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INTRODUCTION: Oral mucositis is an iatrogenic condition of erythematous inflammatory changes which tends to occur on buccal and labial surfaces, the ventral surface of the tongue, the floor of the mouth and the soft palate of patients receiving chemotherapy. This protocol of ongoing randomised parallel group clinical trial aims to access the therapeutic effect of an herbal gel containing 2.5% Arrabidaea chica Verlot standardised extract on oral mucositis in patients with head and neck cancer compared with low-level laser therapy. METHODS AND ANALYSIS: Patients with head and neck cancer held at Clinics Hospital of University of Campinas, Sao Paulo, who develop early signs/symptoms of oral mucositis are eligible. Baseline characteristics of participants include oral mucositis grade and quality of life assessments. Enrolment started in November 2017 with allocation of patients to one of the study groups by means of randomisation. Patients will be treated either with Arrabidaea chica or laser until wound healing. Monitoring includes daily assessment of mucositis grade and diameter measurement by photographs and millimetre periodontal probe. Treatments will be concluded once mucositis is healed. A blinded assessor will evaluate mucositis cure after referred by the study team. At this point, the gel tube will be weighed to indirectly assess patient's compliance. At close-out, data will be analysed by a blinded researcher following the procedures described in the statistical analyses. ETHICS AND DISSEMINATION: This clinical trial was approved by the ethics committee of research in humans at the Faculty of Medical Sciences of University of Campinas (report no. 1,613,563/2016). Results from this trial will be communicated in peer-reviewed publications and scientific presentations. TRIAL REGISTRATION NUMBER: RBR-5×4397.
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Protocolos Antineoplásicos/normas , Bignoniaceae , Terapia com Luz de Baixa Intensidade/métodos , Extratos Vegetais/uso terapêutico , Estomatite/tratamento farmacológico , Feminino , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
UNLABELLED: Halitosis is an embarrassing symptom with a significant social impact. Halitosis affects millions of people worldwide and many resources are spent annually in products to improve halitus, unsuccessfully. The study of halitosis in a scientific basis is justified once halitosis causes social restriction, decreases life quality and may be an indication of serious diseases. AIM: To elaborate a protocol for halitosis assessment in order to minimize costs, avoid unnecessary tests and provide a guideline for diagnosis. METHODS: The protocol was created based on the literature and on the authors personal experiences, adopting an evidence-based anamnesis. RESULTS: There are many causes of halitosis and most of them are related to the oral cavity; others are related to otolaryngologic and respiratory diseases. Gastrointestinal diseases, liver/renal impairment and other metabolic syndromes are less frequent, but also important causes of halitosis. CONCLUSION: There are important costs involved in halitosis assessment and treatment, including medical appointments, specialist assessment, and complementary tests. Such costs would be minimized by adopting a protocol of evidence-based anamnesis and a flowchart for a rational clinical investigation.
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Halitose/etiologia , Protocolos Clínicos , Medicina Baseada em Evidências , Humanos , AnamneseRESUMO
Introduction Foreign body in the oral cavity may be asymptomatic for long time and only sometimes it can lead to a typical granulomatous foreign body reaction. Some patients may complain of oral pain and present signs of inflammation with purulent discharge. A granuloma is a distinct, compact microscopic structure composed of epithelioid-shaped macrophages typically surrounded by a rim of lymphocytes and filled with fibroblasts and collagen. Nowadays, the increase of cosmetic invasive procedures such as injection of prosthetic materials in lips and cheeks may lead to unusual forms of inflammatory granulomas. Objectives Describe an unusual presentation of a foreign body reaction in the buccal mucosa due to previous injection of cosmetic agent. Resumed Report A 74-year-old woman was referred to the Department of Otorhinolaryngology, Head and Neck Surgery to investigate the presence of multiple painless, bilateral nodules in the buccal mucosa, with progressive growth observed during the previous 2 months. The histologic results showed a foreign body inflammatory reaction. Conclusion Oral granulomatosis lesions represent a challenging diagnosis for clinicians and a biopsy may be necessary. Patients may feel ashamed to report previous aesthetic procedures, and the clinicians must have a proactive approach.
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Linear epidermal nevus is an uncommon diagnosis of benign lesions of the oral cavity. It is characterized by a congenital malformation arising from the ectoderm cells, which are arranged according to a typical linear configuration known as Blaschko's lines. We report a case of linear epidermal nevus of oral cavity in a 51-year-old lady or woman. The linear epidermal nevus of the oral cavity, although rare, can be considered a differential diagnosis of oral papillomatosis (OP). The histopathological studies and detailed description are the center of the diagnostic and clinical evolution.
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A Halitose é um sintoma constrangedor com significativo impacto social. Ela afeta milhões de pessoas ao redor do mundo e muitos recursos são investidos em produtos para a melhora do hálito, sem sucesso. O estudo da halitose com uma abordagem científica se justifica, uma vez que a halitose é causa de restrição social, diminui a qualidade de vida e pode ser indicativo da presença de doenças mais graves. OBJETIVO: Elaborar um protocolo de avaliação da halitose com o objetivo de minimizar custos, evitar exames desnecessários e orientar o diagnóstico causal. MÉTODO: O protocolo foi elaborado baseado na literatura e na experiência pessoal dos autores, adotando uma anamnese baseada em evidências. RESULTADO: Existem muitas causas da halitose e a maioria delas está relacionada com a cavidade oral, outras estão relacionadas com doenças otorrinolaringológicas e respiratórias. Doenças gastrointestinais, alterações das funções renais e hepáticas e outras síndromes metabólicas são causas menos freqüentes, porém importantes de halitose. CONCLUSÃO: Existem custos importantes envolvidos no diagnóstico e tratamento da halitose, incluindo consultas ambulatoriais, avaliação de especialistas e exames complementares. Estes custos poderiam ser minimizados adotando uma anamnese baseada em evidências e um organograma para uma investigação clínica racional.
Halitosis is an embarrassing symptom with a significant social impact. Halitosis affects millions of people worldwide and many resources are spent annually in products to improve halitus, unsuccessfully. The study of halitosis in a scientific basis is justified once halitosis causes social restriction, decreases life quality and may be an indication of serious diseases. AIM: To elaborate a protocol for halitosis assessment in order to minimize costs, avoid unnecessary tests and provide a guideline for diagnosis. METHODS: The protocol was created based on the literature and on the authors personal experiences, adopting an evidence-based anamnesis. RESULTS: There are many causes of halitosis and most of them are related to the oral cavity; others are related to otolaryngologic and respiratory diseases. Gastrointestinal diseases, liver/renal impairment and other metabolic syndromes are less frequent, but also important causes of halitosis. CONCLUSION: There are important costs involved in halitosis assessment and treatment, including medical appointments, specialist assessment, and complementary tests. Such costs would be minimized by adopting a protocol of evidence-based anamnesis and a flowchart for a rational clinical investigation.
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Humanos , Halitose/etiologia , Protocolos Clínicos , Medicina Baseada em Evidências , AnamneseRESUMO
Objetivo: Este artigo tem o objetivo de analisar dadosepidemiológicos e clínicos do serviço de faringoestomatologia dadisciplina de otorrinolaringologia, cabeça e pescoço de todos ospacientes atendidos nos primeiros dez meses de funcionamento.Método: Foram atendidos 41 pacientes, a idade média dospacientes atendidos foi de 52 anos (12-80). Resultados: O tempomédio de duração das queixas principais foi de 38 meses. A queixamais frequente foi lesão na cavidade oral, seguida de xerostomiae ardência bucal. Dez (24%) dos 41 pacientes eram tabagistase seis (14%) ex-tabagistas. As patologias mais frequentes foramcandidíase, refluxo faringolaríngeo, má adaptação da prótesedentária, leucoplasias e síndrome da ardência bucal. A presençade serviços de faringoestomatogia em hospitais terciários éessencial para a avaliação, seguimento e tratamento adequado depacientes com patologias específicas da área. Conclusão: Houvediversidade e riqueza de situações clínicas em nosso serviço.Alguns hábitos como o tabagismo, uso e manutenção inadequadosde prótese dentária foram bastante frequentes. A abordagemmultidisciplinar na avaliação e tratamento dos pacientes faz partedo serviço contribuindo para uma melhor formação do residente.
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Uma grande dificuldade encontrada pelos histopatologistas é graduar a malignidade de uma neoplasia. Muitos estudos têm sido realizados na tentativa de facilitar essa gradaçäo e alguns incluem a técnica que evidencia as regiöes organizadoras nucleolares (NORs). Assim sendo, e diante da possibilidade da técnica de AgNOR favorecer este estudo, propusemo-nos a observar diferenças quantitativas das NORs entre o tumor epitelial benigno, denominado papiloma, e o tumor epitelial maligno, denominado carcinoma de células escamosas. A técnica histoquímica utilizada para visualizaçäo das NORs foi a coloraçäo pelo nitrato de prata. Foram coradas 20 lâminas: 10 para os casos de papiloma e 10 para os de carcinoma de células escamosas. As lâminas foram observadas ao microscópio de luz. Após a contagem, foi realizada a análise estatística dos resultados, näo se observando diferença estatisticamente significante entre os valores de NORs por célula nos dois tipos de lesöes