The Efficacy of a Dietary Supplement with Carnosine and Hibiscus Sabdariffa L. (AqualiefTM) in Patients with Xerostomia: a Randomized, Placebo-Controlled, Double-Blind Trial.

The purpose of this study was to test the safety and efficacy of AqualiefTM in patients affected by xerostomia. The main ingredients of AqualiefTM are carnosine and dried calyces of Hibiscus sabdariffa L. (karkadè) for their buffering effect at pH 7 as well as for their antioxidant, antimicrobial and lenitive properties. In a Randomized, Placebo-Controlled, Double-Blind Trial, sixty patients with xerostomia (RTOG/EORTC grade 1-2) were randomly assigned to receive either placebo, or AqualiefTM tablets (three times/day after meals) for 6 consecutive days. A questionnaire was used to evaluate dry mouth symptoms before and after 6 days of AqualiefTM or placebo application. Unstimulated and stimulated salivary flow rates and pH were measured before and after application. Treatment with AqualiefTM for 6 days induced a significant increase in saliva pH from 6.2 ± 0.5 to 6.4 ± 0.6 (P < 0.05) while placebo was ineffective (from 6.2 ± 0.5 to 6.3 ± 0.5). AqualiefTM also induced a significant increase in the pH of stimulated saliva from 6.3 ± 0.5 to 6.6 ± 0.5 (P < 0.01). Placebo was ineffective also in this setting (from 6.2 ± 0.5 to 6.3 ± 0.5). Besides an expected normalization of the saliva pH value, AqualiefTM treatment for 6 days greatly increased (56%, P < 0.0001) saliva production. Placebo induced a 19% increase (P < 0.05), which was likely due to mechanical stimulation. AqualiefTM also increased stimulated saliva production (27% increase with respect to day 0, P < 0.05), while placebo was ineffective. AqualiefTM was effective in regulating the saliva pH, in increasing saliva production and improving dry mouth symptoms in xerostomic patients.

Dietetic management in gastrointestinal complications from antimalignant chemotherapy.

Antineoplastic chemotherapy (CT) represents the systemic treatment of malignant tumors. It can be used alone or combined with surgery and / or radiotherapy. The cytotoxic agents used in chemotherapy work on both cancerous cells and noncancerous cells of the body, generally resulting in high toxicity. The biological aggressiveness of chemotherapy particularly affects rapidly replicating cells, such as those of the digestive tract, resulting in adverse effects that impair food intake, leading to compromised nutritional status and which may lead to cachexia. The main toxic effects of chemotherapy in the gastrointestinal tract include nausea, vomiting -these are the most frequent- constipation, diarrhea, xerostomia, mucositis, dysphagia and anorexia. Given the high frequency of such effects, nutritional intervention should be an integral part of cancer treatment, to maintain and/or improve the patient's nutritional status and reduce or minimize the side effects caused by treatment. Accordingly, the goal of this study is to review dietetic conduct in the process of caring for patients undergoing cancer chemotherapy.

Managing xerostomia in nursing homes: pilot testing of the Sorbet Increases Salivation intervention.

OBJECTIVE: The purpose of this article was to describe the pilot testing of the Sorbet Increases Salivation (SIS) intervention and describe its impact on salivation and subsequent resident food intake. METHODS: Using a repeated treatment design with each elder serving as his or her own control, 12 elders were served 2 ounces of sugar-free lemon-lime sorbet just before the lunch meal for two 3-week periods separated by a 6-week observation (no treatment) period. A plate waste protocol was used to determine actual food intake. Before the initiation of the intervention, salivation was measured (using a Modified Schirmer Test [MST] strip) at baseline and then at 1, 2, and 3 minutes of consuming 2 oz of sugar-free lemon-lime sorbet or 2 oz of water. Summary statistics (means, standard deviations, proportions) were used to describe the study sample. Bivariate statistics determined whether there were significant differences between MST measures or food intake within subjects. RESULTS: Salivation significantly increased after consuming sorbet or water. Most importantly, residents who consumed sorbet salivated more on average in comparison with residents who consumed water. During pilot testing, most residents consumed more food on average during treatment weeks in comparison with observation weeks. CONCLUSION: The intervention has the potential to increase salivation, decrease complaints of xerostomia, and increase food intake in institutionalized elders with drug-induced xerostomia. The new knowledge gained from this study will lead to further research and testing of the intervention with the long-term goal of transforming the "care-as-usual" approach to meal service in nursing homes.

Radioterapia (II)

No disponible

The use of milk as a saliva substitute.

Xerostomia, a clinical manifestation of salivary gland dysfunction, affects many people. These individuals frequently sip liquids to alleviate the discomforts associated with hyposalivation. Milk appears to have many of the chemical and physical properties of a good saliva substitute. Besides the obvious benefit of providing moisture and lubrication for the dehydrated mucosa, milk buffers oral acids, reduces enamel solubility, and contributes to enamel remineralization. These anticariogenic factors are generally attributed to the high calcium and phosphate content along with the milk phosphoproteins that strongly adsorb to enamel. Patients with xerostomia frequently have difficulty in obtaining proper nutrition due to problems associated with lubricating, masticating, tasting, and swallowing food. Milk is a food with high nutritional quality that would certainly benefit most patients with xerostomia. Because of the nutritional, anticariogenic, and moisturizing properties of milk, patients with xerostomia may find milk of value as a saliva substitute to help reduce the oral health problems associated with hyposalivation.