Background and Objectives: This research attempts to provide a clear view of the literature on randomized clinical trials (RCTs) concerning the efficacy of topical dexamethasone, clobetasol and budesonide in oral graft versus host disease (GVHD). Materials and Methods: An electronic search of the PubMed, Web of Science and Scopus databases was carried out for eligible RCTs. Studies were included if they had adult patients with oral GVHD treatment with topical corticosteroids, and if the RCT study was published in English. The Cochrane Risk of Bias tool was used to assess the quality of these studies. Overall, three RCTs were included (an Open, Randomized, Multicenter Trial; a Randomized Double-Blind Clinical Trial; and an Open-Label Phase II Randomized Trial). Results: The trials involved 76 patients, of which 44 patients received topical dexamethasone, 14 patients received topical clobetasol and 18 patients received topical budesonide. Topical agents were most frequently used when oral tissues were the sole site of involvement. It appears that the best overall response is present for budesonide with no difference between the four arms, followed by clobetasol, and then by dexamethasone. The limitation of the current study is mainly represented by the fact that overall response was derived in two of the studies from other parameters. Moreover, both budesonide and clobetasol were used in only one study each, while two assessed dexamethasone. Conclusions: Based on the clinical trials, all three agents seem to be effective in treating oral GVHD and had a satisfactory safety profile. There is still a need for assessing high quality RCTs to assess the efficacy of these therapies on a larger cohort.
once with the growth of the population's life expectancy in the world but also in romania, the patients in dental offices often suffer from associated diseases for which they are under constant medication. the objectives of the study were to evaluate the prevalence of the associated diseases and of constant medication for a group of socially assisted patients. methods: the study included a total of 1176 socially assisted patients from the sanodentaprim program who were seen during the period from april 15, 2010 to december 1, 2010. the observation files, medical notes and certificates from the general practitioner or from the attending specialist physician were studied. results: the patients from the studied group presented a prevalence of comorbidities of 92%. the most frequent associated diseases were cardiovascular (36%). a percentage of 84% of the studied patients were under constant medication. Conclusion: the risks of the patient with general disease have to be evaluated according to a detailed anamnesis corroborated with paraclinical examinations and, if needed, in collaboration with the attending doctor. the adverse effects of constant medication need a special attention, especially when certain classes of drugs interfere with dental treatments.
Introduction: Breastfeeding is the feeding of babies and young children with milk from a woman's breast. Breastfeeding has numerous health benefits, including the lower risk for respiratory tract infections, asthma, diarrhea, food allergies, type 1 diabetes, and leukemia. It may also improve cognitive development and prevent obesity in adulthood.Purpose: To assess the dentists' medical knowledge regarding the dental treatment allowed during the breastfeeding period.Methodology: In this study were included active dentists. An online questionnaire was applied. The questionnaire was anonymous and the responses were collected online. The questions assessed the therapeutic approach of the patients during the breastfeeding period, what kind of treatments they perform in this category of patients and the time chosen for the dental treatments. The last category of questions collected data about the medication used or prescribed in breastfeeding patients. The data was analyzed using the descriptive statistics and the results were presented as means.Results: More than half of the doctors surveyed would treat a breastfeeding woman in any emergency situations, only if she postpone breastfeeding for the next 24 hours. About 85% of the respondents will perform the anesthesia in a nursing woman, but about just 1/3 will use mepivacaine and less than 3% will use lidocaine, anesthetic substances admitted in a breastfeeding woman. In our study, about 90% of doctors who indicated the administration of an antibiotic to a breastfeeding woman chose a synthetic penicillins drug that are admitted during the lactation period. Conclusion:Most dentists have insufficient knowledge regarding the treatments that can be performed in breastfeeding women. Therefore, post-graduate courses are required to update the knowledge of dentists in this domain.
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