapy, Mohammed VI Cancer Treatment Center, Ibn Rochd University Hospital, Casablanca, MAR
| | - Hassan Jouhadi
- Department of Oncology and Radiotherapy, Mohammed VI Cancer Treatment Center, Ibn Rochd University Hospital, Casablanca, MAR
| | - Soumiya Chiheb
- Department of Dermatology and Venerology, Ibn Rochd University Hospital, Casablanca, MAR
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Vetter CAM, Lourenço BN, Meindl AG, Mees A, Stone A, Farnsworth R, Everett SE, Gonzalez SE, Roth IG, Schmiedt C. Cross-sectional characterization of renal function in cats with caudal stomatitis. J Feline Med Surg 2023; 25:1098612X231179883. [PMID: 37350300 DOI: 10.1177/1098612x231179883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
OBJECTIVES The objective of the study was to compare renal functional biomarkers in cats and in caudal stomatitis (CS) and in age-matched control cats. METHODS A cross-sectional, case-control study was conducted on 44 client-owned cats with CS that were prospectively enrolled and evaluated for a Comprehensive Oral Health Assessment and Treatment at one of four institutions. Renal function was assessed with measurement of serum creatinine, urea nitrogen, serum symmetric dimethylarginine, urinalysis, urine protein:creatinine ratio and urine protein electrophoresis. Affected gingiva was biopsied to confirm the diagnosis of stomatitis. Renal biochemical analyses from the experimental group were compared with those of 44 age-matched controls without CS enrolled prospectively or retrospectively after presenting to the primary institution for routine healthcare. Control cats were included if they were clinically stable, their chronic illnesses were well managed and minimal dental disease was present on examination. Renal biomarkers were compared between groups using a t-test or the Mann-Whitney U-test. Frequency of azotemia, proteinuria and the clinical diagnosis of renal disease were compared using Fisher's exact test. RESULTS Relative to the control group, cats in the CS group had significantly lower serum creatinine (P <0.001) and albumin concentrations (P <0.001), urine specific gravity (P = 0.024) and hematocrit (P = 0.003), and higher serum phosphorus (P <0.001), potassium (P <0.001) and globulin concentrations (P <0.001), white blood cell count (P <0.001) and urine protein:creatinine ratio (P = 0.009). There were no significant differences in serum symmetric dimethylarginine or urea nitrogen concentrations. No clinically significant findings were noted on urine protein electrophoresis. There were no significant differences in the frequency of azotemia, proteinuria or renal disease categories between the two groups. CONCLUSIONS AND RELEVANCE The present study does not demonstrate a significant difference in the frequency of kidney disease between cats with and without CS. Longitudinal evaluation is warranted to investigate the relationship between renal disease and CS.
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Affiliation(s)
- C Autumn M Vetter
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Bianca N Lourenço
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Alison G Meindl
- Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, CO, USA
| | - Angela Mees
- Atlanta Veterinary Dental Services, Roswell, GA, USA
| | - Amy Stone
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Raelynn Farnsworth
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | - S Ellen Everett
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Sara E Gonzalez
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Ira G Roth
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Chad Schmiedt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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Nayak NG, Modi P, Shah S, Patel P, Devangkumar Patel D, Rohitbhai Patel R, Hapani D. Comparison of Effectiveness of Hiora SG Gel With Triamcinolone Acetonide Gel in Recurrent Aphthous Stomatitis. Cureus 2023; 15:e40403. [PMID: 37456467 PMCID: PMC10347882 DOI: 10.7759/cureus.40403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Background The oral condition known as recurrent aphthous ulceration (RAU) or recurrent aphthous stomatitis (RAS) is very prevalent. Its etiopathogenesis is unknown; hence, symptomatic therapy is all that can be offered if it manifests clinically. Lesion care aims to minimize discomfort and the frequency of relapses by bringing active illness under local control in the affected area. The current treatment options that may have negative side effects include the use of topical and systemic steroids, antibiotics, cauterization, and laser therapy. Objectives and Importance This study aimed to compare the efficiency of HiOra SG gel with triamcinolone acetonide gel in the management of RAS. Materials and Methods Fifty individuals with RAS were recruited for the trial and randomly assigned to either group I (HiOra SG gel) or group II (0.1% triamcinolone acetonide ointment; Oraways). After each meal for a total of 10 days, those with mouth ulcers were instructed to topically administer the drugs. The clinical data were analyzed by comparing the ulcer severity scores from the first, fifth, and 10th days. Results There was a statistically significant (p = 0.001) reduction in reported pain, pain duration, and overall ulcer severity across all groups. After therapy, however, neither the HiOra gel group nor the triamcinolone group showed any discernible improvement over the other. Conclusion The present study's findings corroborate the efficacy of HiOra SG gel in the treatment of RAS when compared to triamcinolone acetonide gel (0.1%). In this trial, no patients had any negative reactions to HiOra SG gel. In the future, further studies are needed with larger samples to prove its benefits.
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Affiliation(s)
- Nirmal G Nayak
- Public Health Dentistry, Karnavati School of Dentistry, Gandhinagar, IND
| | - Panthi Modi
- Dentistry, AMC Dental College & Hospital, Ahmedabad, IND
| | - Swasti Shah
- Dentistry, AMC Dental College & Hospital, Ahmedabad, IND
| | - Pranjal Patel
- Dentistry, Sure Align Orthodontix n Dentistry Clinic, Ahmedabad, IND
| | | | | | - Devanshi Hapani
- Dentistry, Smile and Face Dental Care & Implant Centre, Ahmedabad, IND
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Bruno JS, Al-Qadami GH, Laheij AMGA, Bossi P, Fregnani ER, Wardill HR. From Pathogenesis to Intervention: The Importance of the Microbiome in Oral Mucositis. Int J Mol Sci 2023; 24:ijms24098274. [PMID: 37175980 PMCID: PMC10179181 DOI: 10.3390/ijms24098274] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Oral mucositis (OM) is a common and impactful toxicity of standard cancer therapy, affecting up to 80% of patients. Its aetiology centres on the initial destruction of epithelial cells and the increase in inflammatory signals. These changes in the oral mucosa create a hostile environment for resident microbes, with oral infections co-occurring with OM, especially at sites of ulceration. Increasing evidence suggests that oral microbiome changes occur beyond opportunistic infection, with a growing appreciation for the potential role of the microbiome in OM development and severity. This review collects the latest articles indexed in the PubMed electronic database which analyse the bacterial shift through 16S rRNA gene sequencing methodology in cancer patients under treatment with oral mucositis. The aims are to assess whether changes in the oral and gut microbiome causally contribute to oral mucositis or if they are simply a consequence of the mucosal injury. Further, we explore the emerging role of a patient's microbial fingerprint in OM development and prediction. The maintenance of resident bacteria via microbial target therapy is under constant improvement and should be considered in the OM treatment.
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Affiliation(s)
- Julia S Bruno
- Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo 01308-060, Brazil
| | - Ghanyah H Al-Qadami
- School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5005, Australia
| | - Alexa M G A Laheij
- Department of Oral Medicine, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
- Department of Preventive Dentistry, Academic Centre for Dentistry (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
- Department of Oral Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Paolo Bossi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Eduardo R Fregnani
- Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo 01308-060, Brazil
| | - Hannah R Wardill
- School of Biomedicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide 5005, Australia
- The Supportive Oncology Research Group, Precision Cancer Medicine Theme, The South Australian Health and Medical Research Institute, Adelaide 5000, Australia
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15
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Villa A, Kuten-Shorrer M. Pathogenesis of Oral Toxicities Associated with Targeted Therapy and Immunotherapy. Int J Mol Sci 2023; 24:ijms24098188. [PMID: 37175898 PMCID: PMC10179284 DOI: 10.3390/ijms24098188] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/04/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Targeted therapy and immunotherapy have redefined cancer treatment. While they have enhanced tumor response and improved survival rates in many cancer types, toxicities continue to occur, and these often involve the oral cavity. Broadly reported as "mucositis" or "stomatitis," oral toxicities induced by targeted therapies differ clinically and mechanistically from those associated with conventional chemotherapy. Manifesting primarily as mucosal lesions, salivary gland hypofunction, or orofacial neuropathies, these oral toxicities may nonetheless lead to significant morbidity and impact patients' quality of life, thereby compromising clinical outcomes. We conclude that familiarity with the spectrum of associated toxicities and understanding of their pathogenesis represent important areas of clinical research and may lead to better characterization, prevention, and management of these adverse events.
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Affiliation(s)
- Alessandro Villa
- Oral Medicine, Oral Oncology and Dentistry, Miami Cancer Institute, Baptist Health South Florida, Miami, FL 33176, USA
- The Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33176, USA
- Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Michal Kuten-Shorrer
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, NY 14642, USA
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Li J, Zhu C, Zhang Y, Guan C, Wang Q, Ding Y, Hu X. Incidence and risk factors for radiotherapy-induced oral mucositis among patients with nasopharyngeal carcinoma: A meta-analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:70-82. [PMID: 37094771 DOI: 10.1016/j.anr.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 03/29/2023] [Accepted: 04/18/2023] [Indexed: 04/26/2023] Open
Abstract
PURPOSE To evaluate the incidence and identify the risk factors for radiotherapy-induced oral mucositis among patients with nasopharyngeal carcinoma. METHODS A meta-analysis was conducted. Eight electronic databases (Medline, Embase, Cochrane Library, CINAHL Plus with Full Text, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and Chinese Scientific Journals Database) were systematically searched from inception to 4 March 2023 for relevant studies. Study selection and data extraction were conducted by two independent authors. The Newcastle‒Ottawa Scale was used for quality assessment among the included studies. Data synthesis and analyses were performed in R software package version 4.1.3 and Review Manager Software 5.4. The pooled incidence was calculated using proportions with 95% confidence intervals (CIs), and the risk factors were evaluated using the odds ratio (OR) with 95% CIs. Sensitivity analysis and predesigned subgroup analyses were also conducted. RESULTS A total of 22 studies published from 2005 to 2023 were included. The results of the meta-analysis showed that the incidence of radiotherapy-induced oral mucositis was 99% among nasopharyngeal carcinoma patients, and the incidence of severe radiotherapy-induced oral mucositis was 52%. Poor oral hygiene, overweight before radiotherapy, oral pH < 7.0, the use of oral mucosal protective agents, smoking, drinking, combined chemotherapy, and the use of antibiotics at early treatment stage are risk factors for severe radiotherapy-induced oral mucositis. Sensitivity analysis and subgroup analyses also revealed that our results are stable and reliable. CONCLUSIONS Almost all patients with nasopharyngeal carcinoma have suffered from radiotherapy-induced oral mucositis, and more than half of patients have experienced severe oral mucositis. Facilitating oral health might be the key focus of reducing the incidence and severity of radiotherapy-induced oral mucositis among nasopharyngeal carcinoma patients. REGISTRATION NUMBER CRD42022322035.
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Affiliation(s)
- Juejin Li
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, PR China
| | - Chuanmei Zhu
- Outpatient Department, West China Hospital, Sichuan University, PR China
| | - Yun Zhang
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, PR China
| | - Chang Guan
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, PR China
| | - Qi Wang
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, PR China
| | - Yuxin Ding
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, PR China
| | - Xiaolin Hu
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, PR China.
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17
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McReynolds DE, Moorthy A, Moneley JO, Jabra-Rizk MA, Sultan AS. Denture Stomatitis - An interdisciplinary clinical review. J Prosthodont 2023. [PMID: 36988151 DOI: 10.1111/jopr.13687] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023] Open
Abstract
PURPOSE An interdisciplinary clinical review on denture stomatitis formulated by experts from prosthodontics, oral medicine, and oral microbiology is presented. The review outlines the etiopathogenesis, clinical features and management strategies of denture stomatitis from an interdisciplinary perspective. MATERIALS AND METHODS English-language articles relating to the definition, incidence, gender distribution, geographical distribution, etiology, pathogenesis, symptoms, signs, treatment and prognosis of denture stomatitis were retrieved via electronic literature search. Relevant articles were summarized for this manuscript with a view towards providing pragmatic information. RESULTS Denture stomatitis represents a very common, multi-factorial infectious, inflammatory and hyperplastic condition which is primarily caused by poor oral hygiene, poor denture hygiene and full-time; mainly night-time denture wear, bringing about the emergence of advanced Candida-containing polymicrobial biofilms in close proximity to the host's mucosal tissues. Denture stomatitis shares clinically relevant associations with dental caries, periodontitis, median rhomboid glossitis, angular cheilitis, aspirational pneumonia and associated mortality. CONCLUSIONS Effective, long-term treatment of denture stomatitis relies upon sustained patient-driven behavioral change which should focus on daily prosthesis-level cleaning and disinfection, removal of dentures at night, every night, engagement with professional denture maintenance, and when required, denture replacement. Anti-fungal medications offer limited benefit outside of short-term use due to the emergence of anti-fungal resistance. For frail, elderly, medically-compromised and nursing-home populations, treatment of denture stomatitis lowers the risk of aspirational pneumonia and associated mortality. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- David E McReynolds
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | | | | | - Mary Ann Jabra-Rizk
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, Maryland, USA
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ahmed S Sultan
- Department of Oncology and Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, Maryland, USA
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
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Affiliation(s)
- Takuya Suda
- Department of Nephrology and Rheumatology, Ishikawa Prefectural Central Hospital, Japan
| | - Hiroshi Fujii
- Department of Nephrology and Rheumatology, Ishikawa Prefectural Central Hospital, Japan
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19
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Gomes JT, Wanzeler AMV, Júnior SM, Soares RHFC, de Oliveira CP, Rodrigues EDM, Soares BM, Alcantara DD, Burbano RM, Tuji FM. The chromatographic constitution of andiroba oil and his healing effects, compared to the LLLT outcomes, in oral mucositis induced in golden Syrian hamsters: a new treatment option. Oncotarget 2023; 14:23-39. [PMID: 36634224 PMCID: PMC9836383 DOI: 10.18632/oncotarget.28338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The oral mucositis is a mucosal alteration that usually arises from oncological treatments, such as chemotherapy, and it is characterized as an inflammatory process. The aim of this study is to demonstrate the chromatographic constitution of Andiroba oil, comparing and evaluating Andiroba oil and laser scarring efficiency in treatments of oral mucositis in hamsters. These animals were submitted to 5-Fluorouracil. A total of 122 animals were used, randomized and divided into the following groups: (a) positive control; (b) laser associated to andiroba oil; (c) laser; (d) andiroba oil; (e) negative control; (f) cyclophosphamide (genotoxicity control). The induction of oral mucositis occurred by the administration of intraperitoneal Fluorouracila (60 mg/kg) and trauma to the mucosa. The laser protocol was performed once a day and the andiroba oil applied 3 times a day (1,5 ml/day). The mucosae were photographed and removed for clinical and histopathological analysis on day 4, 8, 12 and 15. The analysis was based in OM severity, in specific scoring for the clinical and histopathological aspect. Toxicity was evaluated on day 15 using comet assay and it was performed by variant DNA damage parameters. The data were analysed using analysis of variance (ANOVA) Tukey post-test and Kruskal-Wallis Dunn post-test. The "andiroba oil" and "laser" groups presented better results when compared to the control groups and the treatment associations. The andiroba oil presented the best scarring results, even considering its efficiency proximity to the laser treatment. Andiroba and laser, separately, did not present genotoxicity, however their association evidences damage to DNA.
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Affiliation(s)
- Jessica T. Gomes
- 1Department of Dentistry, Federal University of Pará, Guamá, Belém, Pará 66075-970, Brazil
| | - Ana Márcia V. Wanzeler
- 1Department of Dentistry, Federal University of Pará, Guamá, Belém, Pará 66075-970, Brazil
| | - Sergio M.A. Júnior
- 1Department of Dentistry, Federal University of Pará, Guamá, Belém, Pará 66075-970, Brazil
| | | | | | | | - Bruno M. Soares
- 3Department of Genetics, Laboratory of Human Cytogenetics, Federal University of Pará, Guamá, Belém, Pará 66075-970, Brazil
| | - Diego D.F.A. Alcantara
- 3Department of Genetics, Laboratory of Human Cytogenetics, Federal University of Pará, Guamá, Belém, Pará 66075-970, Brazil,Correspondence to:Diego D.F.A. Alcantara, email:
| | - Rommel M.R. Burbano
- 3Department of Genetics, Laboratory of Human Cytogenetics, Federal University of Pará, Guamá, Belém, Pará 66075-970, Brazil
| | - Fabrício M. Tuji
- 1Department of Dentistry, Federal University of Pará, Guamá, Belém, Pará 66075-970, Brazil
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Kim DH, Kwak HH, Woo HM. Prevalence of feline chronic gingivo stomatitis in feral cats and its risk factors. J Feline Med Surg 2023; 25:1098612X221131453. [PMID: 36655688 DOI: 10.1177/1098612x221131453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES This study investigated the prevalence of feline chronic gingivostomatitis in urban feral cats in South Korea and analysed its risk factors. METHODS Three hundred and forty-five feral cats that visited the hospital for neutering using a trap-neuter-return approach were screened for feline chronic gingivostomatitis based on clinical criteria. In addition, we determined if body weight, sex and the presence of tongue lesions are risk factors for feline chronic gingivostomatitis. The difference in severity due to the presence or absence of risk factors, and the relationship between gross findings and histopathological lesions, were analysed by grading lesion severity. RESULTS Feline chronic gingivostomatitis was diagnosed in 92 cats. Disease prevalence did not significantly differ with body weight and sex but was significantly related to tongue lesions. CONCLUSIONS AND RELEVANCE The prevalence of feline chronic gingivostomatitis in urban feral cats in South Korea was 26.6%. It was significantly more prevalent in cats that had tongue lesions. Severity was also significantly associated with tongue lesions. Feline chronic gingivostomatitis may be associated with an infectious agent that causes tongue lesions.
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Affiliation(s)
- Dae-Hwan Kim
- Department of Veterinary Surgery, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon, South Korea.,Gang-Buk Woori Animal Medical Center, Seoul, South Korea
| | - Ho-Hyun Kwak
- Department of Veterinary Surgery, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon, South Korea
| | - Heung-Myong Woo
- Department of Veterinary Surgery, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon, South Korea
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Zlatović JJ, Omrčen T, Marijanović I, Kraljević M. Co-administration of pazopanib and enteral nutrition with omega-3 fatty acids as a safety issue in a patient treated for metastatic clear cell renal cancer: A case report. J Cancer Res Ther 2023; 19:474-476. [PMID: 37006081 DOI: 10.4103/jcrt.jcrt_533_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Pazopanib is an oral multitargeting tyrosine kinase inhibitor (TKI) of vascular endothelial growth factor receptors (VEGFRs), approved as the first-line treatment of metastatic renal cell carcinoma (mRCC) and soft tissue sarcoma (STS) at a fixed dose of 800 mg daily taken fasted. Potential drug-meal interactions and adverse events (AEs) may lack recognition and the related data in literature. We report one case of stomatitis/oral mucositis associated with pazopanib administrated with an oral nutritional supplement enriched with omega-3 fatty acids. The 50-year-old patient with mRCC started pazopanib treatment at standard doses of 800 mg daily as first-line therapy for mRCC, and after a few days, he developed stomatitis. Co-administration of pazopanib with high-fat meals could increase the solubility of highly lipophilic pazopanib, increasing its plasma pazopanib area under the curve (AUC), and maximum concentration (Cmax) above optimal therapeutic level can consequently lead to increased frequency/grade of AEs.
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Affiliation(s)
- Josipa Jović Zlatović
- Department of Internal Medicine, General Hospital of Šibenik-Knin County, Šibenik, Croatia
| | - Tomislav Omrčen
- Department of Oncology and Radiotherapy, University Hospital Split, Split, Croatia
| | - Inga Marijanović
- Department of Oncology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina, Balkans, Bosnia and Herzegovina
| | - Marija Kraljević
- Department of Oncology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina, Balkans, Bosnia and Herzegovina
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22
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Muñoz-Duque JD, Duque-Arias S, Correa-Valencia NM. Histopathological Results of Mouth Lesions in Dogs and Cats from Colombia. J Vet Dent 2022; 40:164-173. [PMID: 36575614 DOI: 10.1177/08987564221146896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Mouth-related neoplastic and non-neoplastic lesions are commonly found in dogs and cats, and their diagnosis and classification are important for treatment planning and prognosis. This retrospective study analyzed mouth-related lesions in dogs and cats between 2000-2019 from the animal pathology laboratory of the Universidad de Antioquia, Medellín, Colombia. A total of 640 mouth-related lesions affecting 572 dogs (89.4%) and 68 cats (10.6%) were reviewed. Lesions were classified as neoplastic or non-neoplastic. The average age for neoplastic lesions was 8.6 years in dogs and 6.4 years in cats, while for non-neoplastic lesions the average age was 7.7 years for dogs and 5 years for cats. Data was analyzed using descriptive statistical methods according to year and source of report, demographic information for the animal, location of the lesion, and diagnosis. Tissue origin and behavior were variables considered for neoplastic lesions. Melanoma was the most common neoplasia in dogs and squamous cell carcinoma was most common in cats. The most frequent non-neoplastic lesion in dogs was gingival hyperplasia, while in cats the inflammatory lesions showed a wide range of morphological diagnoses. This study described many pathological lesions affecting the oral cavity for both dogs and cats and provides useful epidemiological data for both pathologists and clinicians.
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Liu Z, Huang L, Wang H, Shi Z, Huang Y, Liang L, Wang R, Hu K. Predicting Nomogram for Severe Oral Mucositis in Patients with Nasopharyngeal Carcinoma during Intensity-Modulated Radiation Therapy: A Retrospective Cohort Study. Curr Oncol 2022; 30:219-232. [PMID: 36661666 PMCID: PMC9857735 DOI: 10.3390/curroncol30010017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Oral mucositis is an acute adverse reaction with high incidence during radiotherapy. Severe oral mucositis can seriously affect patients' quality of life and compliance with radiotherapy. The aim of this study was to identify the risk factors for severe oral mucositis and to develop a nomogram for predicting severe oral mucositis in patients with nasopharyngeal carcinoma. METHODS One hundred and ninety patients with nasopharyngeal carcinoma were retrospectively screened in this study. Least absolute shrinkage and selection operator regression and multivariate logistic regression analyses were performed to identify the best predictors of severe oral mucositis. A nomogram was constructed based on the factors. Finally, the discriminative ability of the nomogram was evaluated. RESULTS Four independent factors predicting severe oral mucositis were identified: age, N stage, the cycle of induction chemotherapy, and dose-volumetric parameter V40 (%) of oral cavity. The area under the receiver of operating characteristic curve of the nomogram was 0.759 (95% confidence interval: 0.691-0.827). CONCLUSIONS A predictive nomogram for severe oral mucositis was established and validated in this study. The nomogram provides a reliable and practical model for clinically predicting the probability of severe oral mucositis in patients with nasopharyngeal carcinoma before intensity-modulated radiation therapy.
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Affiliation(s)
- Zhibing Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, China
| | - Lulu Huang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, China
| | - Housheng Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, China
| | - Zhiling Shi
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, China
| | - Yaqin Huang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, China
| | - Lixing Liang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, China
| | - Rensheng Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, China
| | - Kai Hu
- Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
- Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning 530021, China
- Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning 530021, China
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Al-Dulaijan YA, Balhaddad AA. Prospects on Tuning Bioactive and Antimicrobial Denture Base Resin Materials: A Narrative Review. Polymers (Basel) 2022; 15. [PMID: 36616404 DOI: 10.3390/polym15010054] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
Denture base resin (DBR) materials are used in dentistry in constructing removable dentures and implant-supported prostheses. A plethora of evidence has demonstrated that DBR materials are associated with a high risk of denture stomatitis, a clinical complication where the soft oral tissues underneath the resin-based material are inflamed. The prevalence of denture stomatitis among denture wearers is high worldwide. Plaque accumulation and the infiltration of oral microbes into DBRs are among the main risk factors for denture stomatitis. The attachment of fungal species, mainly Candida albicans, to DBRs can irritate the underneath soft tissues, leading to the onset of the disease. As a result, several attempts were achieved to functionalize antimicrobial compounds and particles into DBRs to prevent microbial attachment. This review article explored the advanced approaches in designing bioactive and antimicrobial DBR materials. It was reported that using monomer mixtures, quaternary ammonium compounds (QACs), and organic and inorganic particles can suppress the growth of denture stomatitis-related pathogens. This paper also highlighted the importance of characterizing bioactive DBRs to be mechanically and physically sustainable. Future directions may implement a clinical translational model to attempt these materials inside the oral cavity.
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Schmidt M, Lübbe K, Decker T, Thill M, Bauer L, Müller V, Link T, Furlanetto J, Reinisch M, Mundhenke C, Hoffmann O, Zahn MO, Müller L, Denkert C, van Mackelenbergh M, Fasching P, Burchardi N, Nekljudova V, Loibl S. A multicentre, randomised, double-blind, phase II study to evaluate the tolerability of an induction dose escalation of everolimus in patients with metastatic breast cancer (DESIREE). ESMO Open 2022; 7:100601. [PMID: 36356410 PMCID: PMC9832733 DOI: 10.1016/j.esmoop.2022.100601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Stomatitis is one of the main reasons to discontinue everolimus in patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (mBC). To decrease stomatitis and subsequently early treatment discontinuations or dose reductions, the DESIREE trial investigated the use of a stepwise dose-escalation schedule of everolimus (EVE esc). PATIENTS AND METHODS DESIREE is a phase II, multicentre, randomised, double-blind, placebo-controlled trial in patients with HR+/HER2- mBC and progression/relapse after nonsteroidal aromatase inhibitor treatment. Patients were randomised to EVE esc (2.5 mg/day, week 1; 5 mg/day, week 2; 7.5 mg/day, week 3; 10 mg/day, weeks 4-24) or everolimus 10 mg/day (EVE 10mg) for 24 weeks plus exemestane. The primary endpoint was the incidence of stomatitis episodes grade ≥2 within 12 weeks of treatment. The secondary endpoints included toxicity, relative total dose intensity (RTDI) and quality of life (QoL). RESULTS A total of 160 patients were randomised and 156 started treatment (EVE esc: 80; EVE 10mg: 76). The median age of patients was 64 years (range 33-85), 56.3% patients in the EVE esc arm versus 42.1% in the EVE 10mg arm had liver metastasis (P = 0.081) and 62.5% versus 51.3% received over one metastatic therapy line (P = 0.196). Within 12 weeks, the incidence of stomatitis episodes grade ≥2 was significantly lower in the EVE esc arm compared with the EVE 10mg arm (28.8% versus 46.1%; odds ratio 0.47, 95% confidence interval 0.24-0.92; P = 0.026). Toxicity was in line with the known safety profile without new safety concerns. The median RTDI was 91.1% in the EVE esc arm versus 80.0% in the EVE 10mg arm (P = 0.329). Discontinuation rate in the first 3 weeks was 6.3% versus 15.8%, respectively (P = 0.073). QoL was comparable between the two treatment arms. CONCLUSIONS A dose-escalation schema of everolimus over 3 weeks can be successfully used to reduce the incidence of high-grade stomatitis in the first 12 weeks of treatment in patients with HR+/HER2- mBC. TRIAL REGISTRATION ClinicalTrials.govNCT02387099; https://clinicaltrials.gov/ct2/show/NCT02387099.
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Affiliation(s)
- M. Schmidt
- Universitätsmedizin Mainz, Mainz, Germany
| | - K. Lübbe
- Diakovere Henriettenstift Hannover, Hanover, Germany
| | - T. Decker
- Onkologie und Hämatologie Ravensburg, Ravensburg, Germany
| | - M. Thill
- Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus, Frankfurt, Germany
| | - L. Bauer
- GRN gGmbH Klinik Weinheim, Weinheim, Germany
| | - V. Müller
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - T. Link
- Department of Gynecology and Obstetrics, Technische Universität Dresden, Dresden, Germany
| | | | - M. Reinisch
- Interdisciplinary Breast Unit, Kliniken Essen-Mitte, Essen, Germany
| | - C. Mundhenke
- Brustzentrum, Gynäkologisches Krebszentrum, Perinatalzentrum Level I, Klinikum Bayreuth, Bayreuth, Germany
| | | | - M.-O. Zahn
- MVZ Onkologische Kooperation Harz Dres./Zahn Fachärzte für Innere Medizin, Goslar, Germany
| | | | - C. Denkert
- Institut für Pathologie, Philipps-Universität Marburg und Universitätsklinikum Marburg (UKGM), Marburg, Germany
| | - M. van Mackelenbergh
- Universitätsklinikum Schleswig-Holstein, Klinik für Gynäkologie und Geburtshilfe, Schleswig-Holstein, Kiel, Germany
| | | | | | | | - S. Loibl
- German Breast Group, Neu-Isenburg, Germany,Correspondence to: Prof. Sibylle Loibl, German Breast Group, Dornhofstr. 10, 63263 Neu-Isenburg, Germany. Tel: +49 6102 7480 335 @GBG_Forschunghttps://twitter.com/GBG_Forschung
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26
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Thornton CP, Perrin N, Kozachik S, Lukkahatai N, Ruble K. Biobehavioral Influences of Stress and Inflammation on Mucositis in Adolescents and Young Adults with Cancer: Results from a Pilot Study. J Adolesc Young Adult Oncol 2022. [PMID: 36169621 DOI: 10.1089/jayao.2022.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
Purpose: Chemotherapy-induced mucositis is a prevalent and burdensome toxicity among adolescent and young adults (AYAs) with cancer and impedes the delivery of optimal therapy. Its development is not well understood, but baseline stress and inflammation may be contributory factors. This pilot study evaluates stress and inflammation as risk factors for mucositis, identifies effect size estimates, and evaluates the feasibility of a prospective study to investigate mucositis development. Methods: Thirty AYAs receiving chemotherapy with substantial risk of mucositis completed baseline stress measures, and serum was collected for inflammatory biomarker analysis. Regression and mediation analyses determined the relationship between stress/inflammation and mucositis. Results: Stress appears to be a significant risk factor for incidence of mucositis (odds ratio 1.13, p = 0.125) and predicts total mucositis score (β = 0.281, p = 0.023) as well as peak incidence (β = 0.052, p = 0.018). Baseline levels of interleukin (IL)-1a and epidermal growth factor (EGF) predicted mucositis development, and EGF and IL-8 may mediate the relationship between stress and mucositis. Findings suggest that stress-induced inflammation exacerbates symptom development. Conclusion: Results from this pilot study inform mucositis symptom models, suggesting that psychosocial and physiologic factors are involved in development. Importantly, this pilot study provides initial effect size estimates, including magnitude and direction of relationships, that are essential to informing larger, more robustly powered studies. High enrollment, low attrition, and minimal missing data in this study suggest this model is feasible for research in this population. Importantly, this work is a first step in identifying new risk factors for mucositis and targets for nurse-led interventions to prevent toxicity development.
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Affiliation(s)
- Clifton P Thornton
- Division of Pediatric Hematology/Oncology, Herman and Walter Samuelson Children's Hospital at Sinai, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Nancy Perrin
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Sharon Kozachik
- Medical University of South Carolina College of Nursing, Charleston, South Carolina, USA
| | - Nada Lukkahatai
- Division of Pediatric Hematology/Oncology, Herman and Walter Samuelson Children's Hospital at Sinai, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Kathy Ruble
- Division of Pediatric Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Hattori N, Narita Y, Mitsui T, Uehara S, Ichihara K. The protective effects of blueberry honey from Canada against H 2O 2-induced cytotoxicity in human buccal mucosal cells. J Oral Biosci 2022; 64:359-365. [PMID: 35995412 DOI: 10.1016/j.job.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Several clinical trials have been conducted worldwide to evaluate the efficacy of honey against stomatitis. However, it is unclear which types of honey are effective at preventing and/or treating stomatitis. This study aimed to evaluate the potencies of several types of honey in preventing and/or curing aphthous stomatitis in in vitro studies. METHODS The following experiments were performed: H2O2-induced cytotoxicity and mucosal cell migration in a scratch assay using buccal mucosa squamous carcinoma (HO-1-N-1) cells and the cellular expression of heme oxygenase-1 (HO-1) mRNA encoding an enzyme involved in protection against oxidative stress by real-time RT-PCR analysis, and liquid-liquid extraction and UHPLC analysis in order to examine the active components of honey. RESULTS Of the 13 types of honey used, Canadian blueberry honey exhibited the protective effect on H2O2-induced cytotoxicity and enhanced cell migration. In addition, blueberry honey increased the expression of HO-1 mRNA with and without cotreatment with H2O2. With regard to active components of blueberry honey, the water-soluble components with a mass of >10 kDa showed a cytoprotective effect, but they have not been identified. CONCLUSION Canadian blueberry honey, but not the other types of honey, prevents H2O2-induced oxidation of cells, probably through activation of the antioxidant and cytoprotective enzyme HO-1. Blueberry honey also enhanced cell migration, which may be relevant to wound healing. The results of this study suggest the possibility of prophylactic and therapeutic effects of Canadian blueberry honey on human stomatitis that could complement existing treatments.
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Affiliation(s)
- Noriko Hattori
- Nagaragawa Research Center, API Co., Ltd., 692-3 Nagara, Gifu 502-0071, Japan
| | - Yukio Narita
- Nagaragawa Research Center, API Co., Ltd., 692-3 Nagara, Gifu 502-0071, Japan
| | - Taichi Mitsui
- Nagaragawa Research Center, API Co., Ltd., 692-3 Nagara, Gifu 502-0071, Japan
| | - Saori Uehara
- Nagaragawa Research Center, API Co., Ltd., 692-3 Nagara, Gifu 502-0071, Japan.
| | - Kenji Ichihara
- Nagaragawa Research Center, API Co., Ltd., 692-3 Nagara, Gifu 502-0071, Japan
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de Almeida LC, Orcina BDF, Maciel AP, dos Santos D, Manzano BR, Santos PSDS. Severe oral mucositis relating to pain and worse oral condition among patients with solid tumors undergoing treatment with FOLFIRI and 5-FU: a retrospective study. SAO PAULO MED J 2022; 140:588-594. [PMID: 35946677 PMCID: PMC9491478 DOI: 10.1590/1516-3180.2021.0522.r1.22112021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is a need for studies that correlate the severity of oral mucositis (OM) with chemotherapy protocols, transient myelosuppression and oral health. OBJECTIVE To analyze the severity of OM among individuals with solid tumors during hospitalization and its correlation with the type of chemotherapy, myelosuppression and oral health condition. DESIGN AND SETTING Retrospective study at a public hospital in Bauru, state of São Paulo, Brazil, that is a regional referral center. METHODS Individuals diagnosed with solid malignant tumors who received chemotherapy during hospitalization for completion of the antineoplastic treatment cycle or who presented complications resulting from this were assessed. RESULTS Twenty-eight individuals (24.3%) manifested some degree of OM. The most prevalent degrees of OM according to the World Health Organization (WHO) and modified WHO classification were grades 2 (11.3%) and 5 (4.3%), respectively. It was observed that the higher the OM-WHO (P < 0.001; r = 0.306) and modified OM-WHO (P < 0.001; r = 0.295) classifications were, the greater the oral pain reported by the individuals was. Presence of mucositis in the upper lip and buccal mucosa contributed to increased severity of OM and worsening of swallowing during hospitalization. Thus, severe OM was associated with use of the FOLFIRI protocol (folinic acid, fluorouracil and irinotecan). CONCLUSION Individuals with tumors who presented severe OM had greater severity of oral pain and worse oral health. Use of the FOLFIRI protocol was associated with higher prevalence of severe OM, while use of 5-fluorouracil (5-FU) was correlated with worse oral condition.
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Affiliation(s)
| | - Bernardo da Fonseca Orcina
- DDS. Master’s Student, Department of Surgery, Stomatology, Pathology and Radiology, Faculdade de Odontologia de Bauru (FOB), Universidade de Sao Paulo (USP), Bauru (SP), Brazil
| | - Aloizio Premoli Maciel
- DDS, MSc. Doctoral Student, Department of Surgery, Stomatology, Pathology and Radiology, Faculdade de Odontologia de Bauru (FOB), Universidade de Sao Paulo (USP), Bauru (SP), Brazil
| | - Dayanne dos Santos
- DDS. Master’s Student, Department of Surgery, Stomatology, Pathology and Radiology, Faculdade de Odontologia de Bauru (FOB), Universidade de Sao Paulo (USP), Bauru (SP), Brazil
| | - Brena Rodrigues Manzano
- DDS, MSc. Doctoral Student, Department of Surgery, Stomatology, Pathology and Radiology, Faculdade de Odontologia de Bauru (FOB), Universidade de Sao Paulo (USP), Bauru (SP), Brazil
| | - Paulo Sérgio da Silva Santos
- DDS, PhD. Associate Professor, Department of Surgery, Stomatology, Pathology and Radiology, Faculdade de Odontologia de Bauru (FOB), Universidade de Sao Paulo (USP), Bauru (SP), Brazil
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29
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He W, Hu X, Hua H, Li K, Zhang C, Wei P. Allergic contact stomatitis due to desensitizing toothpastes. J Dermatol 2022; 49:648-651. [PMID: 35261076 DOI: 10.1111/1346-8138.16338] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/18/2022] [Accepted: 02/11/2022] [Indexed: 11/30/2022]
Abstract
Toothpastes are one of the most common personal care products among people of all ages. The various toothpaste types and their complex ingredients could cause irritation or allergic reactions. Allergic contact stomatitis has been often seen in clinical practice; however, desensitizing toothpastes as a trigger are often unrecognized. Here, we report three cases of allergic contact stomatitis due to stannous chloride-containing desensitizing toothpastes. General dentists and other professionals should pay more attention to the safety and adverse effects of toothpastes.
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Affiliation(s)
- Wenxiu He
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xiaosheng Hu
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Hong Hua
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Kaiyi Li
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Chang Zhang
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Pan Wei
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
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30
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Bernaola-Paredes WE, Filho VB, Vilela Dias EM, Sugaya NN. A case of migratory stomatitis in a young male patient: Management and differential diagnosis. J Oral Maxillofac Pathol 2022; 26:S17-S21. [PMID: 35450243 PMCID: PMC9017832 DOI: 10.4103/jomfp.jomfp_446_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 05/31/2021] [Accepted: 07/07/2021] [Indexed: 11/22/2022] Open
Abstract
Migratory stomatitis (MS) is an uncommon inflammatory condition with unclarified etiology, which despite its benign nature, may raise concerns for patients and diagnostic difficulties for professionals. This case report aims to describe the clinical features of a patient who presented with MS in conjunction with benign migratory glossitis (BMG), and its diagnostic process and management. The patient, a 25-year-old man, sought diagnosis of an oral condition, with cyclic behavior, which had been causing him great discomfort for a year. The patient presented erythematous patches on his lower lips and right side of the buccal mucosa, surrounded by a slightly elevated halo with a concomitant classical picture of BMG. After analysis of his entire symptomatology, the diagnosis of MS associated with BMG was concluded. The patient received clear explanations and symptomatic treatment. The diagnosis of MS may be challenging, even to oral medicine practitioners, especially if it occurs alone. MS with concurrent manifestation of BMG may make the conditions easier to diagnose, but it does not exclude the need to apply a complete process of differential diagnosis to rule out other similar possibilities.
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Affiliation(s)
| | - Valdener Bella Filho
- Department of Stomatology, School of Dentistry, Federal University of Goias (UFG), Sao Paulo, Brazil
| | | | - Norberto Nobuo Sugaya
- Department of Stomatology, School of Dentistry, University of Sao Paulo (USP), Sao Paulo, Brazil
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31
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Jazdarehee A, Huget-Penner S, Pawlowska M. Pseudo-pheochromocytoma due to obstructive sleep apnea: a case report. Endocrinol Diabetes Metab Case Rep 2022; 2022:21-0100. [PMID: 35212265 PMCID: PMC8897593 DOI: 10.1530/edm-21-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/02/2022] [Indexed: 11/11/2022] Open
Abstract
SUMMARY Obstructive sleep apnea (OSA) is a condition of intermittent nocturnal upper airway obstruction. OSA increases sympathetic drive which may result in clinical and biochemical features suggestive of pheochromocytoma. We present the case of a 65-year-old male with a 2.9-cm left adrenal incidentaloma on CT, hypertension, symptoms of headache, anxiety and diaphoresis, and persistently elevated 24-h urine norepinephrine (initially 818 nmol/day (89-470)) and normetanephrine (initially 11.2 µmol/day (0.6-2.7)). He was started on prazosin and underwent left adrenalectomy. Pathology revealed an adrenal corticoadenoma with no evidence of pheochromocytoma. Over the next 2 years, urine norepinephrine and normetanephrine remained significantly elevated with no MIBG avid disease. Years later, he was diagnosed with severe OSA and treated with continuous positive airway pressure. Urine testing done once OSA was well controlled revealed complete normalization of urine norepinephrine and normetanephrine with substantial symptom improvement. It was concluded that the patient never had a pheochromocytoma but rather an adrenal adenoma with biochemistry and symptoms suggestive of pheochromocytoma due to untreated severe OSA. Pseudo-pheochromocytoma is a rare presentation of OSA and should be considered on the differential of elevated urine catecholamines and metanephrines in the right clinical setting. LEARNING POINTS Obstructive sleep apnea (OSA) is a common condition among adults. OSA may rarely present as pseudo-pheochromocytoma with symptoms of pallor, palpitations, perspiration, headache, or anxiety. OSA should be considered on the differential of elevated urine catecholamines and metanephrines, especially in patients with negative metaiodobenzylguanidine (MIBG) scan results.
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Key Words
- adolescent/young adult
- adult
- geriatric
- neonatal
- paediatric
- pregnant adult
- female
- male
- american indian or alaska native
- asian - bangladeshi
- asian - chinese
- asian - filipino
- asian - indian
- asian - japanese
- asian - korean
- asian - pakistani
- asian - vietnamese
- asian - other
- black - african
- black - caribbean
- black - other
- hispanic or latino - central american or south american
- hispanic or latino - cuban
- hispanic or latino - dominican
- hispanic or latino - mexican, mexican american, chicano
- hispanic or latino - puerto rican
- hispanic or latino - other
- native hawaiian/other pacific islander
- white
- other
- afghanistan
- aland islands
- albania
- algeria
- american samoa
- andorra
- angola
- anguilla
- antarctica
- antigua and barbuda
- argentina
- armenia
- aruba
- australia
- austria
- azerbaijan
- bahamas
- bahrain
- bangladesh
- barbados
- belarus
- belgium
- belize
- benin
- bermuda
- bhutan
- bolivia
- bosnia and herzegovina
- botswana
- bouvet island
- brazil
- british indian ocean territory
- brunei darussalam
- bulgaria
- burkina faso
- burundi
- cambodia
- cameroon
- canada
- cape verde
- cayman islands
- central african republic
- chad
- chile
- china
- christmas island
- cocos (keeling) islands
- colombia
- comoros
- congo
- congo, the democratic republic of the
- cook islands
- costa rica
- côte d'ivoire
- croatia
- cuba
- cyprus
- czech republic
- denmark
- djibouti
- dominica
- dominican republic
- ecuador
- egypt
- el salvador
- equatorial guinea
- eritrea
- estonia
- ethiopia
- falkland islands (malvinas)
- faroe islands
- fiji
- finland
- france
- french guiana
- french polynesia
- french southern territories
- gabon
- gambia
- georgia
- germany
- ghana
- gibraltar
- greece
- greenland
- grenada
- guadeloupe
- guam
- guatemala
- guernsey
- guinea
- guinea-bissau
- guyana
- haiti
- heard island and mcdonald islands
- holy see (vatican city state)
- honduras
- hong kong
- hungary
- iceland
- india
- indonesia
- iran, islamic republic of
- iraq
- ireland
- isle of man
- israel
- italy
- jamaica
- japan
- jersey
- jordan
- kazakhstan
- kenya
- kiribati
- korea, democratic people's republic of
- korea, republic of
- kuwait
- kyrgyzstan
- lao people's democratic republic
- latvia
- lebanon
- lesotho
- liberia
- libyan arab jamahiriya
- liechtenstein
- lithuania
- luxembourg
- macao
- macedonia, the former yugoslav republic of
- madagascar
- malawi
- malaysia
- maldives
- mali
- malta
- marshall islands
- martinique
- mauritania
- mauritius
- mayotte
- mexico
- micronesia, federated states of
- moldova, republic of
- monaco
- mongolia
- montenegro
- montserrat
- morocco
- mozambique
- myanmar
- namibia
- nauru
- nepal
- netherlands
- netherlands antilles
- new caledonia
- new zealand
- nicaragua
- niger
- nigeria
- niue
- norfolk island
- northern mariana islands
- norway
- oman
- pakistan
- palau
- palestinian territory, occupied
- panama
- papua new guinea
- paraguay
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- gonadal dysgenesis
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- hyperparathyroidism (primary)
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- hyperparathyroidism (tertiary)
- hyperpituitarism
- hyperprolactinaemia
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- hypoaldosteronism
- hypocalcaemia
- hypoestrogenism
- hypoglycaemia
- hypoglycaemic coma
- hypogonadism
- hypogonadotrophic hypogonadism
- hypoinsulinaemia
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- hyponatraemia
- hypoparathyroidism
- hypophosphataemia
- hypophosphatasia
- hypophysitis
- hypopituitarism
- hypothyroidism
- iatrogenic disorder
- idiopathic bilateral adrenal hyperplasia
- idiopathic pituitary hyperplasia
- igg4-related systemic disease
- inappropriate tsh secretion
- incidentaloma
- infertility
- insulin autoimmune syndrome
- insulin resistance
- insulinoma
- intracranial vasospasm
- intrauterine growth retardation
- iodine allergy
- ischaemic heart disease
- kallmann syndrome
- ketoacidosis
- klinefelter syndrome
- kwashiorkor
- kwashiorkor (marasmic)
- leg ulcer
- laron syndrome
- latent autoimmune diabetes of adults (lada)
- laurence-moon syndrome
- left ventricular hypertrophy
- leukocytoclastic vasculitis
- leydig cell tumour
- lipodystrophy
- lipomatosis
- liver failure
- lung metastases
- luteoma
- lymphadenopathy
- macronodular adrenal hyperplasia
- macronodular hyperplasia
- macroprolactinoma
- marasmus
- maturity onset diabetes of young (mody)
- mccune-albright syndrome
- mckittrick-wheelock syndrome
- medullary thyroid cancer
- meigs syndrome
- membranous nephropathy
- men1
- men2a
- men2b
- men4
- menarche
- meningitis
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- metabolic acidosis
- metabolic syndrome
- metastatic carcinoma
- metastatic chromaffin cell tumour
- metastatic gastrinoma
- metastatic melanoma
- metastatic tumour
- microadenoma
- microprolactinoma
- motor neurone disease
- myasthenia gravis
- myelolipoma
- myocardial infarction
- myositis
- myotonic dystrophy type 1
- myotonic dystrophy type 2
- myxoedema
- myxoedema coma
- nelson's syndrome
- neonatal diabetes
- nephrolithiasis
- neuroblastoma
- neuroendocrine tumour
- neurofibromatosis
- nodular hyperplasia
- non-functioning pituitary adenoma
- non-hodgkin lymphoma
- non-islet-cell tumour hypoglycaemia
- noonan syndrome
- oculocerebrorenal syndrome
- osteogenesis imperfecta
- osteomalacia
- osteomyelitis
- osteoporosis
- osteoporosis (pregnancy/lactation-associated)
- osteosclerosis
- ovarian cancer
- ovarian dysgenesis
- ovarian hyperstimulation syndrome
- ovarian tumour
- paget's disease
- paget's disease (juvenille)
- pancreatic neuroendocrine tumour
- pancreatitis
- panhypopituitarism
- papillary thyroid cancer
- paraganglioma
- paranasal sinus lesion
- paraneoplastic syndromes
- parasitic thyroid nodules
- parathyroid adenoma
- parathyroid adenoma (ectopic)
- parathyroid carcinoma
- parathyroid cyst
- parathroid hyperplasia
- pcos
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- phaeochromocytoma
- phaeochromocytoma crisis
- pickardt syndrome
- pituitary abscess
- pituitary adenoma
- pituitary apoplexy
- pituitary carcinoma
- pituitary cyst
- pituitary haemorrhage
- pituitary hyperplasia
- pituitary hypoplasia
- pituitary tumour (malignant)
- plurihormonal pituitary adenoma
- poems syndrome
- polycythaemia
- porphyria
- pneumonia
- posterior reversible encephalopathy syndrome
- post-prandial hypoglycaemia
- prader-willi syndrome
- prediabetes
- pre-eclampsia
- pregnancy
- premature ovarian failure
- premenstrual dysphoric disorder
- premenstrual syndrome
- primary hypertrophic osteoarthropathy
- prolactinoma
- prostate cancer
- pseudohypoaldosteronism type 1
- pseudohypoaldosteronism type 2
- pseudohypoparathyroidism
- psychosocial short stature
- puberty (delayed or absent)
- puberty (precocious)
- pulmonary oedema
- quadrantanopia
- rabson-mendenhall syndrome
- rhabdomyolysis
- rheumatoid arthritis
- rickets
- schwannoma
- sellar reossification
- sertoli cell tumour
- sertoli-leydig cell tumour
- sexual development disorders
- sheehan's syndrome
- short stature
- siadh
- small-cell carcinoma
- small intestine neuroendocrine tumour
- solitary fibrous tumour
- solitary sellar plasmacytoma
- somatostatinoma
- somatotrophic adenoma
- squamous cell thyroid carcinoma
- stiff person syndrome
- struma ovarii
- subcutaneous insulin resistance
- systemic lupus erythematosus
- takotsubo cardiomyopathy
- tarts
- testicular cancer
- thecoma
- thyroid adenoma
- thyroid carcinoma
- thyroid cyst
- thyroid dysgenesis
- thyroid fibromatosis
- thyroid hormone resistance syndrome
- thyroid lymphoma
- thyroid nodule
- thyroid storm
- thyroiditis
- thyrotoxicosis
- thyrotrophic adenoma
- traumatic brain injury
- tuberculosis
- tuberous sclerosis complex
- tumour-induced osteomalacia
- turner syndrome
- unilateral adrenal hyperplasia
- ureterolithiasis
- urolithiasis
- von hippel-lindau disease
- wagr syndrome
- waterhouse-friderichsen syndrome
- williams syndrome
- wolcott-rallison syndrome
- wolfram syndrome
- xanthogranulomatous hypophysitis
- xlaad/ipex
- zollinger-ellison syndrome
- abdominal adiposity
- abdominal distension
- abdominal cramp
- abdominal discomfort
- abdominal guarding
- abdominal lump
- abdominal pain
- abdominal tenderness
- abnormal posture
- abdominal wall defects
- abrasion
- acalculia
- accelerated growth
- acne
- acrochorda
- acroosteolysis
- acute stress reaction
- adverse breast development
- aggression
- agitation
- agnosia
- akathisia
- akinesia
- albuminuria
- alcohol intolerance
- alexia
- alopecia
- altered level of consciousness
- amaurosis
- amaurosis fugax
- ambiguous genitalia
- amblyopia
- amenorrhoea
- ameurosis
- amnesia
- amusia
- anasarca
- angiomyxoma
- anhedonia
- anisocoria
- ankle swelling
- anorchia
- anorectal malformations
- anorexia
- anosmia
- anosognosia
- anovulation
- antepartum haemorrhage
- anuria
- anxiety
- apathy
- aphasia
- aphonia
- apnoea
- appendicitis
- appetite increase
- appetite reduction/loss
- apraxia
- aqueductal stenosis
- arteriosclerosis
- arthralgia
- articulation impairment
- ascites
- asperger syndrome
- asphyxia
- asthenia
- astigmatism
- asymptomatic
- ataxia
- atrial fibrillation
- atrial myxoma
- atrophy
- adhd
- autism
- autonomic neuropathy
- avulsion
- babinski's sign
- back pain
- bacteraemia
- behavioural problems
- belching
- bifid scrotum
- biliary colic
- bitemporal hemianopsia
- blindness
- blistering
- bloating
- bloody show
- boil(s)
- bone cyst
- bone fracture(s)
- bone lesions
- bone pain
- bony metastases
- borborygmus
- bowel movements - bleeding
- bowel movements - increased frequency
- bowel movements - pain
- bowel obstruction
- bowel perforation
- brachycephaly
- brachydactyly
- bradycardia
- bradykinesia
- bradyphrenia
- bradypnea
- breast contour change
- breast enlargement
- breast lump
- breast reduction
- breast tenderness
- breastfeeding difficulties
- breathing difficulties
- bronchospasms
- brushfield spots
- bruxism
- buffalo hump
- cachexia
- calcification
- cardiac fibrosis
- cardiac malformations
- cardiac tamponade
- cardiogenic shock
- cardiomegaly
- cardiomyopathy
- cardiopulmonary arrest
- carpal tunnel syndrome
- caruncle - inflammation
- cataplexy
- cataract(s)
- catathrenia
- central obesity
- cerebrospinal fluid rhinorrhoea
- cervical pain
- cheeks - full
- cheiloschisis
- chemosis
- chest pain
- chest pain (pleuritic)
- chest pain (precordial)
- cheyne-stokes respiration
- chills
- cholecystitis
- cholestasis
- chondrocalcinosis
- chordee
- chorea
- choroidal atrophy
- chronic pain
- circulatory collapse
- cirrhosis
- citraturia
- claudication
- clitoromegaly
- cloacal exstrophy
- clonus
- club foot
- clumsiness
- coagulopathy
- coarctation
- coeliac disease
- cognitive problems
- cold intolerance
- collapse
- colour blindness
- coma
- concentration difficulties
- confusion
- congenital heart defect
- conjunctivitis
- constipation
- convulsions
- coordination difficulties
- coughing
- crackles
- cramps
- craniofacial abnormalities
- craniotabes
- cutaneous ischaemia
- cutaneous myxoma
- cutaneous pigmentation
- cyanosis
- dalrymple's sign
- deafness
- deep vein thrombosis
- dehydration
- delayed puberty
- delirium
- dementia
- dental abscess(es)
- dental problems
- depression
- diabetes insipidus
- diabetic neuropathy
- diabetic foot infection
- diabetic foot neuropathy
- diabetic foot ulceration
- diarrhoea
- diplopia
- dizziness
- duodenal atresia
- duplex kidney(s)
- dysarthria
- dysdiadochokinesia
- dysgraphia
- dyslexia
- dyslipidaemia
- dysmenorrhoea
- dyspareunia
- dyspepsia
- dysphagia
- dysphonia
- dysphoria
- dyspnoea
- dystonia
- dysuria
- ear, nose and/or throat infection
- early menarche
- ears - low set
- ears - pinna abnormalities
- ears - small
- ecchymoses
- ectopic ureter
- emotional immaturity
- encopresis
- endometrial hyperplasia
- enlarged bladder
- enlarged prostate
- eosinophilia
- epicanthic fold
- epilepsy
- epistaxis
- erectile dysfunction
- erythema
- euphoria
- eyebrows - bushy
- eyelid retraction
- eyelid swelling
- eyelids - redness
- eyes - almond-shaped
- eyes - dry
- eyes - feeling of grittiness
- eyes - inflammation
- eyes - irritation
- eyes - itching
- eyes - pain (gazing down)
- eyes - pain (gazing up)
- eyes - redness
- eyes - watering
- face - change in appearance
- face - coarse features
- face - numbness
- facial fullness
- facial palsy
- facial plethora
- facial weakness
- facies - abnormal
- facies - hippocratic
- facies - moon
- faecal incontinence
- failure to thrive
- fallopian tube hyperplasia
- fasciculation
- fatigue
- fatigue (post-exertional)
- feet - cold
- feet - increased size
- feet - large
- feet - pain
- feet - small
- fingers - thick
- flaccid paralysis
- flatulence
- flushing
- fontanelles - enlarged
- frontal bossing
- fungating lesion
- fungating mass
- funny turns
- gait abnormality
- gait unsteadiness
- gallbladder calculi
- gallstones
- gangrene
- gastro-oesophageal reflux
- genital oedema
- genu valgum
- genu varum
- gestational diabetes
- glaucoma
- glucose intolerance
- glucosuria
- growth hormone deficiency
- growth retardation
- haematemesis
- haematochezia
- haematoma
- haematuria
- haemoglobinuria
- haemoptysis
- hair - coarse
- hair - dry
- hair - temporal balding
- hairline - low
- hallucination
- hands - enlargement
- hands - large
- hands - single palmar crease
- hands - small
- head - large
- headache
- hearing loss
- heart failure
- heart murmur
- heat intolerance
- height loss
- hemiballismus
- hemianopia
- hemiparesis
- hemispatial neglect
- hepatic cysts
- hepatic metastases
- hepatomegaly
- hidradenitis suppurativa
- high-arched palate
- hip dislocation
- hippocampal dysgenesis
- hirschsprung's disease
- hot flushes
- hydronephrosis
- hypolipidaemia
- hyperactivity
- hyperacusis
- hyperandrogenaemia
- hypercalciuria
- hypercapnea
- hypercholesterolaemia
- hypercortisolaemia
- hyperflexibility
- hyperglucagonaemia
- hyperhidrosis
- hyperhomocysteinaemia
- hypernasal speech
- hyperopia
- hyperoxaluria
- hyperpigmentation
- hyperplasia
- hyperpnoea
- hypersalivation
- hyperseborrhea
- hypersomnia
- hyperthermia
- hypertrichosis
- hypertrophy
- hyperuricaemia
- hyperventilation
- hypoadrenalism
- hypoalbuminaemia
- hypocalciuria
- hypocitraturia
- hypomagnesaemia
- hypopigmentation
- hypoplastic scrotum
- hypopotassaemia
- hypoprolactinaemia
- hyporeflexia
- hyposmia
- hypospadias
- hypotension
- hypothermia
- hypotonia
- hypoventilation
- hypovitaminosis d
- hypovolaemia
- hypovolaemic shock
- hypoxia
- immunodeficiency
- impulsivity
- inattention
- infections
- inflexibility
- insomnia
- instability
- intussusception
- irritability
- ischaemia
- ischuria
- itching
- jaundice
- keratoconus
- ketonuria
- ketotic odour
- kidney dysplasia
- kidney stones
- kyphoscoliosis
- kyphosis
- labioscrotal fold abnormalities
- laceration
- late dentition
- learning difficulties
- leg pain
- legs - increased length
- leukaemia
- leukocytosis
- libido increase
- libido reduction/loss
- lichen sclerosus
- lips - dry
- lips - thin
- little finger - in-curved
- little finger - short
- liver masses
- lordosis
- lordosis (loss of)
- lymphadenectomy
- lymphadenitis
- lymphocytosis
- lymphoedema
- macroglossia
- malaise
- malaise (post-exertional)
- malodorous perspiration
- mania
- marcus gunn pupil
- mastalgia
- meckel's diverticulum
- melena
- menorrhagia
- menstrual disorder
- mesenteric ischaemia
- metabolic alkalosis
- microalbuminuria
- microcephaly
- micrognathia
- micropenis
- milk-alkali syndrome
- miscarriage
- mood changes/swings
- mouth - down-turned
- mouth - small
- movement - limited range of
- mucosal pigmentation
- muscle atrophy
- muscle freezing
- muscle hypertrophy
- muscle rigidity
- myalgia
- myasthaenia
- mydriasis
- myelodysplasia
- myeloma
- myoclonus
- myodesopsia
- myokymia
- myopathy
- myopia
- myosis
- nail clubbing
- nail dystrophy
- nasal obstruction
- nausea
- neck - loose skin (nape)
- neck - short
- neck mass
- neck pain/discomfort
- necrolytic migratory erythema
- necrosis
- nephrocalcinosis
- nephropathy
- neurofibromas
- night terrors
- nipple change
- nipple discharge
- nipple inversion
- nipple retraction
- nipples widely spaced
- nocturia
- normochromic normocytic anaemia
- nose - depressed bridge
- nose - flat bridge
- nose - thickening
- nystagmus
- obsessive-compulsive disorder
- obstetrical haemorrhage
- obstructive sleep apnoea
- odynophagia
- oedema
- oesophageal atresia
- oesophagitis
- oligomenorrhoea
- oliguria
- onychauxis
- oophoritis
- ophthalmoplegia
- optic atrophy
- orbital fat prolapse
- orbital hypertelorism
- orthostatic hypotension
- osteoarthritis
- osteopenia
- otitis media
- ovarian cysts
- ovarian hyperplasia
- palatoschisis
- pallor
- palmar erythema
- palpebral fissure (downslanted)
- palpebral fissure (extended)
- palpebral fissure (reduced)
- palpebral fissure (upslanted)
- palpitations
- pancreatic fibrosis
- pancytopaenia
- panic attacks
- papilloedema
- paraesthesia
- paralysis
- paranoia
- patellar dislocation
- patellar subluxation
- pedal ulceration
- pellagra
- pelvic mass
- pelvic pain
- penile agenesis
- peptic ulcer
- pericardial effusion
- periodontitis
- periosteal bone reactions
- peripheral oedema
- personality change
- pes cavus
- petechiae
- peyronie's disease
- pharyngitis
- philtrum - long
- philtrum - short
- phosphaturia
- photophobia
- photosensitivity
- pleurisy
- poikiloderma
- polydactyly
- polydipsia
- polyphagia
- polyuria
- poor wound healing
- postmenopausal bleeding
- post-nasal drip
- postprandial fullness
- postural instability
- prehypertension
- premature birth
- premature labour
- prenatal growth retardation
- presbyopia
- pretibial myxoedema
- proctalgia fugax
- prognathism
- proptosis
- prosopagnosia
- proteinuria
- pruritus
- pruritus scroti
- pruritus vulvae
- pseudarthrosis
- psoriatic arthritis
- psychiatric problems
- psychomotor retardation
- psychosis
- pterygium colli
- ptosis
- puberty (delayed/absent)
- puberty (early/precocious)
- puffiness
- pulmonary embolism
- purpura
- pyelonephritis
- pyloric stenosis
- pyrexia
- pyrosis
- pyuria
- rash
- rectal pain
- rectorrhagia
- refractory anemia
- reluctance to weight-bear
- renal agenesis
- renal clubbing
- renal colic
- renal cyst
- renal failure
- renal insufficiency
- renal phosphate wasting (isolated)
- renal tubular acidosis
- respiratory failure
- reticulocytosis
- retinitis pigmentosa
- retinopathy
- retrobulbar pain
- retrograde ejaculation
- retroperitoneal fibrosis
- salivary gland swelling
- salpingitis
- salt craving
- salt wasting
- sarcoidosis
- schizophrenia
- scoliosis
- scotoma
- seborrhoeic dermatitis
- seizures
- sensory loss
- sepsis
- septic arthritis
- septic shock
- shivering
- singultus
- sinusitis
- sixth nerve palsy
- skeletal deformity
- skeletal dysplasia
- skin - texture change
- skin infections
- skin necrosis
- skin pigmentation - spotty
- skin thickening
- skin thinning
- sleep apnoea
- sleep difficulties
- sleep disturbance
- sleep hyperhidrosis
- slow growth
- slurred speech
- social difficulties
- soft tissue swelling
- somnambulism
- somniloquy
- somnolence
- sore throat
- spasms
- spastic paraplegia
- spasticity
- speech delay
- spider naevi
- splenomegaly
- sputum production
- steatorrhoea
- stomatitis
- strabismus
- strangury
- striae
- stridor
- stroke
- subfertility
- suicidal ideation
- supraclavicular fat pads
- supranuclear gaze palsy
- sweating
- syncope
- syndactyly
- tachycardia
- tachypnoea
- teeth gapping
- telangiectasias
- telecanthus
- tetraparesis
- t-reflex (absent)
- t-reflex (depressed)
- tetany
- thermodysregulation
- thrombocytopenia
- thrombocytosis
- thrombophilia
- thrush
- tics
- tinnitus
- toe clubbing
- toe deformities
- toes - thick
- toes - widely spaced
- tongue - protruding
- tracheo-oesophageal compression
- tracheo-oesophageal fistula
- tremulousness
- tricuspid insufficiency
- umbilical hernia
- uraemia
- ureter duplex
- uricaemia
- urinary frequency
- urinary incontinence
- urogenital sinus
- urticaria
- uterine hyperplasia
- uterus duplex
- vagina duplex
- vaginal bleeding
- vaginal discharge
- vaginal dryness
- vaginal pain/tenderness
- vaginism
- ventricular fibrillation
- ventricular hypertrophy
- vertigo
- viraemia
- virilisation (abnormal)
- vision - acuity reduction
- vision - blurred
- visual disturbance
- visual field defect
- visual impairment
- visual loss
- vitiligo
- vocal cord paresis
- vomiting
- von graefe's sign
- weight gain
- weight loss
- wheezing
- widened joint space(s)
- xeroderma
- xerostomia
- 3-methoxy 4-hydroxy mandelic acid
- 17-hydroxypregnenolone (urine)
- 17-ketosteroids
- 25-hydroxyvitamin-d3
- 5hiaa
- aberrant adrenal receptors
- acid-base balance
- acth stimulation
- activated partial thromboplastin time
- acyl-ghrelin
- adrenal antibodies
- adrenal function
- adrenal scintigraphy
- adrenal venous sampling
- afp tumour marker
- alanine aminotransferase
- albumin
- albumin to creatinine ratio
- aldosterone (24-hour urine)
- aldosterone (blood)
- aldosterone (plasma)
- aldosterone (serum)
- aldosterone to renin ratio
- alkaline phosphatase
- alkaline phosphatase (bone-specific)
- alpha-fetoprotein
- ammonia
- amniocentesis
- amylase
- angiography
- anion gap
- anti-acetylcholine antibodies
- anticardiolipin antibody
- anti-insulin antibodies
- anti-islet cell antibody
- anti-gh antibodies
- antinuclear antibody
- anti-tyrosine phosphatase antibodies
- asvs
- barium studies
- basal insulin
- base excess
- apolipoprotein h
- beta-hydroxybutyrate
- bicarbonate
- bilirubin
- biopsy
- blood film
- blood pressure
- bmi
- body fat mass
- bone age
- bone biopsy
- bone mineral content
- bone mineral density
- bone mineral density test
- bone scintigraphy
- bone sialoprotein
- bound insulin
- brca1/brca2
- c1np
- c3 complement
- c4 complement
- ca125
- calcifediol
- calcium (serum)
- calcium (urine)
- calcium to creatinine clearance ratio
- carcinoembryonic antigen
- cardiac index
- catecholamines (24-hour urine)
- catecholamines (plasma)
- cd-56
- chemokines
- chest auscultation
- chloride
- chorionic villus sampling
- chromatography
- chromogranin a
- chromosomal analysis
- clomid challenge
- clonidine suppression
- collagen
- colonoscopy
- colposcopy
- continuous glucose monitoring
- core needle biopsy
- corticotropin-releasing hormone stimulation test
- cortisol (9am)
- cortisol (plasma)
- cortisol (midnight)
- cortisol (salivary)
- cortisol (serum)
- cortisol day curve
- cortisol, free (24-hour urine)
- c-peptide (24-hour urine)
- c-peptide (blood)
- c-reactive protein
- creatinine
- creatine kinase
- creatinine (24-hour urine)
- creatinine (serum)
- creatinine clearance
- crh stimulation
- ctpa scan
- ct scan
- c-telopeptide
- cytokines
- deoxypyridinoline
- dexa scan
- dexamethasone suppression
- dexamethasone suppression (high dose)
- dexamethasone suppression (low dose)
- dhea sulphate
- discectomy
- dldl cholesterol
- dmsa scan
- dna sequencing
- domperidone
- down syndrome screening
- ductal lavage
- echocardiogram
- eeg
- electrocardiogram
- electrolytes
- electromyography
- endoscopic ultrasound
- endoscopy
- endosonography
- enzyme immunoassay
- epinephrine (plasma)
- epinephrine (urine)
- erythrocyte sedimentation rate
- estimated glomerular filtration rate
- ethanol ablation
- ewing and clarke autonomic function
- exercise tolerance
- fbc
- ferritin
- fine needle aspiration biopsy
- flow cytometry
- fludrocortisone suppression
- fluticasone-propionate-17-beta carboxylic acid
- fmri
- folate
- ft3
- ft4
- gada
- gallium nitrate
- gallium scan
- gastric biopsy
- genetic analysis
- genitography
- gh day curve
- gh stimulation
- gh suppression
- glp-1
- glp-2
- glucose suppression test
- glucose (blood)
- glucose (blood, fasting)
- glucose (blood, postprandial)
- glucose (urine)
- glucose tolerance
- glucose tolerance (intravenous)
- glucose tolerance (oral)
- glucose tolerance (prolonged)
- gluten sensitivity
- gnrh stimulation
- gonadotrophins
- growth hormone-releasing peptide-2 test
- gut hormones (fasting)
- haematoxylin and eosin staining
- haemoglobin
- haemoglobin a1c
- hcg (serum)
- hcg (urine)
- hcg stimulation
- hdl cholesterol
- hearing test
- heart rate
- hepatic venous sampling with arterial stimulation
- high-sensitivity c-reactive protein
- histopathology
- hla genotyping
- holter monitoring
- homa
- homocysteine
- hyaluronic acid
- hydrocortisone day curve
- hydroxyproline
- hydroxyprogesterone
- hysteroscopy
- igfbp2
- igfbp3
- igg4/igg ratio
- immunocytochemistry
- immunohistochemistry
- immunoglobulins
- immunoglobulin g2
- immunoglobulin g4
- immunoglobulin a
- immunoglobulin m
- immunostaining
- inferior petrosal sinus sampling
- inhibin b
- insulin (fasting)
- insulin suppression
- insulin tissue resistance tests
- insulin tolerance
- intracranial pressure
- irm imaging
- ketones (plasma)
- ketones (urine)
- kidney function
- lactate
- lactate dehydrogenase
- laparoscopy
- laparoscopy and dye
- laparotomy
- ldl cholesterol
- leuprolide acetate stimulation
- leukocyte esterase (urine)
- levothyroxine absorption
- lipase (serum)
- lipid profile
- liquid-based cytology
- liquid chromatography-mass spectrometry
- liver biopsy
- liver function
- lumbar puncture
- lung function testing
- luteinising hormone releasing hormone test
- macroprolactin
- magnesium
- mag3 scan
- mammogram
- mantoux test
- metanephrines (plasma)
- metanephrines (urinary)
- methoxytyramine
- metoclopramide
- metyrapone cortisol day curve
- metyrapone suppression
- metyrapone test dose
- mibg scan
- microarray analysis
- molecular genetic analysis
- mri
- myocardial biopsy
- nerve conduction study
- neuroendocrine markers
- neuron-specific enolase
- norepinephrine
- ntx
- oct
- octreotide scan
- octreotide suppression test
- osmolality
- ovarian venous sampling
- p1np
- palpation
- pap test
- parathyroid scintigraphy
- pentagastrin
- perchlorate discharge
- percutaneous umbilical blood sampling
- peripheral blood film
- pet scan
- ph (blood)
- phosphate (serum)
- phosphate (urine)
- pituitary function
- plasma osmolality
- plasma viscosity
- platelet count
- pneumococcal antigen
- pneumococcal pcr
- polymerase chain reaction
- polysomnography
- porter-silber chromogens
- potassium
- pregnancy test
- proinsulin
- prostate-specific antigen
- protein electrophoresis
- protein fingerprinting
- protein folding analysis
- psychiatric assessment
- psychometric assessment
- pulse oximetry
- pyelography
- pyridinium crosslinks
- quicki
- plasma renin activity
- radioimmunoassay
- radionuclide imaging
- raiu test
- red blood cell count
- renal biopsy
- renin (24-hour urine)
- respiratory status
- renin (blood)
- renin plasma activity
- rheumatoid factor
- salt loading
- sdldl cholesterol
- secretin stimulation
- selective parathyroid venous sampling
- selective transhepatic portal venous sampling
- semen analysis
- serotonin
- serum osmolality
- serum free insulin
- sestamibi scan
- sex hormone binding globulin
- shbg
- skeletal muscle mass
- skin biopsy
- sleep diary
- sodium
- spect scan
- supervised 72-hour fast
- surgical biopsy
- sweat test
- synaptophysin
- systemic vascular resistance index
- tanner scale
- thoracocentesis
- thyroid transcription factor-1
- thyroglobulin
- thyroid antibodies
- thyroid function
- thyroid scintigraphy
- thyroid ultrasonography
- total cholesterol
- total ghrelin
- total t3
- total t4
- trabecular thickness
- transaminase
- transvaginal ultrasound
- trap 5b
- trh stimulation
- triglycerides
- triiodothyronine (t3) suppression
- troponin
- tsh receptor antibodies
- type 3 precollagen
- type 4 collagen
- ultrasound-guided biopsy
- ultrasound scan
- urea and electrolytes
- uric acid (blood)
- uric acid (urine)
- urinalysis
- urinary free cortisol
- urine 24-hour volume
- urine osmolality
- vaginal examination
- vanillylmandelic acid (24-hour urine)
- visual field assessment
- vitamin b12
- vitamin e
- waist circumference
- water deprivation
- water load
- weight
- western blotting
- white blood cell count
- white blood cell differential count
- x-ray
- zinc
- abscess drainage
- acetic acid injection
- adhesiolysis
- adrenalectomy
- amputation
- analgesics
- angioplasty
- arthrodesis
- assisted reproduction techniques
- bariatric surgery
- bilateral salpingo-oophorectomy
- blood transfusion
- bone grafting
- caesarean section
- cardiac transplantation
- cardiac pacemaker
- cataract extraction
- chemoembolisation
- chemotherapy
- chemoradiotherapy
- clitoroplasty
- continuous renal replacement therapy
- contraception
- cordotomy
- counselling
- craniotomy
- cryopreservation
- cryosurgical ablation
- debridement
- dialysis
- diazoxide
- diet
- duodenotomy
- endonasal endoscopic surgery
- exercise
- external fixation
- extracorporeal shock wave lithotripsy
- extraocular muscle surgery
- eye surgery
- eyelid surgery
- fasciotomy
- fluid repletion
- fluid restriction
- gamma knife radiosurgery
- gastrectomy
- gastrostomy
- gender reassignment surgery
- gonadectomy
- heart transplantation
- hormone replacement
- hormone suppression
- hypophysectomy
- hysterectomy
- inguinal orchiectomy
- internal fixation
- intra-cardiac defibrillator
- islet transplantation
- ivf
- kidney transplantation
- laparoscopic adrenalectomy
- laryngoplasty
- laryngoscopy
- laser lithotripsy
- light treatment
- liver transplantation
- lumpectomy
- lymph node dissection
- mastectomy
- molecularly targeted therapy
- neuroendoscopic surgery
- oophorectomy
- orbital decompression
- orbital radiation
- orchidectomy
- orthopaedic surgery
- osteotomy
- ovarian cystectomy
- ovarian diathermy
- oxygen therapy
- pancreas transplantation
- pancreatectomy
- pancreaticoduodenectomy
- parathyroidectomy
- percutaneous adrenal ablation
- percutaneous nephrolithotomy
- pericardiocentesis
- pericardiotomy
- physiotherapy
- pituitary adenomectomy
- plasma exchange
- plasmapheresis
- psychotherapy
- radiofrequency ablation
- radionuclide therapy
- radiotherapy
- reconstruction of genitalia
- resection of tumour
- right-sided hemicolectomy
- salpingo-oophorectomy
- small bowel resection
- speech and language therapy
- spinal surgery
- splenectomy
- stereotactic radiosurgery
- termination of pregnancy
- thymic transplantation
- thyroidectomy
- tracheostomy
- transcranial surgery
- transsphenoidal surgery
- transtentorial surgery
- vaginoplasty
- vagotomy
- 5-alpha-reductase inhibitors
- 17?-estradiol
- abiraterone
- acarbose
- acetazolamide
- acetohexamide
- adalimumab
- albiglutide
- alendronate
- alogliptin
- alpha-blockers
- alphacalcidol
- alpha-glucosidase inhibitors
- amiloride
- amlodipine
- amoxicillin
- anastrozole
- angiotensin-converting enzyme inhibitors
- angiotensin receptor antagonists
- anthracyclines
- antiandrogens
- antibiotics
- antiemetics
- antiepileptics
- antipsychotics
- antithyroid drugs
- antiseptic
- antivirals
- aripiprazole
- aromatase inhibitors
- aspirin
- astragalus membranaceus
- ativan
- atenolol
- atorvastatin
- avp receptor antagonists
- axitinib
- azathioprine
- bendroflumethiazide
- benzodiazepines
- beta-blockers
- betamethasone
- bexlosteride
- bicalutamide
- bisphosphonates
- bleomycin
- botulinum toxin
- bromocriptine
- cabergoline
- cabozantinib
- calcimimetics
- calcitonin (salmon)
- calcium
- calcium carbonate
- calcium chloride
- calcium dobesilate
- calcium edta
- calcium gluconate
- calcium-l-aspartate
- calcium polystyrene sulphonate
- canagliflozin
- capecitabine
- captopril
- carbimazole
- carboplatin
- carbutamide
- carvedilol
- ceftriaxone
- chlorothiazide
- chlorpropamide
- cholecalciferol
- cholinesterase inhibitors
- ciclosporin
- cinacalcet
- cisplatin
- clodronate
- clomifene
- clomiphene citrate
- clopidogrel
- co-cyprindiol
- codeine
- colonic polyps
- combined oral contraceptive pill
- conivaptan
- cortisone acetate
- continuous subcutaneous hydrocortisone infusion
- continuous subcutaneous insulin infusion
- coumadin
- corticosteroids
- cortisol
- cyproterone acetate
- dacarbazine
- danazol
- dapagliflozin
- daunorubicin
- deferiprone
- demeclocycline
- denosumab
- desmopressin
- dexamethasone
- diazepam
- diethylstilbestrol
- digoxin
- diltiazem
- diphenhydramine
- diuretics
- docetaxel
- dopamine agonists
- dopamine antagonists
- dopamine receptor agonists
- doxazosin
- doxepin
- doxorubicin
- dpp4 inhibitors
- dutasteride
- dutogliptin
- eflornithine
- enoxaparin
- empagliflozin
- epinephrine
- epirubicin
- eplerenone
- epristeride
- equilenin
- equilin
- erlotinib
- ethinylestradiol
- etidronate
- etomidate
- etoposide
- everolimus
- exenatide
- fenofibrate
- finasteride
- fluconazole
- fluticasone
- fludrocortisone
- fluorouracil
- fluoxetine
- flutamide
- furosemide
- gaba receptor antagonists
- gefitinib
- gemcitabine
- gemigliptin
- ginkgo biloba
- glibenclamide
- glibornuride
- gliclazide
- glimepiride
- glipizide
- gliquidone
- glisoxepide
- glp1 agonists
- glucose
- glyclopyramide
- gnrh analogue
- gnrh antagonists
- heparin
- hrt (menopause)
- hydrochlorothiazide
- hydrocortisone
- ibandronate
- ibuprofen
- idarubicin
- idebenone
- imatinib
- immunoglobulin therapy
- implanon
- indapamide
- infliximab
- iron supplements
- isoniazid
- insulin aspart
- insulin glargine
- insulin glulisine
- insulin lispro
- interferon
- intrauterine system
- iopanoic acid
- ipilimumab
- ipragliflozin
- irbesartan
- izonsteride
- ketoconazole
- labetalol
- lactulose
- lanreotide
- leuprolide acetate
- levatinib
- levodopa
- levonorgestrel
- levothyroxine
- linagliptin
- liothyronine
- liraglutide
- lithium
- lisinopril
- lixivaptan
- loperamide
- loprazolam
- lormetazepam
- losartan
- low calcium formula
- magnesium glycerophosphate
- magnesium sulphate
- mecasermin
- medronate
- medroxyprogesterone acetate
- meglitinides
- menotropin
- metformin
- methadone
- methimazole
- methylprednisolone
- metoprolol
- metyrapone
- miglitol
- mitotane
- mitoxantrone
- mozavaptan
- mtor inhibitors
- multivitamins
- naproxen
- natalizumab
- nateglinide
- nelivaptan
- neridronate
- nifedipine
- nilutamide
- nitrazepam
- nivolumab
- nsaid
- octreotide
- oestradiol valerate
- olanzapine
- olpadronate
- omeprazole
- opioids
- oral contraceptives
- orlistat
- ornipressin
- otelixizumab
- oxandrolone
- oxidronate
- oxybutynin
- paclitaxel
- pamidronate
- pancreatic enzymes
- pantoprazole
- paracetamol
- paroxetine
- pasireotide
- pegvisomant
- perindopril
- phenobarbital
- phenoxybenzamine
- phosphate binders
- phosphate supplements
- phytohaemagglutinin induced interferon gamma
- pioglitazone
- plicamycin
- potassium chloride
- potassium iodide
- pramlintide
- prazosin
- prednisolone
- prednisone
- premarin
- promethazine
- propranolol
- propylthiouracil
- protease inhibitors
- proton pump inhibitors
- pyridostigmine
- quetiapine
- quinagolide
- quinestrol
- radioactive mibg
- radioactive octreotide
- radioiodine
- raloxifene
- ramipril
- relcovaptan
- remogliflozin etabonate
- repaglinide
- risperidone
- risedronate
- rituximab
- romidepsin
- rosiglitazone
- salbutamol
- saline
- salmeterol
- salt supplements
- satavaptan
- saxagliptin
- selective progesterone receptor modulators
- selenium
- sglt2 inhibitors
- sildenafil
- simvastatin
- sirolimus
- sitagliptin
- sodium bicarbonate
- sodium chloride
- sodium polystyrene sulfonate (kayexalate)
- somatostatin analogues
- sorafenib
- spironolactone
- ssris
- statins
- streptozotocin
- steroids
- strontium ranelate
- sucralfate
- sulphonylureas
- sunitinib
- tamoxifen
- taspoglutide
- temazepam
- temozolomide
- teplizumab
- terazosin
- teriparatide
- testolactone
- testosterone enanthate esters
- tetrabenazine
- thalidomide
- thiazolidinediones
- thyrotropin alpha
- tibolone
- tiludronate
- tiratricol (triac)
- tofogliflozin
- tolazamide
- tolbutamide
- tolvaptan
- tramadol
- trastuzumab
- trazodone
- triamcinolone
- triamterene
- trimipramine
- troglitazone
- tryptophan
- turosteride
- tyrosine-kinase inhibitors
- valproic acid
- valrubicin
- vandetanib
- vaptans
- vildagliptin
- vinorelbine
- voglibose
- vorinostat
- warfarin
- zaleplon
- z-drugs
- zoledronic acid
- zolpidem
- zopiclone
- cardiology
- dermatology
- gastroenterology
- general practice
- genetics
- geriatrics
- gynaecology
- nephrology
- neurology
- nursing
- obstetrics
- oncology
- otolaryngology
- paediatrics
- pathology
- podiatry
- psychology/psychiatry
- radiology/rheumatology
- rehabilitation
- surgery
- urology
- insight into disease pathogenesis or mechanism of therapy
- novel diagnostic procedure
- novel treatment
- unique/unexpected symptoms or presentations of a disease
- new disease or syndrome: presentations/diagnosis/management
- unusual effects of medical treatment
- error in diagnosis/pitfalls and caveats
- february
- 2022
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Affiliation(s)
- Aria Jazdarehee
- Department of Medicine and Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Sawyer Huget-Penner
- Division of Endocrinology and Metabolism, Fraser Health Authority, British Columbia, Canada
| | - Monika Pawlowska
- Division of Endocrinology and Metabolism, University of British Columbia, British Columbia, Canada
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Elad S, Yarom N, Zadik Y, Kuten-Shorrer M, Sonis ST. The broadening scope of oral mucositis and oral ulcerative mucosal toxicities of anticancer therapies. CA Cancer J Clin 2022; 72:57-77. [PMID: 34714553 DOI: 10.3322/caac.21704] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/24/2021] [Accepted: 09/27/2021] [Indexed: 01/15/2023] Open
Abstract
Oral mucositis (OM) is a common, highly symptomatic complication of cancer therapy that affects patients' function, quality of life, and ability to tolerate treatment. In certain patients with cancer, OM is associated with increased mortality. Research on the management of OM is ongoing. Oral mucosal toxicities are also reported in targeted and immune checkpoint inhibitor therapies. The objective of this article is to present current knowledge about the epidemiology, pathogenesis, assessment, risk prediction, and current and developing intervention strategies for OM and other ulcerative mucosal toxicities caused by both conventional and evolving forms of cancer therapy.
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Affiliation(s)
- Sharon Elad
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York
| | - Noam Yarom
- Sheba Medical Center, Tel Hashomer, Israel
- School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yehuda Zadik
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - Michal Kuten-Shorrer
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York
- Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Stephen T Sonis
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts
- Primary Endpoint Solutions, Waltham, Massachusetts
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Meirovitz A, Baider L, Peretz T, Stephanos S, Barak V. Effect of pentoxifylline on colon cancer patients treated with chemotherapy (Part I). Tumour Biol 2021; 43:341-349. [PMID: 34957976 DOI: 10.3233/tub-211533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Cancer progression is associated with significant systemic clinical manifestations including cachexia induced weight loss and anorexia. Pentoxifylline (PTX) is a drug that has been shown to have multiple beneficial effects in cancer patients through its anti-inflammatory properties. MAIN OBJECTIVE To evaluate PTX effects on colon cancer patients treated with chemotherapy. PATIENTS AND METHODS Forty metastatic colon cancer patients receiving chemotherapy were enrolled in this randomized study. 17 patients were treated with a full dose of PTX (400 mg TID), 9 patients with a reduced dose PTX (200 mg TID) and 23 served as controls (no PTX). RESULTS Follow-up evaluations of patients included the following: physical examination; leukopenia determination; weight determination; stomatitis determination; and survival rate. Patients treated with PTX (both full and reduced doses), experienced a significant increase in weight and a reduction in stomatitis relative to the control group. Treatment with PTX also significantly increased patient survival rate. All patients treated with PTX, had a median overall survival (OS) rate of 20.4 months as compared to 13.2 months in the control group. CONCLUSIONS PTX treatment of colon cancer patients, in addition to chemotherapy, significantly improved survival rates, induced weight gain and reduced stomatitis occurrence -all important parameters of cachexia.
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Affiliation(s)
- Amichay Meirovitz
- Department of Oncology, Hadassah Medical Center and Faculty of Medicine Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lea Baider
- Department of Oncology, Hadassah Medical Center and Faculty of Medicine Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tamar Peretz
- Department of Oncology, Hadassah Medical Center and Faculty of Medicine Hebrew University of Jerusalem, Jerusalem, Israel
| | - Samir Stephanos
- Psychosomatic Department, Ulm University Medical Center, Ulm, Germany
| | - Vivian Barak
- Department of Oncology, Hadassah Medical Center and Faculty of Medicine Hebrew University of Jerusalem, Jerusalem, Israel
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Pose K, Morales-Cabeza C, De Las Vecillas L, González Muñoz M, Feito-Rodriguez M, Fiandor A. Varenicline-induced Erosive Stomatitis: First case report. Contact Dermatitis 2021; 86:317-318. [PMID: 34913173 DOI: 10.1111/cod.14026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Katherine Pose
- Department of Allergy, La Paz University Hospital, Madrid, Spain
| | | | | | | | | | - Ana Fiandor
- Department of Allergy, La Paz University Hospital, Madrid, Spain.,Department of Allergy, La Paz University Hospital. Institute for Health Research (IdiPAZ), Madrid, Spain
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Naniwa M, Nakatomi C, Hitomi S, Matsuda K, Tabuchi T, Sugiyama D, Kubo S, Miyamura Y, Yoshino K, Akifusa S, Ono K. Analgesic Mechanisms of Steroid Ointment against Oral Ulcerative Mucositis in a Rat Model. Int J Mol Sci 2021; 22:12600. [PMID: 34830488 DOI: 10.3390/ijms222212600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 12/23/2022] Open
Abstract
Despite the long history of use of steroid ointments for oral mucositis, the analgesic mechanism has not been fully elucidated. In this study, we examined the effects of triamcinolone acetonide (Tmc) on oral ulcerative mucositis-induced pain in conscious rats by our proprietary assay system. Based on evaluations of the physical properties and retention periods in the oral mucosa of human volunteers and rats, we selected TRAFUL® ointment as a long-lasting base. In oral ulcerative mucositis model rats, TRAFUL® with Tmc suppressed cyclooxygenase-dependent inflammatory responses with upregulations of glucocorticoid receptor-induced anti-inflammatory genes and inhibited spontaneous nociceptive behavior. When an ointment with a shorter residual period was used, the effects of Tmc were not elicited or were induced to a lesser extent. Importantly, TRAFUL® with Tmc also improved oral ulcerative mucositis-induced mechanical allodynia, which has been reported to be independent of cyclooxygenase. Ca2+ imaging in dissociated trigeminal ganglion neurons showed that long-term preincubation with Tmc inhibited the hypertonic stimulation-induced Ca2+ response. These results suggest that the representative steroid Tmc suppresses oral ulcerative mucositis-induced pain by general anti-inflammatory actions and inhibits mechanical sensitivity in peripheral nerves. For drug delivery, long-lasting ointments such as TRAFUL® are needed to sufficiently induce the therapeutic effects.
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Ishii N, Mizobuchi S, Kawano Y, Hanawa T. Preparation and Evaluation of a Powdered Rebamipide Mouthwash as In-Hospital Formulation: Considering Dispersion before Use in Patients. Pharmaceutics 2021; 13:1848. [PMID: 34834266 DOI: 10.3390/pharmaceutics13111848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/15/2021] [Accepted: 10/28/2021] [Indexed: 11/17/2022] Open
Abstract
In Japan, rebamipide (RB) mouthwash (RB-MW) for oral mucositis induced by cancer chemotherapy has been prepared using in-hospital formulation. Usually, RB-MW is prepared by dispersing crushed commercial RB tablets in the dispersion medium; however, uniformity is difficult to obtain due to low solubility. The current study aims is to prepare homogenously dispersed formulations using the fine particles of crushed tablets by a method that is convenient for hospital use. Commercial RB tablets were pre-milled at different milling times as "RB-Ts". A ground mixture was then prepared by co-grinding the RB-Ts with HPC-L or PVP K30 via a benchtop ball milling machine (MM400). The physicochemical properties of samples were evaluated for PXRD, FTIR, turbidity, particle size, and solubility. Although the milling of RB tablets decreased the crystallinity, the length of milling time did not affect them. In contrast, grinding using MM400 significantly decreased RB crystallinity; their PXRD patterns showed a halo, suggesting the amorphization of RB crystals by grinding. Although solubility and turbidity seemed to be affected by the type of polymer rather than the particle size, every ground mixture showed high dispersibility. Thus, grinding the RB-Ts with polymers appeared to be the most promising way to obtain stable dispersion as an in-hospital formulation.
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Gobbi MF, Eduardo FDP, Bezinelli LM, de Carvalho DLC, Monção do Vale SK, Corrêa L. Severe oral ulcerative and lichenoid lesions associated with adrenal insufficiency in a patient treated with nivolumab: Report of a case and review of literature. Spec Care Dentist 2021; 42:286-293. [PMID: 34717001 DOI: 10.1111/scd.12660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/20/2021] [Accepted: 09/24/2021] [Indexed: 01/15/2023]
Abstract
Nivolumab, an antibody against anti-programmed death type 1, has been used for treatment of advanced non-small cell lung cancer with improvement of overall survival. Usually, diarrhea, cutaneous rash, and pruritus are reported as the most common immune-related adverse effects of nivolumab therapy. Oral lesions and secondary adrenal insufficiency sometimes occur but usually are rare events. We report a case of a patient treated with nivolumab who then showed persistent oral ulcerative and lichenoid lesions, which were refractory to topical corticosteroids. The oral lesions were concomitant to nivolumab-induced adrenal insufficiency. These adverse events led to nivolumab discontinuation, which favored oral lesion healing and adrenal insufficiency remission. Through a brief review of the literature concerning nivolumab toxicity in the oral cavity, we discuss the clinical aspect and management of these lesions.
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Affiliation(s)
- Marcella Ferreira Gobbi
- Hospital Israelita Albert Einstein, São Paulo, Brazil.,Pathology Department, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | - Luciana Corrêa
- Pathology Department, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Takeuchi Y, Noritake H, Matsumoto M, Umemura M, Yamashita M, Kitsugi K, Takatori S, Ohta K, Ito J, Shimoyama S, Kaysuya A, Maruyama C, Fukuchi K, Dohtan S, Sakata H, Kawata K. Azathioprine-induced severe myelosuppression accompanied by massive hair loss and painful oral ulcer in an autoimmune hepatitis patient with NUDT15 minor variant: A case report. Clin Case Rep 2021; 9:e04696. [PMID: 34466252 PMCID: PMC8385330 DOI: 10.1002/ccr3.4696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/26/2021] [Indexed: 11/11/2022] Open
Abstract
This report highlights azathioprine-induced severe myelosuppression in the patient with NUDT15 minor variant. This case report is particularly instructive because several typical symptoms are the clues to this critical adverse drug reaction.
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Affiliation(s)
- Yu Takeuchi
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Hidenao Noritake
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Moe Matsumoto
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Masahiro Umemura
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Maho Yamashita
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Kensuke Kitsugi
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Shingo Takatori
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Kazuyoshi Ohta
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Jun Ito
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Shin Shimoyama
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
| | - Akira Kaysuya
- Department of DermatologyHamamatsu University School of MedicineHamamatsuJapan
| | - Chiaki Maruyama
- Department of DermatologyHamamatsu University School of MedicineHamamatsuJapan
| | - Kensuke Fukuchi
- Department of DermatologyHamamatsu University School of MedicineHamamatsuJapan
| | - Satoshi Dohtan
- Department of HematologyHamamatsu University School of MedicineHamamatsuJapan
| | - Hiroe Sakata
- Department of Dentistry and Oral and Maxillofacial SurgeryHamamatsu University School of MedicineHamamatsuJapan
| | - Kazuhito Kawata
- Division of HepatologyDepartment of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
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39
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Long Q, Li X, Wu G, Zhang J, Li H. Oral adverse effects of CDK4/6 inhibitors among breast cancer patients: a systematic review and meta-analysis. Ann Palliat Med 2021; 10:6556-6563. [PMID: 34237967 DOI: 10.21037/apm-21-1156] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/15/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cyclin-dependent kinase (CDK) inhibitors are widely used to treat hormone receptor-positive (HR+) breast cancer due to their efficient performance in improving survival outcomes. Although the side effects of these agents on the hematological and gastrointestinal systems have attracted significant attention, the adverse effects that have direct impacts on patients' quality of life, such as stomatitis, have not been well explored to date. METHODS A systematic literature search was conducted in the PubMed, Google Scholar, European Society of Medical Oncology (ESMO), and American Society of Clinical Oncology databases. Phase 2 and 3 randomized trials on CDK4/6 inhibitors (CDK4/6Is) were identified and used in the meta-analysis based on the completeness of their safety data. RESULTS Of the 904 records screened, 40 studies were considered relevant. Six studies were used in the meta-analysis, with a total of 2,980 patients in the safety population. The pooled relative risk (RR) and risk difference (RD) for any-grade stomatitis were 2.02 (95% CI: 1.65-2.48) and 0.10 (95% CI: 0.05-0.15), respectively. In the subgroup analysis, higher RRs were observed among patients receiving letrozole as basic endocrine therapy (ET) (8.50, 95% CI: 2.22-32.57) or palbociclib-containing regimens (2.44, 95% CI: 1.88-3.18), whereas the RDs showed no significant difference. DISCUSSION All CDK4/6Is, especially palbociclib, could increase the risk of developing stomatitis among patients with breast cancer. Prevention and management of CDK4/6Is-related stomatitis may effectively reduce its secondary impacts. Due to the lack of individual-level data, some important personal confounding variables could not be controlled. Besides, the explanations of the secondary effects of stomatitis in this study were only based on the literature and professional knowledge. The specific quantitative impacts on patient quality of life and compliance require further questionnaire investigation. More in-depth individual-level data are needed to quantify the effect of stomatitis on patients' quality of life and treatment compliance.
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Affiliation(s)
- Quanyi Long
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaomin Li
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Gonghua Wu
- Department of Biostatistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Jia Zhang
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Hongjiang Li
- Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
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40
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Berzin D, Lahad A, Weiss B, Barzilai A, Greenberger S. Inflammatory bowel disease presenting with pyodermatitis-pyo stomatitis vegetans in a pediatric patient: A case report and review of the literature. Pediatr Dermatol 2021; 38:868-871. [PMID: 34021919 DOI: 10.1111/pde.14625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Pyodermatitis-pyostomatitis vegetans (PD-PSV) is rarely reported in the pediatric population. Here, we provide a review of pediatric PD-PSV in the literature and report a case of widespread PD-PSV in a 15-year-old male without a previous history of inflammatory bowel disease or gastrointestinal symptoms. Clinical, histological, and immunopathological workup established PD-PSV and revealed subclinical Crohn's disease. Treatment with infliximab was effective in inducing rapid resolution of the lesions.
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Affiliation(s)
- Daniella Berzin
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Avishai Lahad
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.,Israel Center for Medical Simulation, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Batia Weiss
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Aviv Barzilai
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shoshana Greenberger
- Department of Dermatology, The Chaim Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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41
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Mirzaei M, Zarabadipour M, Mirzadeh M. Evaluation the relationship between psychological profile and salivary cortisol in patients with recurrent aphthous stomatitis. Dent Res J (Isfahan) 2021; 18:50. [PMID: 34429870 PMCID: PMC8351933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 06/28/2020] [Accepted: 09/20/2020] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases which are diagnosed with recurrent and painful ulcers. The possible association between psychological factors and salivary stress related factors in patients with aphthous ulcers has been discussed in various studies. The aim of this study was to evaluate salivary cortisol level, anxiety, and depression in patients with RAS. MATERIALS AND METHODS In this case control study, 30 patients with RAS and 30 healthy individuals were enrolled by matching their age and sex. Anxiety and depression were assessed by beck anxiety inventory and beck depression inventory. Unstimulated saliva of both groups were collected and then tested by DiaMetra kit and the ELISA method. Data were analyzed by SPSS using an Independent t-test and Mann-Whitney test. A statistical significance level of <0.05 was considered. RESULTS The mean salivary cortisol in the case group was 5.35 ng/ml and in the control group was 4.73 ng/ml which was not statistically significant (P > 0.05). There was no significant difference in anxiety and depression level between the two groups (P > 0.05). According to Spearman correlation coefficient, there was an average, negative, and significant correlation between salivary cortisol and anxiety and depression scores in the case group (P < 0.05). CONCLUSION This study shows that, although the mean salivary cortisol was slightly higher in patients with aphthous lesions, anxiety, and depression were not possible factors for RAS. There was a moderate, negative correlation between salivary cortisol level and stress and anxiety in patients with RAS.
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Affiliation(s)
- Marjan Mirzaei
- Department of Oral and Maxillofacial Medicine, Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mahdieh Zarabadipour
- Department of Oral and Maxillofacial Medicine, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran,Address for correspondence: Dr. Mahdieh Zarabadipour, Department of Oral and Maxillofacial Medicine, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Bahonar Blvd., Qazvin, Iran. E-mail:
| | - Monirsadat Mirzadeh
- Department of Community Medicine, Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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42
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Martella V, Lanave G, Camero M, Larocca V, Lorusso E, Catella C, Capozza P, Tempesta M, Buonavoglia C. Identification of a Novel α-herpesvirus Associated with Ulcerative Stomatitis in Donkeys. Emerg Infect Dis 2021; 26:3044-3047. [PMID: 33219790 PMCID: PMC7706971 DOI: 10.3201/eid2612.200201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
An outbreak of ulcerative stomatitis was observed in a donkey (Equus asinus) dairy herd. Similar lesions were also observed on the dams’ udders and, sporadically, in genital areas. The lesions typically resolved in 1–3 weeks. An α-herpesvirus, Varicellovirus, genetically related to equid herpesvirus type 3, was identified.
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43
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Badr-Eldin SM, Fahmy UA, Aldawsari HM, Ahmed OAA, Alhakamy NA, Okbazghi SZ, El-Moselhy MA, Alghaith AF, Anter A, Matouk AI, Mahdi WA, Alshehri S, Bakhaidar R. Optimized Self-Nanoemulsifying Delivery System Based on Plant-Derived Oil Augments Alpha-Lipoic Acid Protective Effects Against Experimentally Induced Gastric Lesions. Dose Response 2021; 19:15593258211001259. [PMID: 33867893 PMCID: PMC8020240 DOI: 10.1177/15593258211001259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/14/2022] Open
Abstract
Peptic ulcer disease is an injury of the alimentary tract that leads to a mucosal defect reaching the submucosa. Alpha-lipoic acid (ALA), a natural potent antioxidant, has been known as a gastroprotective drug yet its low bioavailability may restrict its therapeutic efficacy. This study aimed to formulate and optimize ALA using a self-nanoemulsifying drug delivery system (SNEDDS) with a size of nano-range, enhancing its absorption and augmenting its gastric ulcer protection efficacy. Three SNEDDS components were selected as the design factors: the concentrations of the pumpkin oil (X1, 10–30%), the surfactant tween 80 (X2, 20–50%), and the co-surfactant polyethylene glycol 200 (X3, 30–60%). The experimental design for the proposed mixture produced 16 formulations with varying ALA-SNEDDS formulation component percentages. The optimized ALA-SNEDDS formula was investigated for gastric ulcer protective effects by evaluating the ulcer index and by the determination of gastric mucosa oxidative stress parameters. Results revealed that optimized ALA-SNEDDS achieved significant improvement in gastric ulcer index in comparison with raw ALA. Histopathological findings confirmed the protective effect of the formulated optimized ALASNEDDS in comparison with raw ALA. These findings suggest that formulation of ALA in SNEDDS form would be more effective in gastric ulcer protection compared to pure ALA.
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Affiliation(s)
- Shaimaa M Badr-Eldin
- Faculty of Pharmacy, Department of Pharmaceutics, King Abdulaziz University, Jeddah, Saudi Arabia.,Faculty of Pharmacy, Department of Pharmaceutics and Industrial Pharmacy, Cairo University, Cairo, Egypt
| | - Usama A Fahmy
- Faculty of Pharmacy, Department of Pharmaceutics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hibah M Aldawsari
- Faculty of Pharmacy, Department of Pharmaceutics, King Abdulaziz University, Jeddah, Saudi Arabia.,Advanced Drug Delivery Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Osama A A Ahmed
- Faculty of Pharmacy, Department of Pharmaceutics, King Abdulaziz University, Jeddah, Saudi Arabia.,Advanced Drug Delivery Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nabil A Alhakamy
- Faculty of Pharmacy, Department of Pharmaceutics, King Abdulaziz University, Jeddah, Saudi Arabia.,Advanced Drug Delivery Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.,Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah, Saudi Arabia.,King Abdulaziz University, Jeddah, Saudi Arabia
| | - Solomon Z Okbazghi
- Global Analytical and Pharmaceutical Development, Alexion Pharmaceuticals, New Haven, CT, USA
| | - Mohamed A El-Moselhy
- Faculty of Pharmacy, Department of Pharmacology and Toxicology, Minia University, Minia, Egypt.,Department of Pharmacology, School of Pharmacy, Ibn Sina National College, Jeddah, Saudi Arabia
| | - Adel F Alghaith
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Aliaa Anter
- Faculty of Pharmacy, Department of Pharmacology and Toxicology, Minia University, Minia, Egypt
| | - Asmaa I Matouk
- Faculty of Pharmacy, Department of Pharmacology and Toxicology, Minia University, Minia, Egypt
| | - Wael Ali Mahdi
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Department of Pharmaceutical Sciences, College of Pharmacy, Almaarefa University, Riyadh, Saudi Arabia
| | - Rana Bakhaidar
- Faculty of Pharmacy, Department of Pharmaceutics, King Abdulaziz University, Jeddah, Saudi Arabia
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Bansal S, Singhania N, Nukala CM, Singh AK, Al‐Rabadi L. Histoplasma stomatitis unveiled: Not all opportunistic infections get better after initiation of antiretroviral therapy. Clin Case Rep 2021; 9:1466-1468. [PMID: 33768869 PMCID: PMC7981768 DOI: 10.1002/ccr3.3799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/16/2020] [Accepted: 12/27/2020] [Indexed: 11/30/2022] Open
Abstract
Immune reconstitution inflammatory syndrome in AIDS patients can lead to an initial worsening of underlying diseases due to body's ability to mount a strong immune response after recovery of CD4 counts.
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Affiliation(s)
- Saurabh Bansal
- Department of Internal MedicineUniversity of Illinois College of Medicine at PeoriaPeoriaILUSA
| | - Namrata Singhania
- Department of Hospital MedicineMount Carmel East HospitalColumbusOHUSA
| | | | - Anil Kumar Singh
- Department of Internal MedicineGeisinger Community Medical CenterScrantonPAUSA
| | - Laith Al‐Rabadi
- Division of NephrologyUniversity of UtahSalt Lake City, UtahUSA
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Jordan CT, Bradford EM, Cheek DC, Kudrimoti M, Miller CS, Smith MH, Hilt JZ, Dziubla TD. Radiation-induced oral mucositis hamster model using a linear accelerator enhances clinical relevance of preclinical studies for treatment strategy investigation. Animal Model Exp Med 2021; 4:47-53. [PMID: 33738436 PMCID: PMC7954840 DOI: 10.1002/ame2.12148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/23/2020] [Indexed: 12/15/2022] Open
Abstract
Translational animal models for oral mucositis (OM) are necessary to simulate and assess the bioclinical effects and response in humans. These models should simulate high levels of radiation exposure that leads to oxidative stress and inflammatory-initiated tissue changes. Hamster models have been extensively studied to observe pathological effects of radiation exposure and help in the development of effective treatments. To successfully evaluate the potential for treatment regimens with consistency and relevance, a radiation-induced OM hamster model was developed using a clinical linear accelerator utilized by cancer patients daily. The dose exposure to the isolated, everted cheek pouch of a hamster, as well as the progression of injury, pro-inflammatory marker, histological, and elasticity analyses of the buccal pouch were conducted to verify replicability and reproducibility of the injury model. The findings from this model demonstrated its ability to consistently induce injury and resolution over 28 days using an acute dose of 60 Gy. This model was developed to enhance clinical relevance when evaluating potential efficacious treatments and can now be utilized in efficacy studies to better evaluate developed therapeutics in a preclinical model that is easy to translate to clinical studies..
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Affiliation(s)
- Carolyn T. Jordan
- Department of Chemical and Materials EngineeringUniversity of KentuckyLexingtonKYUSA
| | | | - Dennis C. Cheek
- Department of Radiation MedicineUniversity of KentuckyLexingtonKYUSA
| | - Mahesh Kudrimoti
- Department of Radiation MedicineUniversity of KentuckyLexingtonKYUSA
| | - Craig S. Miller
- Department of Oral Health PracticeUniversity of KentuckyLexingtonKYUSA
| | - Molly H. Smith
- Department of Oral and Maxillofacial PathologyUniversity of KentuckyLexingtonKYUSA
| | - J. Zach Hilt
- Department of Chemical and Materials EngineeringUniversity of KentuckyLexingtonKYUSA
| | - Thomas D. Dziubla
- Department of Chemical and Materials EngineeringUniversity of KentuckyLexingtonKYUSA
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46
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Xu Y, Wen N, Sonis ST, Villa A. Oral side effects of immune checkpoint inhibitor therapy (ICIT): An analysis of 4683 patients receiving ICIT for malignancies at Massachusetts General Hospital, Brigham & Women's Hospital, and the Dana-Farber Cancer Institute, 2011 to 2019. Cancer 2021; 127:1796-1804. [PMID: 33595843 DOI: 10.1002/cncr.33436] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/11/2020] [Accepted: 12/21/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) are increasingly accepted as a treatment option for several cancers. Although various systemic immune-related adverse events (irAEs) have been characterized, the effect of ICIs on the oral cavity and contiguous structures is still poorly understood. METHODS Electronic medical records of 4683 patients in the Mass General Brigham Registered Patient Data Registry who received ICI therapy (ICIT) between December 2011 and September 2019 were reviewed. Reports of oral conditions were categorized into oral mucosal disorders, xerostomia, and dysgeusia. After applying exclusion criteria, demographic characteristics and clinical features were summarized for the patients who had oral irAEs. RESULTS In total, 317 patients developed oral conditions that were associated with ICIT (incidence, 6.8%; 317 of 4683 patients). These conditions included xerostomia (68.5%), oral mucosal disorders (33.4%), and dysgeusia (24.0%). In patients with oral irAEs, respiratory cancer (28.4%) was the most common primary cancer, followed by melanoma (26.2%), and head and neck cancer (14.8%). Oral mucosal disorders developed after the initiation of ICIT between 2 and 851 days (between 1 and 1332 days in patients with xerostomia and between 1 and 1455 days in patients with dysgeusia). Of all oral irAEs, 50.9% developed within 3 months, and 85.5% developed within 12 months. CONCLUSIONS Oral side effects appear to be more common among patients who receive ICIT than has been previously reported. Concomitant cytotoxic regimens may exacerbate the risk of oral adverse events, perhaps representing the sum of the effects of different, but simultaneous or sequential, pathogenic mechanisms. Additional studies are warranted to better characterize oral irAEs and their biologic basis.
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Affiliation(s)
- Yuanming Xu
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard School of Dental Medicine, Boston, Massachusetts
| | - Natalie Wen
- Harvard School of Dental Medicine, Boston, Massachusetts
| | - Stephen T Sonis
- Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts.,Harvard School of Dental Medicine, Boston, Massachusetts
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California, San Francisco, California
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47
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Steinmann D, Babadağ Savaş B, Felber S, Joy S, Mertens I, Cramer H, Paul A, Layer M, Klafke N, Stolz R, Heyder U, Neuberger P, Winkler M, Idler C, Heine R, Kaschdailewitsch E, John H, Schmeling B, Zielke T, Horneber M, Witt CM, Voiss P. Nursing Procedures for the Prevention and Treatment of Mucositis Induced by Cancer Therapies: Clinical Practice Guideline Based on an Interdisciplinary Consensus Process and a Systematic Literature Search. Integr Cancer Ther 2021; 20:1534735420940412. [PMID: 33467951 PMCID: PMC7960907 DOI: 10.1177/1534735420940412] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Patients with cancer receiving tumor therapy often suffer from oral mucositis. Objectives: The aim of this project was to summarize experiences with nursing procedures by experts in integrative oncology and to establish recommendations for nursing interventions that can prevent or cure mucositis. Methods: The study design was an interdisciplinary consensus process based on a systematic literature search. Results: The panel discussed and agreed on 19 nursing procedures, which included mouthwashes, such as teas, supplements, oil applications, and different kinds of ice cubes to suck, as well as flaxseed solution, propolis, and mare milk. Twelve interventions were classified as effective, with effectiveness for OraLife, propolis, sea buckthorn pulp oil, marshmallow root tea also for xerostomia, Helago chamomile oil, mare milk, and Saliva Natura rated as highly effective in clinical experience. In the systematic literature search, a total of 12 out of 329 randomized controlled trials and meta-analyses on chamomile (n = 3), Calendula (n = 1) and sage (n = 1), propolis (n = 2), and sucking ice cubes (cryotherapy; n = 5) met all inclusion criteria. Trial evidence for effectiveness in oral mucositis was revealed for propolis and cryotherapy. Conclusions: The current evidence supports the use of some nursing procedures (f.e. propolis for 2 and 3 grade mucositis) for improving oral mucositis during cancer therapies. There is still a need to define general clinical practice guidelines for the supportive treatment of mucositis, as well as for more interdisciplinary research in this area.
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Affiliation(s)
| | | | - Sabine Felber
- Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Sosamma Joy
- Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Isabelle Mertens
- Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Holger Cramer
- Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Anna Paul
- Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Monika Layer
- Kantonsspital St. Gallen, Centre for Integrative Medicine, Sankt Gallen, Switzerland
| | - Nadja Klafke
- University Hospital Heidelberg, Heidelberg, Germany
| | - Regina Stolz
- University Hospital Tuebingen, Baden-Württemberg, Germany.,Tropenklinik Paul-Lechler-Krankenhaus, Tuebingen, Germany
| | - Ute Heyder
- Community Hospital Karlsruhe, Karlsruhe, Baden-Württemberg, Germany
| | | | - Marcela Winkler
- Robert-Bosch-Krankenhaus Stuttgart, Stuttgart, Baden-Württemberg, Germany
| | - Christel Idler
- Robert-Bosch-Krankenhaus Stuttgart, Stuttgart, Baden-Württemberg, Germany
| | - Rolf Heine
- Akademie für Pflegeberufe an der Filderklinik, Filderstadt, Germany
| | | | - Heike John
- Medizinische Hochschule Hannover, Hannover, Germany
| | | | | | | | - Claudia M Witt
- University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Petra Voiss
- Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
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Bacali C, Nastase V, Constantiniuc M, Lascu L, Badea ME. Oral Hygiene Habits of Complete Denture Wearers in Central Transylvania, Romania. Oral Health Prev Dent 2021; 19:107-113. [PMID: 33600087 DOI: 10.3290/j.ohpd.b965699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To identify the oral hygiene habits and denture hygiene status (e.g. sociodemographic characteristics, general health status) of complete denture wearers in Central Transylvania, Romania. MATERIALS AND METHODS This descriptive cross-sectional study was based on an original self-administered questionnaire. It included 162 patients who experienced complete tooth loss in one or both jaws and wore polymethylmethacrylate acrylic (PMMA) complete dentures. The exclusion criteria were partial dentures, dentures fabricated from materials other than PMMA, and the patient being unable to provide all the required information. The questionnaire solicited information regarding sociodemographic status, general health and oral hygiene-related habits. The dentures were clinically evaluated in order to assess denture hygiene. RESULTS Most respondents were completely edentulous (38.0% wore maxillary dentures, 10.6% mandibular dentures, while 51.6% had both), with an average age above 60, all wearing dentures. The clinical evaluation of the dentures revealed that 12.3% exhibited optimal hygiene status, 40.1% good, 32.7% unsatisfactory and 14.8% bad, with more women than men having well-cleaned dentures. Cleaning frequency was found to be 2-3 times per day for 54.3% of the patients, with 93.2% of the subjects using a toothbrush and 76.5% using toothpaste. Most of the participants felt at ease with the cleaning procedures. Only 30.9% of the respondents reported denture removal overnight. The results showed that the hygiene of the patients' dentures was not correlated with their answers regarding oral hygiene habits. CONCLUSIONS Competent oral health and denture hygiene promotion should be established, especially regarding nocturnal denture removal, denture hygiene methods, instruments and cleaning frequency.
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Costa MDC, de Carvalho MM, Sperandio FF, Ribeiro Junior NV, Hanemann JAC, Pigossi SC, de Carli ML. Oral Paracoccidioidomycosis affecting women: A systematic review. Mycoses 2020; 64:108-122. [PMID: 33031605 DOI: 10.1111/myc.13194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/25/2020] [Accepted: 10/01/2020] [Indexed: 12/14/2022]
Abstract
Paracoccidioidomycosis (PCM) is an infection caused by fungi of the genus Paracoccidioides and is marked by a strong predilection for men; nevertheless, some women have had developed PCM and have presented oral involvement by the disease. OBJECTIVES To review all published cases until August 2020 of oral PCM in women, with emphasis on the presence of systemic changes, deleterious habits (tobacco and alcohol) and oral manifestation features through a systematic review. METHODS Observational studies (both prospective and retrospective) and case reports indexed in the Embase, PubMed, Scopus, Web of Science and LIVIVO databases were selected by two reviewers in a two-phase process following the pre-established PICOS criteria. RESULTS Twenty-five studies met the eligibility criteria and were selected for qualitative synthesis, of which 72 participants were enrolled. Brazilian White women between 40 and 50 years were the most affected and social history revealed them to be housewives or rural workers. Fifteen women (33.3% of the informed cases) presented any systemic change at the time of PCM diagnosis, namely pregnancy, HIV infection and/or depression. Moriform stomatitis was predominant and affected preferentially the gingivae and alveolar processes in the form of a single painful lesion. Most patients were treated with sulfamethoxazole + trimethoprim or itraconazole. CONCLUSIONS Oral PCM in women is rare; some cases showed systemic changes at the time of PCM diagnosis, namely HIV infection, pregnancy and depression. New studies should be conducted to elucidate the influence of systemic alterations on the development of oral PCM in women.
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Affiliation(s)
- Matheus de Castro Costa
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Milena Moraes de Carvalho
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Felipe Fornias Sperandio
- Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas, Alfenas, MG, Brazil.,Oral Medicine Oral Pathology Resident, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Noé Vital Ribeiro Junior
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, MG, Brazil
| | - João Adolfo Costa Hanemann
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Suzane Cristina Pigossi
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, MG, Brazil
| | - Marina Lara de Carli
- Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, MG, Brazil
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Muhvić-Urek M, Saltović E, Braut A, Kovačević Pavičić D. Association between Vitamin D and Candida-Associated Denture Stomatitis. Dent J (Basel) 2020; 8:dj8040121. [PMID: 33096916 PMCID: PMC7712357 DOI: 10.3390/dj8040121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/25/2020] [Accepted: 10/14/2020] [Indexed: 12/19/2022] Open
Abstract
Candida-associated denture stomatitis (CADS) is a fungal infection affecting 60–65% of denture wearers. Its etiology is complex and multifactorial and often associated with host immunodeficiency. Evidence exists that vitamin D has potential immunomodulatory and anti-inflammatory effects. The aim of this case–control study was to assess the association between vitamin D levels and CADS. The study included 32 complete denture wearers with CADS and 32 sex- and age-matched complete denture wearers without CADS. The patients were clinically examined, and the severity of denture stomatitis was assessed according to Newton’s classification scale. The serum vitamin D level was determined via the use of an electrochemiluminescence assay. The vitamin D level in the CADS group and control group was 54.68 ± 17.07 and 56.82 ± 17.75 nmol/L, respectively. There was no significant difference between the groups (p = 0.622). Univariate logistic regression analysis showed that the presence of CADS was not associated with hypovitaminosis D (odds ratio (OR) = 1.44; 95% confidence interval (CI) = 0.37–5.54). It can be concluded that vitamin D is not associated with CADS and does not play a significant role in host susceptibility to CADS. This finding suggests that vitamin D screening is not indicated routinely in patients with Candida-associated denture stomatitis.
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Affiliation(s)
- Miranda Muhvić-Urek
- Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Kresimirova 40, 51 000 Rijeka, Croatia
- Dental Clinic, Clinical Hospital Center Rijeka, Kresimirova 40, 51 000 Rijeka, Croatia
| | - Ema Saltović
- Dental Clinic, Clinical Hospital Center Rijeka, Kresimirova 40, 51 000 Rijeka, Croatia
| | - Alen Braut
- Dental Clinic, Clinical Hospital Center Rijeka, Kresimirova 40, 51 000 Rijeka, Croatia
- Department of Restorative Dentistry and Endodontics, Faculty of Dental Medicine, University of Rijeka, Kresimirova 40, 51 000 Rijeka, Croatia
| | - Daniela Kovačević Pavičić
- Dental Clinic, Clinical Hospital Center Rijeka, Kresimirova 40, 51 000 Rijeka, Croatia
- Department of Prosthodontics, Faculty of Dental Medicine, University of Rijeka, Kresimirova 40, 51 000 Rijeka, Croatia
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