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1.
Cient. dent. (Ed. impr.) ; 15(1): 31-35, ene.-abr. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-172858

RESUMO

El objetivo de este trabajo es realizar una revisión bibliográfica sobre la enfermedad inflamatoria intestinal (EII) y sus manifestaciones clínicas orales. La EII es un término que abarca dos enfermedades idiopáticas del tracto gastrointestinal: la colitis ulcerosa y la enfermedad de Crohn. Cuando un paciente que tiene una de estas condiciones se presenta para el tratamiento en nuestra consulta dental, es necesario ser consciente de la condición del paciente, controlar los síntomas indicativos de enfermedad inicial o recaída, y haber realizado una correcta historia clínica que incluya los fármacos que interactúan con medicamentos gastrointestinales o que pueden agravar la situación del paciente. Además, las manifestaciones orales de la enfermedad gastrointestinal no son infrecuentes, por lo que el dentista también debe estar familiarizado con los patrones orales de la enfermedad


The objective was to perform a literature review of the inflammatory bowel disease (IBD) and it's clinical oral manifestations. It is a term that encompasses two idiopathic diseases of the gastrointestinal tract: ulcerative colitis and Crohn’s disease. When a patient who has one of these conditions comes for treatment at our dental office, it is necessary to be aware of the patient's condition, to control the symptoms indicative of initial illness or relapse, and to have a correct medical history including the drugs which interact with gastrointestinal drugs or which may aggravate the patient's condition. In addition, oral manifestations of gastrointestinal disease are not infrequent, so the dentist should also be familiar with the oral patterns of the disease


Assuntos
Humanos , Doenças Inflamatórias Intestinais/complicações , Doenças da Boca/epidemiologia , Doença de Crohn/complicações , Colite Ulcerativa/complicações , Doenças da Boca/terapia , Estomatite/epidemiologia , Erupções Liquenoides/epidemiologia
2.
Enferm. clín. (Ed. impr.) ; 28(supl.1): 5-8, feb. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-173046

RESUMO

Objective: This quasi-experimental study compared the effectiveness of chewing gum and gargling with a saline solution as two types of intervention to reduce oral mucositis scores. Method: The sample consisted of 44 children who were divided into two groups, one of which chewed gum, and the other gargled with a saline solution. The Mann-Whitney U test was used to analyze the data. Results: There was a significant difference (p = 0.001) in post-intervention oral-mucositis scores. The significant mean difference between the groups indicated that the decreased oral mucositis scores for the chewing gum group was more substantial than for the group gargling with a saline solution (p = 0.001). Conclusions: The data showed that chewing gum is more effective than gargling with a saline solution, and it can be incorporated into the nursing protocol for treating pediatric cancer patients


No disponible


Assuntos
Humanos , Estomatite/prevenção & controle , Goma de Mascar , Neoplasias/complicações , Solução Salina Hipertônica/uso terapêutico , Substâncias Protetoras/farmacocinética , Antineoplásicos/efeitos adversos , Mucosite/prevenção & controle
3.
Aten. prim. (Barc., Ed. impr.) ; 49(10): 611-618, dic. 2017. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-169953

RESUMO

Nuestro objetivo es intentar contribuir al uso racional de los antibióticos prescritos por los médicos de familia cuando un paciente consulta por un problema odontológico. Actualmente la pregunta que nos debemos hacer es si hay que tomar antibiótico, en lugar de cuál dar. Revisamos las principales infecciones odontológicas, cuál debe ser el tratamiento adecuado y el papel de la prevención. Es necesario conocer la complejidad de la microflora de la cavidad oral, pues de ella dependerá la conveniencia de antibioterapia, la evolución hacia la curación o la progresión de algunas infecciones odontogénicas. La placa bacteriana, formada por el biofilm, se comporta como una barrera para la acción de los antimicrobianos. Es en la prevención de su formación, así como en la eliminación mecánica de esta una vez formada, en lo que el médico de familia debe insistir. Debemos transmitir a la población que los antibióticos no curan el dolor dental


Our aim is to contribute to the rational use of antibiotics prescribed by family doctors when a patient consults for a dental problem. Nowadays we should not ask which antibiotic to give. The question has to be if we need to prescribe antibiotics in front of the most common odontogenic infections seen in our practice. We review the main dental infections, which should be their appropriate management and the role of prevention. We need to know the complexity of the oral microbiome because it’l depend on the appropriateness of the antibiotherapy, the evolution towards cure or progression of some odontogenic infections. The bacterial plaque, formed by the biofilm, behaves as a barrier to the action of antimicrobials. It’s in the prevention of its development as well as in it mechanical elimination once shaped, in what the family doctor should insist. We must transmit antibiotics don’t heal dental pain


Assuntos
Humanos , Doenças Dentárias/microbiologia , Infecções Bacterianas/tratamento farmacológico , Atenção Primária à Saúde/estatística & dados numéricos , Antibioticoprofilaxia , Odontologia Baseada em Evidências/tendências , Controle de Doenças Transmissíveis/métodos , Abscesso Periodontal/tratamento farmacológico , Estomatite/microbiologia , Peri-Implantite/tratamento farmacológico
4.
Clin. transl. oncol. (Print) ; 19(5): 593-598, mayo 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-162193

RESUMO

Purpose. The aim of the current analysis was to evaluate the effectiveness and tolerability of rapid onset opioid in a cohort of head and neck cancer (HNC) patients affected by painful mucositis influencing swallowing function during RT ± ChT with definitive or adjuvant intent. Methods. A retrospective analysis was conduct on HNC patients during RT ± ChT that received fentanyl pectin na sal spray (FPNS) for incidental BTP due to painful mucositis 13 min before the main meals. The period of observation has been 90 days starting from the beginning of RT ± ChT. Results. Forty HNC patients with incidental BTP due to painful mucositis treated with FPNS were analyzed. The mean NRS of untreated episodes of BTP was 5.73 ± 1.54 decreasing to 2.25 ± 2.45 with FPNS (median dose 100 mcg). During the pain treatment, the number of meals increased from 2.08 ± 0.35 to 2.868 ± 0.4 (p = 0.000), and the BMI remained stable (from 25.086 ± 3.292 to 25.034 ± 3.090; p = 0.448). The 94.9% of patients was satisfied or very satisfied for the rapidity of the effect, and 97.4% for the easiness and convenience in the use. Conclusions. FPNS showed an acceptable safety activity profile in predictable BTP due to painful mucositis in HNC patients during RT ± ChT. FPNS was also effective in reducing the mucositis sequelae and allowing the completion of RT scheduled scheme. Moreover, patients declared satisfaction in terms of ease of use (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Mucosite/radioterapia , Fentanila/uso terapêutico , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/radioterapia , Manejo da Dor , Estudos Retrospectivos , Comorbidade , Estado Nutricional , Xerostomia/terapia , Estomatite/complicações , Estomatite/radioterapia , Cavidade Nasal , Cavidade Nasal/patologia
5.
Med. oral patol. oral cir. bucal (Internet) ; 22(1): e15-e23, ene. 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-159762

RESUMO

Background and Objectives: Considering the high possibility of dentist consult a patient with oral complications of chemotherapy and/or radiotherapy for oral cancer because of the advances in this area, this study aims to systematically review the literature to identify and suggest effective and safe protocols for the managements of oral complications in oncology patients. Material and Methods: The systematic review was designed by PICO and PRISMA including eligibility and exclusion criteria; the source of information and search strategy in PubMed according MeSH: «Mouth Neoplasms and Radiotherapy» and «Mouth Neoplasms and Drug Therapy» the period from 2010 to 2015; selection and data collection of study was carried form blind and independently by two researchers; risk of bias and methodological quality: ensured by the PEDro scale; synthesis of data: of oral complications were evaluated by adapted version of associative direction classification proposed by Costigan and collaborators; and data analysis was performed by the meta-analysis of BioEstat program (5.0) in the included studies. Results: 2,700 articles found, 2,371 were selected after removal of duplicate and elected 40 full-text articles. Of these, only 06 articles were included in the systematic review with exclusion of others, per obtain punctuation ≥ 7 with high methodological quality for synthesis of the managements of oral complications. Since 05 articles were associated with low risk of bias composing the protocols suggestive for managements and the meta-analysis in odds ratio (0.916) to cure and relative risk (1.049) for the development of oral mucositis and pain. Conclusions: The protocols suggestive for managements of oral mucositis and pain with MuGard - mucoadhesive hydrogel; PerioAid Tratamiento® antiseptic mouthrinse with chlorhexidine and cetylpyridinium chloride; Episil® plus benzydamine - bioadhesive oromucosal gel; 0,03% of Triclosan mouthwash Colgate Plax; and Diode Laser Therapy of low-level are safe for oncology patients applied according to adopted clinical parameters (AU)


No disponible


Assuntos
Humanos , Neoplasias Bucais/complicações , Estomatite/tratamento farmacológico , Neoplasias Bucais/terapia , Radioterapia/efeitos adversos , Antineoplásicos/efeitos adversos , Segurança do Paciente , Antissépticos Bucais/uso terapêutico
6.
Med. oral patol. oral cir. bucal (Internet) ; 22(1): e36-e42, ene. 2017. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-159765

RESUMO

Introduction: Inflammatory papillary hyperplasia (IPH) is a benign lesion of the palatal mucosa. It is usually found in denture-wearers but also has been reported in patients without a history of use of a maxillary prosthesis use. Objectives: The aim of this study is to review the literature to assess the prevalence of denture stomatitis and inflammatory papillary hyperplasia and the etiological factors associated. Material and Methods: A search was carried out in PubMed (January 2005 to October 2015) with the key words «inflammatory papillary hyperplasia», «denture stomatitis», «granular stomatitis» and «Newton’s type III» The inclusion criteria were studies including at least a sample of 50 apparently healthy patients, articles published from 2005 to 2015 written in English. The exclusion criteria were reviews and non-human studies. Results: Out of the 190 studies obtained initially from the search 16 articles were selected to be included in our systematic review. The prevalence of denture stomatitis was 29.56% and 4.44% for IPH. We found 5 cases of denture stomatitis among non-denture-wearer individuals. All IPH cases were associated with the use of prosthesis. Smoking and continued use of ill-fitting dentures turned out to be the most frequent risk factors for developing IPH. Conclusions: IPH is a rare oral lesion and its pathogenesis still remains unclear. Its presentation among nondenture-wearers is extremely unusual (AU)


No disponible


Assuntos
Humanos , Mucosa Bucal/patologia , Neoplasias Palatinas/patologia , Estomatite/patologia , Neoplasias Bucais/patologia , Fatores de Risco , Prótese Dentária/efeitos adversos , Boca Edêntula/epidemiologia
7.
Cient. dent. (Ed. impr.) ; 13(3): 177-181, sept.-dic. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-158864

RESUMO

La rehabilitación oral mediante implantes dentales es una opción altamente predecible con una alta tasa de éxito. Sin embargo, las enfermedades que afectan a los tejidos que rodean al implante, como la mucositis periimplantaria y la periimplantitis pueden dar lugar a la pérdida del mismo. Por esta razón es de especial importancia la organización de un programa de citas en los que se debe analizar los signos indicativos de enfermedad periimplantaria, además de realizar técnicas de prevención y eliminación de los factores de riesgo. Existen numerosas estrategias de tratamiento frente a las enfermedades periimplantarias. La mucositis periimplantaria puede ser manejada de forma conservadora, similar al tratamiento de la gingivitis. El tratamiento de la periimplantitis puede ser conservador, mediante terapia mecánica apoyada por terapia química o laser. En casos avanzados, la terapia debe ser quirúrgica. Dependiendo de diversos factores como la configuración del defecto óseo, puede seleccionarse técnicas quirúrgicas resectivas, para la eliminación del tejido enfermo y favorecer la higiene oral o pueden realizarse técnicas de regeneración ósea (AU)


Dental implants are a predictable treatment option with high success rate in oral rehabilitation. However, those diseases affecting tissues around the implants, like periimplant mucositis or peri-implantitis, could cause their loss. Therefore, it is esential to establish scheduled check-ups, in order to analyse any signs related to preiimplant disease and to carry out risk factor elimination and prevention techniques. There are several treatment strategies for periimplant diseases. Periimplant mucositis may be treated in a conservative way, similar to gingivitis treatment. Periimplantitis treatment can also be conservative, using a mechanic therapy based on chemical or laser therapy. In advanced cases, therapy must be surgical. Depending on several factors, such as bone defect configuration, resective surgical techniques may be used to eliminate the granulation tissue and to favour oral hygine. Bone regeneration techniques may also be used (AU)


Assuntos
Humanos , Peri-Implantite/terapia , Estomatite/terapia , Gengivite/terapia , Implantação Dentária Endo-Óssea/métodos , Reabilitação Bucal/métodos , Regeneração Óssea , Complicações Intraoperatórias/prevenção & controle
8.
Av. odontoestomatol ; 32(6): 291-300, nov.-dic. 2016. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-158171

RESUMO

La mucositis oral es una complicación importante de la terapia antineoplásica En la actualidad, la mucositis es uno de los efectos secundarios del tratamiento del cáncer al cual se le está dedicando un gran esfuerzo terapéutico para encontrar medidas farmacológicas, que reduzcan su incidencia, así como su impacto o gravedad debido a las consecuencias planteadas. El objetivo de este trabajo es revisar la patogénesis de la enfermedad y presentar los resultados de las diferentes alternativas terapéuticas estudiadas de forma experimental (AU)


Oral mucositis is a complication of antineoplastic therapy. Currently, it is devoting a great effort to find pharmacological therapeutic measures to reduce its incidence and its impact or severity due to raised consequences. The aim of this paper is to review the pathogenesis and the different therapeutic drugs in experimental oral mucositis (AU)


Assuntos
Animais , Estomatite/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Fatores Imunológicos/uso terapêutico , Antineoplásicos/efeitos adversos , Estomatite/induzido quimicamente , Índice de Gravidade de Doença , Modelos Animais de Doenças
9.
Rev. clín. med. fam ; 9(3): 159-166, oct. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-159609

RESUMO

Metotrexato ha sido durante años ampliamente utilizado para el tratamiento de diversas enfermedades. El tratamiento con bajas dosis de metotrexato oral ha alcanzado gran aceptación para su uso en la artritis reumatoide debido a su eficacia y tolerabilidad. La toxicidad del metotrexato es la causa principal para la interrupción del tratamiento. Las complicaciones gastrointestinales son los efectos adversos más comunes del tratamiento con metotrexato oral a bajas dosis, seguido de la estomatitis, hepatotoxicidad, erupción cutánea, pérdida de cabello, toxicidad pulmonar y hematológica, aunque la pancitopenia es un efecto adverso raro de la terapia oral con bajas dosis. El factor de riesgo más importante para la toxicidad de metotrexato es la disminución de la función renal (AU)


Methotrexate has been widely used for many years in the treatment of a variety of diseases. Low-dose oral methotrexate therapy has gained wide acceptance for its use in rheumatoid arthritis because of its efficacy and tolerability. The toxicity of methotrexate is the main reason for cessation of treatment. Gastrointestinal complications are the most common adverse effects of low-dose oral methotrexate therapy, followed by stomatitis, hepatotoxicity, skin rash, hair loss, pulmonary and haematological toxicity, although pancytopenia is a rare adverse effect of low-dose oral methotrexate therapy. The most important risk factor for methotrexate toxicity is impaired renal function (AU)


Assuntos
Humanos , Masculino , Feminino , Metotrexato/administração & dosagem , Metotrexato/efeitos adversos , Metotrexato/uso terapêutico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Fatores de Risco , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Estomatite/complicações , Exantema/complicações , Falência Renal Crônica/induzido quimicamente , Doenças Pulmonares Intersticiais/induzido quimicamente , Doenças Pulmonares Intersticiais/complicações , Taxa de Filtração Glomerular , Pancitopenia/complicações
10.
Cient. dent. (Ed. impr.) ; 13(2): 97-101, mayo-ago. 2016.
Artigo em Espanhol | IBECS | ID: ibc-155282

RESUMO

El éxito del tratamiento con implantes dentales como método para reemplazar dientes perdidos se ha convertido en un método predecible. Sin embargo, es cada vez mayor el número de éstos que sufren enfermedades periimplantarias. Estas enfermedades ocurren por la falta de equilibrio entre la respuesta del individuo y la carga bacteriana, sobre todo flora anaerobia gram-negativa. Los tratamientos actuales carecen de eficacia. Es por tanto fundamental conocer la etiopatogenia de dicha entidad para prevenir su formación. Actualmente se conocen diferentes factores etiológicos relacionados con la aparición de periimplantitis y mucositis periimplantaria, como la infección bacteriana, la sobrecarga oclusal, el tabaco, la mala higiene oral, la historia previa de enfermedad periodontal, la diabetes y otras enfermedades sistémicas (AU)


Treatment success with dental implants as a way to replace missing teeth has become a predictable method. However, it is increasing the number of dental implants suffering from peri-implant diseases. These diseases are described as the result of an imbalance between host response and bacterial load, especially gram-negative anaerobic flora. Current treatments are ineffective. It is therefore essential to understand the pathogenesis of this entity to prevent its formation. Currently several risk factors related to the occurrence of peri-implantitis and peri-implant mucositis, as bacterial infection, occlusal overload, smoking habit, poor oral hygiene, previous history of periodontal disease, diabetes and other systemic diseases are known (AU)


Assuntos
Humanos , Peri-Implantite/prevenção & controle , Estomatite/prevenção & controle , Controle de Infecções/métodos , Implantação Dentária Endo-Óssea/métodos , Fatores de Risco , Perda do Osso Alveolar/prevenção & controle
11.
Cient. dent. (Ed. impr.) ; 13(2): 103-106, mayo-ago. 2016. graf
Artigo em Espanhol | IBECS | ID: ibc-155283

RESUMO

La utilización de implantes dentales como método para reemplazar dientes perdidos ha demostrado ser un tratamiento con una alta tasa de éxito. No obstante, el número de implantes que se colocan continua incrementándose y con ello también la prevalencia de enfermedades periimplantarias como son la mucositis periimplantaria y la periimplantitis, lo que puede dar lugar a un fracaso de los implantes. La capacidad del clínico para detectar y diagnosticar estas enfermedades periimplantarias son fundamentales para saber cuándo es necesario el tratamiento. Para ello existen diferentes métodos diagnósticos disponibles como la movilidad del implante, la profundidad de sondaje, el sangrado al sondaje o la evaluación radiográfica. Fundamentalmente se identificará clínicamente la mucositis periimplantaria con el sangrado al sondaje junto con la ausencia de reabsorción ósea y la periimplantitis con una profundidad de sondaje profunda acompañada siempre de pérdida ósea marginal (AU)


The use of dental implants as a way to replace missing teeth is proven to be a treatment with a high success rate. However, the number of implants placed continues to increase as well as the prevalence of peri-implant diseases such as peri-implant mucositis and peri-implantitis, which can lead to implant failure. The ability of the clinicians to detect and diagnose these peri-implant diseases is essential to know when the treatment is necessary. There are several diagnostic methods available as implant mobility, probing depth, bleeding on probing and radiographic evaluation. Basically, peri-implant mucositis can be identified with bleeding on probing with no bone resorption and periimplantitis with a deep probing depth always accompanied by marginal bone loss (AU)


Assuntos
Humanos , Peri-Implantite/diagnóstico , Estomatite/diagnóstico , Implantação Dentária Endo-Óssea/métodos , Perda do Osso Alveolar/diagnóstico , Fatores de Risco , Índice Periodontal , Hemorragia Gengival/diagnóstico
12.
Med. clín (Ed. impr.) ; 146(supl.1): 25-29, abr. 2016. graf
Artigo em Espanhol | IBECS | ID: ibc-155624

RESUMO

El carcinoma escamoso de pulmón (SCC) representa un 30% del cáncer de pulmón de célula no pequeña (CPCNP). Docetaxel y el inhibidor de la tirosincinasa (ITK) del EGFR, erlotinib, han sido los 2 únicos fármacos aprobados para el tratamiento de segunda línea del SCC avanzado. La sobreexpresión de EGFR puede explicar la sensibilidad de SCC a ITK. Erlotinib demostró beneficio significativo en supervivencia global (SG) en líneas sucesivas en CPCNP, incluyendo histología escamosa. La magnitud de este beneficio es similar a la de la QT. Afatinib es un inhibidor irreversible de toda la familia ErbB (EGFR, HER2-4), que ha sido aprobado recientemente para su indicación actual, CPCNP avanzado con mutación de EGFR, y tiene una toxicidad básicamente gastrointestinal y cutánea, bien definida y manejable. El ensayo LUX-Lung 8 fue un estudio fase III aleatorizado en pacientes con CPCNP con histología escamosa en segunda línea, que comparó erlotinib frente a afatinib. Se incluyeron 795 pacientes y se observó beneficio significativo para afatinib en supervivencia libre de progresión (2,7 frente a 1,9 meses; HR: 0,79; IC del 95%, 0,68-0,91; p = 0,0012) y en SG (7,9 frente a 6,8 meses; HR: 0,81; IC del 95%, 0,69-0,95; p = 0,0077), así como mejoría significativa en SG a 12 y 18 meses. Se observó más diarrea y estomatitis con afatinib y más exantema con erlotinib, pero la proporción global de toxicidad fue similar en cada grupo. Afatinib ofreció mejores resultados en calidad de vida. En resumen, afatinib es una opción de tratamiento en segunda línea en CPCNP escamocelular sobre la base de los resultados de mejoría en supervivencia respecto a erlotinib (AU)


Squamous cell carcinoma (SCC) of the lung represents 30% of non-small cell lung cancers (NSCLC). Docetaxel and the EGFR tyrosine kinase inhibitor (TKI), erlotinib, are the only two drugs approved for second-line treatment of advanced SCC. The sensitivity of SCC to TKIs can be explained by EGFR overexpression. Erlotinib demonstrated a significant benefit in terms of overall survival (OS) in successive lines in NSCLC, including squamous histology. The magnitude of this benefit is similar to that of chemotherapy. Afatinib is an irreversible inhibitor of the entire ErbB family (EGFR, HER2-4) that has recently been approved for its current indication, advanced EGFR mutation-positive NSCLC and has well-defined and manageable toxicity, mainly gastrointestinal and cutaneous. The LUX-Lung 8 study was a phase III randomized trial in patients with NSCLC with squamous histology that compared erlotinib versus afatinib as second-line treatment. A total of 795 patients were included and a significant benefit was observed for afatinib in progression-free survival (2.7 vs 1.9 months (HR 0.79 [95%CI 0.68-0.91]; p=0.0012) and in OS (7.9 vs 6.8 months (HR 0.81 [95%CI 0.69-0.95]; p=0.0077), as well as a significant improvement in OS at 12 and 18 months. More diarrhoea and stomatitis was observed with afatinib and more rash with erlotinib, but the overall proportion of toxicity was similar in each group. Afatinib offered better results in quality of life. In summary, afatinib is a second-line treatment option in squamous NSCLC based on its survival advantage over erlotinib (AU)


Assuntos
Humanos , Masculino , Feminino , Neoplasias Pulmonares/tratamento farmacológico , Carcinoma de Células Escamosas/tratamento farmacológico , Receptores ErbB/uso terapêutico , Cloridrato de Erlotinib/uso terapêutico , Proteínas Tirosina Quinases/uso terapêutico , Genes erbB-2 , Diarreia/complicações , Diarreia/diagnóstico , Diarreia/tratamento farmacológico , Estomatite/complicações , Estomatite/tratamento farmacológico , Qualidade de Vida
13.
Med. clín (Ed. impr.) ; 146(supl.1): 30-35, abr. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-155625

RESUMO

Afatinib es un inhibidor irreversible de la tirosincinasa de la familia ErbB, aprobado para el tratamiento de pacientes con cáncer de pulmón no microcítico y mutaciones sensibilizadoras del gen EGFR. Como otros inhibidores de EGFR, afatinib puede provocar efectos adversos de clase como la diarrea, el exantema, la paroniquia o la mucositis. El manejo adecuado de estos efectos adversos es clave para mantener la calidad de vida de los pacientes y obtener el máximo beneficio del tratamiento con afatinib. El objetivo de este trabajo es revisar la toxicidad y resumir las recomendaciones de prevención y tratamiento de los efectos adversos más significativos de afatinib (AU)


Afatinib is an irreversible tyrosine kinase inhibitor of the ErbB family, approved for the treatment of patients with non-small cell lung cancer with EGFR-sensitizing mutations. Like other EGFR inhibitors, afatinib can provoke adverse events such as diarrhoea, rash, paronychia or mucositis. The correct management of these adverse events is essential to maintain quality of life in these patients and obtain the maximum benefit from afatinib therapy. This study aimed to review the toxicity of the drug and summarize recommendations for the prevention and treatment of the most significant adverse events associated with afatinib (AU)


Assuntos
Humanos , Masculino , Feminino , Genes erbB-1 , Receptores ErbB/toxicidade , Receptores ErbB/uso terapêutico , Neoplasias Pulmonares/tratamento farmacológico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/tratamento farmacológico , Proteínas Tirosina Quinases/efeitos adversos , Proteínas Tirosina Quinases/toxicidade , Diarreia/induzido quimicamente , Diarreia/complicações , Exantema/complicações , Estomatite/induzido quimicamente , Estomatite/complicações , Paroniquia/induzido quimicamente , Paroniquia/complicações , Vômito/complicações , Neutropenia/complicações
14.
Pediatr. aten. prim ; 18(69): 45-48, ene.-mar. 2016. ilus
Artigo em Espanhol | IBECS | ID: ibc-152272

RESUMO

La enfermedad de mano-pie-boca (EMPB) es una de las enfermedades exantemáticas más frecuentes en niños menores de cinco años, generalmente producida por los virus Coxsackie A16 y enterovirus 71. En los últimos años se están observando manifestaciones dérmicas diferentes a la habitual causadas por serotipos menos frecuentes como el Coxsackievirus A6. Los pacientes con la EMPB por Coxsakievirus A6 presentan fiebre y síntomas sistémicos como la EMPB típica, pero tienen una manifestación cutánea más grave, pudiendo simular un cuadro Gianotti Crosti-like, o, incluso, un eccema herpeticum. En estos casos, recomendamos analizar el serotipo de enterovirus para prevenir pruebas diagnósticas innecesarias o tratamientos antivirales inapropiados. Presentamos dos casos en niños menores de cinco años, de presentación atípica de EMPB, atendidos en nuestro Servicio de Urgencias. Ambos referían como antecedente padecer dermatitis atópica (AU)


Hand, foot and mouth disease (HFMD) is one of the most frequent exanthematic disease in children younger than five years. It is usually caused by Coxsackievirus A16 and enterovirus 71. Last years, other different skin presentations are observed and they are produced by less common serotypes of enterovirus such as Coxsackievirus A6. Patients with Coxsackievirus A6 HFMD present with fever and systemic symptoms as in typical HFMD, but usually have a more severe cutaneous involvement, being able to pretend a Giannotti Crosti-like symptoms, or even, an eczema herpeticum. In this cases, we recommend to analyze coxsackievirus A6 HFMD to prevent unnecessary diagnostic tests and inappropriate antiviral treatment. We report two cases of atypical hand, foot and mouth disease in children younger of five years. Both of them referred atopic dermatitis as precedent (AU)


Assuntos
Humanos , Masculino , Criança , Eczema/complicações , Eczema/terapia , Exantema/complicações , Exantema/diagnóstico , Infecções por Coxsackievirus/complicações , Infecções por Coxsackievirus/diagnóstico , Estomatite/complicações , Estomatite/diagnóstico , Infecções por Enterovirus/diagnóstico , Infecções por Enterovirus/terapia , Infecções por Coxsackievirus/microbiologia , Erupção Variceliforme de Kaposi/complicações , Diagnóstico Diferencial , Infecções por Coxsackievirus/terapia , Aciclovir/uso terapêutico , Reação em Cadeia da Polimerase/métodos , Reação em Cadeia da Polimerase
15.
Med. oral patol. oral cir. bucal (Internet) ; 21(1): e72-e81, ene. 2016. graf, tab
Artigo em Inglês | IBECS | ID: ibc-149428

RESUMO

Background: Oral Graft-versus-Host Disease (oGvHD) is a common complication of haematopoietic stem cell transplantation. Choosing the right topical application to be used intra orally can be a challenge. Consequently, the aim of this work is to review the effectiveness and safety of topical agents currently used in the management of the inflammatory mucosal lesions encountered in oGVHD. Material and Methods: We carried out electronic searches of publications up to May 2015 of the databases Pubmed, National Library of Medicine’s Medline, Embase and the Cochrane Central Register of Controlled Clinical trials to identify potentially relevant studies (keywords: "oral", "graft", "versus", "host", "disease" and "treatment"). The main inclusion criterion was the reported use of a topical agent which was not intentionally swallowed when used for the treatment of oGVHD. A 3-point grading system, described by the Swedish Council on Technology Assessment in Health Care and the Centre for Reviews and Dissemination, University of York, was used to rate the methodological quality of the papers. Results: From the 902 entries identified in the search, 7 studies qualifying for inclusion were analysed. Overall, there is limited evidence with regards to the effectiveness of topical steroids for oGVHD. However, the studies showed some effect of Budesonide alone and when combined with dexamethasone. Topical tacrolimus also appears to have some effect and clobetasol propionate mouthwash had a significantly better clinical response than dexamethasone mouthwash in treating oGVHD. Conclusions: As the number of clinical trials conducted is limited, there is little evidence to support the use of topical therapies to treat the inflammatory mucosal lesions found in oGVHD. High quality randomised control trials are needed in order to measure the effectiveness of any topical application for the treatment of the inflammatory mucosal lesions found in oGVHD (AU)


No disponible


Assuntos
Humanos , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Doença Enxerto-Hospedeiro/epidemiologia , Estomatite/tratamento farmacológico , Complicações Pós-Operatórias , Administração Tópica , Mucosa Bucal
16.
Cient. dent. (Ed. impr.) ; 12(3): 219-224, sept.-dic. 2015. graf
Artigo em Espanhol | IBECS | ID: ibc-147164

RESUMO

El tratamiento del cáncer de cabeza y cuello puede incluir técnicas quirúrgicas y no quirúrgicas como la quimioterapia y radioterapia. Estas técnicas no quirúrgicas pueden producir una serie de efectos adversos asociados. En la cavidad oral los efectos adversos más comunes son la mucositis, la xerostomía, infecciones, caries, alteraciones en el gusto y osteorradionecrosis. El objetivo de este trabajo es hacer una revisión de la literatura sobre los diferentes colutorios existentes para tratar dichos efectos adversos. Existen colutorios con agentes protectores de la mucosa oral, agentes antiinflamatorios, agentes antimicrobianos, agentes anestésicos, agentes inmunomoduladores y otras sustancias como los sustitutos salivales y el flúor. Ante la gran variedad de colutorios de los que se disponen existe una gran controversia a cerca de cual es más eficaz (AU)


The treatment of head-and-neck tumors may include surgical and nonsurgical techniques as chemotherapy and radiotherapy. These non-surgical techniques can produce some associated adverse effects. In the oral cavity, the most common adverse effects include mucositis, xerostomia, infections, tooth decay, taste changes, and osteoradionecrosis. The aim of this paper is to review the existing literature on the different mouthrinses to treat these adverse effects. There are mouthwashes with protective agents of the oral mucosa, inflammatory agents, antimicrobial agents, anesthetic agents, immunomodulatory agents and other substances such as saliva substitutes and fluoride. Due to the variety of existing mouthwashes, there is much controversy about which is more effective (AU)


Assuntos
Humanos , Neoplasias de Cabeça e Pescoço/complicações , Lesões por Radiação/tratamento farmacológico , Doenças da Boca/tratamento farmacológico , Antissépticos Bucais/farmacocinética , Radioterapia/efeitos adversos , Estomatite/tratamento farmacológico , Antineoplásicos/efeitos adversos , Clorexidina/farmacocinética , Povidona-Iodo/farmacocinética , Mucosa Bucal
17.
Nutr. hosp ; 32(3): 1208-1211, sept. 2015. tab
Artigo em Inglês | IBECS | ID: ibc-142487

RESUMO

Purpose: the objective was to demonstrate if treatment modality, nutritional status and oropharyngeal flora contribute to the development of mucositis in radiotherapy-treated head and neck cancer. Methods: single-cohort study of patients with head and neck cancer (H&N) in which radiotherapy was indicated. Nutritional status was evaluated using SGA, BMI, and FFMI. A buccal smear was performed before radiotherapy for cultivation of bacteria and yeasts. Mucositis was evaluated using the WHO grades. Relative risk (RR) and its 95% CI were calculated. Results: the study included 35 patients, 74.3% males, 63.8 (9.9) years of age, and 34.3% malnourished. The diagnoses included larynx (40.0%), oral (25.7%), and pharynx cancer (11.4%). Treatment comprised 66.0 Gy of radiation, chemotherapy (60.0%), and surgery (57.1%). Bacteria were found in 28.6%, including Staphylococcus aureus (8.6%) and Escherichia coli (8.6%). Yeasts (Candida spp.) were found in 35.3%. Mucositis was more frequent in patients with definitive radiotherapy [100% vs. 65%, p = 0.01; RR = 1.54 (CI95% 1.12 to 2.12)]. Neither SGA nor BMI or FFMI were related to the development or severity of mucositis. Positive cultures for bacteria before radiotherapy were related to severe mucositis [44.4% vs. 12%, p = 0.039; RR = 4.17 (CI95% 1.22 to 14.24)], but there was no relationship with the presence of yeasts. Previous surgery was not associated with the appearance of the studied strains of bacteria. Conclusion: bacterial colonization of the oropharynx prior to radiotherapy may be a factor for severe mucositis in H&N patients (AU)


Objetivo: el objetivo fue demostrar si la modalidad de tratamiento, el estado nutricional y la flora orofaríngea contribuyen al desarrollo de mucositis en pacientes con cáncer de cabeza y cuello tratados con radioterapia. Métodos: estudio de cohorte de pacientes con cáncer de cabeza y cuello (CyC) tratados con radioterapia. El estado nutricional se evaluó utilizando VGS, IMC e IMM. Se realizó un frotis bucal antes de la radioterapia para el cultivo de bacterias y levaduras. Se evaluó la mucositis usando los criterios de la OMS. Se calcularon el riesgo relativo (RR) y su IC del 95%. Resultados: el estudio incluyó a 35 pacientes, 74,3% hombres, 63,8 (9,9) años de edad, y 34,3% desnutridos. Los tumores estaban localizados en laringe (40,0%), boca (25,7%) y faringe (11,4%). El tratamiento consistió en 66,0 Gy de radiación, quimioterapia (60,0%) y cirugía (57,1%). Se encontraron bacterias en 28,6%, incluyendo Staphylococcus aureus (8,6%) y Escherichia coli (8,6%). Se encontró Candida spp. en el 35,3%. La mucositis fue más frecuente en los pacientes con radioterapia radical [100% vs. 65%, p = 0,01; RR = 1,54 (IC95% 1,12 a 2,12)]. Ni VGS, IMC ni IMM se relacionaron con el desarrollo o la gravedad de la mucositis. Los cultivos positivos para bacterias antes de la radioterapia se relacionaron con mucositis severa [44,4% vs. 12%, p = 0,039; RR = 4,17 (IC95% 1,22 a 14,24)], pero no hubo ninguna relación con la presencia de levaduras. La cirugía no se asoció con la aparición de las cepas estudiadas de bacterias. Conclusión: la colonización bacteriana de la orofaringe antes de la radioterapia puede ser un factor para la mucositis graves en pacientes con cáncer CyC (AU)


Assuntos
Humanos , Estomatite/epidemiologia , Neoplasias de Cabeça e Pescoço/complicações , Desnutrição/epidemiologia , Estomatite/dietoterapia , Estudos de Coortes , Radioterapia/efeitos adversos , Orofaringe/microbiologia
18.
An. sist. sanit. Navar ; 38(2): 225-234, mayo-ago. 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-140724

RESUMO

Fundamento: El instrumento Oral Assessment Guide (OAG) es una herramienta diseñada y ampliamente utilizada para evaluar problemas de la mucosa oral en pacientes con cáncer, sin embargo no está validada en español. El objetivo de este trabajo es traducir y validar al español la escala de la valoración de la cavidad oral (OAG) diseñada por Eilers. Método: El proceso de traducción se realizó utilizando el método de traducción retrotraducción por bilingües. El estudio se llevó a cabo en pacientes con cáncer ambulatorios y hospitalizados del Departamento Onco-hematológico y con enfermeras que trabajaban con pacientes de cáncer. Se evaluaron las siguientes propiedades psicométricas de la OAG: consistencia interna, validez concurrente con la escala de la mucositis de la OMS, la armonía interjueces entre dos enfermeras diferentes. También se recogió la percepción de los pacientes y enfermeras sobre la utilización de la OAG. Resultados: Se obtuvo una adecuada versión española de la OAG. Todos los participantes (n=40) completaron el estudio. La consistencia interna con el alpha de Cronbach fue de 0,71 y la armonía interjueces obtuvo un índice de Kappa moderado y bueno en la mayoría de los ítems (k=0,4-0,81) excepto en "lengua y encía" (k=0,33-0,37). La validez concurrente con la escala de la mucositis de la OMS fue aceptable (r=0,458). Todas las enfermeras (n=6) consideraron que la escala era fácil de entender y útil en la práctica clínica. Los pacientes dijeron que no les pareció incómoda la valoración de la boca con la escala. Conclusiones: La versión española de la OAG es un instrumento válido y fiable en pacientes con cáncer. Es una escala fácil de usar en la práctica clínica y bien aceptada por los pacientes (AU)


Background: The Oral Assessment Guide (OAG) is a widely used tool designed for evaluating problems of oral mucous in cancer patients, but it has not been validated in Spanish. The aim of this work is to translate and validate into Spanish the scale of the OAG designed by Eilers. Method: The translation process was carried out using the method of back-translation by bilingual translators. The study was carried out with cancer patients, both outpatient and inpatients, of the Hematology/Oncology Department and with oncology nurses. The following psychometric properties of the OAG were evaluated: internal consistency, concurrent validity with WHO’s mucositis scale, interjudge agreement between two different nurses. The perception of patients and nurses on the use of the OAG was also assessed. Results: An adequate Spanish version of the OAG was obtained. All the participants (n=40) completed the study. Internal consistency measured by Cronbach’s alpha was 0.71 and interjudge agreement obtained a moderate to good Kappa index in the majority of items (k=0.4-0.81), except in "tongue and gums" (k=0.33-0.37). Concurrent validity with WHO mucositis scale was acceptable (r=0.458). All the nurses (n=6) considered that the scale was easy to understand and useful in clinical practice. The patients said that oral evaluation with the scale did not cause them discomfort. Conclusions: The Spanish version of the OAG is a valid and reliable instrument in cancer patients. It is a scale that is easy to use in clinical practice and is well accepted by patients (AU)


Assuntos
Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Boca/fisiologia , Doenças da Boca/epidemiologia , Doenças da Boca/prevenção & controle , Psicometria/métodos , Neoplasias/complicações , Estomatite/prevenção & controle , Indicadores Básicos de Saúde , Psicometria/organização & administração , Psicometria/normas , Psicometria/tendências , Saúde Bucal/normas , Saúde Bucal/tendências , Protocolos/métodos , Consentimento Livre e Esclarecido/normas , Inquéritos e Questionários
20.
Rev. esp. cir. oral maxilofac ; 37(2): 80-86, abr.-jun. 2015. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-139753

RESUMO

Objetivo: Evaluar la efectividad de los enjuagues de ketamina asociados o no a fentanilo transmucoso en una serie de diversos dolores orofaciales de etiología neoplásica de difícil control analgésico. Material y métodos: Estudio prospectivo de 20 pacientes, con 8 pacientes que recibieron enjuagues de ketamina (40 mg = 4 ml), 8 pacientes que recibieron ketamina asociada a citrato de fentanilo por vía transmucosa oral a dosis de 200 mcg y 4 pacientes con opiáceos sistémicos para el dolor orofacial y mucositis refractaria. Resultados: Un total de16 de los 20 pacientes tenían dolor orofacial o mucositis refractaria al tratamiento con lidocaína y opiáceos. La tasa de éxito del empleo de enjuagues de ketamina fue del 50% (8/16 pacientes). La asociación ketamina y fentanilo transmucoso obtuvo una tasa de éxito del 94,1% (15/16 pacientes). Los efectos adversos se asocian al uso de la ketamina; todos los efectos secundarios fueron transitorios y desaparecieron cuando se suspendieron los enjuagues con ketamina. Conclusión: Los enjuagues de ketamina son una opción eficaz para el tratamiento del dolor orofacial secundario al cáncer. En caso de presencia de episodios de dolor irruptivo recurrente, la asociación de ketamina en enjuague bucal y citrato de fentanilo oral transmucoso puede ser una opción viable en dolor refractario a otros tratamientos (AU)


Purpose: The objective of this study was to determine if an oral ketamine mouth wash and expectorant, that may or may not rinse transmucosal fentanyl, was a safe and effective method to alleviate a series of various difficult to control orofacial pain of cancer origin. Material and methods: A prospective review was made of the medical charts of 20 patients, finding 8 patients who received ketamine mouthwash (40 mg = 4 ml), 8 patients who received ketamine mouthwash and oral transmucosal fentanyl citrate 200 mcg, and 4 patients with systemic opioids for refractory orofacial and mucositis pain. Results: Of the 20 patients, 16 had orofacial or mucositis pain refractory to a mixture of lidocaine and opioids. The effectiveness of ketamine mouthwash was 50% (8/16 patients). The combination of ketamine and/or fentanyl transmucosal had an analgesic efficacy of 94.1% (15/16 patients). The adverse effects were associated with the ketamine mouthwash; all side effects were transient and subsided when the ketamine mouthwash was stopped. Conclusion: Ketamine mouthwash for orofacial pain due to cancer may be an effective treatment option. In cases of reported episodes of breakthrough pain, the combination of a ketamine mouthwash and oral transmucosal fentanyl citrate may be a viable treatment option in refractory mucositis pain (AU)


Assuntos
Humanos , Dor Facial/tratamento farmacológico , Neoplasias Bucais/complicações , Ketamina/administração & dosagem , Fentanila/administração & dosagem , Manejo da Dor/métodos , Antissépticos Bucais/administração & dosagem , Estomatite/tratamento farmacológico , Estudos Prospectivos
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