scholarly journals Impact of the absence of dental support on cancer patients during the COVID-19 pandemic

Author(s):  
Verônica Caroline Brito Reia ◽  
Maria Gabriela Robles-Mengoa ◽  
Bernardo da Fonseca Orcina ◽  
Milenka Gabriela Quenta-Huayhua ◽  
Mailon Cury Carneiro ◽  
...  

Abstract Purpose With the suspension of routine services due to the coronavirus disease-2019 (COVID-19) pandemic, a significant number of the population has been presenting acute oral alterations without proper treatment. Through telecontact, this study aimed to identify individuals in treatment and had been treated for cancer who had their clinical dental care interrupted by the COVID-19 pandemic. Methods Individuals with oncologic diseases were selected from a telephone list of a clinical research center specializing in the care of cancer patients. We included those who answered an online questionnaire about their general health status and oral problems when they were unable to access dental care during the pandemic. Statistical analysis was performed using Fisher and Chi-square tests. The significance level was set at 5% (p<0.05). Results Of the 280 patients recruited, 104 answered the questionnaire. There were 75 (72.1%) were women, of which 22 (36.7%) were under antineoplastic treatment, and 30 (68.2%) had already been treated; 29 (27.9%) were men, of which 15 (25.0%) were under antineoplastic treatment and 14 (31.8%) had already been treated. Of the universal sample, 64 (61.5%) had no complaints regarding their general health, and 74 (71.1%) had no difficulties in their daily activities due to teeth/mouth problems. However, the rates of oral problems were not statistically significant (p=NS). Conclusion In dentistry, telephone support and digital tools are useful and necessary instruments for the follow-up of cancer patients during the pandemic.

2013 ◽  
Vol 88 (1) ◽  
pp. 56-63
Author(s):  
Eudes Euler de Souza Lucena ◽  
Ana Claudia de Queiroz Castro ◽  
Danielle Bezerra de Farias ◽  
Pérola Teixeira de Lima ◽  
Éricka Janine Dantas da Silveira ◽  
...  

BACKGROUND: Ephelides are small hyperpigmented macules common in the skin, presenting as areas with increased melanin production. Ephelides are observed in genetically predisposed individuals, particularly fair-skinned people highly susceptible to sunburn. OBJECTIVES: This study aimed to determine the prevalence of lip and perioral ephelides in 362 beach workers in the city of Natal (Rio Grande do Norte) and to investigate potential associations with sociodemographic, occupational and general health. METHODS: For this purpose clinical tests were performed by calibrated examiners in the epidemiological area around the lips and the area bounded laterally by the nasolabial groove and at the bottom by the chin. A questionnaire was completed and assessed. The possible associations between sociodemographic variables, occupational and general health with the presence of lip and perioral ephelides were evaluated by chi-square test for a significance level of 5%. RESULTS: Approximately one third of the workers were affected by perioral ephelides (33.7%) and around a quarter of them by lip ephelides (24.0%). Gender was the only variable significantly associated with the presence of perioral ephelides (p = 0.002), unlike lip ephelides which proved to be significantly associated with habits (p = 0.036) and alcoholism (0.030). CONCLUSIONS: The prevalence of ephelides in lip and perioral region was high in the study population, with gender and certain habits associated with its occurrence.


2017 ◽  
Vol 11 (03) ◽  
pp. 317-322 ◽  
Author(s):  
Naser Sargolzaie ◽  
Hamid Reza Arab ◽  
Marzieh Mohammadi Moghaddam

ABSTRACT Objective: The purpose of this clinical study was to evaluate the effect of implant body form (cylindrical and conical implants) on crestal bone levels during 6 months' follow-up after loading. Materials and Methods: A total of 32 SPI implants (19 conical implants/13 cylindrical implants) were randomly placed in 12 male patients using a submerged approach. None of the patients had compromising medical conditions or parafunctional habits. Periapical radiographs using the parallel technique were taken after clinical loading and 6 months later. Clinical indices including pocket depth and bleeding on probing (BOP) were recorded on 6-month follow-up. Data were analyzed by independent samples t-test and Chi-square test with a significance level of 0.05. Results: Six months after loading, crestal bone loss was 0.84 (±0.29) mm around the cylindrical implants and 0.73 (±0.62) mm around the conical types, which was not significantly different (P = 0.54). Pocket depth around the cylindrical and conical implants was 2.61 (±0.45) mm and 2.36 (±0.44) mm, respectively (P = 0.13). BOP was observed among 53.8% and 47.4% of the cylindrical implants and conical (P = 0.13). Bone loss and pocket depth in the maxilla and mandible had no significant difference (P = 0.46 and P = 0.09, respectively). Conclusion: In this study, although bone loss and clinical parameters were slightly higher in the cylindrical implants, there was no significant difference between the conical- and cylindrical-shaped implants.


2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Jisleny da Cruz Pereira ◽  
Marcio Roberto Silva ◽  
Ronaldo Rodrigues da Costa ◽  
Mark Drew Crosland Guimarães ◽  
Isabel Cristina Gonçalves Leite

OBJECTIVE To analyze the cases of tuberculosis and the impact of direct follow-up on the assessment of treatment outcomes.METHODS This open prospective cohort study evaluated 504 cases of tuberculosis reported in the Sistema de Informação de Agravos de Notificação (SINAN – Notifiable Diseases Information System) in Juiz de Fora, MG, Southeastern Brazil, between 2008 and 2009. The incidence of treatment outcomes was compared between a group of patients diagnosed with tuberculosis and directly followed up by monthly consultations during return visits (287) and a patient group for which the information was indirectly collected (217) through the city’s surveillance system. The Chi-square test was used to compare the percentages, with a significance level of 0.05. The relative risk (RR) was used to evaluate the differences in the incidence rate of each type of treatment outcome between the two groups.RESULTS Of the outcomes directly and indirectly evaluated, 18.5% and 3.2% corresponded to treatment default and 3.8% and 0.5% corresponded to treatment failure, respectively. The incidence of treatment default and failure was higher in the group with direct follow-up (p < 0.05) (RR = 5.72, 95%CI 2.65;12.34, and RR = 8.31, 95%CI 1.08;63.92, respectively).CONCLUSIONS A higher incidence of treatment default and failure was observed in the directly followed up group, and most of these cases were neglected by the disease reporting system. Therefore, effective measures are needed to improve the control of tuberculosis and data quality.


2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 57-57
Author(s):  
Neha Gupta ◽  
Shipra Gandhi ◽  
Sidra Anwar ◽  
Katy Wang ◽  
Yashodhara Satchidanand

57 Background: Many cancer patients (pts) with GU cancer suffer from uncontrolled pain, and may benefit from more focused palliative care. We assessed the frequency and impact of specialist PCC referrals on pain management of our GU Medical oncology clinic (GUMOC) pts. Methods: 239 consecutive pts were collected from a retrospective review of GUMOC records from 12/1/2013 to 2/28/2014. This group of pts was used to assess the frequency of PCC referral. Pts were divided into two arms- Arm A= GUMOC pts referred to PCC; Arm B: GUMOC pts not referred to PCC. To be able to detect a 15% between the two arms at 95% significance, 37 additional pts (who were already being seen at GUMOC) were collected from retrospective review of PCC records over 9/1/2013 to 2/28/2014. Total 276 pts were divided into Arm A (n=49), Arm B (n=227 pts). Data for baseline pain score and 4-week follow up pain scores were collected. A palliative care screening tool (retrieved from Center to Advance Palliative care [CAPC] website) was used to assign palliative care screening score (PCSS) to all study pts. Chi square test and T-test were used for statistical analysis. Results: Out of the 239 initially collected GUMOC pts, 5% were referred to PCC. 10% (n=24) had PCSS score of ≥ 4, and 33% pts with PCSS ≥ 4 were referred to PCC. Arm A had worse baseline symptoms, ECOG status and more advanced cancer stage. 4-week pain score follow up revealed significant improvement in Arm A -2.74 vs. Arm B -0.13 (p<0.01). Conclusions: GU cancer pts who are referred to PCC from medical oncology clinic have significant decrease in pain symptoms. Frequency of PCC consultation is still low in comprehensive cancer institutes, and not in congruence with the available palliative care screening tools criteria suggested by CAPC. Standardized tools should be developed to guide PCC referrals, and routine use of these tools will significantly help in pain control by seeking specialist palliative care.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mieke H. Bakker ◽  
Arjan Vissink ◽  
Gerry M. Raghoebar ◽  
Lilian L. Peters ◽  
Anita Visser

Abstract Background Cross-sectional studies have shown that elderly with a natural dentition have better general health than edentulous elderly, but this has not been confirmed in studies with longitudinal design. Methods This prospective longitudinal study with a follow-up of 8 years aimed to assess differences in general health, healthcare costs and dental care use between elderly with a natural dentition and edentulous elderly wearing implant-retained or conventional dentures. Based on data of all national insurance claims for dental and medical care from Dutch elderly (aged ≥75 years) general health outcomes (chronic conditions, medication use), healthcare costs and dental care use could be assessed of three groups of elderly, viz. elderly with a natural dentition, elderly with conventional dentures and elderly with implant-retained overdentures. Results At baseline (2009), a total of 168,122 elderly could be included (143,199 natural dentition, 18,420 conventional dentures, 6503 implant-retained overdentures). Here we showed that after 8 years follow-up elderly with a natural dentition had more favorable general health outcomes (fewer chronic conditions, less medication use), lower healthcare costs and lower dental costs – but higher dental care use – than edentulous elderly. At baseline the general health of elderly with an implant-retained overdentures resembled the profile of elderly with a natural dentition, but over time their general health problems became comparable to elderly with conventional dentures. Conclusions It was concluded that elderly with a natural dentition had significant better health and lower healthcare costs compared to edentulous elderly (with or without dental implants).


2021 ◽  
Vol 14 ◽  
pp. 117863882199712
Author(s):  
Jacksaint Saintila ◽  
Yaquelin E Calizaya-Milla ◽  
David J Javier-Aliaga

Background: The vegetarian diet continues to gain recognition and popularity among people; however, few studies have considered the level of knowledge of professional dietitians about this dietary pattern. Objective: This study aimed to compare the level of knowledge of vegetarian and nonvegetarian Peruvian dietitians regarding vegetarianism at different life stages. Methods: A cross-sectional study was carried out. An online questionnaire based on the recommendations of the current dietary guidelines was administered to more than 400 registered dietitians. Of which, a total of 179 decided to participate in the study: 72 vegetarians and 107 nonvegetarians. The data were analyzed using the chi-square test, considering a significance level of 5%. Results: Women represented the largest proportion of the sample. The participants demonstrated a complete and exhaustive knowledge of the definition of vegetarian diets. Regarding the risks and benefits associated with vegetarianism, the largest proportion of those who got the correct answers were vegetarians. The percentage of correct answers selected for both groups regarding the critical nutrients were less than 50%. Only 17.6% identified the correct answer regarding the risk of eating disorders of vegetarianism. Conclusions: Dietitians did not demonstrate complete and comprehensive knowledge of the critical nutrients of vegetarianism and lack information on the risks of eating disorders from the vegetarian diet.


Author(s):  
Loghman Ghaderi ◽  
Ali Reza Naseri

Background: Chemotherapy-induced neutropenia is one of the risk factors for infection in patients undergoing chemotherapy (due to the weakened immune system). Febrile neutropenia (FN) may be the sole indicator of an underlying infection in these patients. Objectives: Since infection is associated with an increased risk of mortality in patients undergoing chemotherapy, the present study aimed to assess the incidence of FN in neutropenic cancer patients admitted to an oncology ward. Methods: This retrospective, descriptive, and cross-sectional study was conducted on 52 patients (selected using the census method) with signs of infection (i.e., FN) hospitalized in Ghazi Tabatabai Hospital in Tabriz, Iran, within 2018 - 2020. The data were collected by a researchermade form and analyzed using descriptive statistics (e.g., frequency, percentage, and mean) and chi-square in SPSS software (version 20). The significance level was considered less than 0.05 Results: The absolute neutrophil count was less than 500 cells/ml in 15.38% of the patients (n = 8). Infection was the cause of FN in 69.23% of the subjects (n = 36). An unknown factor was the cause of infection in 30.77% of the cases. The incidence of all types of infections (i.e., perianal abscess, sepsis, oral infection, cutaneous infection, gastrointestinal infection, pharyngitis, pneumonia, and urinary tract infection) was higher in patients undergoing chemotherapy than that reported for those not receiving chemotherapy. Conclusions: The results of this study suggested that cancer patients undergoing chemotherapy should be aware of infection signs; accordingly, they can visit treatment centers in case of the first symptoms of infection to prevent progression of infection and reduce mortality rates.  


2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Karine Marques Costa dos Reis ◽  
Cristine Alves Costa de Jesus

Objetivo: Analisar a funcionalidade e os sintomas de pacientes oncológicos em fim de vida durante internação em unidade especializada em cuidados paliativos. Método: Trata-se de avaliação longitudinal da admissão até o óbito, com monitorização semanal da funcionalidade e score de sintomas, de 59 participantes. Utilizou-se o teste paramétrico Wilcoxon pareado, para avaliação da mediana dos scores de sintomas e funcionalidade com nível de significância de 5%. Resultados: A amostra do estudo consistiu em indivíduos do sexo feminino, com idade média de 60 anos e funcionalidade limitada. Predominou o diagnóstico de câncer do trato digestório. Quanto a avaliação dos sintomas e funcionalidade, considerando a segunda e terceira semana de internação observou-se melhora do score dor, cansaço e tristeza, como também da função. Conclusão: Apesar de internação tardia e com grande extensão da doença, o participante apresentou melhora de alguns sintomas sugerindo o benefício dos cuidados paliativos. Em unidade especializada, houve melhora dos sintomas dor, cansaço e tristeza, com também da funcionalidade dos participantes em duas semanas de internação. Assim, esses achados corroboram quanto a importância do cuidado baseado no conforto e auxiliará na elaboração de políticas públicas e no planejamento do cuidado do enfermeiro.Descritores:  Cuidados Paliativos; Sinais e Sintomas; Neoplasias; Enfermagem. Longitudinal follow-up of the management of symptoms in specialized palliative oncological care serviceObjective: To analyze the functionality and symptoms of end-of-life cancer patients during hospitalization in a specialized unit in palliative care. Method: This is a longitudinal assessment from admission to death, with weekly monitoring of functionality and symptom score, of 59 participants. The paired Wilcoxon parametric test was used to assess the median of symptom scores and functionality with a significance level of 5%. Results: The study sample consisted of female individuals, with an average age of 60 years and limited functionality. The diagnosis of cancer of the digestive tract predominated. Regarding the assessment of symptoms and functionality, considering the second and third week of hospitalization, an improvement was noted in the pain, tiredness and sadness score, as well as in function. Conclusion: Despite late hospitalization and with a large extent of the disease, the participant showed improvement in some symptoms suggesting the benefit of palliative care. In a specialized unit, the symptoms of pain, tiredness and sadness, as well as the functionality of the participants in the weeks of hospitalization. Therefore, these results corroborate the importance of care based on convenience and assistance in the development of public policies and guide the planning of care for the sick.Descriptor: Palliative Care; Signs and Symptoms; Neoplasms; Nursing.Seguimiento longitudinal del manejo de sintomas en servicio especializado de atención oncológica paliativaObjetivo: Analizar la funcionalidad y los síntomas de los pacientes con cáncer al final de la vida durante la hospitalización en una unidad especializada de atención paliativa. Método: Esta es una evaluación longitudinal desde el ingreso hasta la muerte, con monitoreo semanal de la funcionalidad y la puntuación de los síntomas, de 59 participantes. La prueba de Wilcoxon paramétrica pareada se utilizó para evaluar la mediana de las puntuaciones de los síntomas y la funcionalidad con un nivel de significación del 5%. Resultados: La muestra del estudio consistió en individuos femeninos, con una edad promedio de 60 años y funcionalidad limitada. Predominó el diagnóstico de cáncer del tracto digestivo. En cuanto a la evaluación de los síntomas y la funcionalidad, considerando la segunda y tercera semana de hospitalización, se observó una mejora en el puntaje de dolor, cansancio y tristeza, así como en la función. Conclusión: A pesar de la hospitalización tardía y con una gran extensión de la enfermedad, el participante mostró una mejoría en algunos síntomas que sugieren el beneficio de los cuidados paliativos. En una unidad especializada, los síntomas de dolor, cansancio y tristeza, así como la funcionalidad de los participantes en las semanas de hospitalización. Por lo tanto, estos resultados corroboran la importancia de la atención basada en la conveniencia y la asistencia en el desarrollo de políticas públicas y guían la planificación de la atención a los enfermos.Descriptor: Cuidados Paliativos; Signos Y Síntomas; Neoplasias; Enfermería.


2021 ◽  
Vol 8 (10) ◽  
pp. 253-268
Author(s):  
Maryam Ghasemisarukolai

As a result of the global crisis caused by the coronavirus outbreak in late December 2019, Iran was also severely affected. The three provinces of Tehran, Mazandaran, and Gillan were high-risk cities exposed to infection and grievously damaged. Therefore, we decided to look at the level of knowledge, depth of attitude, and quality of physicians' practice in these three provinces. The most significant goal was to assess the level of KAP relative to the COVID-19 virus to provide comprehensive information to identify the strengths and weaknesses of the treatment staff to better cope and more effectively prevent and control critical situations. For research methodology, a cross-sectional study was performed on a sample of 300 people using a self-made questionnaire. An online questionnaire via virtual networks and a paper questionnaire were also distributed by the principal author in medical hospitals, which included four sections: demographic information, knowledge, attitude, and practice. Cronbach's alpha confirmed the validity and reliability of each component. The final results prove that the knowledge of physicians was acceptable and significant at the level of 0.05. Physicians' attitudes showed a level of fear and anxiety that was significant according to a one-sample t-test and chi-square (Sig <0.05). In order to rank the physicians' practice, a T-test was used, and the results of the Friedman test in the first stage of the Chi-square test showed that the significance level is 0.05. Looking at the research results, it can be said that the development of educational programs can have a beneficial effect in increasing physicians' knowledge and controlling the disease as effectively as possible. Also, due to the attitude associated with stress and fear, it can be seen that providing laboratory and treatment equipment has been one of the concerns of physicians.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18110-e18110
Author(s):  
Madeline MacDonald ◽  
Yuanyuan Lu ◽  
Ethan Song ◽  
Noura Ayoubi ◽  
Katherine Robinson ◽  
...  

e18110 Background: Cancer is the second leading cause of death in the United States and approximately 38.4% of Americans will be diagnosed with cancer during their lifetime. Cancer treatment and follow-up care is expensive and uninsured individuals may face barriers to receiving necessary treatments. Minorities may encounter additional barriers to accessing healthcare. There is limited research about socioeconomic disparities in uninsured cancer patients seen at free clinics in the United States. Methods: A retrospective chart review was conducted to collect chronic disease parameters from electronic medical records and paper charts at nine free clinics in the Tampa Bay area in Florida. Demographics were compared between cancer patients and the non-cancer population via chi-square test or independent samples t-test. Results: Between January 2016 and December 2017, 9127 uninsured patients were seen at nine free clinics. 2137 patients were excluded from the study because there was no cancer data in their charts. Of the patients included in the study, 221 (3.2%) had a current or past diagnoses of cancer. Cancer patients were more likely to be female (n = 145, 65.9), p = 0.048, compared to non-cancer patients. Cancer patients were more likely to be Caucasian (n = 106, 89.1%), p < 0.001 compared to non-cancer patients (n = 2489, 69.3%). Cancer patients were less likely to be African American compared to non-cancer patients (n = 6, 5.0% vs. n = 754, 21%), p < 0.001. Cancer patients were significantly older than non-cancer patients (M = 54.1, SD = 12.0) vs. (M = 41.0, SD = 16.7), p < 0.001. Patients who had cancer were more likely to be unemployed compared to non-cancer patients (n = 78, 54.9% vs. n = 1685, 46.6%), p = 0.050. Conclusions: The study revealed that uninsured cancer patients are more likely to be unemployed, female, of older age, and Caucasian compared to non-cancer patients. It appears that uninsured African Americans are not utilizing free clinics for their healthcare and may be lost to follow-up. A variety of factors may have contributed to these disparities in this vulnerable population including lack of transportation, lack of awareness of free resources in the area, and more. This study increases awareness of disparities in uninsured, cancer patients.


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