• Title, Summary, Keyword: mucositis

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Incidence and Factors Influencing Oral Mucositis in Patients with Hematopoietic Stem Cell Transplantation (조혈모세포이식 환자의 구강 점막염 발생실태와 영향요인)

  • Jo, Kwan Suk;Kim, Nam Cho
    • Journal of Korean Academy of Nursing
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    • v.44 no.5
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    • pp.542-551
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    • 2014
  • Purpose: This study was done to examine the incidence of oral mucositis in hematopoietic stem cell transplantation patients and to identify factors influencing oral mucositis and patient outcomes according to severity. Methods: In this retrospective study, data were collected from electronic medical records of 222 patients who had received hematopoietic stem cell transplantation. Oral mucositis was evaluated using WHO's assessment scale. Data were analyzed using Chi-square test, Fisher exact test, Spearman's correlation, Ordinal logistic regression, ANOVA and Kruskal-Wallis test. Results: A total of 69.8% of the patients evaluated developed oral mucositis (grade II and over). As a results of ordinal regression, factors influencing oral mucositis severity were found to be diagnosis, type of transplantation, oxygen inhalation and the number of antiemetics administration before transplantation. The severity of oral mucositis was found to increase the days of hospitalization, days of TPN administration, days of using antibiotics and the number and dosage of analgesics. Conclusion: The results would help predict severity of oral mucositis in hematopoietic stem cell transplantation patients and suggest that provision of appropriate nursing assessment and oral care would improve patient outcomes.

Pathophysiology of Oral Mucositis induced by Anticancer Therapy (항암치료 후 발생하는 구강 점막염의 병태생리)

  • Yoon, Jung-Hoon;Choj, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.25 no.4
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    • pp.365-369
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    • 2000
  • Oral mucositis or stomatitis produced by stomatotoxic chemotherapy and/or radiation therapy are painful, restrict oral intake and, importantly, act as sites of secondary infection and potals of entry for the endogenous oral microflora often leading to bacteremias or sepsis. A number of clinical observations and studies of animal model suggests a pathophysiological complexity in the development of mucositis. The condition appears to represent a sequential interaction of the oral mucosal cells and tissues, pro-inflammatory cytokines, and local environmental factors in the mouth. This article discussed and reviewed biological process of the mucositis and, the role of cytokines as initiators and amplifiers of the process. The recognition that the pathophysiology of mucositis is a multifactorial process has presented opportunities for intervention based upon biological attenuation.

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Effects of Oral Care Protocol on Oral Mucositis in Hematologic Malignancy Patients Receiving Chemotherapy (구강관리 프로토콜 적용이 항암화학요법을 받는 혈액암 환자의 구내염에 미치는 영향)

  • Park, Soo Jin;Cha, Gyeong Suk;Kim, Hyeung Sun;Park, Eun Young
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.1
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    • pp.1-9
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    • 2016
  • Purpose: This study was done to identify effects of oral care protocol on oral mucositis and oral care performance in hematologic malignancy patients receiving chemotherapy. Methods: The design of this study was a nonequivalent control group pretest-posttest design. Both groups were patients diagnosed with hematologic malignancies who were receiving chemotherapy-each group had 20 patients. In the experimental group, patients were given intensive education on oral care based on the oral care protocol, whereas in the controlled group, each patient was given an educational brochure. Before chemotherapy, and 3 days, 7 days, and 14 days after chemotherapy, oral mucositis status of two groups were assessed using the guide to physical assessment of the oral cavity. Oral care performance was examined before chemotherapy and 14 days later. Results: The experimental group with the oral care protocol showed a significant difference (F=18.15, p<.001) in the oral mucositis status, and also in oral care performance (t=-10.33, p<.001). Conclusion: Findings indicate that the application of the oral care protocol is an effective tool for lowering the occurrence of oral mucositis and enhancing oral care performance in hematologic malignancy patients receiving chemotherapy.

Risk indicators for mucositis and peri-implantitis: results from a practice-based cross-sectional study

  • Rinke, Sven;Nordlohne, Marc;Leha, Andreas;Renvert, Stefan;Schmalz, Gerhard;Ziebolz, Dirk
    • Journal of Periodontal and Implant Science
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    • v.50 no.3
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    • pp.183-196
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    • 2020
  • Purpose: This practice-based cross-sectional study aimed to investigate whether common risk indicators for peri-implant diseases were associated with peri-implant mucositis and peri-implantitis in patients undergoing supportive implant therapy (SIT) at least 5 years after implant restoration. Methods: Patients exclusively restored with a single implant type were included. Probing pocket depth (PPD), bleeding on probing (BOP), suppuration, and radiographic bone loss (RBL) were assessed around implants. The case definitions were as follows: peri-implant mucositis: PPD ≥4 mm, BOP, no RBL; and peri-implantitis: PPD ≥5 mm, BOP, RBL ≥3.5 mm. Possible risk indicators were compared between patients with and without mucositis and peri-implantitis using the Fisher exact test and the Wilcoxon rank-sum test, as well as a multiple logistic regression model for variables showing significance (P<0.05). Results: Eighty-four patients with 169 implants (observational period: 5.8±0.86 years) were included. A patient-based prevalence of 52% for peri-implant mucositis and 18% for peri-implantitis was detected. The presence of 3 or more implants (odds ratio [OR], 4.43; 95 confidence interval [CI], 1.36-15.05; P=0.0136) was significantly associated with an increased risk for mucositis. Smoking was significantly associated with an increased risk for peri-implantitis (OR, 5.89; 95% CI, 1.27-24.58; P=0.0231), while the presence of keratinized mucosa around implants was associated with a lower risk for peri-implantitis (OR, 0.05; 95% CI, 0.01-0.25; P<0.001). Conclusions: The number of implants should be considered in strategies to prevent mucositis. Furthermore, smoking and the absence of keratinized mucosa were the strongest risk indicators for peri-implantitis in patients undergoing SIT in the present study.

Reliability and Validity of Patient Self-reported Daily Questionnaire on Oral Mucositis in Acute Leukemic Patients under Chemotherapy (화학요법을 받는 급성백혈병 환자 자가보고형 구강점막염 사정도구의 신뢰도와 타당도 분석)

  • Choi, So-Eun;Kim, Hee-Seung
    • Journal of Korean Biological Nursing Science
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    • v.12 no.3
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    • pp.148-156
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    • 2010
  • Purpose: Oral mucositis (OM) is a serious consequence of chemotherapy that cancer patients must undergo. The objectives of this study were to find out reliability and validity of patients self-reported daily questionnaires on OM, and the impact OM makes on daily functions. Method: To test the reliability of oral mucositis daily questionnaire (OMDQ), internal consistency of the instrument (Cronbach's ${\alpha}$ and correlation between items) and test-retest reliability were analyzed. Criterion validity and discriminative validity were evaluated using WHO, oral assessment guide, and Nicolatou assessment tool. Forty-eight acute leukemic patients under chemotherapy were enrolled in this study. Result: The Cronbach's ${\alpha}$ coefficient indicated sufficient internal consistency. Correlations of Mouth and throat soreness (MTS) and MTSActivity Limitations (MTS-AL) were statistically significant. MTS and MTS-AL scores on consecutive days were highly correlated (days13,14=.84-.96; test-retest reliability). OMDQ scale had high criterion validity and discriminative validity. Patients with more severe WHO OM grades had higher MTS mean scores. Conclusion: Oral mucositis in acute leukemic patients under going chemotherapy can be easily quantified by patient self-administered OMDQ with reliability and validity.

Methotrexate-induced Oral Mucositis

  • Lee, Hye-Jin;Kwon, Jeong-Seung;Choi, Young-Chan;Ahn, Hyung Joon
    • Journal of Oral Medicine and Pain
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    • v.40 no.2
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    • pp.82-87
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    • 2015
  • Methotrexate (MTX) is a chemotherapeutic agent that is used to treat a host of malignancies. But recently, MTX has also been used as a therapeutic agent for chronic inflammatory disorders such as rheumatoid arthritis, psoriasis, and systemic lupus erythematosus. However, MTX is an antimetabolite that affects rapidly dividing normal cells such as oral mucosal epithelial cells, gastrointestinal epithelial cells, and bone marrow cells-which explains why oral mucositis is often an initial manifestation of MTX toxicity. Because oral lesions are frequently initially presented in dental clinics, dentists should consider the possibility of adverse drug reactions in the differential diagnoses of oral lesions through a meticulous collection of patients' medical histories. In this report, we examine patients who suffered from oral ulcerative lesions upon diagnosis of MTX-induced oral mucositis. Then, we suggest approaches for the diagnosis and treatment of MTX-induced oral mucositis through a review of literature.

The Effects of Oral Cryotherapy on Oral Mucositis, Reactive Oxygen Series, Inflammatory Cytokines, and Oral Comfort in Gynecologic Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial (구강 냉요법이 항암화학요법을 받는 부인암환자의 구내염, 활성산소, 염증성 사이토카인, 구강 안위감에 미치는 효과: 무작위대조군실험설계)

  • Shin, Nayeon;Kang, Younhee
    • Journal of Korean Academy of Nursing
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    • v.49 no.2
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    • pp.149-160
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    • 2019
  • Purpose: The purpose of this study was to examine the effects of oral cryotherapy on oral mucositis, reactive oxygen series, inflammatory cytokines, and oral comfort in patients undergoing chemotherapy for gynecologic cancers. Methods: Participants were randomly assigned to the experimental group (n=25, receiving oral cryotherapy during chemotherapy) and the control group (n=25, receiving the usual care consisting of 0.9% normal saline gargles three times before meals). Oral mucositis was assessed using the oral assessment guide, while oral comfort was assessed using the oral perception guide. Reactive oxygen series was measured as total oxidant stress, and the level of two inflammatory markers, interleukin-6 (IL-6) and tumor necrosis factor-alpha ($TNF-{\alpha}$), were examined. The data were analyzed using t-test, chi-square test, Fisher's exact test, Mann-Whitney U-test, and repeated measures analysis of variance. Results: There was a significant difference in the oral mucositis score, reactive oxygen series score, $TNF-{\alpha}$ level, and oral comfort score between the two groups, and there were significant changes over time and in the group-by-time interactions. There was a significant difference in the IL-6 score between the two groups, but there were no significant changes over time or in the group-by-time interactions. Conclusion: The study results revealed that oral cryotherapy was more effective than the usual care regime of normal saline gargles for reducing oral mucositis, reactive oxygen series, and inflammatory cytokines and for improving oral comfort in gynecologic cancer patients undergoing chemotherapy.

Efficacy of three oral gargling protocols for Prevention of oral mucositis in acute leukemia during chemotherapy (항암화학요법 중 가글링 유형에 따른 급성백혈병 환자의 구강감염 예방효과에 관한 연구)

  • Jun Myung-Hee;Kim Yeon-Hee;Choi Jin-Sun;Chae Soo-Won
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3 no.2
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    • pp.193-206
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    • 1997
  • Because the oral mucositis is often inevitable in acute leukemia patients during chemotherapy, the efforts must be made to keep these leukemia patients from oral mucositis. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. This quasi-experimental study was performed to compare the prohpylatic value of these oral care protocols. Thirty-nine subjects were assigned to one of three groups. The first group performed bivon-normal saline gargling protocol, the second group performed chlorhexidine gargling protocol, and the last contrast group kept traditonal gargling protocol. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count (ANC) reached $1,000/mm^3$. It continued about 2-4 weeks. The data was analyzed by ANCOVA and Kruskal-Wallis one way ANOVA, chi-sqare, survival analysis. The results were as follows : The contrast group showed significantly highest mean score of the OAG and Beck's perception of oral discomfort among three groups from second week to third week. However chie-test and survial analysis showed that the incidence of severe mucositis were not significantly different among three groups. Conclusively we recommend that nurses who care acute leukmia patients use bivon-normal saline gargling protocol be careful to occur severe mucositis during chemotherapy.

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Mycoplasma pneumoniae-induced Rash and Mucositis (Mycoplasma pneumoniae에 의해 발생한 피부발진과 점막염)

  • Park, Sung-Min;Kim, Jeong-Min;Kim, Gun-Wook;Mun, Je-Ho;Song, Margaret;Kim, Hoon-Soo;Kim, Byung-Soo;Kim, Moon-Bum;Ko, Hyun-Chang
    • Korean journal of dermatology
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    • v.55 no.3
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    • pp.186-190
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    • 2017
  • Mycoplasma pneumoniae (M. pneumoniae) is one of the most common causes of respiratory tract infections in pediatric and adult populations worldwide. M. pneumoniae is also associated with extrapulmonary complications, such as mucocutaneous eruptions. In dermatologic disorders, M. pneumoniae infection is known to be associated with erythema multiforme and Stevens-Johnson syndrome in children and young adults. Recently, several cases with M. pneumoniae-associated mucositis, which lacks typical target lesions, have been reported. The term Mycoplasmainduced rash and mucositis was suggested as a revised version of the term, Mycoplasma pneumoniae-associated mucocutaneous disease, which previously included erythema multiforme and Stevens-Johnsons syndrome. This revision helps to distinguish Mycoplasma-induced rash and mucositis, which has a distinct morphology, mild disease course, and potentially important clinical implications regarding treatment. Herein, we report a patient with Mycoplasma-induced rash and mucositis.

Effects of Low Level Laser Therapy on Oral Mucositis Caused by Anticancer Chemotherapy in Pediatric Patients (소아 암 환자에서 항암제 치료 후 발생한 구내염에 대한 저출력 레이저의 효과)

  • Kim, Hae-Ja;Rho, Shi-Youn;Shin, Yong-Sup
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.51-55
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    • 2001
  • Background: Oral mucositis is a common complication of anticancer chemotherapy. The sequelae of this consist of an increased risk of infection, moderate to severe pain, compromised oral function, and bleeding. This study was performed to evaluated the effects of the He-Ne laser and the Ga-Al-As laser on oral mucositis caused by anticancer chemotherapy in pediatric patients. Methods: There were 3 cases of osteosarcoma and 6 cases of leukemia. All patients received He-Ne laser (632.8 nm wavelength, power 60 mW) application on 400-600 Hz scanning for 5-20 minutes and Ga-Al-As laser (904 nm wavelength, power 40 mW) application by fiberoptic hand piece placed in immediate proximity to the tissue without direct contact with it for 30 seconds per point for 5 days per week. During the application patients wore wavelength-specific dark glasses and were instructed to keep their eyes closed. Results: The mean number of treatments with oral intake was $4.89{\pm}0.64$. The mean number of total treatments was $9.44{\pm}2.59$. There were no significant side effects during and after the laser treatments. Conclusions: He-Ne laser and Ga-Al-As (IR) laser treatment were well tolerated and reduced the severity and duration of chemotherapy-induced oral mucositis in pediatric oncologic patients.

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