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Other Complications of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Thrush is a condition also known as candidiasis. White or red patches develop on the gums, tongue, cheeks, or roof of the mouth. Thrush is prevented via proper cleaning of dentures, removing dentures for part of the day or night, and soaking them in a prescribed medication. Xerostomia is another condition linked to diabetes mellitus, and is commonly known as dry mouth. There is insufficient saliva, increasing risks for tooth decay and gum disease. There may be mouth pain, cracking of the lips, and sores or infections. Xerostomia results in problems chewing, eating, and even swallowing or talking. Humidifying devices increase moisture in the air surrounding the patient. There may be a need to avoid spicy or salty foods, since they can cause pain in a dry mouth. Oral burning may occur in the mouth because of hyperglycemia. There may be a bitter taste, and symptoms often worsen throughout the day. Oral burning may require changes in diabetes medications. Once the blood glucose is controlled, the condition resolves. Other symptoms in the mouth include sores or ulcers that do not heal, dark spots or holes in the teeth, loose teeth, pain while chewing, altered taste sensations, and chronic bad breath. Some patients have pain chronic pain in the mouth, face, or jaw.
Promotion of Preventive Measures
Published in Lars Granath, William D. McHugh, Systematized Prevention of Oral Disease: Theory and Practice, 2019
Alice M. Horowitz, P. Jean Frazier
Hospitals are frequently overlooked as sites for the implementation of preventive oral health education and promotion programs. Yet, any condition or treatment that impairs salivary function can cause xerostomia. Common causes include drugs used for cancer chemotherapy, head and neck irradiation treatment, and Sjogren’s Syndrome. Xerostomia-related dental caries can have serious consequences; thus, a community-wide effort to educate physicians, dentists, pharmacists, medical and dental auxiliaries, and patients and their families about effective preventive measures for this condition would be essential.
Oral Mucosal Reactions to Anticancer Therapies
Published in Gabriella Fabbrocini, Mario E. Lacouture, Antonella Tosti, Dermatologic Reactions to Cancer Therapies, 2019
Emmanuelle Vigarios, Vincent Sibaud
Chemotherapy-related mucositis usually starts 4–7 days after the first cycle. It typically involves the nonkeratinized mucosa (floor of the mouth, soft palate, oral mucosa, ventral part of the tongue, lips), with a relative sparing of keratinized areas. The premonitory phase includes erythema and burning. Lesions may evolve to form erosions and ulcerations (1,10,11,13), covered by a pseudomembrane consisting of fibrin, altered leucocytes, and epithelial debris (Figure 8.1a through d). Ulcerations are initially distinct, but may ultimately become diffuse, poorly circumscribed, and confluent. Pain and xerostomia are readily reported by patients. Inference with food/fluid intake is also common. Concomitant gastrointestinal involvement is also frequently noted (1,12,13).
Management of iodine contrast induced salivary gland swelling (sialadenitis): experiences from an observational study
Published in Acta Oto-Laryngologica, 2023
Miguel Saro-Buendía, Lidia Torres-García, Claudia Mossi Martínez, Eduardo Battig Arriagada, Joan Carreres Polo, José María Perolada Valmaña, Miguel Armengot Carceller
Four cases of CIS were diagnosed and managed during the study period at our institution ER. Demographic, clinical and radiological features of the patients are summarized in Table 1. Moreover, clinical and radiological features are represented in Figures 1 (case 1), 2 (case 2), 3 (case 3) and 4 (case 4). Individuals were aged between 68 and 76 years and three of them were females. None of the patients had allergy history and all of them got a CT with IC 12 to 72 h before CIS onset. The submandibular glands were the only salivary glands affected in all the cases. Enlargement was always bilateral and in half of the cases it was painful. Two patients referred xerostomia. Diagnosis was clinical supported by ultrasonography which often described gland enlargement, heterogenous echotexture, increased doppler flow and hypoechoic internal septa. Glomerular filtration rate (GFR) at ER admission ranged between 47 and 70 ml/min/1.73m2. The course was benign, and all four patients were symptomless 60 to 150 h after CIS onset. Only two patients required analgesia.
Lutetium Lu 177 vipivotide tetraxetan for metastatic castration-resistant prostate cancer
Published in Expert Review of Anticancer Therapy, 2022
Hina Shah, Praful Ravi, Guru Sonpavde, Heather Jacene
The toxicities from 177Lu-vipivotide tetraxetan are generally mild and transient. Methods to decrease xerostomia have yielded mixed results, but not proven highly effective [81–84]. Xerostomia is more common and severe with alpha emitters, and if the highly potent alpha labeled agents are to move forward, it will be important to find a way to decrease salivary gland uptake and thus the side-effect of xerostomia which could affect quality of life of the patients receiving this therapy [82]. Although the kidneys are another target organ and there is concern for potential renal toxicity in patients receiving PSMA radioligand therapy, the data have not shown that the renal function is affected permanently leading to renal failure [85]. The rates of AML/MDS after 177Lu-vipivotide tetraxetan have not been specifically reported. AML/MDS occurs in about 2% of patients receiving 177Lu-dotatate for neuroendocrine tumors [86,87]. It will be important to monitor this, and hematologic toxicity based on tumor volume in the bone marrow, in the clinical setting. The use of patient-specific dosimetry for administered activity/dose optimization may facilitate balancing risk/benefit of 177Lu-vipivotide tetraxetan.
Dysphagia and medicine regimes in patients following lung transplant surgery: A retrospective review
Published in International Journal of Speech-Language Pathology, 2021
Anna Miles, Sujay Barua, Naomi McLellan, Lejla Brkic
Xerostomia is perhaps the most common medicine side effect and has a detrimental impact on oral, pharyngeal and oesophageal transit as well as mealtime enjoyment (Logemann et al., 2001). Oral and dental health are also vulnerable in patients with xerostomia (Thomson, Lawrence, Broadbent, & Poulton, 2006) and poor oral health is associated with increased risk of aspiration pneumonia (Langmore et al., 1998). The majority of our patients had more than one medicine prescribed with a listed side effect of xerostomia: anticholinergics, antidepressants, antiemetics, ACE inhibitors, antihistamine, diuretics, opiates and antipsychotics. Dietary changes and behavioural strategies should be advised to alleviate dry mouth. Stringent oral care regimes are critical post-operatively. Appetite, smell and taste all contribute to mealtime enjoyment and nutrition – both important in patients post-lung transplant where nutritional status is a critical factor in positive health outcomes (Jomphe, Lands, & Mailhot, 2018). Antibiotics, anticholinergics and psychotropic medicines are common contributors to reduced appetite, smell and taste. Nutrition should be monitored carefully and all opportunities to maximise mealtime enjoyment should be initiated.