Trehalose versus carboxymethylcellulose oral spray for relieving radiation-induced xerostomia in head and neck cancer patients: a randomized controlled trial.

BACKGROUND: The aim of this study was to investigate the effect of trehalose oral spray to relieve radiation-induced xerostomia on a randomized controlled trial (RCT). METHODS: Prior to RCT, the effect of trehalose (5-20%) on the epithelial growth of fetal mouse salivary gland (SG) explants was evaluated to confirm if 10% trehalose exerted the best epithelial outcomes. Participants who completed radiotherapy for head and neck cancer (HNC) treatment were enrolled in a double-blind RCT, according to inclusion and exclusion criteria as per the CONSORT statement. The experimental group (n = 35) received 10% trehalose spray, while the control group (n = 35) received carboxymethylcellulose (CMC) spray to apply intra-orally 4 times/day for 14 days. Salivary pH and unstimulated salivary flow rate were recorded pre- and post-interventions. The Xerostomia-related Quality of Life scale (XeQoLs) was filled, and scores assessed post-interventions. RESULTS: In the SG explant model, pro-acinar epithelial growth and mitosis was supported by 10% topical trehalose. As for RCT outcomes, salivary pH and unstimulated salivary flow rate were significantly improved after use of 10% trehalose spray when compared to CMC (p < 0.05). Participants reported an improvement of XeQoLs dimension scores after using trehalose or CMC oral sprays in terms of physical, pain/discomfort, and psychological dimensions (p < 0.05), but not social (p > 0.05). When comparing between CMC and trehalose sprays, XeQoLs total scores were not statistically different (p > 0.05). CONCLUSIONS: The 10% trehalose spray improved salivary pH, unstimulated salivary flow rate, and the quality-of-life dimensions linked with physical, pain/discomfort, and psychological signs. The clinical efficacy of 10% trehalose spray was equivalent with CMC-based saliva substitutes for relieving radiation-induced xerostomia; therefore, trehalose may be suggested in alternative to CMC-based oral spray.(Thai Clinical Trials Registry; https://www.thaiclinicaltrials.org/ TCTR20190817004).

Aerosol Concentrations During Otolaryngology Procedures in a Negative Pressure Isolation Room.

OBJECTIVE: To evaluate the role of a negative pressure room with a high-efficiency particulate air (HEPA) filtration system on reducing aerosol exposure in common otolaryngology procedures. STUDY DESIGN: Prospective quantification of aerosol generation. SETTINGS: Tertiary care. METHODS: The particle concentrations were measured at various times during tracheostomy tube changes with tracheostomy suctioning, nasal endoscopy with suctioning, and fiberoptic laryngoscopy (FOL), which included 5 times per procedure in a negative pressure isolation room with a HEPA filter and additional 5 times in a nonpressure-controlled room without a HEPA filter. The particle concentrations were measured from the baseline, during the procedure, and continued until 30 minutes after the procedure ended. The particle concentrations were compared to the baseline concentrations. RESULTS: The particle concentration significantly increased from the baseline during tracheostomy tube changes (mean difference [MD] 0.80 × 106 p/m3 , p = .01), tracheostomy suctioning (MD 0.78 × 106 p/m3 , p = .004), at 2 minutes (MD 1.29 × 106 p/m3 , p = .01), and 3 minutes (MD 1.3 × 106 p/m3 , p = .004) after suctioning. There were no significant differences in the mean particle concentrations among various time points during nasal endoscopy with suctioning and FOL neither in isolation nor nonpressure-controlled rooms. CONCLUSION: A negative pressure isolation room with a HEPA filter was revealed to be safe for medical personnel inside and outside the room. Tracheostomy tube change with tracheostomy suctioning required an isolation room because this procedure generated aerosol, while nasal endoscopy with suctioning and FOL did not. Aerosol generated in an isolation room was diminished to the baseline after 4 minutes.

The effectiveness of a calcium sodium phosphosilicate desensitizer in reducing cervical dentin hypersensitivity: a pilot study.

BACKGROUND: NovaMin (NovaMin Technology, Alachua, Fla.) was introduced into the dental market as a desensitizer in December 2004. However, to the authors' knowledge, no researchers yet have evaluated the effectiveness of 100 percent NovaMin powder with NovaMin-containing toothpaste in reducing dentin hypersensitivity compared with the effectiveness of NovaMin-containing toothpaste only and a desensitizing toothpaste containing potassium nitrate as a control. METHODS: The authors divided 60 participants randomly into three groups: NovaMin powder with NovaMin-containing toothpaste (group 1), a placebo powder with NovaMin-containing toothpaste (group 2) and a placebo powder with the control toothpaste (group 3). The authors used tactile and cold stimuli and a visual analog scale to evaluate participants' pain at baseline, immediately after powder application and at one week, two weeks and four weeks after powder application. They analyzed data by using Friedman and Wilcoxon signed-rank tests for within-group comparison. They used Kruskal-Wallis and Mann-Whitney U tests for between-group comparison. They considered P < .05 to be statistically significant. RESULTS: Groups 1 and 2 showed significant hypersensitivity reduction over baseline at all time points. Group 3 showed significant hypersensitivity reduction at one week onward. Group 1 showed significant improvement compared with groups 2 and 3, except for response to tactile stimulus at four weeks with group 2. Between groups 2 and 3, there were significant differences at two and four weeks. CONCLUSIONS: and CLINICAL IMPLICATIONS: The use of NovaMin powder and NovaMin-containing toothpaste for hypersensitivity reduction is more effective than the use of a desensitizing toothpaste containing potassium nitrate and fluoride.