Dysgeusia increases the risk for death and other side effects during antineoplastic systemic treatment for solid tumors: a cross-sectional study.

BACKGROUND: Chemotherapy (CT) is a systemic treatment using a combination of antineoplastic drugs, orally or intravenously, that inhibit tumor growth and fast-growing normal cells. Due to its nonspecificity, chemotherapy can cause a series of adverse effects, such as altered taste (dysgeusia), associated with malnutrition and, consequently, other adverse effects in the gastrointestinal tract and increased mortality risk. This study aimed to evaluate the influence of dysgeusia on the incidence of other adverse effects and overall survival during antineoplastic chemotherapy. MATERIAL AND METHODS: An observational, retrospective, cross-sectional study was conducted using data from the Electronic Health Record system of the Cancer Institute of Ceará over two years. Before the CT session, the multi-professional team evaluated the patient for the presence and severity of adverse effects (AE), using scores from the CTCAE v5.0 scale. Dysgeusia scores were collected and associated with clinical pathological data, with other adverse effects (nausea, vomiting, diarrhea, oral mucositis, anorexia, constipation), and with overall survival. Chi-square and Mantel-Cox log-rank tests were used. RESULTS: Of 5744 patients evaluated, dysgeusia presented a frequency of 50.6%, being directly associated with female gender (p=0.001), overweight (p=0.022), high tumor stages (p=0.009), a combination of adjuvant and neoadjuvant (p=0.010) and four-year survival (p=0.030). Dysgeusia frequency was directly associated with diarrhea (p<0.001), anorexia (p<0.001), oral mucositis (p<0.001), nausea (p<0.001), constipation (p<0.001) and vomiting (p<0.001), and inversely associated with fatigue (p=0.035). CONCLUSIONS: Dysgeusia during CT increases the risk of other adverse effects and negatively impacts prognosis.

Comparison of a daily and alternate-day photobiomodulation protocol in the prevention of oral mucositis in patients undergoing radiochemotherapy for oral cancer: a triple-blind, controlled clinical trial.

BACKGROUND: Preventive Photobiomodulation Therapy (PBMT) significantly reduces oral mucositis (OM) severity in patients undergoing Radiochemotherapy (RCT) for the treatment of oral cancer, but daily applications generate cost, overload the dental team, and reduce the number of patients assisted.To evaluate the effectiveness of two PBMT protocols in preventing OM in patients undergoing RCT for oral cancer. MATERIAL AND METHODS: 16 patients diagnosed with oral cancer undergoing RCT were included, equally divided into two groups: a group treated daily with PBMT, and another group also submitted to daily treatment, however, performing the application of PBMT every three days, interspersed with a simulation of PBMT (placebo). A red laser was used (~660 nm), 0.1W power, 1J of energy applied per point, 9 points per area (labial mucosa, buccal mucosa, lateral borders of the tongue, body of the tongue, and floor of the mouth) from the beginning of RCT until the end of the oncological treatment. Daily assessments were performed regarding OM scores, the World Health Organization (WHO) pain scale, and the visual analog scale (VAS). Weight, salivary flow (SGAPP), OHIP-14, and DMFT were evaluated on the initial and final days of RT. OM incidence and clinical data were compared by Pearson's chi-square test or Fisher's exact test. Pain and other scale scores were compared using the Mann-Whitney and Friedman/Dunn tests (SPSS v20.0 p<0.05). RESULTS: In the group with PBMT on alternate days, there was an increase in the frequency of grade 2 and grade 3 oral mucositis and an increased risk of grade 2 oral mucositis, in addition to higher mean pain scores and greater reduction in salivary flow. CONCLUSIONS: The daily PBMT protocol proved more effective in controlling the frequency and severity of OM, pain, and salivary flow.

Percutaneous portal vein recanalization using self-expandable nitinol stents in patients with non-cirrhotic non-tumoral portal vein occlusion.

PURPOSE: The purpose of this study was to evaluate the feasibility, safety, and efficacy of portal vein recanalization (PVR) and propose a new classification for better selecting candidates with portal vein occlusion (PVO) in whom PVR could be feasible. MATERIALS AND METHODS: The charts of 15 non-cirrhotic patients in whom stent placement using a trans-hepatic approach was attempted for the treatment of PVO with cavernous transformation were reviewed. There were 12 men and 3 women with a mean age of 47 ± 12 years (range: 22­60 years) [corrected]. Intrahepatic involvement was classified into 3 groups according to the intrahepatic extent of PVO: type 1 included occlusions limited to the origin of the main portal vein and/or the right or left portal branches, type 2 included type 1 plus extension to the origin of segmental branches, type 3 included type 2 plus extension to distal branches. RESULTS: There were 6 patients with PVO type 1, 7 patients with PVO type 2, and 2 patients with PVO type 3. Indications for PVR were gastrointestinal bleeding (n=6), portal biliopathy (n=2), reduce portal pressure before surgery (n=4), or other (n=3). PVR was successful in 13 patients (87%) with no severe side effects. Failure of PVR or early stent thrombosis occurred in 100% of type 3 vs. 8% of type 1 and 2 patients (P=0.03). During a mean follow-up of 42±28 months (range: 6-112 months), patients with a permeable stent had resolution of portal hypertension-related manifestations. In 13 patients in whom PVR was feasible, stent permeability was 77% at 2 years (87% vs. 60% in patients who received anticoagulation or not, respectively; P=0.3). CONCLUSION: PVR is feasible in most patients with non-cirrhotic, non-tumoral portal vein occlusion when there is no extension of the occlusion to distal branches.

The role of behavior in the survival of Biomphalaria a glabrata in biossays with the plant molluscicide Phytolacca dodecandra

Este trabalho investiga o papel do comportamento na sobrevivência de Biomphalaria glabarta exposta a 25, 50, 75 e 100 mgI-1 de Phytolacca dodecandra. Foi utilizada a técnica de cinematografia com lapso de tempo para quantificar acuradamente os seguintes parâmetros (a) freqüência de saídas da soluçäo, (b) tempo de permanência fora da soluçäo e (e) tempo decorrido até a primeira saída da soluçao. Estes padröes comportamentais foram estatisticamente comparados no que se refere aos caramujos sobreviventes e aos que vieram a morrer. Dentre os camundongos que abandonaram o meio líquido, a proporçäo de sobreviventes foi significativamente maior que a de mortos. Além disso, um tempo significativamente maior de permanência fora da soluçäo foi observado no grupo que sobreviveu, em relaçäo ao grupo que veio a morrer, exceto no que diz respeito à concentraçäo de 100 mgI-1. No entanto, nenhuma diferença significativa foi detectada no tempo decorrido até a primeira saída da soluçäo. Conclui-se que a tendência a abandonar as soluçöes de P.dodecandra e o tempo de permenência fora delas favorecem a sobrevivência dos caramujos. Bioensaios com moluscicidas deveriam levar em conta a possibilidade de que alguns padräoes comprtamentais dos planorbídeos venham a contribuir para a sua sobrevivência

Studies on survival, biological activities and behavior of Biomphalaria glabrata, the host snail of Schistosomiasis, submitted to increased hydrostatic pressure: a technique

Para estudar mudanças na sobrevivência, atividades biológicas e comportamento de planorbídeos submetidos a aumento de pressäo hidrostática, desenvolvemos uma técnica que utiliza duas câmaras transparentes e um pistäo hidráulico. O aparelho permitiu a renovaçäo do meio líquido sem variaçöes substanciais na pressäo, eliminando assim os produtos de excreçäo e mantendo o nível de O2 disseolvido desejado, e desse modo permitido-nos avaliar o efeito da pressäo independente da ocorrência de anoxia. A pressäo foi mantida sem nenhum contato do meio líquido com o ar comprimido, situaçäo que produziu com relativa fidelildade o que ocorre na natureza, e assegurou a presença da mesma quantidade de gases nas duas câmaras de observaçäo. Biomphalaria glabrata foi capaz de sobreviver pelo menos 48 horas quando submetida a 49,02 x 10 Pa (equivalente a 48 m de profundidade) continuando a pôr massas ovíferas, e mostrando poucas modificaçöes comportamentais quando comparada com o grupo de controle

The role of behavior in the survival of Biomphalaria glabrata in bioassays with the plant molluscicide Phytolacca dodecandra.

This work examines the role of behavior in the survival of Biomphalaria glabrata exposed to 25, 50, 75 and 100 mg l-1 of Phytolacca dodecandra. Time-lapse cinematography was used to quantify accurately the following parameters: (a) frequency of exits from the solution, (b) time spent out of the solution and (c) time elapsed until the first exit from the solution. These behavior patterns were statistically compared between surviving snails and those which later died. The proportion of surviving snails leaving the liquid medium was significantly higher than that of dying snails. In addition, the surviving group spent significantly more time out of the solution than the group which died, except for the 100 mg l-1 concentration. However, no significant difference was detected in the time elapsed until the first exit from the solution. It can be concluded that both the tendency to leave the P. dodecandra solutions, and the time spent out of them, contributed significantly to snail survival. Molluscicide bioassays should take into account the possibility that some behavior patterns of planorbids might contribute to the protection of the snails.

Studies on survival, biological activities and behavior of Biomphalaria glabrata, the host snail of schistosomiasis, submitted to increased hydrostatic pressure: a technique.

To study changes in survival, in biological activities and behavior of planorbids submitted to increased hydrostatic pressure, we developed a technique using two transparent chambers and a hydraulic piston. The apparatus permitted renewal of the liquid medium without substantial variations in pressure, thus eliminating excretion products and maintaining the desired O2 level and thereby permitting us to evaluate the effects of pressure independently of the occurrence of anoxia. Pressure was maintained without any contact of the liquid medium with compressed air, a situation which reproduced with relative fidelity what occurs in nature and assured the presence of the same amounts of gases in the two observation chambers (Control and Experimental). Biomphalaria glabrata was found to be able to survive at least 48 hours when submitted to 49.02 x 10(4) Pa (equivalent to a water depth of 48.8 m), continuing to lay egg masses and showing few behavioral changes when compared with the control group.

Behavior of Biomphalaria glabrata, the intermediate host snail of Schistosoma mansoni, at different depths in water in laboratory conditions

Investigamos a possibilidade de Biomphalaria glabrata deslocar-se para regiöes profundas, em três colunas de diferentes profundidades (1,10 m, 8,40 m e 10,40 m). Na coluna de 1,10 m evidenciamos que os deslocamentos podem ser de duas maneiras: 1) Quando o pé está em contato com o substrato: (i) deslizar para baixo; (ii) deslizar para cima; (iii) arrastar para baixo; (iiii) arrastar para cima. 2) Quando o pé näo está em contato com o substrato: (i) descida súbida sem saída de bolhas de ar; (ii) descida súbida com saída de bolhas de ar; (iii) subida súbita. Na coluna de 8,40 m em que havia alimento no fundo (grupo experimental) observamos que os caramujos permaneceram maior tempo nesta profundidade em relaçäo ao grupo que näo recebeu alimento (grupo de controle). Verificamos que o comportamento de deslizar é característico dos deslocamentos em torno de 0 a 1 m, tanto para subir como para descer. O comportamento de arrastar foi típico de subida dos caramujos que atingiram níveis mais profundos. Quando os caramujos arrastavam-se a concha ficava pendente como se estivesse mais pesada, o que pode estar relacionado à entrada de água na câmara pulmonar. Na coluna de 10,40 m verificamos que os caramujos deslizavam para baixo até 4 m ou apresentavam descidas súbitas até o fundo. As subidas se davam pelo padräo comportamental denominado arrastar, do fundo até a superfície. Nas colunas de 8,40 m e 10,40 m verificamos cópula, alimentaçäo e desova nos níveis mais profundos

Behavior of Biomphalaria glabrata, the intermediate host snail of Schistosoma mansoni, at different depths in water in laboratory conditions.

Using three columns of different depths (1.10m, 8.40m and 10.40m), we investigated the possibility of Biomphalaria glabrata moving towards deep regions. In the 1.10m column, we noted that locomotion can occur in two manners: 1) when the foot is in contact with the substrate: a) sliding descent; b) sliding ascent; c) creeping descent; d) creeping ascent, 2) when the foot is not in contact with the substrate: a) sudden descent without emission of air bules; b) sudden descent with emission of air bules; c) sudden ascent. In the 8.40m column containing food on the bottom (experimental group), the snails remained longer at this depth when compared to those of the group which received no food (control). The sliding behavior was characteristic of locomotion occurring at 0 to 1m both in upward and downward directions. Creeping behavior was typical for the ascent of the snails that reached deeper levels. When the snails were creeping, the shell remained hanging as if it were heavier, a fact that may have been due to water entering the pulmonary chamber. In the 10.40m column, the snails slid downward to a depth of 4m or descended suddenly all the way to the bottom. Ascent occurred by creeping from the bottom to the surface. In the 8.40m and 10.40m columns, copulation, feeding and oviposition occurred at the deepest levels.