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1.
Curr Probl Cardiol ; : 102882, 2024 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-39427867

RESUMEN

Over the past 70 years, there has been extensive research focused on preventing chemotherapy-related cardiovascular complications. However, the current state of cardio-oncology research has raised more questions than answers. Experimental studies often present data that are difficult to compare and, at times, contradictory. One notable limitation in translating experimental findings to clinical practice is the reliance on models that administer only one chemotherapeutic drug to experimental animals, despite the common use of multidrug cancer treatments in real clinical settings. This article aims to discuss our own experience in modeling an experimental rat model of cardiomyopathy induced by the administration of two chemotherapeutic drugs, doxorubicin (adriamycin) and cyclophosphamide (AC mode of chemotherapy) - Avagimyan A., et al model, along with a subsequent review of morphological changes based on our personal archive.

2.
Photobiomodul Photomed Laser Surg ; 42(10): 609-619, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39422592

RESUMEN

Objective: This study aimed to review the current body of literature on underexplored areas of photobiomodulation (PBM) for preventing and/or treating oral adverse events. Background: Recent studies suggest that PBM may offer potential benefits in managing cancer-related toxicities other than oral mucositis. Nevertheless, further research to establish conclusive evidence is still missing. Methods: A panel of specialists conducted a narrative review to evaluate the evidence on PBM therapy for oral mucositis, xerostomia, dysgeusia, dysphagia, and trismus/fibrosis. Each topic was reviewed by two specialists who discussed treatment rationale, summarized current evidence, evaluated risk/benefit ratio, and identified future research directions. Results: The current evidence suggests promising outcomes in nonroutine uses of PBM for xerostomia, dysgeusia, odynophagia, oral mucositis (extraoral PBM and the pediatric population), and trismus/fibrosis. However, the primary studies are often small and may have biases that require further evaluation, particularly regarding treatment safety. Conclusion: Despite the overall positive impression of PBM therapy for oral adverse events of cancer treatment, robust evidence from large multicentered studies is necessary to support its widespread clinical use.


Asunto(s)
Terapia por Luz de Baja Intensidad , Humanos , Trismo/radioterapia , Trismo/etiología , Neoplasias de la Boca/radioterapia , Xerostomía/etiología , Xerostomía/radioterapia , Estomatitis/radioterapia , Estomatitis/etiología , Trastornos de Deglución/radioterapia , Trastornos de Deglución/etiología , Disgeusia/etiología
3.
Cardiovasc Pathol ; 74: 107698, 2024 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-39332510

RESUMEN

Sudden infant death syndrome (SIDS) "gray zone" or borderline cases are those in which it is challenging to define whether the pathological findings are sufficiently severe to lead to death. We report a case of a 17-day old male newborn who came to our attention for unexplained death. A complete autopsy was performed, including close examination of the cardiac conduction system. Lungs presented diffuse alveolar damage and interstitial inflammation, the cardiac conduction system showed fetal dispersion, resorptive degeneration, junctional tissue islands and cartilaginous hypermetaplasia of the central fibrous body. The final cause of death was a "gray zone" SIDS. This case report will highlight the intersection of SIDS and pneumonia in newborns, exploring the challenges and controversies surrounding the diagnosis and management of this complex condition.

4.
Cardiovasc Pathol ; 73: 107683, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39111556

RESUMEN

Over the years, advancements in the field of oncology have made remarkable strides in enhancing the efficacy of medical care for patients with cancer. These modernizations have resulted in prolonged survival and improved the quality of life for these patients. However, this progress has also been accompanied by escalation in mortality rates associated with anthracycline chemotherapy. Anthracyclines, which are known for their potent antitumor properties, are notorious for their substantial cardiotoxic potential. Remarkably, even after 6 decades of research, a conclusive solution to protect the cardiovascular system against doxorubicin-induced damage has not yet been established. A comprehensive understanding of the pathophysiological processes driving cardiotoxicity combined with targeted research is crucial for developing innovative cardioprotective strategies. This review seeks to explain the mechanisms responsible for structural and functional alterations in doxorubicin-induced cardiomyopathy.


Asunto(s)
Antibióticos Antineoplásicos , Cardiotoxicidad , Doxorrubicina , Humanos , Doxorrubicina/efectos adversos , Antibióticos Antineoplásicos/efectos adversos , Animales , Cardiomiopatías/inducido químicamente , Cardiomiopatías/fisiopatología , Cardiomiopatías/patología , Transducción de Señal/efectos de los fármacos
5.
Support Care Cancer ; 32(8): 547, 2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39048887

RESUMEN

PURPOSE: A MASCC/ISOO Clinical Practice Statement (CPS) is aimed at generating a concise tool for clinicians that concentrates practical information needed for the management of oral complications of cancer patients. This CPS raises awareness to the prevention of medication-related osteonecrosis of the jaw (MRONJ) in patients with breast cancer treated with adjuvant bone-modifying agents (BMA). METHODS: This CPS was developed based on a critical evaluation of the literature followed by a structured discussion of a group of leading experts, members of the Oral Care Study Group of MASCC/ISOO. The information is presented in the form of succinct bullets and tables to generate a short manual about the best standard of care. RESULTS: In patients treated with adjuvant BMA, dento-alveolar surgery poses a moderate risk for MRONJ that ranges between the high risk for MRONJ in patients with metastatic breast cancer and the low risk for MRONJ in patients with osteoporosis. Existing MRONJ guidelines serve as a starting point for adjuvant BMA use. Urgent procedures should be delivered without delay using the accepted precautions to prevent MRONJ. If elective surgery is considered, the individual risk for MRONJ following surgery should be assessed according to common risk factors. CONCLUSION: Prevention of MRONJ in primary breast cancer patients treated with adjuvant BMA requires risk-benefit assessment; collaboration between the medical team, dental professional, and patient; and patient-specific tailored dental treatment planning. The patient should be informed about this risk. Additional research is needed to define optimal MRONJ care for this population.


Asunto(s)
Osteonecrosis de los Maxilares Asociada a Difosfonatos , Conservadores de la Densidad Ósea , Neoplasias de la Mama , Humanos , Neoplasias de la Mama/tratamiento farmacológico , Femenino , Conservadores de la Densidad Ósea/efectos adversos , Conservadores de la Densidad Ósea/uso terapéutico , Conservadores de la Densidad Ósea/administración & dosificación , Osteonecrosis de los Maxilares Asociada a Difosfonatos/prevención & control , Osteonecrosis de los Maxilares Asociada a Difosfonatos/etiología , Quimioterapia Adyuvante/métodos , Quimioterapia Adyuvante/efectos adversos , Factores de Riesgo , Osteoporosis/tratamiento farmacológico , Difosfonatos/efectos adversos , Difosfonatos/administración & dosificación , Difosfonatos/uso terapéutico
6.
Support Care Cancer ; 32(8): 558, 2024 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-39080025

RESUMEN

Advances in the treatment of cancer have significantly improved mortality rates; however, this has come at a cost, with many treatments still limited by their toxic side effects. Mucositis in both the mouth and gastrointestinal tract is common following many anti-cancer agents, manifesting as ulcerative lesions and associated symptoms throughout the alimentary tract. The pathogenesis of mucositis was first defined in 2004 by Sonis, and almost 20 years on, the model continues to be updated reflecting ongoing research initiatives and more sophisticated analytical techniques. The most recent update, published by the Multinational Association for Supportive Care in Cancer and the International Society for Oral Oncology (MASCC/ISOO), highlights the numerous co-occurring events that underpin mucositis development. Most notably, a role for the ecosystem of microorganisms that reside throughout the alimentary tract (the oral and gut microbiota) was explored, building on initial concepts proposed by Sonis. However, many questions remain regarding the true causal contribution of the microbiota and associated metabolome. This review aims to provide an overview of this rapidly evolving area, synthesizing current evidence on the microbiota's contribution to mucositis development and progression, highlighting (i) components of the 5-phase model where the microbiome may be involved, (ii) methodological challenges that have hindered advances in this area, and (iii) opportunities for intervention.


Asunto(s)
Antineoplásicos , Microbioma Gastrointestinal , Mucositis , Humanos , Microbioma Gastrointestinal/fisiología , Antineoplásicos/efectos adversos , Mucositis/microbiología , Mucositis/etiología , Neoplasias/complicaciones , Microbiota , Estomatitis/microbiología , Estomatitis/etiología , Progresión de la Enfermedad
7.
Medicina (Kaunas) ; 60(6)2024 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-38929534

RESUMEN

Chronic diffuse sclerosing osteomyelitis is a very rare condition, described as a non-suppurative, inflammatory disease of the bone and characterized by a proliferative endosteal reaction, which clinically reveals itself with cyclic pain of the jaw and swelling. We reported two clinical cases, where patients suffered recurrent swelling and pain at the mandible irradiating to the preauricular area, denying any previous trauma or significant medical history. Odontogenic causes were excluded. An initial treatment with antibiotics and NSAIDs temporarily relieved the symptoms without complete resolution, prompting further investigations. After a comprehensive array of diagnostic tools (X-rays, CT scans, scintigraphy, bone biopsy, serum markers), both patients were diagnosed with chronic diffuse sclerosing osteomyelitis of the mandible. Bisphosphonates (clodronate and zolendronate) with different treatment schemes were used to treat the condition, until a full recovery from symptoms was reported. Bisphosphonates could therefore represent an effective option in managing this rare but impactful condition. Further research is warranted to better understand the underlying mechanisms of the disease and to optimize treatment strategies.


Asunto(s)
Difosfonatos , Osteomielitis , Humanos , Osteomielitis/tratamiento farmacológico , Difosfonatos/uso terapéutico , Masculino , Femenino , Conservadores de la Densidad Ósea/uso terapéutico , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Enfermedad Crónica , Enfermedades Mandibulares/tratamiento farmacológico , Enfermedades Mandibulares/diagnóstico por imagen , Ácido Zoledrónico/uso terapéutico , Adulto
8.
EClinicalMedicine ; 73: 102675, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38933098

RESUMEN

Background: Mucositis is a common and highly impactful side effect of conventional and emerging cancer therapy and thus the subject of intense investigation. Although common practice, mucositis assessment is heterogeneously adopted and poorly guided, impacting evidence synthesis and translation. The Multinational Association of Supportive Care in Cancer (MASCC) Mucositis Study Group (MSG) therefore aimed to establish expert recommendations for how existing mucositis assessment tools should be used, in clinical care and trials contexts, to improve the consistency of mucositis assessment. Methods: This study was conducted over two stages (January 2022-July 2023). The first phase involved a survey to MASCC-MSG members (January 2022-May 2022), capturing current practices, challenges and preferences. These then informed the second phase, in which a set of initial recommendations were prepared and refined using the Delphi method (February 2023-May 2023). Consensus was defined as agreement on a parameter by >80% of respondents. Findings: Seventy-two MASCC-MSG members completed the first phase of the study (37 females, 34 males, mainly oral care specialists). High variability was noted in the use of mucositis assessment tools, with a high reliance on clinician assessment compared to patient reported outcome measures (PROMs, 47% vs 3%, 37% used a combination). The World Health Organization (WHO) and Common Terminology Criteria for Adverse Events (CTCAE) scales were most commonly used to assess mucositis across multiple settings. Initial recommendations were reviewed by experienced MSG members and following two rounds of Delphi survey consensus was achieved in 91 of 100 recommendations. For example, in patients receiving chemotherapy, the recommended tool for clinician assessment in clinical practice is WHO for oral mucositis (89.5% consensus), and WHO or CTCAE for gastrointestinal mucositis (85.7% consensus). The recommended PROM in clinical trials is OMD/WQ for oral mucositis (93.3% consensus), and PRO-CTCAE for gastrointestinal mucositis (83.3% consensus). Interpretation: These new recommendations provide much needed guidance on mucositis assessment and may be applied in both clinical practice and research to streamline comparison and synthesis of global data sets, thus accelerating translation of new knowledge into clinical practice. Funding: No funding was received.

9.
Oral Dis ; 2024 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-38808363

RESUMEN

OBJECTIVES: Few studies used thermal quantitative sensory testing to assess the effects of repeated capsaicin gel administration in the oral cavity. This study aimed to investigate thermal sensory and pain thresholds before and after repeated capsaicin gel administration. SUBJECTS AND METHODS: Ten healthy females (22 ± 2 years) applied a capsaicin gel on the gingival mucosa twice daily for 14 days, and heat pain threshold, warm detection threshold, cold pain threshold, and cold detection threshold were assessed on the oral mucosa. Measurements were performed before and after the 14 days and were compared to a control sample (n = 10, all females, 23 ± 3 years). RESULTS: Capsaicin increased heat pain threshold in the anterior maxilla by 2.9°C (95% CI: 1.6-4.2) (p < 0.001) and in the anterior mandible by 2.2°C (95% CI: 1.0-3.4) (p = 0.001), similar to warm detection threshold that increased by Δ1.1°C (95% CI: 0.3-1.9) (p = 0.009). No significant changes were found in the controls. CONCLUSIONS: These findings encourage the use of thermal quantitative sensory testing in the oral cavity to assess thermal sensation, which might be useful for assessing the effects of therapies aimed at reducing pain.

10.
Quintessence Int ; 55(6): 482-493, 2024 06 28.
Artículo en Inglés | MEDLINE | ID: mdl-38619258

RESUMEN

OBJECTIVE: Photobiomodulation therapy is recommended by multiple international societies for managing oral mucositis. These recommendations are based on extensive evidence. However, the search for an optimal photobiomodulation protocol continues. This mapping review focuses on a novel aspect of photobiomodulation therapy which is the immediate effect on pain levels associated with oral ulcerative conditions. DATA SOURCES: This literature review systematically compiles and evaluates the evidence about oral mucositis, alongside other oral ulcerative conditions, as the protocols that achieved pain relief for these oral conditions may have potential applicability to oral mucositis management. The scientific database used was PubMed. CONCLUSION: Whereas most of the randomized controlled trials about photobiomodulation therapy for oral mucositis and other ulcerative oral diseases reported delayed pain relief, certain photobiomodulation therapy protocols reported immediate pain relief. The results of this review highlight the concept of preemptive photobiomodulation therapy, in which photobiomodulation therapy is delivered early in the development of oral mucositis throughout the oncotherapy and may achieve immediate pain relief consistently in most of the patients and close to a negligible pain level. Photobiomodulation therapy, as a powerful nonpharmacologic tool for immediate pain relief, has a great beneficial value in patients suffering from oral mucositis and other painful oral ulcerative diseases such as recurrent aphthous stomatitis and chronic graft-versus-host disease.


Asunto(s)
Terapia por Luz de Baja Intensidad , Manejo del Dolor , Estomatitis , Humanos , Terapia por Luz de Baja Intensidad/métodos , Estomatitis/radioterapia , Estomatitis/etiología , Estomatitis/terapia , Estomatitis/prevención & control , Manejo del Dolor/métodos , Úlceras Bucales/radioterapia , Úlceras Bucales/etiología , Dimensión del Dolor
11.
Artículo en Inglés | MEDLINE | ID: mdl-38653605

RESUMEN

OBJECTIVE: This study aimed to assess the impact of oral medicine (OM) practitioners on the literature regarding oral potentially malignant disorders (OPMDs), focusing on oral leukoplakia. STUDY DESIGN: Using a bibliometric approach on the Scopus database until September 1, 2022, the top 100 cited articles were analyzed for article type, subtopic, specialty contributions, author metrics, and keywords. The Bibliometrix package for R and VOSviewer were used to evaluate interactions and generate science maps. RESULTS: OM practitioners, comprising 39% of contributors, played a significant role in studies related to nomenclature and screening of OPMDs. Notably, 4 OM specialists ranked among the most prolific authors, demonstrating denser collaboration with OM co-authors compared to other cancer specialists. However, there was a scarcity of OPMD management studies authored by OM practitioners. CONCLUSIONS: Despite the paucity of OM practitioners, the findings underscored the substantial contribution of OM practitioners in developing OPMD nomenclature and classification, emphasizing the need for increased collaboration with cancer specialists to conduct comprehensive clinical trials for OPMD management. The study highlights the importance of standardized criteria in OPMDs research for better data comparison and encourages further efforts from the OM scientific community.


Asunto(s)
Bibliometría , Leucoplasia Bucal , Neoplasias de la Boca , Medicina Oral , Humanos , Lesiones Precancerosas
12.
Biology (Basel) ; 13(4)2024 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-38666878

RESUMEN

This review explores the historical development of cardiology knowledge, from ancient Egyptian psychostasis to the modern comprehension of cardiac neuromodulation. In ancient Egyptian religion, psychostasis was the ceremony in which the deceased was judged before gaining access to the afterlife. This ritual was also known as the "weighing of the heart" or "weighing of the soul". The Egyptians believed that the heart, not the brain, was the seat of human wisdom, emotions, and memory. They were the first to recognize the cardiocentric nature of the body, identifying the heart as the center of the circulatory system. Aristotle (fourth century BC) considered the importance of the heart in human physiology in his philosophical analyses. For Galen (third century AD), the heart muscle was the site of the vital spirit, which regulated body temperature. Cardiology knowledge advanced significantly in the 15th century, coinciding with Leonardo da Vinci and Vesalius's pioneering anatomical and physiological studies. It was William Harvey, in the 17th century, who introduced the concept of cardiac circulation. Servet's research and Marcello Malpighi's discovery of arterioles and capillaries provided a more detailed understanding of circulation. Richard Lower emerged as the foremost pioneer of experimental cardiology in the late 17th century. He demonstrated the heart's neural control by tying off the vagus nerve. In 1753, Albrecht von Haller, a professor at Göttingen, was the first to discover the heart's automaticity and the excitation of muscle fibers. Towards the end of the 18th century, Antonio Scarpa challenged the theories of Albrecht von Haller and Johann Bernhard Jacob Behrends, who maintained that the myocardium possessed its own "irritability", on which the heartbeat depended, and was independent of neuronal sensitivity. Instead, Scarpa argued that the heart required innervation to maintain life, refuting Galenic notions. In contemporary times, the study of cardiac innervation has regained prominence, particularly in understanding the post-acute sequelae of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection (PASC), which frequently involves cardiorespiratory symptoms and dysregulation of the intrinsic cardiac innervation. Recently, it has been recognized that post-acute sequelae of acute respiratory infections (ARIs) due to other pathogens can also be a cause of long-term vegetative and somatic symptoms. Understanding cardiac innervation and modulation can help to recognize and treat long COVID and long non-COVID-19 (coronavirus disease 2019) ARIs. This analysis explores the historical foundations of cardiac neuromodulation and its contemporary relevance. By focusing on this concept, we aim to bridge the gap between historical understanding and modern applications. This will illuminate the complex interplay between cardiac function, neural modulation, cardiovascular health, and disease management in the context of long-term cardiorespiratory symptoms and dysregulation of intrinsic cardiac innervations.

13.
Oral Dis ; 30(7): 4653-4667, 2024 10.
Artículo en Inglés | MEDLINE | ID: mdl-38462757

RESUMEN

OBJECTIVES: This study investigates the psychological impact of COVID-19 on burning mouth syndrome (BMS) patients. It focuses on comparing post-traumatic stress symptoms (PTSS), post-traumatic growth (PTG), and resilience between BMS patients and Controls. METHODS: A total of 100 BMS patients and 100 Controls from five Italian centers participated in this observational cross-sectional study. They completed several assessments, including the General Health Questionnaire, Depression Anxiety and Stress Scale, Insomnia Severity Index, National Stressful Events Survey Short Scale, Impact of Event Scale-Revised, Post Traumatic Growth Inventory Short Form, and Connor-Davidson Resilience Scale. RESULTS: BMS patients had significantly higher stress, anxiety, and depression (DASS-21 score) and post-traumatic stress symptoms (IES-R-6 score), particularly in terms of intrusive thoughts. They showed lower post-traumatic growth (PTGI-SF score) compared to Controls. The resilience scale (CDRS-10) was a key predictor of PTG in both groups, explaining a significant variance in PTGI-SF scores. CONCLUSIONS: BMS patients experienced heightened post-traumatic stress, stress, anxiety, and depression during the COVID-19 pandemic, with reduced post-traumatic growth. This highlights the need to prioritize their psychological well-being, focusing on stress management and fostering post-traumatic growth in challenging times.


Asunto(s)
Ansiedad , Síndrome de Boca Ardiente , COVID-19 , Depresión , Trastornos por Estrés Postraumático , Humanos , Síndrome de Boca Ardiente/psicología , COVID-19/psicología , Masculino , Femenino , Estudios Transversales , Persona de Mediana Edad , Anciano , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/etiología , Depresión/psicología , Depresión/etiología , Ansiedad/psicología , Ansiedad/etiología , Italia , Resiliencia Psicológica , Crecimiento Psicológico Postraumático , Estudios de Casos y Controles , Encuestas y Cuestionarios
14.
Cardiovasc Pathol ; 71: 107633, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38485103

RESUMEN

Left ventricular noncompaction (LVNC), involving mainly the right ventricle, is a rare form of congenital heart disorder characterized by a developmental arrest in myocardial compaction, resulting in a spongy appearance of the myocardium, mainly of the right ventricle, rarely detected in fetuses. We report the case of a female fetus with a gestational age of 41+4 weeks who came to our attention for intrapartum sudden unexpected death, resulting in stillbirth. The ventricular walls, particularly the right ventricular wall, appeared thick, hypertrabeculated and spongy, leading to the diagnosis of LVNC involving mainly the right ventricle. The atrioventricular node and His bundle presented areas of fetal dispersion and resorptive degeneration; islands of conduction tissue were detected in the central fibrous body. Arcuate nucleus of the brainstem showed bilateral severe hypoplasia. The right bundle branch was hypoplastic. The final cause of death was an electrical conduction disfunction in an LVNC involving mainly the right ventricle. To the best of our knowledge, the herein described case is the first reported observation of sudden intrapartum death from LVNC involving mainly the right ventricle well documented post-mortem with cardiac conduction and brainstem studies. Our findings confirm the need of an accurate post-mortem examination including the study of the cardiac conduction system on serial section in every case of sudden unexpected fetal death, although there are no universally recognized guidelines.


Asunto(s)
Ventrículos Cardíacos , Mortinato , Humanos , Femenino , Embarazo , Ventrículos Cardíacos/anomalías , Ventrículos Cardíacos/patología , Adulto , Autopsia , Muerte Súbita Cardíaca/etiología , Muerte Súbita Cardíaca/patología , Edad Gestacional , No Compactación Aislada del Miocardio Ventricular/patología , No Compactación Aislada del Miocardio Ventricular/diagnóstico por imagen , Muerte Fetal
15.
Support Care Cancer ; 32(3): 208, 2024 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-38438625

RESUMEN

PURPOSE: There is increasing evidence that photobiomodulation (PBM) therapy is both an effective and safe approach in hematopoietic stem cell transplantation (HSCT) for both prevention and management of oral mucositis (OM), but its use in clinical practice is still limited and the timing of application is under discussion. The aim of this retrospective study was to evaluate possible differences between patients treated either with preventive or curative PBM therapy. METHODS: The retrospective case series included 24 patients suffering from multiple myeloma who underwent the same conditioning and transplantation protocol. Patients were treated either with preventive PBM starting from the first day of conditioning up to two days post-HSCT or with curative PBM (starting at OM onset for four consecutive days). OM score, pain, and functional parameters were recorded. RESULTS: All patients developed OM. Preventive PBM was significantly more effective in reducing OM severity (p < 0.0001) and pain (p < 0.0001) post-HSCT than curative PBM. Furthermore, we found a lower number of patients reporting discomfort in all subjective parameters (pain during swallowing, chewing, and speaking) in the preventive PBM group. No adverse events related to PBM therapy were recorded in both groups. CONCLUSION: The timing for PBM therapy in patients undergoing HSCT is crucial: when started on the first day of conditioning, it significantly reduces both pain and OM severity, providing an important benefit also in subjective oral functions such as speaking, swallowing, and chewing, thus increasing the overall adherence to the oncological therapies.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Terapia por Luz de Baja Intensidad , Mieloma Múltiple , Estomatitis , Humanos , Mieloma Múltiple/radioterapia , Estudios Retrospectivos , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Estomatitis/etiología , Estomatitis/prevención & control , Estomatitis/radioterapia , Dolor
17.
Medicina (Kaunas) ; 60(1)2024 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-38256352

RESUMEN

Background and Objectives: Special Needs Patients (SNPs) and young non-collaborative children are more predisposed to develop oral pathologies due to poor collaboration and scarce access to dental treatment. The aim of this retrospective study was to analyze a sample of SNPs who received dental treatments either under general anesthesia (GA) or deep sedation (DS) over a period of 6 years. The number and type of procedure were analyzed. Materials and Methods: In total, 131 patients were included and mostly (>90%) treated under GA. Patients were either uncooperative and phobic (Group 1) or affected by mental, behavioral, and neurological disorders (Group 2), diseases of the nervous system (Group 3), or developmental anomalies (Group 4). Results: Patients in Group 2 required more invasive dental treatments than those in the other groups. Therapies were mainly preventive and restorative, except in Groups 3 and 4, where extractions were more frequent. The type of dental treatment significantly varied according to age and systemic condition. Only 5.3% of the patients needed a second intervention, despite only 17.6% of patients respecting the scheduled follow-up. Conclusions: Treatment under GA is effective, but the poor adherence to follow-ups and the risk of reintervention should be contrasted by improving the perception by parents/guardians of the importance of oral hygiene and periodic visits.


Asunto(s)
Anestesia General , Cooperación del Paciente , Niño , Humanos , Preescolar , Estudios Retrospectivos , Anestesia General/efectos adversos , Atención Odontológica
18.
BMC Oral Health ; 24(1): 89, 2024 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-38229055

RESUMEN

BACKGROUND: Radiomorphometric indices measured on Dental Panoramic Radiography (DPR) can reflect Bone Mineral Density (BMD). The aim of our study is to evaluate changes in DPR radiographic markers in patients undergoing antiresorptive therapy with denosumab and correlate them to BMD and serum bone turnover markers (BTM). METHODS: We evaluated two radiomorphometric indices: Mandibular Cortical Width (MCW) and Panoramic Mandibular Index (PMI), in patients undergoing antiresorptive therapy with denosumab at T0 (before starting the therapy) and at T1 (after 12 months), comparing results with a control group of healthy patients who performed two DPRs at a one-year time distance. Correlation analysis was performed in the denosumab group, as well as ROC curves were obtained for both indices. RESULTS: The study included 18 patients and 21 controls according to specific inclusion and exclusion criteria, matched by gender and age. Both MCW and PMI were significantly lower at T0 in the denosumab group, consistently with lower BMD. MCW showed significant correlation with femoral and lumbar DEXA and was significantly lower in patients with osteoporosis compared to osteopenia. Only PMI index increased significantly in the denosumab group from T0 to T1. After one year (T1), there weren't any differences between patients and controls for both indices. No significant correlations were found with BTMs. Sensitivity and specificity for MCW and PMI were also calculated. CONCLUSIONS: Our results show how CMW shows sufficient sensitivity and specificity to be used as a radiographic marker to screen and intercept patients with osteoporosis. PMI seems to be able to reflect changes in response to antiresorptive therapy with denosumab. Further studies are needed to confirm our hypothesis.


Asunto(s)
Denosumab , Osteoporosis , Humanos , Estudios Retrospectivos , Denosumab/uso terapéutico , Estudios de Casos y Controles , Osteoporosis/diagnóstico por imagen , Osteoporosis/tratamiento farmacológico , Densidad Ósea , Radiografía Panorámica , Biomarcadores , Mandíbula/diagnóstico por imagen
19.
Minerva Dent Oral Sci ; 73(1): 20-26, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37943289

RESUMEN

BACKGROUND: Dentin hypersensitivity is one of the most common complains faced by dental professionals, and there is still lack of consensus for the most effective treatment approaches. The aim of the present study was to evaluate the efficacy of ozone therapy combined with sodium fluoride in reducing pain associated with dental hypersensitivity, compared to a paint-on adhesive desensitizing agent. METHODS: The study included 20 patients (131 teeth), selected according to specific inclusion criteria and divided into two groups according to the type of desensitizing therapy (ozone with sodium fluoride or paint-on adhesive). The efficacy of both treatments were evaluated recording pain for each treated tooth immediately after treatment, after 1 month and after 6 months using a Numeric Rating Scale (NRS). Subjective parameters were also recorded: patients were asked to report whether they experienced pain caused by air, teeth brushing, cold and hot topical stimuli (present/absent). RESULTS: In both groups, pain values significantly decreased over time. Six months after treatment we registered significantly lower pain values in the ozone-treated group compared with the adhesive group and the mean percentage of NRS reduction from was significantly higher in the ozone-treated group. We did not register significant differences in subjective pain-related parameters between groups. CONCLUSIONS: The results of this exploratory study were aimed at exploring the combined effect of ozone with natrium fluoride, which was before described only in vitro. With the limitation of the sample size, our results suggest that this approach provides a pain reduction that was comparable to the paint-on adhesive.


Asunto(s)
Sensibilidad de la Dentina , Fluoruro de Sodio , Humanos , Fluoruro de Sodio/uso terapéutico , Sensibilidad de la Dentina/tratamiento farmacológico , Estudios de Seguimiento , Fluoruros/uso terapéutico , Dolor
20.
Biomedicines ; 11(12)2023 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-38137487

RESUMEN

In exploring chronic orofacial pain (COFP), this review highlights its global impact on life quality and critiques current diagnostic systems, including the ICD-11, ICOP, and ICHD-3, for their limitations in addressing COFP's complexity. Firstly, this study outlines the global burden of chronic pain and the importance of distinguishing between different pain types for effective treatment. It then delves into the specific challenges of diagnosing COFP, emphasizing the need for a more nuanced approach that incorporates the biopsychosocial model. This review critically examines existing classification systems, highlighting their limitations in fully capturing COFP's multifaceted nature. It advocates for the integration of these systems with the DSM-5's Somatic Symptom Disorder code, proposing a unified, multidisciplinary diagnostic approach. This recommendation aims to improve chronic pain coding standardization and acknowledge the complex interplay of biological, psychological, and social factors in COFP. In conclusion, here, we highlight the need for a comprehensive, universally applicable classification system for COFP. Such a system would enable accurate diagnosis, streamline treatment strategies, and enhance communication among healthcare professionals. This advancement holds potential for significant contributions to research and patient care in this challenging field, offering a broader perspective for scientists across disciplines.

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