Background: Inflammatory/immunological serum markers are useful for the early detection of organ dysfunction, helping the diagnosis of sepsis. Although the detection of blood biomarkers is a standard practice, the use of noninvasive samples (eg saliva) would be beneficial. Aim: To investigate the saliva of hospitalized patients with and without sepsis and identify the levels of inflammatory markers such as C-reactive protein (CRP), procalcitonin (PCT), interleukin 6 (IL-6) and nitric oxide (NO). Methods: Saliva samples were collected from 26 patients in intensive care unit with diagnosis of sepsis and from 26 without sepsis (control). The levels of CRP were determined by using latex agglutination test, whereas those of procalcitonin and IL-6 by ELISA and NO by the Griess reaction. Results: Of 26 patients with sepsis, 14 were males (54%) with a mean age of 63.81 ± 3.48 years. The control group had the same distribution for gender, with mean age 65.04 ± 4.07 years. Sepsis group showed higher salivary concentrations of CRP, PCT, IL-6 and NO, with only levels of IL-6 being statistically different (P = .0001). Conclusions: Patients with sepsis had significantly higher levels of IL-6 in their saliva, suggesting that this biological sample could be useful in the diagnosis of this condition. K E Y W O R D Sbiomarkers, intensive care unit, saliva, sepsis
Oral health conditions of patients in intensive care units (ICU) is often very precarious. This study was conducted in the ICU to identify oral changes of this population. Material and Methods this was an exploratory, descriptive and cross-sectional study. The data collected included age, gender, oral hygiene condition, reasons for hospitalization, oral changes and management. Two trained dentists performed the clinical oral examinations using wooden spatulas and sterile gauze. 104 patients between 19 and 92 years of age (56.82 ± 18.23 years) were analyzed, comprising 26 women and 78 men. Most of the patients presented good hygiene. The most common reason for admission was traumatic severe brain injury. Fifty-nine patients (56.7%) had at least one oral lesion. Most frequent lesions were lip dryness (26.3%), traumatic ulcers (TU) (20.0%) and tongue coating (20.0%). According to our results, traumatic ulcers represent a challenge for physicians, the participation of a dentist and a dental hygienist would help to manage and prevent infections of these lesions, making a truly interdisciplinary team essential for the quick recovery of ICU patients.
Introduction: Mucositis has been a complication of great importance in antineoplastic treatments of head and neck tumors because when not treated properly it can lead to the interruption of radiotherapy or chemotherapy. Knowing that mucositis is a common inflammatory condition in patients undergoing radiotherapy and that nitric oxide (NO) can be a marker of inflammation. Aim: to seek an association between mucositis, pain and NO levels in patients diagnosed with squamous cell carcinoma (SCC) in different periods of radiotherapy. Methodology: Clinical examination was performed weekly to investigate presence of mucositis, in which the degree and intensity of pain were evaluated by using the visual analogue scale (VAS) and mouthwash samples were collected from twenty patients. In the collected samples, the concentrations of NO were measured by using the Griess method. Results: of the twenty patients, two were excluded due to worsening of the clinical picture. Of the 18 patients who had their treatment finished, ten had some degree of mucositis and pain, with the highest levels being observed in the last week of treatment. As for the levels of NO, it was observed that low values varied widely among the patients and weeks studied. There was a statistically significant positive correlation between mucositis degrees and pain intensities, although the NO levels were correlated neither with mucositis nor with pain intensity throughout the experimental weeks. Conclusion: Although NO is an inflammatory mediator involved in diseases of the oral cavity, its presence cannot be associated with mucositis and pain in patients with head and neck cancer who are on radiotherapy.
Introdução: Pacientes em tratamento oncológico estão sujeitos a desenvolver complicações bucais, que comprometem a integridade e função da cavidade oral. Isso se deve ao fato de que a destruição causada pela terapia antitumoral (quimioterapia e radioterapia) não se limita apenas as células neoplásicas, ela acomete também células normais, principalmente as que estão em constante renovação. As principais complicações causadas pelo tratamento oncológico na cavidade bucal são: mucosite, xerostomia, hemorragias gengivais, perda de paladar, trismo e osteorradionecrose. Objetivo: Avaliar por meio de um questionário, o nível de informação acerca de saúde bucal de pacientes portadores de neoplasias. Metodologia: Foram entrevistados 100 pacientes, atendidos no ambulatório de oncologia do Hospital Regional do Vale do Paraíba. Resultados: Ao serem questionados sobre a última consulta odontológica, menos da metade (45%) alegaram ter ido nos últimos 12 meses, 42% usavam como artifícios para a higienização somente escova e pasta, 51% acreditavam que a quimioterapia não teria efeito algum a cavidade bucal. Conclusão: O conhecimento dos pacientes em tratamento oncológico sobre saúde bucal ainda é deficiente e existe falta de instrução e informação quanto à higiene bucal e acompanhamento do cirurgião-dentista ao paciente oncológico.
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