[Orodental status before radiation therapy of the head and neck area: A prospective analysis on 48 patients]. / État buccodentaire des patients avant radiothérapie des voies aérodigestives supérieures : analyse prospective de 48 patients.

PURPOSE: The treatment by irradiation of tumours of the upper head and neck tract cause many complications on the oral sphere, such as mucositis, dysphagia, asialia and tooth decay. Associated manifestations are frequent and their severity has been poorly studied. However, the patient's quality of life is directly correlated with their oral health. PATIENTS AND METHODS: We carried out an evaluation of the oral health of 48 patients with an upper head and neck tract cancer treated by irradiation at the Paul-Strauss Centre in Strasbourg. The inclusion criteria of this study concerned the localization of the tumour in the upper head and neck tract and a treatment by irradiation associated or not to chemotherapy. RESULTS: The patients of the study were concerned by alcohol and smoking intoxication, on average, 22.2 pack-year and 2.2 glasses of alcohol per day. They received an irradiation of 60.9Gy on average. Their oral health was characterized by a DMFT (decayed, missing, filled teeth) index of 16.1, with, in mean, eight missing teeth and eight filling teeth and, by the presence of dental plaque in 70% of cases. Along the treatment by irradiation, the oral complications evaluation showed that on average, patients developed mucositis 18 days after the beginning of radiotherapy, xerostomia after 20 days, and dysphagia after 17 days. At the end of the treatment, we noted an oral hygiene improvement, with teeth brushing more frequent (two to three per day), mouthwash use, and daily fluoride prophylaxis. CONCLUSION: This study provides insights of the dental status of patients irradiated in the oral cavity. This series lays the groundwork for the study of prosthesis requirement and dosimetry calculation.

[Dental state in patients with head and neck cancers]. / État dentaire des patients atteints d'un cancer des voies aérodigestives supérieures.

In France, in 2005, there were approximately 16,000 new cases of head and neck cancer. These cancers have an unfavourable prognosis: the survival rates at 3 and 10 years are 50% and 10% respectively. The consumption of alcohol and tobacco is the most important risk factor; in some countries HPV infection was identified as a risk factor of head and neck tumours. Furthermore, a poor oral hygiene seems to raise this risk. We found many decay and periodontium problems in patients with an upper aerodigestive tract cancer. An evaluation of dental state is necessary before any cancer treatment. Treatments by radiotherapy engender noxious effects: hypocellular, hypovascularization, hypoxie of the irradiated tissues, which lead to immediate and chronically oral complications such as mucositis, fibrosis, xerostomia, decay, or osteoradionecrosis. An oral follow-up of these patients can prevent these complications, or reduce the severity of oral complications, and promote a good oral state.

Vigilance in industry: cosmetics and household cleaning products. Balance sheet of case report from 2005 to 2007.

BACKGROUND: Unlike medicinal products, cosmetics are not subject to marketing authorization in France. Nevertheless, the Agence Francaise de Sécurité Sanitaire des Produits de Santé (AFSSAPS; French Agency for the Safety of Healthcare Products) has been working on the development of a cosmetovigilance system for several years, with the aim of establishing standard procedures for collecting adverse reactions to cosmetics from the manufacturers. AIM: To assess the incidence of skin reactions to cosmetics or household products. Unilever established its own 'vigilance' standard system in France in late 2003. This report describes the experience acquired from 2005 to 2007. METHODS: Case reports were collected in compliance with a standard procedure. The cases were then analysed by the consultant dermatologist in accordance with a pharmacovigilance-based method (chronological criteria, clinical criteria, possible rechallenge test, patch tests). RESULTS: During the period 2005 to 2007, a total of 102,689 consumers contacted the consumer department, including 842 (0.82%) who reported skin reactions. After analysis of the collected data, 0.144 skin reaction cases per million units sold were found to be attributable to cosmetic or household products. CONCLUSIONS: The implementation of a structured vigilance system in the cosmetics and household products industry is an efficient tool for manufacturers, both for information purposes and for product improvement, as well as meeting the transparency requirements of health authorities and consumers.