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Journal of Clinical Medicine Jun 2023Celiac disease (CD) is a chronic immune-mediated gluten-sensitive enteropathy, affecting about 1% of the population. The most common symptoms include diarrhea, abdominal... (Review)
Review
BACKGROUND
Celiac disease (CD) is a chronic immune-mediated gluten-sensitive enteropathy, affecting about 1% of the population. The most common symptoms include diarrhea, abdominal pain, weight loss, and malabsorption. Extra-intestinal symptoms include oral manifestations. This systematic review aims to catalog and characterize oral manifestations in patients with CD.
METHODS
a systematic literature review among different search engines using PICOS criteria has been performed. The studies included used the following criteria: tissues and anatomical structures of the oral cavity in humans, published in English and available in full text. Review articles and papers published before 1990 were excluded.
RESULTS
209 articles were identified in the initial search. In the end, 33 articles met the selection criteria. The information extracted from the articles was classified based on the type of oral manifestation. Recurrent aphthous stomatitis (34.6%), atrophic glossitis and geographic tongue (15.26%), enamel defects (42.47%), delayed dental eruption (47.34%), xerostomia (38.05%), glossodynia (14.38%), and other manifestations including cheilitis, fissured tongue, periodontal diseases, and oral lichen planus were found in the celiac subjects of the studies analyzed. The quality of articles on the topic should be improved; however, oral manifestations in CD patients are widely described in the literature and could help diagnose celiac disease.
PubMed: 37373569
DOI: 10.3390/jcm12123874 -
Asian Pacific Journal of Cancer... Dec 2023Allogeneic hematopoietic cell transplantation (allo-HCT) serves as a potentially curative intervention for various hematologic disorders. However, its utility can be...
INTRODUCTION
Allogeneic hematopoietic cell transplantation (allo-HCT) serves as a potentially curative intervention for various hematologic disorders. However, its utility can be limited by the emergence of chronic graft-versus-host disease (cGVHD). The clinical manifestations of cGVHD result from a complex immune response characterized by the involvement of both B and T cells. Ibrutinib, a pharmacological agent, acts as an inhibitor of Bruton's tyrosine kinase (BTK) pathway, which becomes activated through the B-cell receptor and regulates B-cell survival. By exerting inhibitory effects on both BTK and inhibitor of interleukin-2 inducible T-cell kinase (ITK), ibrutinib exhibits promise as a therapeutic approach for managing cGVHD. Ibrutinib may be considered as a viable treatment option for active cGVHD in cases where patients exhibit an inadequate response to corticosteroid-based therapies. This systematic review seeks to assess the efficacy and safety of ibrutinib in the context of cGVHD patient management.
METHOD
We incorporated search engines from PubMed, Embase, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov. The study was performed following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and Assessing The Methodological Quality of Systematic Review (AMSTAR). We used Risk of Bias- 2 (RoB-2) tool for assess the risk of bias in randomized controlled studies (RCTs) and Newcastle Ottawa Scale (NOS) for observational and open-label studies.
RESULTS
A total of 7 studies were included in this study consisted of four open-label studies, two retrospective cohort studies, and one RCT study. These studies compared Ibrutinitib with standard therapies. Two studies investigated the pediatric population, and five studies investigated the adult population. Overall, these studies reported the overall response rate (ORR) of ibrutinib for cGVHD were 54%-78%. The results showed that in pediatric patients, the ORR were 54-78%. The results also showed that in adult patients, the ORR were 67%-76%. The most common adverse effects observed across the seven studies included pyrexia, diarrhea, abdominal pain, cough, nausea, stomatitis, vomiting, headache, bleeding and bruising, infection, muscle aches, fatigue, oral bleeding, elevated transaminases, lower gastrointestinal bleeding, persistent dizziness, sepsis, pneumonia, reduced platelet count, exhaustion, sleeplessness, peripheral edema, and fatigue.
CONCLUSION
The majority of studies have indicated that ibrutinib exhibits a high ORR and provides long-lasting responses, while also having manageable side effects.
Topics: Adult; Humans; Child; Bronchiolitis Obliterans Syndrome; Graft vs Host Disease; B-Lymphocytes; Fatigue
PubMed: 38156834
DOI: 10.31557/APJCP.2023.24.12.4025 -
Clinical Oral Investigations Nov 2023This meta-analysis was designed to provide new insights into the relationship between Helicobacter pylori (H. pylori) infection and recurrent aphthous stomatitis (RAS). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This meta-analysis was designed to provide new insights into the relationship between Helicobacter pylori (H. pylori) infection and recurrent aphthous stomatitis (RAS).
MATERIALS AND METHODS
We included and evaluated studies on H. pylori infection and RAS from PubMed, EMBASE, Cochrane Library, and Web of Science databases published up to January 31, 2023. The characteristics of these studies were collected, and the quality was evaluated by Newcastle-Ottawa Scale (NOS). The random effects model was used to calculate the pooled odds ratio (OR) and 95% confidence interval (CI). To further explore the sources of heterogeneity, meta-regression analysis and subgroup analyses were performed. Funnel plot, Egger's test, and Begg's test were used to assess publication bias.
RESULTS
In total, fifteen case-control studies with 1137 individuals (601 cases and 536 controls) were included. The H. pylori was found to be significantly associated with RAS (OR: 1.83 95% CI: 1.41-2.37, P = 0.001). In the subgroup analyses, studies that used PCR (OR: 2.03 95% CI: 1.31-3.15) or UBT (OR: 1.83 95% CI: 1.13-2.96) yielded a significant positive association, while a non-significant association (OR: 1.12 95% CI: 0.61-2.08) was found from studies that used ELISA method. Sensitivity analyses showed that the results were robust. No significant publication bias was found.
CONCLUSIONS
The current evidence does not rule out an association between H. pylori and RAS. The effect of H. pylori on RAS varies in detection methods and sources of sample. Large samples, multiple clinical studies, and improved methods are still needed to determine the exact effect of H. pylori on RAS.
CLINICAL SIGNIFICANCE
H. pylori infection may be a risk factor for the pathogenesis of RAS.
Topics: Humans; Stomatitis, Aphthous; Helicobacter pylori; Helicobacter Infections; Risk Factors
PubMed: 37798535
DOI: 10.1007/s00784-023-05273-y -
Journal of Dentistry Oct 2017The aim of this systematic review was to compare the presence of enamel defects and aphthous stomatitis between celiac patients and healthy controls. (Review)
Review
OBJECTIVES
The aim of this systematic review was to compare the presence of enamel defects and aphthous stomatitis between celiac patients and healthy controls.
DATA SOURCES
A systematic review of articles selected from MEDLINE, EMBASE and Google Scholar was performed by two independent operators. Additional studies hand-searched and found in the principal dental and gastroenterology journals were included.
STUDY SELECTION
Only controlled studies on celiac patients compared to healthy subjects were included.
DATA EXTRACTION
Independent extraction of articles by 2 authors using predefined data fields, including study quality indicators.
DATA SYNTHESIS
In total, the celiac patients had greater frequency of enamel defects (odds ratio=5.69, 95%CI from 3.47 to 9.33, P<0.00001, I=90%, 30 studies). Considering only the children, the odds ratio was 5.63 (95%CI from 3.95 to 8.01, P<0.00001, I=65%, 24 studies), while in the adults the odds ratio was not significant (odds ratio=2.16, 95%CI from 0.95 to 4.88, P=0.06, I=40%, 3 studies). In total, the celiac patients had greater frequency of aphthous stomatitis (odds ratio=3.79, 95%CI from 2.67 to 5.39, P<0.00001, I=49%, 21 studies). Considering only the children, the odds ratio was 4.31 (95%CI from 3.03 to 6.13, P<0.00001, I=29%, 13 studies), while in the adults the odds ratio was 47.90 (95%CI from 6.29 to 364.57, P=0.0002, 1 study).
CONCLUSIONS
In children, celiac disease was associated with both enamel defects and aphthous stomatitis. The odds ratio estimates, however, should be interpreted with caution due to the high risk of bias showed by all the studies. In adults, the association between celiac disease and enamel defects or aphthous stomatitis was unclear because very few studies were performed on this population.
CLINICAL SIGNIFICANCE
The presence of enamel defects and/or aphthous stomatitis in a child affected by other typical or atypical symptoms of celiac disease represents an indication for further diagnostic exams for celiac disease.
Topics: Adolescent; Adult; Celiac Disease; Child; Databases, Factual; Dental Enamel; Dental Enamel Hypoplasia; Female; Healthy Volunteers; Humans; Male; Odds Ratio; Research Design; Stomatitis, Aphthous
PubMed: 28688949
DOI: 10.1016/j.jdent.2017.07.001 -
Journal of Prosthodontics : Official... Jun 2016Denture stomatitis is a common inflammatory condition affecting the mucosa underlying complete dentures. It is associated with denture microbial biofilm, poor denture... (Review)
Review
Denture stomatitis is a common inflammatory condition affecting the mucosa underlying complete dentures. It is associated with denture microbial biofilm, poor denture hygiene, poor denture quality, and nocturnal denture use. Numerous treatment methodologies have been used to treat stomatitis; however, a gold standard treatment has not been identified. The aim of this systematic review is to report on the current knowledge available in studies representing a range of evidence on the treatment of denture stomatitis.
Topics: Denture, Complete; Humans; Oral Hygiene; Stomatitis; Stomatitis, Denture
PubMed: 27062660
DOI: 10.1111/jopr.12454 -
International Journal of Oncology Jul 2021Recent studies have focused on identifying novel targeted agents in order to reduce the undesired side‑effects of conventional chemotherapeutic agents on normal cells.... (Meta-Analysis)
Meta-Analysis
Recent studies have focused on identifying novel targeted agents in order to reduce the undesired side‑effects of conventional chemotherapeutic agents on normal cells. However, even targeted therapies may exert certain negative effects on healthy tissues. The present systematic review was performed in order to evaluate the type and the incidence of side‑effects in patients treated with everolimus. The PubMed and Scopus databases were searched using the following free words and MESH terms: 'everolimus' AND 'side‑effects' OR 'toxicities' OR 'adverse events'. A total of 912 potentially relevant studies that were screened based on the title and abstracts were identified. A total of 731 were excluded as they did not fulfil the inclusion criteria. Of the 181 remaining studies included, the adverse events reported were obtained. The primary adverse events reported were stomatitis, leukopenia, anorexia, anaemia and fatigue. The majority of the patients reported adverse events limited to grade 1 or 2. On the whole, the data presented herein confirm the findings of previous studies on the relative safety of everolimus, a targeted therapeutic agent, which differs from that of conventional chemotherapy, and highlight the potential adverse events associated with the therapeutic use of everolimus.
Topics: Antineoplastic Agents; Drug-Related Side Effects and Adverse Reactions; Everolimus; Humans; Incidence
PubMed: 34132370
DOI: 10.3892/ijo.2021.5234 -
The Ocular Surface Apr 2023Mycoplasma pneumoniae induced rash and mucositis (MIRM) is a relatively newly identified clinical entity which is characterized by mucocutaneous manifestations in the... (Review)
Review
Mycoplasma pneumoniae induced rash and mucositis (MIRM) is a relatively newly identified clinical entity which is characterized by mucocutaneous manifestations in the setting of Mycoplasma infection. Though a clinically distinct disease, MIRM exists on a diagnostic continuum with entities including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, and the recently described reactive infectious mucocutaneous eruption (RIME). In this systematic review, we discuss published findings on the epidemiology, clinical manifestations, diagnosis, and management of MIRM, with an emphasis on ocular disease. Lastly, we discuss some of the most recent developments and challenges in characterizing MIRM with respect to the related diagnosis of RIME.
Topics: Humans; Mucositis; Mycoplasma pneumoniae; Stevens-Johnson Syndrome; Eye; Exanthema
PubMed: 36396020
DOI: 10.1016/j.jtos.2022.11.007 -
Pharmaceutics Jan 2022(1) Background: Colchicine is a natural alkaloid with anti-inflammatory properties used to treat various disorders, including some skin diseases. This paper aims to... (Review)
Review
(1) Background: Colchicine is a natural alkaloid with anti-inflammatory properties used to treat various disorders, including some skin diseases. This paper aims to incorporate all the available studies proposing colchicine as a treatment alternative in the management of cutaneous conditions. (2) Methods: In this systematic review, the available articles present in various databases (PubMed, Scopus-Embase, and Web of Science), proposing colchicine as a treatment for cutaneous pathological conditions, have been selected. Exclusion criteria included a non-English language and non-human studies. (3) Results: Ninety-six studies were included. Most of them were case reports and case series studies describing colchicine as single therapy, or in combination with other drugs. Hidradenitis suppurativa, pyoderma gangrenosum, erythema nodosum, erythema induratum, storage diseases, perforating dermatosis, bullous diseases, psoriasis, vasculitis, acne, urticaria, stomatitis, actinic keratosis, and pustular dermatosis were the main diseases discussed in literature. Although the therapeutic outcomes were variable, most of the studies reported, on average, good clinical results (4) Conclusions: Colchicine could be, as a single therapy or in combination with other drugs, a possible treatment to manage several skin diseases.
PubMed: 35214027
DOI: 10.3390/pharmaceutics14020294 -
Journal of the American Geriatrics... Dec 2016To assess the effectiveness of different interventions for treating or preventing denture stomatitis (DS). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess the effectiveness of different interventions for treating or preventing denture stomatitis (DS).
DESIGN
Systematic review.
SETTING
Randomized controlled trials (RCTs) comparing any agent or procedure prescribed to treat or prevent DS in adults.
PARTICIPANTS
Older adults with denture stomatitis.
MEASUREMENTS
There were two main outcomes reported in the trials included in this review: clinical signs of DS and remaining presence of yeast. There were no restrictions regarding language or date of publication. The search period was up to February 2016.
RESULTS
Thirty-five studies were included in the systematic review, with 32 judged as having high risk of bias. Three RCTs compared nystatin with placebo and found a significant effect on the reduction of clinical signs of stomatitis (risk ratio (RR) = 0.51, 95% confidence interval (CI) = 0.36-0.72), four RCTs compared nystatin with placebo and found a significant effect on mycological assessment (RR = 0.61, 95% CI = 0.46-0.80). Five studies of disinfectant agents also showed a significant effect in comparison with an inactive agent (RR = 0.52, 95% CI = 0.30-0.92) in clinical assessment. No evidence was found of an effect of miconazole, amphotericin, or imidazolic drugs. No RCT evaluated the effectiveness of preventive approaches.
CONCLUSION
The results are supportive of the use of nystatin and disinfecting agents in the treatment of DS, but clinicians need to be aware that individual studies had high risk of bias and that the overall quality of the individual reports was judged to be low.
Topics: Humans; Randomized Controlled Trials as Topic; Risk Factors; Stomatitis, Denture
PubMed: 27889906
DOI: 10.1111/jgs.14399 -
Supportive Care in Cancer : Official... Jul 2023Management of head and neck cancers requires a multidisciplinary approach where surgery followed by radio and chemotherapy is the mainstay of treatment. The... (Meta-Analysis)
Meta-Analysis Review
Efficacy of bioadhesives in the management of oral mucositis in patients undergoing radio-chemotherapy for treatment of head and neck cancer-a systematic review and meta-analysis.
BACKGROUND
Management of head and neck cancers requires a multidisciplinary approach where surgery followed by radio and chemotherapy is the mainstay of treatment. The above-mentioned treatment can cause mucositis, a severely debilitating side effect. This can have a significant impact on quality of life. A recent advancing mode of drug delivery is the bioadhesive system. This interacts with mucosa by adhering to it and thereby improving the efficacy of the therapeutic agent delivered.
AIM AND OBJECTIVE
The purpose of this systematic review is to evaluate the effectiveness of bioadhesives in reducing oral mucositis and relieving pain associated with mucositis in head and neck cancer patients receiving radio-chemotherapy.
MATERIALS AND METHOD
Studies assessing the effectiveness of bioadhesives for the treatment of radiation-induced oral mucositis were retrieved from specialized databases (PubMed/MEDLINE, Scopus, ProQuest, Google Scholar, LILACS, OpenGrey) as well as institutional repositories. Data on incidence, pain reduction, resolution, and improvement of oral mucositis using bioadhesive were compiled. A Cochrane tool was used for randomized controlled trials and a JBI tool for non-randomized controlled trials and observational studies to assess the quality of included studies. Based on the eligible study data, a meta-analysis was conducted with STATA version 16, 2019 software, and 95% confidence intervals and p values greater than 0.05.
RESULTS
A total of 15 studies were included which assessed the effectiveness of bioadhesives in managing mucositis and its associated pain. Studies included in the review described either reduction, resolution, or incidence of oral mucositis respectively. A total of three meta-analyses were conducted to assess the incidence of oral mucositis and the pain associated with it, as well as the reduction in incidence. Bioadhesives showed statistically significant differences in the incidence of severe mucositis (p = 0.04). A meta-analysis comparing bioadhesives efficacy in reducing mucositis and pain associated with it found no statistically significant differences (p = 0.36).
CONCLUSION
Bioadhesives are emerging as a novel drug delivery method for treating radio-chemotherapy-induced oral mucositis because of their rapid absorption and easy application. Regardless of its benefits, clinical trials comparing it with conventional treatment methods are necessary to assess its efficacy in treating oral mucositis.
Topics: Humans; Mucositis; Quality of Life; Stomatitis; Head and Neck Neoplasms; Pain
PubMed: 37458879
DOI: 10.1007/s00520-023-07920-2