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1.
Crit Rev Oncol Hematol ; 162: 103335, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33992801

RESUMO

Head and neck squamous cell carcinoma is one of the most common neoplasms. Radiotherapy (RT) plays an essential role in the management of such cases. Despite advances in the technique, hyposalivation, xerostomia, dysphagia, trismus, radiation caries, and osteoradionecrosis remain significant late complications of RT. The aim of this narrative review was to summarize and update the main findings related to late side effects of radiotherapy in survivors of head and neck cancer (HNC). Such effects limit the ability to speak, ingest food and medications, and breathe and also exert a negative impact on social well-being and quality of life. This review highlights research in the field for both researchers and clinicians, assisting in the prevention and management of these adverse conditions. The findings can contribute to improving preventive management and multidisciplinary interventions for HNC patients.


Assuntos
Neoplasias de Cabeça e Pescoço , Lesões por Radiação , Xerostomia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Qualidade de Vida , Sobreviventes , Xerostomia/epidemiologia , Xerostomia/etiologia
2.
J Pak Med Assoc ; 71(3): 938-942, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34057953

RESUMO

Biomarkers are anatomical characteristics or naturally occurring measurable molecules indicating physiological or pathological state of an individual. These biomarkers have the potential to detect or predict diseases at an early stage, which is particularly beneficial in timely management of common complications of radiation therapy done in head and neck cancer treatment regime. Xerostomia is one of the most common oral complaints of radiation therapy. Saliva has an abundance of protein biomarkers; however, those related to post-radiation therapy xerostomia need to be explored further. Textural and imaging-based biomarkers are helpful in predicting xerostomia in such patients. This narrative review provides an account of salivary protein and imaging-based biomarkers of radiation therapy-induced xerostomia in head and neck cancer patients.


Assuntos
Neoplasias de Cabeça e Pescoço , Xerostomia , Biomarcadores , Diagnóstico por Imagem , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Saliva , Xerostomia/etiologia
3.
J Appl Oral Sci ; 29: e20200854, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33886946

RESUMO

Hyposalivation and sensation of dry mouth (xerostomia) are one of the most common adverse effects in the treatment of patients with head and neck cancer. OBJECTIVE: This study evaluates the prevalence of late hyposalivation and associated factors in survivors of squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx treated with radiotherapy with or without concomitant chemotherapy. METHODOLOGY: A cross-sectional study was conducted with 88 patients who had concluded radiotherapy at least three months before the study, at a referral center for the treatment of head and neck cancer in the Southern region of Brazil. Hyposalivation was evaluated based on the stimulated salivary flow rate using the spitting method. Multivariate analysis using binary logistic regression was performed to determine the associations between hyposalivation and clinical and demographic variables. RESULTS: Hyposalivation was found in 78.41% of the sample and the mean radiation dose was 63.01 Gy (±9.58). In the crude model of the multivariate analysis, hyposalivation was associated with higher doses of radiation (p=0.038), treatment with concomitant radiotherapy and chemotherapy (p=0.005), and time elapsed since the end of radiotherapy (p=0.025). In the adjusted model of the multivariate analysis, hyposalivation was only associated with dose and time elapsed. Patient who received higher doses of radiation had a 4.25-fold greater chance of presenting hyposalivation, whereas a longer time elapsed since the end of radiotherapy exerted a 75% protective effect against the occurrence of hyposalivation. CONCLUSION: Hyposalivation is a highly prevalence late-onset side effect of radiotherapy in patients treated for head and neck cancer, with a greater chance of occurrence among those who received higher doses of radiation and those who ended therapy less than 22 months before our study. Concomitant chemotherapy and radiotherapy does not seem to increase the chances of hyposalivation compared to radiotherapy alone.


Assuntos
Neoplasias de Cabeça e Pescoço , Xerostomia , Brasil/epidemiologia , Estudos Transversais , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Prevalência , Sobreviventes , Xerostomia/epidemiologia , Xerostomia/etiologia
4.
Eur Arch Otorhinolaryngol ; 278(7): 2421-2428, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33765165

RESUMO

INTRODUCTION: Sjögren's syndrome (SjS) causes malfunction of the salivary and lacrimal glands. Consequently, patients suffer from xerostomia and keratoconjunctivitis sicca. This can further affect the voice and swallowing function resulting in an impaired quality of life. Aim of this study is the systematic evaluation of the impact on voice and swallowing-related quality of life in patients with SjS. MATERIAL AND METHODS: SjS patients were classified according to the American-European Consensus Group (AECG) criteria; antibodies to Ro (SS-A) or La (SS-B) antigens were detected, ESSPRI was completed. We used the following quality of life questionnaires: EORTC QLQ H&N 35, Anderson Dysphagia Inventory (ADI) and Voice Handicap Index (VHI). Patients additionally received a detailed phoniatric examination (auditory perception, videostroboscopy, acoustic analysis, Dysphonia Severity Index (DSI), aerodynamics measurements). RESULTS: Almost all the 54 patients (96.3%) had a limited quality of life due to their swallowing problems and 48% due to their voice problems. Both values correlated significantly with the degree of xerostomia. In the phoniatric examination, 77.8% had an increased DSI and two-thirds had abnormalities in videostroboscopy. CONCLUSIONS: A reasonable impairment of quality of life in patients with SjS due to the limitations in voice and swallowing function was observed. As SjS does not limitate life expectancy, preservation of quality of life is important. Detection of voice and swallowing problems as potential reasons for quality of life impairment should be detected and, if diagnosed, treated accordingly.


Assuntos
Transtornos de Deglutição , Síndrome de Sjogren , Xerostomia , Deglutição , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/etiologia , Humanos , Qualidade de Vida , Síndrome de Sjogren/complicações , Síndrome de Sjogren/diagnóstico , Xerostomia/diagnóstico , Xerostomia/etiologia
5.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(1): 99-104, 2021 Feb 01.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33723944

RESUMO

Oral squamous cell carcinoma (OSCC) is the most frequent tumour in head and neck malignant. The current treatment is mainly based on surgery therapy, radiation therapy and chemical therapy. Meanwhile, there are many a defect in the treatment. For example, there are many defects in radiotherapy. Radioactive salivatitis is the most common. In addition, there are a series of changes such as dry mouth, oral mucositis, rampant dental caries, and radioactive osteomyelitis of jaw, which cause swallowing, chewing problems, and taste dysfunction. Currently, the research on radioactive salivatitis is progressing rapidly, but its mechanism is more complication. This paper review aims to summarize the research progress in this field.


Assuntos
Carcinoma de Células Escamosas , Cárie Dentária , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Lesões por Radiação , Xerostomia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Glândulas Salivares , Xerostomia/etiologia
6.
J Dent ; 108: 103629, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33684464

RESUMO

OBJECTIVES: This cross-sectional study aimed: 1) to compare the saliva characteristics and the occurrence of caries in patients with type 2 diabetes mellitus (T2DM) and patients without T2DM, 2) to study the impact of inadequate glycemic control on saliva and caries prevalence. METHODS: 23 adults with T2DM and 18 controls participated. Patients with T2DM were divided depending on their metabolic control: a) well-controlled (W.C.): HbA1c≤7 %, and b) poorly-controlled (P.C.): HbA1c> 7 %). The examined clinical parameters were: 1) number of natural teeth, 2) DMFT index of coronal caries, 3) saliva pH, 4) saliva flow and buffering capacity, and 5) subjective feeling of dry mouth. RESULTS: The groups W.C and P.C showed significant differences in the number of teeth, the saliva flow, and DMFT. The C and P.C groups presented differences in pH, saliva flow, buffer capacity, and DMFT. Finally, the W.C and C groups indicated differences in the buffer capacity, saliva flow, and DMFT. The subjective feeling of dry mouth is related to the duration of the disease. The DMFT value correlated negatively with the status of metabolic regulation. Multiple linear regression revealed that the DMFT value was positively associated with serum HbA1c levels. CONCLUSIONS: 1) Adults with T2DM present a lower saliva flow rate and buffering capacity, as well as higher caries prevalence than controls; 2) The metabolic control of T2DM is essential for the maintenance of saliva flow rate and buffering capacity, and caries prevalence; 3) The duration of T2DM is of importance for the subjective sense of dry mouth. CLINICAL SIGNIFICANCE: The duration and metabolic control of T2DM are important clinical parameters for oral complications. Awareness and co-operation of diabetologists and dentists are needed to detect oral lesions in patients with diabetes and be treated timely and effectively.


Assuntos
Cárie Dentária , Diabetes Mellitus Tipo 2 , Xerostomia , Adulto , Estudos Transversais , Índice CPO , Cárie Dentária/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Humanos , Saliva , Xerostomia/epidemiologia , Xerostomia/etiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-33572065

RESUMO

The intact function of the salivary glands is of utmost importance for oral health. During radiotherapy in patients with head and neck tumors, the salivary glands can be damaged, causing the composition of saliva to change. This leads to xerostomia, which is a primary contributor to oral mucositis. Medications used for protective or palliative treatment often show poor efficacy as radiation-induced changes in the physico-chemical properties of saliva are not well understood. To improve treatment options, this study aimed to carefully examine unstimulated whole saliva of patients receiving radiation therapy and compare it with healthy unstimulated whole saliva. To this end, the pH, osmolality, electrical conductivity, buffer capacity, the whole protein and mucin concentrations, and the viscoelastic and adhesive properties were investigated. Moreover, hyaluronic acid was examined as a potential candidate for a saliva replacement fluid. The results showed that the pH of radiation-induced saliva shifted from neutral to acidic, the osmolality increased and the viscoelastic properties changed due to a disruption of the mucin network and a change in water secretion from the salivary glands. By adopting an aqueous 0.25% hyaluronic acid formulation regarding the lost properties, similar adhesion characteristics as in healthy, unstimulated saliva could be achieved.


Assuntos
Neoplasias de Cabeça e Pescoço , Xerostomia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Saúde Bucal , Saliva , Xerostomia/etiologia
8.
Radiother Oncol ; 157: 247-254, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33587972

RESUMO

PURPOSE: To verify clinical significance of submandibular gland (SMG)-sparing during helical tomotherapy (HT) for nasopharyngeal carcinoma (NPC) from the perspective of imaging by using diffusion weighted imaging (DWI). MATERIALS AND METHODS: In this prospective study, 60 NPC patients scheduled for radical SMG-sparing HT were enrolled. All patients underwent DWI examinations prior to HT (pre-HT) and 1, 3, 6, 9, 12 months post HT. Mean apparent diffusion coefficient (ADC) values of bilateral parotid glands (PGs) and submandibular glands (SMGs) were measured. Differences of ADC and changes of ADC pre and pro HT (ΔADC) among SMG-spared, SMG-unspared and PGs were compared and the associations betweenΔADC and variations of patient-rated xerostomia questionnaire summary scores (XQ-sum) were further tested. RESULTS: ADCpost-HT and ΔADCpost-HT of SMG-spared were both much lower than of SMG-unspared and a strong dose-response relationship was detected between mean radiation dose and ΔADC of SMGs. Dynamic change trends of PGs, SMG-spared and SMG-unspared were similar, with initial increase at 1 m-post-HT followed by little change at 3 m-post-HT and then gradual decrease over time. But for SMG-unspared, there was no obvious change of ADC from 6 m-post-HT to 12 m-post-HT. The dynamic change trend of XQ-sum was nearly in line with that of ADC on the whole. And a positive correlation between mean ΔADC1m-post-HT of bilateral SMGs and variation of XQ-sum1m-post-HT in patients with bSMG-unspared were found (r = 0.693, P < 0.001). Multivariate stepwise regression analysis showed that whether spared SMG or not was the only independent predictor correlated to XQ-sumpost-HT at each follow-up timepoint. CONCLUSION: SMG-sparing technique could significantly improve subjective xerostomia post HT in NPC patients from the perspective of imaging.


Assuntos
Neoplasias Nasofaríngeas , Radioterapia de Intensidade Modulada , Xerostomia , Humanos , Carcinoma Nasofaríngeo/diagnóstico por imagem , Carcinoma Nasofaríngeo/radioterapia , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/radioterapia , Glândula Parótida , Estudos Prospectivos , Glândula Submandibular/diagnóstico por imagem , Xerostomia/etiologia
9.
Clin Oral Implants Res ; 32(5): 581-589, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33629453

RESUMO

OBJECTIVES: Previous studies have indicated that xerostomia is a critical factor affecting periodontitis; nonetheless, it is controversial whether xerostomia impairs peri-implant tissue. The objective of this experimental study was to evaluate the effect of xerostomia on the peri-implant hard and soft tissues in the rat model. MATERIALS AND METHODS: Implants were placed in bilateral maxillae of male Wistar rats. The animals underwent submandibular and sublingual gland resection on both sides (DRY group) or sham operation (CTR group). Silk ligatures were placed around one side of abutments, which were randomly selected in each animal. The effects of xerostomia were assessed using micro-CT, histological analysis, real-time PCR, and 16S rRNA-based metagenomic analysis. RESULTS: Ligation with silk thread caused bone resorption around implants. Although xerostomia itself did not induce bone resorption, it significantly enhanced silk ligature-mediated bone resorption around implants. Histological analysis and real-time PCR indicated that xerostomia induced inflammation and osteoclastogenesis around implants with silk ligatures. Furthermore, it altered the microbiota of the plaque on the silk thread around implants. CONCLUSION: Xerostomia accelerates mucosal inflammation and osteoclastogenesis, which aggravates bone resorption around implants.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Peri-Implantite , Xerostomia , Animais , Implantes Dentários/efeitos adversos , Masculino , Peri-Implantite/etiologia , RNA Ribossômico 16S , Ratos , Ratos Wistar , Xerostomia/etiologia
10.
Med. oral patol. oral cir. bucal (Internet) ; 26(1): e14-e20, ene. 2021. tab
Artigo em Inglês | IBECS | ID: ibc-200533

RESUMO

BACKGROUND: Head and neck radiotherapy is typically associated with toxicities that can have profound effects on the patient's quality of life. Xerostomia, which may or may not be related to hypofunction of the salivary gland, leading to negative consequences, mainly in quality of life, leaving patients more susceptible to the development of oral mucositis, dental caries, oral infection and difficulties in speech is one of the most common side effects of such treatment. The aim of the present study was to evaluate salivary function of patients in treatment with radiotherapy for head and neck cancer submitted to photobiomodulation. MATERIAL AND METHODS: A cross-sectional study with a quantitative approach was carried out in the Dentistry Department of the Hospital de Câncer de Pernambuco between February and September 2019. RESULTS: The study sample comprised 23 patients of both genders, treated with radiotherapy for cancer in the head and neck region. The patients were submitted to photobiomodulation with infrared laser, as intraoral applications in order to prevent mucositis and extraoral applications to stimulate salivary glands. The applications were undertaken three times a week on alternate days throughout the radiotherapy period. The following parameters were used: Intraoral 15mW, 12J / cm2, 10s / point, 2.4 J / point, and extraoral 30mW, 7.5J / cm2, 10s / point, 0.3J / point, both with a wavelength of 830nm and area of 0.028cm². Subjective and objective symptoms were evaluated by measuring the unstimulated salivary flow (USF) using the spitting technique before, during and after radiotherapy treatment. For statistical analysis, a significance level of 5% was adopted. Most patients were male (70%) with 60 years of age on average. At the beginning of treatment, 22 patients had USF > 0.2 ml / min (grade 1), at the end of which 15 patients remained unchanged and only 3 patients progressed to grade 3. As for the subjective classification, most (52%) remained in grade 1 (absence of disability) throughout the treatment. CONCLUSION: Based upon the results of this study it was possible to conclude that the use of photobiomodulation did not significantly interfere with the xerostomia complaint of patients in treatment with radiotherapy, however, it does seem to prevent patients from reaching higher degrees of xerostomia taking into account salivary flow measures


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias de Cabeça e Pescoço/radioterapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/radioterapia , Terapia com Luz de Baixa Intensidade/efeitos adversos , Xerostomia/etiologia , Estudos Transversais , Xerostomia/prevenção & controle , Qualidade de Vida , Fatores de Tempo , Resultado do Tratamento , Gradação de Tumores , Neoplasias de Cabeça e Pescoço/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia
11.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 661-665, jan.-dez. 2021. ilus
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1178716

RESUMO

Objetivo: Identificar os estudos que descrevem a prevalência de xerostomia em pacientes com câncer de mama e em quimioterapia. Método: Revisão integrativa, partindo da questão norteadora << Quais as evidências científicas sobre a prevalência de xerostomia em pacientes com câncer de mama e em quimioterapia? >>. Foi realizada uma busca nas bases de dados: US National Library of Medicine and National Institute of Health, Literatura Latino-Americana e do Caribe em Ciências da Saúde e Scientific Electronic Library Online por meio dos Descritores em Ciências da Saúde. Foram encontrados 63 artigos, analisados por dois pesquisadores seguindo os critérios de inclusão e exclusão. Resultados: A prevalência de xerostomia foi descrita em 10 artigos que utilizaram como método de avaliação escalas, questionários com respostas dicotômicas e sialometria. Conclusão: Identificou-se uma prevalência de 47% a 77,3% de xerostomia durante a quimioterapia


Objective: To identify studies describing the prevalence of xerostomia in breast cancer patients undergoing chemotherapy. Method: Integrative review based on the guiding question << What is the scientific evidence on the prevalence of xerostomia in breast cancer patients undergoing chemotherapy? >>. We searched the US National Library of Medicine and National Institute of Health, Latin American and Caribbean Health Sciences Literature and Scientific Electronic Library Online databases using the Health Sciences Descriptors. We found 63 articles, which were analyzed by two researchers, following the inclusion and exclusion criteria. Results: The prevalence of xerostomia was described in 10 articles that used scales, questionnaires with dichotomous answers, and sialometry as evaluation methods. Conclusion: A prevalence of 47% to 77.3% of xerostomia during chemotherapy was identified


Objetivo: Identificar estudios que describen la prevalencia de xerostomía en pacientes con cáncer de mama y quimioterapia. Método: Revisión integradora, basada en la pregunta guía << ¿Cuál es la evidencia científica sobre la prevalencia de xerostomía en pacientes con cáncer de mama y quimioterapia? >>. Se realizaron búsquedas en las bases de datos US National Library of Medicine and National Institute of Health, Literatura Latino-Americana y del Caribe en Ciencias de la Salud y Scientific Electronic Library Online utilizando los Descriptores de Ciencias de la Salud. Encontramos 63 artículos, que fueron analizados por dos investigadores siguiendo los criterios de inclusión y exclusión. Resultados: La prevalencia de xerostomía se describió en 10 artículos que utilizaron escalas, cuestionarios con respuestas dicotómicas y sialometría como método de evaluación. Conclusión: Se identificó una prevalencia de xerostomía del 47% al 77,3% durante la quimioterapia


Assuntos
Humanos , Masculino , Feminino , Xerostomia/etiologia , Neoplasias da Mama/complicações , Quimioterapia Adjuvante/efeitos adversos , Prevalência , Antineoplásicos/efeitos adversos
12.
Ned Tijdschr Tandheelkd ; 127(10): 533-542, 2020 Oct.
Artigo em Holandês | MEDLINE | ID: mdl-33156294

RESUMO

Three patients who were referred to the saliva of the Center for Special Care Dentistry (Stichting Bijzondere Tandheelkunde, SBT) in Amsterdam clearly demonstrate that in the case of patients suffering from xerostomia, it can be useful to have the saliva secretion rate determined and to take saliva into account in the aetiology and in developing a dental treatment plan. In the first case, a 39-year-old woman presented with dry mouth associated with Sjögren's syndrome. A fair degree of saliva secretion was still possible. The teeth were characterised by wear, caries lesions and sensitivity. The second patient was a 42-year-old man suffering from dry mouth associated with the use of medications. His teeth were weakened to the point of deciding to create conventional full dentures, despite a possible moderate prognosis due to oral dryness. The third patient, a 79-year-old woman, was suffering from severe dry mouth, associated with Sjögren's syndrome. Due to the ruinous condition of her teeth and extreme dry mouth, the decision was made to remove the remaining dentition and insert implant-retained dentures.


Assuntos
Síndrome de Sjogren , Xerostomia , Adulto , Idoso , Feminino , Humanos , Masculino , Saliva , Síndrome de Sjogren/complicações , Síndrome de Sjogren/diagnóstico , Xerostomia/etiologia
13.
Crit Rev Oncol Hematol ; 156: 103115, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33039721

RESUMO

INTRODUCTION: Head and neck radiotherapy can cause hypofunction of the salivary glands. Many studies report that laser photobiomodulation (PBM) is able to minimize radiation-induced hyposalivation, yet there is no consensus about its effects. OBJECTIVE: To carry out a meta-analysis of controlled clinical trials that used PBM to prevent radiation-induced hyposalivation. METHODS: A systematic search was performed through Embase, Medline/PubMed, Cochrane, EBSCO, Scopus, LILACS and Web of Science databases. The strategy included comparisons of the effect of PBM with placebo/clinical follow-up on unstimulated and/or stimulated salivary flow in patients undergoing head and neck radiotherapy. RESULTS: Six clinical trials were included, five of which were used for meta-analysis. Evidence was observed between the use of PBM and increased unstimulated salivary flow (MD 0.20 mL/min, 95 % Cl 0.10-0.30, I² = 96 %, p < 0.00001) and in stimulated salivary flow (MD 0.27 mL/min, 95 % CI 0.08-0.46, I² = 95 %, p < 0.00001). CONCLUSION: PBM appears to minimize radiation-induced hyposalivation.


Assuntos
Neoplasias de Cabeça e Pescoço , Xerostomia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Glândulas Salivares , Xerostomia/etiologia , Xerostomia/prevenção & controle
15.
J Oral Rehabil ; 47(12): 1550-1556, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32965698

RESUMO

BACKGROUND: Dry mouth is associated with salivary gland hypofunction, which may result from several conditions such as Sjögren's syndrome (SS), head and neck cancers, and side effects of medications. The Saxon test is a useful diagnostic method for hyposalivation in clinical settings. However, previous reports indicate that the test has mostly been used for patients with SS. OBJECTIVE(S): In the present study, we focused on patients with dry mouth who were not diagnosed with SS (patients without SS). METHODS: For patients without SS (n = 302), we examined the factors affecting Saxon test scores using multiple regression analysis. Additionally, we performed a correlation analysis comparing the Saxon test with other diagnostic methods. RESULTS: In 57.6% patients, the Saxon test score was more than 2.00 g/2 min, which is considered negative for hyposalivation. Multiple regression analysis revealed that the age and sex of patients significantly influenced test scores. The mean Saxon test score was less than 2.00 g/2 min in older patients and women. Moreover, the test showed a significant correlation with other methods used to measure salivary flow. CONCLUSION: The Saxon test is useful not only for patients with SS but also for patients without SS.


Assuntos
Síndrome de Sjogren , Xerostomia , Idoso , Feminino , Humanos , Saliva , Glândulas Salivares , Síndrome de Sjogren/diagnóstico , Xerostomia/diagnóstico , Xerostomia/etiologia
16.
J Cancer Res Ther ; 16(3): 693-696, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32719295

RESUMO

Xerostomia is a subjective symptom of dry mouth. It can occur as a part of the systemic disease, drug-induced side effect, or following therapeutic radiation therapy to the head-and-neck region. The primary complication faced by these xerostomic patients is the difficulty in retention of removable dentures. It is important to recognize that the prosthodontic management of these patients requires special attention and care. In an attempt to overcome the presence of xerostomia, several techniques of introducing reservoirs into the dentures containing salivary substitutes have been proposed. This case report presents a simplified approach for the construction of a reservoir in the maxillary denture, specifically in patients where other treatment modalities have failed. This technique provided excellent lubrication to oral tissues, hygienic for the patient, and utilized routine denture base material.


Assuntos
Planejamento de Dentadura/métodos , Retenção de Dentadura/métodos , Prótese Total Superior/normas , Neoplasias de Cabeça e Pescoço/radioterapia , Lesões por Radiação/terapia , Xerostomia/terapia , Idoso , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Prognóstico , Lesões por Radiação/etiologia , Radioterapia/efeitos adversos , Xerostomia/etiologia
17.
Medicine (Baltimore) ; 99(26): e20788, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590759

RESUMO

BACKGROUND: Treatment for most patients with head and neck cancers includes ionizing radiation with or without chemotherapy. This treatment causes irreversible damage to salivary glands in the irradiation field accompanied by a loss of fluid-secreting acinar cells and a considerable decrease of saliva secretion. There is currently no adequate conventional treatment for this condition. In recent years, we developed an effective culture method to enhance the anti-inflammatory and vasculogenic phenotypes of peripheral blood mononuclear cells (PBMNCs), and such effectively conditioned PBMNC (E-MNC) therapy has shown promising improvements to the function of radiation-injured salivary glands in preclinical studies. However, the safety and effect of E-NMC therapy have yet assessed in human. The objective of this ongoing first-in-man study is to assess the safety, tolerability, and in part the efficacy of E-MNC therapy for treating radiation-induced xerostomia. METHODS/DESIGN: This phase 1 first-in-man study is an open-label, single-center, two-step dose escalation study. A total of 6 patients, who had no recurrence of head and neck cancer over 5 years following radiation therapy and suffered from radiation-induced xerostomia, will receive a transplantation of E-NMCs derived from autologous PBMNCs to a submandibular gland. The duration of the intervention will be 1 year. To analyze the recovery of salivary secretion, a gum test will be performed. To analyze the recovery of atrophic salivary glands, computed tomography (CT), and magnetic resonance imaging (MRI) of salivary glands will be conducted. The primary endpoint is the safety of the protocol. The secondary endpoints are the changes from baseline in whole saliva secretion and salivary gland atrophy. DISCUSSION: This will be the first clinical study of regenerative therapy using E-MNCs for patients with severe radiation-induced xerostomia. The results of this study are expected to contribute to developing the low-invasive cell-based therapy for radiation-induced xerostomia. TRIAL REGISTRATION: This study was registered with the Japan Registry of Clinical Trials (http://jrct.niph.go.jp) as jRCTb070190057.


Assuntos
Terapia Baseada em Transplante de Células e Tecidos/métodos , Leucócitos Mononucleares/transplante , Lesões por Radiação , Glândulas Salivares , Xerostomia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Imageamento por Ressonância Magnética/métodos , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Lesões por Radiação/fisiopatologia , Lesões por Radiação/terapia , Projetos de Pesquisa , Glândulas Salivares/diagnóstico por imagem , Glândulas Salivares/patologia , Glândulas Salivares/fisiopatologia , Glândulas Salivares/efeitos da radiação , Tomografia Computadorizada por Raios X/métodos , Transplante Autólogo/métodos , Resultado do Tratamento , Xerostomia/diagnóstico , Xerostomia/etiologia , Xerostomia/fisiopatologia , Xerostomia/terapia
18.
Medicine (Baltimore) ; 99(24): e20658, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32541507

RESUMO

BACKGROUND: With the number of cancer patients growing, radiotherapy and chemotherapy have been a necessary treatment. Unfortunately, there are many side effects after radiation and chemotherapy, one of which is xerostomia that always harasses patients. Although there are many ways of treatment of xerostomia, they have many disadvantages. With the rare side effects and the excellent effect, acupuncture has been widely applied to dry mouth after radiotherapy, but it has not been recognized as the standard treatment. Because acupuncture prescription is mostly different and the sample size of studies is small, we need more high-quality meta-analysis to provide relatively reliable evidence for the treatment of radiation-induced xerostomia. The objective of this study is to assess the curative effect of acupuncture treatment of cancer patients after radiotherapy and provide more reliable evidence for acupuncture treatment of xerostomia after radiotherapy for cancer patients. METHODS: We will search the following databases: CENTRAL (The Cochrane Central Register of Controlled Trials), MEDLINE, EMBASE, PubMed, CNKI (China National Knowledge Infrastructure), VIP (China Science and Technology Journal Database), Wan Fang Data Knowledge Service Platform. At any rate, 2 review authors will assess all randomized controlled trials (RCTs), seemingly conformance to the inclusion criteria, to confirm qualification, determine the risk of bias and extract data using a running data extraction form. The revolution of disagreements is a discussion. We will use the approach recommended by Cochrane reviews to assess the bias in studies. Risk ratios (RR) and 95% confidence intervals (CIs) will be used to assess the treatment effects of an intervention for dichotomous results. We will use mean differences (MD) and standard deviation (SD) to aggregate the data of every trial for continuous results. The heterogeneity test of Cochran and quantification of the I statistic will be used to assess the variation of treatment effects. Only if there are studies of semblable comparisons reporting the same results, we will conduct a meta-analysis. RESULTS: From the study, we will evaluate the efficacy of acupuncture for xerostomia patients who has cancer and been treated by radiation. CONCLUSION: The conclusion of this study will be the evidence, which can ensure the efficacy of acupuncture for cancer patients with radiation-evoked xerostomia among and provide guidance for the treatment of xerostomia. INPLASY REGISTRATION NUMBER: INPLASY202040211.


Assuntos
Terapia por Acupuntura , Metanálise como Assunto , Neoplasias/radioterapia , Lesões por Radiação/terapia , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Xerostomia/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Xerostomia/etiologia
19.
BMC Oral Health ; 20(1): 79, 2020 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-32188452

RESUMO

BACKGROUND: High incidence of treatable oral conditions has been reported among palliative patients. However, a large proportion of palliative patients lose their ability to communicate their sufferings. Therefore, it may lead to under-reporting of oral conditions among these patients. This review systematically synthesized the published evidence on the presence of oral conditions among palliative patients, the impact, management, and challenges in treating these conditions. METHODS: An integrative review was undertaken with defined search strategy from five databases and manual search through key journals and reference list. Studies which focused on oral conditions of palliative patients and published between years 2000 to 2017 were included. RESULTS: Xerostomia, oral candidiasis and dysphagia were the three most common oral conditions among palliative patients, followed by mucositis, orofacial pain, taste change and ulceration. We also found social and functional impact of having certain oral conditions among these patients. In terms of management, complementary therapies such as acupuncture has been used but not well explored. The lack of knowledge among healthcare providers also posed as a challenge in treating oral conditions among palliative patients. CONCLUSIONS: This review is first in its kind to systematically synthesize the published evidence regarding the impact, management and challenges in managing oral conditions among palliative patients. Although there is still lack of study investigating palliative oral care among specific group of patients such as patients with dementia, geriatric or pediatric advanced cancer patients, this review has however provided baseline knowledge that may guide health care professionals in palliative settings.


Assuntos
Saúde Bucal , Úlceras Orais/etiologia , Cuidados Paliativos/métodos , Doente Terminal , Xerostomia/etiologia , Idoso , Criança , Humanos , Doenças da Boca/etiologia
20.
BMC Oral Health ; 20(1): 86, 2020 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-32204705

RESUMO

BACKGROUND: The aim of the present study was to evaluate the effectiveness of intraductal irrigation using normal saline in chronic obstructive sialadenitis. METHODS: Patients who had one of the following symptoms were recruited: pain, swelling, stiffness, and dry mouth. A total of 58 salivary glands in 33 patients were diagnosed as having sialadenitis using sialography and ultrasonography. The patients were divided into two groups (swelling group and dry mouth group), according to the major complaint. Repeated intraductal irrigation was performed on each gland. Difference of symptom severity evaluated using numerical rating scale (NRS), and ductal width measured using ultrasonography were compared between the two groups. RESULTS: The average NRS score was significantly decreased from 6.0 to 3.3 after 3-5 visits of intraductal irrigation (P < 0.05). The reduction in NRS was greater in the swelling group than in the dry mouth group, although the difference between the groups was not statistically significant. There was no change of ductal width before and after the irrigation. CONCLUSIONS: Intraductal irrigation according to this study method using normal saline is a simple treatment for the patients with chronic obstructive sialadenitis. It provides a conservative treatment option reducing the subjective symptoms.


Assuntos
Solução Salina/uso terapêutico , Glândulas Salivares/diagnóstico por imagem , Sialadenite/tratamento farmacológico , Sialografia/métodos , Irrigação Terapêutica , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Humanos , Pessoa de Meia-Idade , Sialadenite/diagnóstico , Resultado do Tratamento , Ultrassonografia , Xerostomia/etiologia
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