Salivary Flow in Pediatric Cancer Patients Compared to Healthy Children and Adolescents

Bezerra, Paula Maria Maracajá; Costa, Raphael Cavalcante; Ribeiro, Isabella Lima Arrais; Bonan, Paulo Rogério Ferreti; Sousa, Simone Alves de; Valença, Ana Maria Gondim

doi:10.4034/pboci.2019.191.141

Cited by 4 publications

(7 citation statements)

References 23 publications

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“…With respect to the salivary parameters, some studies reported that chemotherapy reduces salivary flow [ 14 , 28 – 31 ]. However, the results found in this study diverged from this pattern and corroborate with another study [ 16 ]. Firstly, this difference can be attributed to the innumerable therapeutic protocols evaluated, which have different mechanisms of action [ 5 ].…”

Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

“…In pediatric patients, these changes may be exacerbated since the synthesis and composition of saliva are physiologically modified during growth (e.g., salivary gland development, bone synthesis and maturation, exfoliation, and dental eruption) [16]. In addition, there is evidence that children on chemotherapy have a higher incidence of dental caries due to changes in the colonization of specific bacterial groups during treatment [16][17][18]. Several studies have been carried out with cancer patients on radiotherapy, but studies evaluating the impact of chemotherapy, the main treatment of childhood cancer, on the quantitative and qualitative aspects of saliva, and cariogenic biofilm and its possible relation with the aggravation of oral mucositis in children and adolescents are limited.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Saliva and Cariogenic Microbiota on the Chemotherapy-Induced Oral Mucositis in Oncopediatric Patients: A Preliminary Longitudinal Study

Costa

Bezerra

Damascena

et al. 2020

International Journal of Dentistry

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The aim of this study is to evaluate salivary and microbiological parameters of pediatric oncological patients and their correlation with severe oral mucositis (SOM).This study aims to evaluate the salivary parameters and cariogenic microbiota of pediatric oncological patients and their correlation with severe oral mucositis (SOM). A preliminary longitudinal study The prospective study included patients in the age range from 4 to 18 years (n = 26), with diagnosis of primary cancer, who were followed up before and after time intervals of two, five, and ten weeks of induction chemotherapy. Oral mucosa examinations were performed by means of the modified Oral Assessment Guide (OAG) by calibrated examiners (κ > 0.70). Saliva analysis (unstimulated saliva flow (USF), clinical saliva viscosity (CSV), and pH) and microbiological (total Streptococcus (TS) and Streptococcus of the mutans group (SMG)) tests were performed using unstimulated saliva. The data were analyzed by the Wilcoxon and Spearman Correlation tests (α = 5%). The patients were predominantly of the female sex (n = 15; 57.7%), adolescents (n = 15; 57.7%), and patients with hematological tumors (n = 21; 80.8%). SOM was more frequent in the tenth week (n = 7; 28.6%). The values of USF, CSV, pH, TS, and SMG were not changed by the institution of chemotherapy (p>0.05). These values were correlated with SOM and the time, TS and SMG, and CSV and SMG. The salivary and microbiological parameters investigated did not influence the severity of oral mucositis in the pediatric patients oncological..

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Section: Discussionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of Saliva and Cariogenic Microbiota on the Chemotherapy-Induced Oral Mucositis in Oncopediatric Patients: A Preliminary Longitudinal Study

Costa

Bezerra

Damascena

et al. 2020

International Journal of Dentistry

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“…Although some studies with oncological pediatric patients have found decreases in the saliva flow rate during the cancer treatment, 9,10,11 other studies 14,15 have not reported saliva parameter changes after chemotherapy started. These controversial results can be explained because these previous studies are different in terms of experimental design, cancer type evaluation, chemotherapy protocol administered, and the saliva collection method.…”

Section: Discussionmentioning

confidence: 98%

“…10,11 Salivary changes in children have consequently been associated with deteriorating oral health status during chemotherapy. 9,[12][13][14] However, some cross-sectional studies 15,16 have shown controversial results regarding chemotherapy's effect on the salivary flow rate because the saliva exams were performed in different early stages of cancer treatment. Moreover, stimulated saliva has been commonly used, 17,18,19,20 but the method applied to stimulate salivation can overestimate the saliva flow results and is not indicated for understanding the specific effect of chemotherapy under clinical saliva parameters.…”

Section: Introductionmentioning

confidence: 99%

Unstimulated salivary flow and oral streptococci in pediatric patients with hematological tumors: A longitudinal study

Araújo

Costa

Ribeiro

et al. 2021

Special Care in Dentistry

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Aims:To evaluate the unstimulated salivary flow (USF) and salivary colonization of total Streptococcus spp. (TS) and mutans-group (MS) in pediatric patients with hematological tumors. Correlations of salivary and microbiological changes with chemotherapy and patient-related factors were also verified. Methods and Results: Eligible children (n = 31) were evaluated before (control) and after (2, 5, and 10-weeks) the chemotherapy protocol was applied. Saliva samples were collected by the traditional spitting method to determine the USF (ml/min). Salivary TS and MS were determined by colony-forming units (CFU ) counts in a selective medium. The caries experience was evaluated by DMFT/dmft indexes. Data were submitted to Student's t-test, one-way ANOVA, and correlation tests (α = 0.05). The USF rate at baseline was 0.89 (±0.73) ml/min with up to 20% reduction during the follow-up and did not differ statistically during chemotherapy (p > .05). Chemotherapy did not modify the salivary TS load (p > .05), but induced a dysbiotic shift with higher MS counts (∼ 5 fold-increase) at 10-weeks (p < .05). There is a correlation of USF with age (r = .390) and SM load with caries experience (r s = −.540) at 5-weeks. Conclusion:Chemotherapy may promote a specific increase of mutans-group streptococci without changing the Streptococcus spp. load and unstimulated saliva flow. Correlation reinforced the need for further enlightenment about the chemotherapy mechanisms in the salivary and microbiological parameters.

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Rapid and non-invasive analysis of paracetamol overdose using paper arrow-mass spectrometry: a prospective observational study

Zhou,

Dliso,

Craske

et al. 2024

BMC Med

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Background Paracetamol is the most consumed medicine globally. Its accessibility contributes to common overdose. Paracetamol overdose is responsible for > 50% of acute liver failure cases, making it the second most common reason for a liver transplant. Rapid quantitation of paracetamol is crucial to guide treatment of paracetamol overdose. Current tests require invasive sampling and relatively long turnaround times. Paper arrow-mass spectrometry (PA-MS) combines sample collection, extraction, separation, enrichment and ionisation onto a single paper strip, achieving rapid, accurate, cost-effective and eco-friendly analysis direct from raw human saliva. Methods To validate PA-MS against an established test, 17 healthy adults were recruited. Samples were collected before and at 15, 30, 60, 120 and 240 min after ingesting 1 g of paracetamol. Plasma measured with an established clinical test served as the reference standard to validate PA-MS with three biofluids—plasma, resting saliva (RS) and stimulated saliva (SS). Participants’ views of blood, RS and SS sampling procedures were assessed qualitatively. Cross-validation was assessed using Lin’s concordance correlation coefficients (CCC), Bland–Altman difference plots, and ratios of PA-MS to the reference standard test. Results PA-MS using stimulated saliva offers a reliable alternative to intravenous blood sampling. The CCC is 0.93, the mean difference with the reference test is − 0.14 mg/L, and the ratios compared to the reference test are 0.84–1.27 from correlated samples collected at 5 intervals over 4 h for each participant. Conclusions Paracetamol detection from SS with PA-MS provides a reliable result that can aid timely treatment decisions. Differences between paracetamol concentration in resting and stimulated saliva were also identified for the first time, highlighting the importance of standardising saliva collection methods in general. This study marks a major milestone towards rapid and convenient saliva analysis.

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Salivary Flow in Pediatric Cancer Patients Compared to Healthy Children and Adolescents

Cited by 4 publications

References 23 publications

Impact of Saliva and Cariogenic Microbiota on the Chemotherapy-Induced Oral Mucositis in Oncopediatric Patients: A Preliminary Longitudinal Study

Impact of Saliva and Cariogenic Microbiota on the Chemotherapy-Induced Oral Mucositis in Oncopediatric Patients: A Preliminary Longitudinal Study

Unstimulated salivary flow and oral streptococci in pediatric patients with hematological tumors: A longitudinal study

Rapid and non-invasive analysis of paracetamol overdose using paper arrow-mass spectrometry: a prospective observational study

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