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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
Supportive care measures should be delivered systematically (Tables 8.3 and 8.7). Treatment essentially relies upon stimulation of the residual secretory capacity of the salivary glands with cholinergic agonists (such as pilocarpine or cevimeline), which have been shown to reduce xerostomia and increase salivary flow rate compared to placebo (32–34). In addition, it has been reported that the concomitant administration of pilocarpine during radiotherapy could also increase the unstimulated salivary flow rate and may be of short-term benefit (34). Saliva substitute solutions might be also useful. Daily application of topical fluoride gel is mandatory to limit dental damage secondary to persistent saliva changes.
Oral problems
Published in Mervyn Dean, Juan-Diego Harris, Claud Regnard, Jo Hockley, Symptom Relief in Palliative Care, 2018
Mervyn Dean, Juan-Diego Harris, Claud Regnard, Jo Hockley
Artificial salivas: Glycerin dehydrates the mucosa39 and should be avoided. All acidic salivas should be avoided. Moi-Stir (Canada only), Saliva Substitute (US) and Salivart have a pH between 6.5 and 7.5 and are acceptable. But these salivas only last 10–15 minutes and may be little better than placebo,40 and frequent sprays with water may be just as effective.
Skin and Oral Hygiene
Published in Susan Carmody, Sue Forster, Nursing Older People, 2017
Many medications play a role in the production of dry mouth, especially some antihypertensives and antibiotics. For those with significantly reduced saliva production, a saliva substitute or mucoadhesive gel can be used to produce or replace moisture. These maintain mouth moistness over long periods of time by leaving a coating on the mucosa and oral structures to maintain oral moistness and promote saliva. Mouth pain can also be reduced using these gels because they adhere to irritated tissue, thus decreasing airflow to the area.
Effect of experimental and commercial artificial saliva formulations on the activity and viability of microcosm biofilm and on enamel demineralization for irradiated patients with head and neck cancer (HNC)
Published in Biofouling, 2022
Natara Dias Gomes da Silva, Pedro Renato Bodo de Paiva, Talita Vaz Moreira Magalhães, Aline Silva Braga, Paulo Sérgio da Silva Santos, Flávio Henrique-Silva, Ana Carolina Magalhães, Marília Afonso Rabelo Buzalaf
The potential to modify the AEP, associated with the low cost of production and the high thermal stability make these proteins promising candidates to be added to artificial saliva formulations that could be employed to reduce caries resulting from radiation therapy in HNC patients. However, their performance for this specific group of patients was never evaluated and, thus, this was the aim of the present study. Here, antibacterial and anticaries effects of experimental artificial saliva formulations containing CaneCPI-5, hemoglobin or the combination of both proteins, were evaluated on the microcosm biofilm formed on irradiated bovine enamel, from the saliva of HNC patients submitted to radiotherapy. A commercial artificial saliva substitute, BioXtra®, indicated for HNC patients with dry mouth, was evaluated as well.
Comparison of the Force Required for Dislodgement Between Secured and Unsecured Airways
Published in Prehospital Emergency Care, 2018
Curtis Davenport, Christian Martin-Gill, Henry E. Wang, James Mayrose, Jestin N. Carlson
We performed a randomized, prospective, cross-over mannequin study utilizing 4 different airway devices, both secured and unsecured. Prior to the placement of each airway device, a saliva substitute (Dry Mouth Moisturizing Spray, Biotene, Warren, NJ) was applied to the posterior oropharynx of the mannequin. Airway placement for ETT was confirmed with the C-MAC video laryngoscope (Karl Storz Corp, Tuttlingen, Germany) and the cuff inflated to 20–25 mm H2O (13,14). LMA, King and iGel were placed in the usual fashion based on manufactured recommendations. After placement, the cuff of the King and LMA were inflated as per the manufacturer recommendations (60 mm H20) to standardize the cuff pressure. When secured, the ETT, King, and LMA, were secured with the Thomas Tube Holder (Laerdal, Stavenger, Norway) while the iGel was secured with its proprietary holder.
Proteases, protease inhibitors and radiation carcinogenesis
Published in International Journal of Radiation Biology, 2023
(A2) In the Phase IIa OL trial, which involved multiple doses of BBIC, there were 6 patient treatment groups, ranging in dose levels from 25 and 1066 C.I. units per day. BBIC was administered to patients twice daily for 4 weeks, with the drug (BBIC reconstituted in Roxane Saliva Substitute) held in the mouth for 1 minute and then swallowed (Armstrong et al. 2000b). Roxane Saliva Substitute (RSS) had previously been used as the vehicle for administration of other oral cancer prevention drugs by our clinical collaborators in California. RSS provides the solution with the necessary viscosity to increase mucosal contact time and bioavailability, and has been shown to provide sustained release of many compounds. Some of the endpoints evaluated in this trial included: size of the oral leukoplakia lesion(s), buccal mucosa cell levels of proteolytic activities, proto-oncogene (c-erb B2/neu) expression levels in buccal mucosal cells and in serum. Some of the conclusions that were drawn from this study are as follows. (1) The total lesion area, at all doses evaluated, was reduced by 24.2% (p < .004), (2) High levels of buccal mucosal cell protease activity (PA) were associated with larger decreases in PA after BBIC treatment (p < .02), (3) BBIC treatment was associated with clinical activity in OL patients, and (4) There was a statistically significant reduction in the size of OL lesions that was linearly correlated with BBIC dose increases, and the results of the surrogate endpoint biomarker (SEB) studies indicated that changes in the proteolytic activities and c-erb-B2/neu expression in the buccal mucosal cells were well correlated, which indicated that protease activity could be as useful as c-erb-B2/neu expression as a SEB in future oral cancer prevention studies (Armstrong et al. 2000b).