BackgroundIt is known that chemotherapeutic agents are not equally stomatotoxic and oral cavity lesions are the most frequent complications encountered in antineoplastic chemotherapy.AimsThe objective of this study was to evaluate the occurrence of severe oral mucositis during a chemotherapy treatment and to identify its relationship with the chemotherapeutic class used.Materials and methodsThis is a longitudinal, prospective, and observational study that used an intensive direct observation technique for assessing the oral clinical conditions and the chemotherapy treatment administered to 105 patients (both children and adolescents).ResultsSevere oral mucositis occurred in all the 10 weeks of evaluation (ranging from 16.2 to 31.4%) and the association between the type of chemotherapy and the occurrence of severe oral mucositis is recorded only in the 6th week, with the chance to develop severe oral mucositis being 3.07 (3.85–2.29) times higher in patients underwent chemotherapy with antimetabolites than in those who have not used chemotherapy (p = 0.012).ConclusionIt was concluded that the chemotherapeutic agents most related to severe oral mucositis and to the interruption in chemotherapy are those of the class of antimetabolites, especially the methotrexate and the Ara C.How to cite this articleRibeiro ILA, de Andrade Lima Neto E, et al. Chemotherapy in Pediatric Oncology Patients and the Occurrence of Oral Mucositis. Int J Clin Pediatr Dent 2019;12(4):261–267.
This study aimed to evaluate the in vitro antibacterial activity of the phytochemicals thymol, linalool, and citronellol against Streptococcus mutans, Streptococcus salivarius and Streptococcus oralis. Disk diffusion screening on solid medium and measurement of the diameter of the bacterial growth inhibition halos was the technique utilized. The Minimum Inhibitory Concentration (MIC) of the substances was determined using serial substance dilutions and microdilution technique in Brain Heart Infusion culture medium. After incubation for 24 hours in an oven at 37 °C, plate reading was completed and confirmed by visual method using 2,3,5 triphenyl tetrazolium chloride dye. The Minimum Bactericidal Concentration (MBC) was determined from MIC subcultures. Assays were performed in triplicate, and chlorhexidine was used as a positive control. The diameters in mm of the growth inhibition halos ranged between 7.3 and 10.7 for S. mutans, 7.3 and 10.0 for S. oralis, and 8.2 and 9.8 for S. salivarius. The MIC and MBC values obtained converged , ranging from maximum values in the presence of Linalool (1,250.0 mg/mL, 2,500.0 mg/mL and 2,500.0 mg/mL, respectively, for S. mutans, S. oralis, and S. salivarius); and minimum values with Thymol (312.5 μg/ml, 156.2 μg/mL and 156.2 μg/ml, respectively for S. mutans, S. oralis, and S. salivarius). All the tested phytochemicals displayed antibacterial activity, thus representing substances with potential applications in preventing tooth decay.Keywords: preventive dentistry, dental caries, citronellol, linalool, thymol. Susceptibilidade de microrganismos cariogênicos a fitoconstituintes ResumoEste estudo objetivou avaliar a atividade antibacteriana in vitro dos fitoquímicos timol, linalol e citronelol sobre Streptococcus mutans, Streptococcus salivaris e Streptococcus oralis. Utilizou-se a técnica de discos de difusão em meio sólido e medição do diâmetro dos halos de inibição. A concentração inibitória mínima (CIM) das substâncias foi determinada utilizando diluições em série das substâncias e técnica de microdiluição em meio de cultura de Brain Heart Infusion. Após incubação durante 24 horas em estufa a 37 °C, a leitura da placa foi confirmada pelo método visual usando o corante 2,3,5 trifenil cloreto de tetrazólio. A concentração bactericida mínima (CBM) foi determinada a partir de subculturas de MIC. Os ensaios foram realizados em triplicata, e clorexidina foi usada como um controle positivo. Os diâmetros dos halos de inibição do crescimento variaram entre 7,3 e 10,7 por S. mutans, 7,3 e 10,0 por S. oralis, e 8,2 e 9,8 para S. salivaris. Os valores de CIM e CBM obtidos variaram de valores máximos na presença de linalol (1.250,0 mg/mL, 2.500.0 mg/mL e 2.500.0 mg/mL, respectivamente, para o S. mutans, S oralis e S. salivaris); a valores mínimos com timol (312,5 μg/ml, 156,2 μg/mL e 156,2 μg
Background:The oral healthcare offered to pediatric cancer patients at the hospital level must include educational and preventive strategies based on dialogical and welcoming professional attitudes. Therefore, the current study aimed to evaluate the perception of pediatric cancer patients and their parents/guardians about an educational and preventive oral healthcare program implemented in a reference hospital for cancer treatment. Methods: A qualitative follow-up investigation was conducted in which we evaluated the perception of pediatric cancer patients and their parents/guardians regarding an educational and preventive oral health program (OHEPP). The participants were 27 children and adolescents undergoing cancer treatment and their parents/guardians, and the assessment was carried out at 15 and 30 days after beginning the program through semi-structured interviews. The program used audiovisual resources, storytelling and playful instruments for the oral health education of patients and parents/guardians. The interviews were then transcribed and the Discourse of the Collective Speech (DCS) technique was performed for data analysis. Results: Patients and parents/guardians reported improvement in oral hygiene habits and conditions. Patients reported greater enthusiasm for oral care and highlighted the recreational aspect of the program. Parents/guardians reported being more clear about oral changes and paying attention to the appearance of comorbidities resulting from anticancer treatment. Conclusions: This study suggests that implementation of the oral health program favored communication between health professionals, patients and their parents/guardians, expanding knowledge and generating behavior change in oral healthcare.
Oral mucositis (OM) is the most common local adverse event of chemotherapy treatment and leads to a debilitating condition from the patient’s perspective. The aim of this study is to report nine cases of severe OM over 10 weeks after initiating chemotherapy in pediatric patients with leukemia. All patients showed changes in normality of hematological data in most week. The most used chemotherapeutic agents were aracytin, etoposide and methotrexate. Saliva and lips were the most affected items. Well-designed observational studies are needed to better understand the risk factors for developing severe OM.
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