scholarly journals Oral mucositis: the hidden side of cancer therapy

2020 ◽  
Vol 39 (1) ◽  
Author(s):  
Claudio Pulito ◽  
Antonio Cristaudo ◽  
Caterina La Porta ◽  
Stefano Zapperi ◽  
Giovanni Blandino ◽  
...  
Keyword(s):  
Oral Mucositis ◽  
Process Development ◽  
Treatment Strategies ◽  
Inflammation Response ◽  
Tnf Α ◽  
Assessment Guidelines ◽  
Antineoplastic Treatment ◽  
Mucositis Management ◽  
The Impact

Abstract Inflammation response of epithelial mucosa to chemo- radiotherapy cytotoxic effects leads to mucositis, a painful side effect of antineoplastic treatments. About 40% of the patients treated with chemotherapy develop mucositis; this percentage rises to about 90% for head and neck cancer patients (HNC) treated with both chemo- and radiotherapy. 19% of the latter will be hospitalized and will experience a delay in antineoplastic treatment for high-grade mucositis management, resulting in a reduction of the quality of life, a worse prognosis and an increase in patient management costs. Currently, several interventions and prevention guidelines are available, but their effectiveness is uncertain. This review comprehensively describes mucositis, debating the impact of standard chemo-radiotherapy and targeted therapy on mucositis development and pointing out the limits and the benefits of current mucositis treatment strategies and assessment guidelines. Moreover, the review critically examines the feasibility of the existing biomarkers to predict patient risk of developing oral mucositis and their role in early diagnosis. Despite the expression levels of some proteins involved in the inflammation response, such as TNF-α or IL-1β, partially correlate with mucositis process, their presence does not exclude others mucositis-independent inflammation events. This strongly suggests the need to discover biomarkers that specifically feature mucositis process development. Non-coding RNAs might hold this potential.

scholarly journals The Influence of Inflammation on Anemia in CKD Patients

2020 ◽  
Vol 21 (3) ◽  
pp. 725 ◽  
Author(s):  
Anna Gluba-Brzózka ◽  
Beata Franczyk ◽  
Robert Olszewski ◽  
Jacek Rysz
Keyword(s):  
Treatment Strategies ◽  
Progression Rate ◽  
Therapeutic Approaches ◽  
Pharmacological Interventions ◽  
Anemia Of Chronic Disease ◽  
New Therapeutic Approaches ◽  
Persistent Inflammation ◽  
Inflammatory State ◽  
The Impact

Anemia is frequently observed in the course of chronic kidney disease (CKD) and it is associated with diminishing the quality of a patient’s life. It also enhances morbidity and mortality and hastens the CKD progression rate. Patients with CKD frequently suffer from a chronic inflammatory state which is related to a vast range of underlying factors. The results of studies have demonstrated that persistent inflammation may contribute to the variability in Hb levels and hyporesponsiveness to erythropoietin stimulating agents (ESA), which are frequently observed in CKD patients. The understanding of the impact of inflammatory cytokines on erythropoietin production and hepcidin synthesis will enable one to unravel the net of interactions of multiple factors involved in the pathogenesis of the anemia of chronic disease. It seems that anti-cytokine and anti-oxidative treatment strategies may be the future of pharmacological interventions aiming at the treatment of inflammation-associated hyporesponsiveness to ESA. The discovery of new therapeutic approaches towards the treatment of anemia in CKD patients has become highly awaited. The treatment of anemia with erythropoietin (EPO) was associated with great benefits for some patients but not all.

Oral Mucositis Incidence and Severity after Methotrexate and Non-Methotrexate Containing GVHD Prophylaxis Regimens.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 351-351 ◽  
Author(s):  
Corey Cutler ◽  
Shuli Li ◽  
Haesook T. Kim ◽  
Patricia Laglenne ◽  
Colleen Ford ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Hospital Discharge ◽  
Cell Transplantation ◽  
Oral Mucositis ◽  
Gvhd Prophylaxis ◽  
Hospital Days ◽  
The Impact

Abstract Oral mucositis (OM) occurs in up to 75% of recipients of high-dose chemoradiotherapy conditioning regimens prior to allogeneic hematopoietic stem cell transplantation (HSCT). OM affects patient quality of life by causing oropharyngeal pain, and by impairing communication and swallowing. As a result, narcotic analgesia and total parenteral nutrition (TPN) are commonly required in the recovery period after HSCT. Methotrexate (MTX), an antiproliferative agent used as GVHD prophylaxis, impairs mucosal regeneration after conditioning-related injury, and worsens and prolongs OM. We assessed the impact of sirolimus, a novel immunosuppressive agent used in lieu of MTX for GVHD prophylaxis, on outcomes associated with OM. Methods: Two cohorts of patients were prospectively analyzed for OM severity, and chart reviews were performed to assess correlative outcomes. All patients underwent HLA-matched sibling PBSC transplantation after Cy-TBI conditioning. GVHD prophylaxis consisted of sirolimus/tacrolimus (ST) in the study group and tacrolimus/methotrexate (TM) in the control group. OM was assessed 3x/week using a prospectively validated 6-point assessment tool, by members of the Oral Medicine Service. At each assessment, the evaluators systematically evaluated for the presence of erythema and ulceration of the oral mucosa at nine pre-defined locations within the oral cavity. The use of narcotics and TPN was recorded from the time of transplantation to hospital discharge. Results: 30 patients received ST and 24 patients received TM as GVHD prophylaxis after HLA-matched PBSCT between 10/2000 and 5/2003. The two groups were balanced for demographic variables, including age, sex, and disease status at transplant. OM severity was reduced in the ST group. Mild, moderate and severe OM was noted in 37, 57 and 7% of the ST group and 8, 42 and 50% of the TM group (p=0.0002). As a result, TPN use was reduced in the ST group (17 vs. 43% of hospital days, p=0.02), and a higher proportion of subjects required no TPN in the ST group (47 vs. 21%, p=0.08). The total number of hospital days where narcotics were required for pain control was lower in the ST group in comparison with the TM group (14 vs. 16 days median, p = NS). The time from transplant to first hospital discharge was shorter in the ST group compared with the TM group (18 vs. 22 days median, p= 0.07) Conclusions: The use of ST for GVHD prophylaxis is associated with less severe oropharyngeal mucositis than TM, despite equivalent conditioning regimen intensity. As a result, TPN use was reduced, narcotic use was reduced and the duration of hospitalization was shortened. The use of less toxic GVHD regimens without MTX may have significant impact on patient quality of life, patient outcomes and economic outcomes associated with allogeneic stem cell transplantation.

Introduction: The Impact of Continuous Levodopa Infusion in the Treatment of Parkinson's Disease

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S7) ◽  
pp. 3-3 ◽  
Author(s):  
Erik Wolters
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Treatment Strategies ◽  
Resting Tremor ◽  
Endogenous Dopamine ◽  
Dopamine Signaling ◽  
The Impact ◽  
Dopaminergic Stimulation

Parkinson's disease was first described in 1817 by James Parkinson. Based on his observation of only six individuals, Parkinson accurately described the resting tremor and festinate gait, bradykinesia, and postural instability associated with the disease today. Parkinson's disease primarily affects people >50 years of age and causes progressive neurological degeneration, physical disability, and worsening quality of life.Consequently, most currently available drugs aim to restore striatal dopamine signaling. This can be best reached by increasing the supply of dopamine with oral levodopa (L-dopa), but also by stimulating dopamine receptors directly using dopamine agonists, or by inhibiting the reuptake of endogenous dopamine. Unfortunately, mainly due to the short half-life of L-dopa and the erratic absorption of oral L-dopa (causing pulsatile dopaminergic stimulation) these treatment strategies become increasingly ineffective in the course of this disease, and motor complications may further reduce the quality of life in these patients.

scholarly journals Overlooked Long-Term Complications of Colorectal Surgery

2019 ◽  
Vol 32 (03) ◽  
pp. 204-211 ◽  
Author(s):  
Matthew Giglia ◽  
Sharon Stein
Keyword(s):  
Quality Of Life ◽  
Colorectal Surgery ◽  
Treatment Strategies ◽  
Autonomic Nerve ◽  
Complication Rates ◽  
Low Anterior Resection Syndrome ◽  
Colon And Rectum ◽  
Surgical Field ◽  
The Impact

AbstractWhile colorectal surgery has been documented to have some of the highest complication rates in the surgical field, some of the more common, functional complications are often overlooked in the literature and in discussion with patients. Urinary, sexual, and defecatory dysfunction are common after colorectal surgery, especially after pelvic dissections, and may severely impact the postoperative quality of life for patients. These complications include urinary retention, erectile dysfunction, retrograde ejaculation, dyspareunia, infertility, and low anterior resection syndrome. The majority is rooted in autonomic nerve damage, both sympathetic and parasympathetic, that occurs during mobilization and resection of the sigmoid colon and rectum. While not all of these postoperative complications are preventable, treatment strategies have been developed to ameliorate the impact on quality of life. Given the high incidence and direct effect on patients, clinicians should be familiar with the etiology, prevention, and treatment strategies of these complications to provide the highest quality of care.

scholarly journals Pain in NMOSD and MOGAD: A Systematic Literature Review of Pathophysiology, Symptoms, and Current Treatment Strategies

2020 ◽  
Vol 11 ◽  
Author(s):  
Susanna Asseyer ◽  
Graham Cooper ◽  
Friedemann Paul
Keyword(s):  
Treatment Strategies ◽  
Current Treatment ◽  
Rare Disorders ◽  
Pain Syndromes ◽  
The Central Nervous System ◽  
Spectrum Disorders ◽  
Mixed Pain ◽  
The Impact

Neuromyelitis optica spectrum disorders (NMOSDs) and myelin oligodendrocyte glycoprotein-antibody-associated disease (MOGAD) are autoimmune inflammatory disorders of the central nervous system (CNS). Pain is highly prevalent and debilitating in NMOSD and MOGAD with a severe impact on quality of life, and there is a critical need for further studies to successfully treat and manage pain in these rare disorders. In NMOSD, pain has a prevalence of over 80%, and pain syndromes include neuropathic, nociceptive, and mixed pain, which can emerge in acute relapse or become chronic during the disease course. The impact of pain in MOGAD has only recently received increased attention, with an estimated prevalence of over 70%. These patients typically experience not only severe headache, retrobulbar pain, and/or pain on eye movement in optic neuritis but also neuropathic and nociceptive pain. Given the high relevance of pain in MOGAD and NMOSD, this article provides a systematic review of the current literature pertaining to pain in both disorders, focusing on the etiology of their respective pain syndromes and their pathophysiological background. Acknowledging the challenge and complexity of diagnosing pain, we also provide a mechanism-based classification of NMOSD- and MOGAD-related pain syndromes and summarize current treatment strategies.

scholarly journals Knowledge, Attitude and Behavior of Women toward Abnormal Menstrual Bleeding and Its Impact on Quality of Life

2015 ◽  
Vol 7 (1) ◽  
pp. 5-9
Author(s):  
Harpreet Kaur ◽  
Sushmita Sharma ◽  
SPS Goraya
Keyword(s):  
Quality Of Life ◽  
Treatment Strategies ◽  
Abnormal Uterine Bleeding ◽  
Menstrual Bleeding ◽  
Treatment Modalities ◽  
Patient’S Satisfaction ◽  
Abnormal Bleeding ◽  
And Behavior ◽  
The Impact

ABSTRACT Abnormal menstrual bleeding (AMB) is a common gynecological complaint. It may have serious repercussions on women's quality of life. Most of the studies on abnormal menstrual bleeding focus on the quantity of blood loss with little emphasis on the effect, it has on the quality of women's life. Recent research in the area of abnormal menstrual bleeding has recognized the importance of the ‘patient experience’ as an outcome that should be measured. So, it is very important to know about women's perception about the problem so that the healthcare professional can provide them appropriate care. The present study was undertaken to assess effect of AMB on various aspects of women's life and to assess their knowledge toward causes and management of AMB and its health impacts. Though majority of women know about abnormal bleeding as something serious, but still they lack in depth understanding of its consequences and various treatment modalities available. Significance for public research The article gives us valuable inputs regarding patient's viewpoint about abnormal uterine bleeding. Knowing the patients perceptions, their attitude toward abnormal menstrual bleeding and various social factors affecting it may be very helpful for the health professionals and researchers in knowing the impact of abnormal bleeding on quality of life and hence selecting the treatment strategies that will improve patient's satisfaction. How to cite this article Kaur H, Sharma S, Goraya SPS. Knowledge, Attitude and Behavior of Women toward Abnormal Menstrual Bleeding and Its Impact on Quality of Life. J South Asian Feder Obst Gynae 2015;7(1):5-9.

scholarly journals The positive impact of dental care on the patient's quality of life after cancer treatment: a case report

2020 ◽  
Vol 9 (9) ◽  
pp. e650997639
Author(s):  
Caroline Gomes Carvalho ◽  
João Victor Frazão Câmara ◽  
Paulo Sérgio da Silva Santos
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Oral Health ◽  
Cancer Treatment ◽  
Dental Treatment ◽  
Positive Impact ◽  
Antineoplastic Treatment ◽  
After Cancer ◽  
The Impact

Objective: To report the case of a patient after cancer treatment and evaluate the impact of oral health on quality of life, through the Oral Health Impact Profile (OHIP-14) before, during, and after dental treatment. Methodology: A patient after antineoplastic treatment attended the clinic specialized. In all consultations, OHIP-14 was applied. Case report: A 68-year-old man diagnosed with keratinizing squamous cell carcinoma of the larynx (T3N0MX), undergoing chemotherapy and adjuvant radiotherapy (2878.2 Grays) and vertical partial laryngectomy surgery without ganglionic emptying. After CT, he complained of tooth loss and discomfort in the tongue after radiotherapy. Ex-drinker for 5 years, ex-smoker for 6 months, but alcoholic for> 10 years and smoker <50 years. Side effects of antineoplastic treatment included labial dryness, hyposalivation, dental fractures, residual roots, changes in swallowing, pain during mouth opening, and cervical movement. The results OHIP-14 was medium (17.85), weak (3.52), weak (2.84) and null impact of oral health on quality of life in the initial consultation, throughout the dental treatment, at the end of dental treatment and 1 year and 2 months after dental treatment, respectively. There was a high impact on psychological discomfort (3.55), medium on psychological disability (1.6), and functional limitation (2.04), in 2015, 2017, and 2018, respectively. Conclusion: The performance of the dentist on the late oral effects of chemotherapy and radiotherapy had a positive impact on improving the quality of life after cancer treatment, with the help of the multidisciplinary team. 

Pulmonary disorders and sleep

2017 ◽  
Author(s):  
Sandrine H. Launois ◽  
Patrick Lévy
Keyword(s):  
Neuromuscular Disorders ◽  
Treatment Strategies ◽  
Chronic Obstructive ◽  
Sleep Related Breathing Disorders ◽  
Obstructive Pulmonary Disease ◽  
Breathing Disorders ◽  
Obstructive Sleep ◽  
Pulmonary Disorder ◽  
The Impact

Sleep disorders and pulmonary diseases are closely associated, a fact clearly underestimated in routine patient care, despite evidence that these disorders interact to impact on quality of life as well as on morbidity and mortality. The prevalence of chronic insomnia, sleep-related breathing disorders, and restless leg syndrome is high in patients with chronic pulmonary disorders such as asthma, chronic obstructive pulmonary disease, cystic fibrosis, interstitial lung disease, chest wall and neuromuscular disorders, and chronic respiratory failure. This association may be fortuitous and reflect the impact of a chronic condition on sleep quality, or it may be due to specific sleep-related phenomena adversely affecting an underlying pulmonary disorder. Furthermore, obstructive sleep apnea has been implicated as a risk factor for pulmonary hypertension and pulmonary embolism. This chapter outlines the implications for both pulmonary and sleep specialists, in terms of clinical management and treatment strategies.

scholarly journals Perception and acceptance of the use of 0.2% polyhexanide versus 0.12% chlorhexidine digluconate in patients at a risk of developing oral mucositis.

2020 ◽  
Vol 9 (3) ◽  
pp. 187-194
Author(s):  
Natalia Garcia Santaella ◽  
◽  
Maiara Gabriela Gonçales ◽  
Lázara Joyce Oliveira Martins ◽  
Bárbara Margarido Brondino ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Mucositis ◽  
Mouth Rinse ◽  
Chlorhexidine Digluconate ◽  
Physical Pain ◽  
Antineoplastic Treatment ◽  
Group 2 ◽  
Study Participants ◽  
Group 1

Objective: To evaluate the perception and acceptance of using polyhexanide (PHMB) and chlorhexidine digluconate (CLX) in individuals at a risk of developing oral mucositis induced by chemoradiotherapy. Materials and Methods: This is a randomised comparative study. Participants were randomised into two groups: Group 1 (PHMB 0.2%) and Group 2 (CLX 0.12%), these groups performed a mouth rinse with the respective solutions for 1 minute every 12 hours during an antineoplastic treatment cycle. The participants were evaluated at three different times: before (t0), during (t1) and after a cycle of antineoplastic treatment (t2). Severity of oral mucositis (OM), mouth pain, quality of life (OHIP-14), oral hygiene index and assessment of the acceptance of the substances in the mouth were assessed. Results: There were 23 individuals, 12 in Group 1 (G1) and 11 in Group 2 (G2). Both groups presented with OM in all three evaluations. Reported mouth pain was lower in G1 than in G2. The PHMB had a better acceptance (p=0.012) than the CLX for the time of mouth rinse at t0. There was a lower impact in the quality of life from oral health in the physical pain aspect (p=0.019) and in social incapacity (p=0.037) in G1 than in G2. Conclusions: PHMB has the same acceptance compared to CLX and is a good option for antiseptic mouth rinse with less adverse effects

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