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Asia-Pacific Journal of Clinical... Apr 2017Mucositis is a major complication of irradiation in head and neck tumors, the addition of chemotherapy to irradiation may enhance this dose-limiting problem. Licorice is... (Randomized Controlled Trial)
Randomized Controlled Trial
Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy-induced oral mucositis: A randomized double-blinded clinical trial.
AIM
Mucositis is a major complication of irradiation in head and neck tumors, the addition of chemotherapy to irradiation may enhance this dose-limiting problem. Licorice is a strong demulcent that had been effectively used in treatment of peptic ulcer. The main purpose of this study was to compare the therapeutic safety and efficacy of triamcinolone acetonide (T) and licorice (L) mucoadhesive films on oral mucositis in terms of pain control and/or ulcer treatment.
METHODS
The study was a double-blind, randomized prospective trial of two types of mucoadhesive films in the management of oral mucositis that occurred during head and neck cancer radiotherapy. Oral mucositis was assessed using a quantitative scale (World Health Organization scales) and symptoms were assessed using visual analog scale. Sixty patients were enrolled in the study: 30 patients in the triamcinolone and 30 in the licorice group.
RESULTS
With respect to visual analog scores, repeated observations in consecutive weeks showed a meaningful difference (P-value < 0.05), suggesting the efficacy of both T and L in reducing pain during radiotherapy. Comparison of the pain scores between two groups by independent sample t-test, however, demonstrated no meaningful difference in any consecutive week.
CONCLUSIONS
We concluded that both triamcinolone and licorice mucoadhesive films are effective in the management of oral mucositis during radiotherapy. Furthermore, comparison of the pain scores between two groups demonstrated no meaningful difference, although an overall trend to reduced oral discomfort was seen in the licorice group.
Topics: Adhesives; Double-Blind Method; Female; Glycyrrhiza; Head and Neck Neoplasms; Humans; Male; Middle Aged; Prospective Studies; Radiation Injuries; Stomatitis; Triamcinolone Acetonide
PubMed: 25347930
DOI: 10.1111/ajco.12295 -
Giornale Italiano Di Nefrologia :... Feb 2016The medicinal use of herbs is a principal achievement of human ingenuity. The most renowned doctors of antiquity: Hippocrates, Dioscorides, Theophrastus, Pliny the Elder...
The medicinal use of herbs is a principal achievement of human ingenuity. The most renowned doctors of antiquity: Hippocrates, Dioscorides, Theophrastus, Pliny the Elder and Galen mentioned herbs in their works. The first printed herbal was published in Mainz in 1485. Outstanding scientists e.g. Otto Brunfels, Hieronymus Bock, Leonard Fuchs and Andreo Mattiola published herbals in the 16th century. Polish doctors also contributed to the development of herbal treatment. The first work: Of Herbs and their Potency by Stefan Falimirz, published in 1534, triggered other publications in the 16th century, the age of herbals. In 1542, Hieronymus Spiczynski published a herbal: Of Local and Overseas Herbs and their Potency. Then, in 1568, Marcin Siennik published his: Herbal, which is the Description of Local and Overseas Herbs, their Potency and Application. In 1595, Marcin of Urzedow published: The Polish Herbal, the Books of Herbs. Completed in mid-16th century, it was only published 22 years after his death. The last work discussed is Herbal Known in Latin as published in 1613 by Simon Syrenius a graduate of Ingolstadt and Padua universities and lecturer at the Academy of Krakow. The work was Europes most complete elaboration on herbal treatment. The herbs described in the herbals worked as diuretics, demulcents, analgesics, relaxants and preventives of kidney stones. Published in Polish, they are still to be found in Poland. All the works presented herein are held by the Library of the Seminary of Wloclawek, and the Ossolinski National Institute in Wroclaw.
Topics: History, 16th Century; History, 17th Century; Humans; Phytotherapy; Poland; Urologic Diseases
PubMed: 26913886
DOI: No ID Found -
Journal of Gastroenterology and... Dec 2018Currently, it is still unclear whether adding a mucoprotective agent to a proton pump inhibitor (PPI) results in better outcomes compared with using a PPI alone in...
BACKGROUND
Currently, it is still unclear whether adding a mucoprotective agent to a proton pump inhibitor (PPI) results in better outcomes compared with using a PPI alone in patients with post-gastric endoscopic submucosal dissection (ESD) ulcers. This study aimed to examine the efficacy of PPI alone versus combination treatment in healing of post-gastric ESD ulcers, as well as on delayed bleeding and amount of blood transfused.
METHODS
A systematic search of MEDLINE, EMBASE, Cochrane, and ISI Web of knowledge databases, up until May 2017, for randomized trials comparing PPI alone versus PPI plus a mucoprotective drug in achieving ulcer healing in patients undergoing gastric ESD was performed. The primary outcome is scarring stage on endoscopic assessment at 4 or 8 weeks after gastric ESD.
RESULTS
From an initial 3071 citations, eight articles (n = 953 lesions from 934 patients) were analyzed. Patients receiving combination treatment achieved a scarring stage significantly more often than those on a PPIs alone at 4 or 8 weeks after ESD, (risk ratio = 1.36, 95% CI; 1.06-1.75). No study reported amount of blood transfused. There were no significant between treatment-group differences in terms of delayed bleeding (risk ratio = 0.58, 95% CI; 0.17-1.99). Neither location of ulcer nor Helicobacter pylori infection was related to ulcer scarring stage.
CONCLUSION
The limited evidences suggested combination treatment may be more effective in accelerating the process of ulcer healing in patients undergoing gastric ESD than the use of PPI alone, but does not appear to alter delayed bleeding risk.
Topics: Aged; Blood Transfusion; Demulcents; Drug Therapy, Combination; Endoscopic Mucosal Resection; Female; Gastroscopy; Humans; Male; Middle Aged; Peptic Ulcer Hemorrhage; Protective Factors; Proton Pump Inhibitors; Risk Factors; Stomach Ulcer; Time Factors; Treatment Outcome; Wound Healing
PubMed: 29870582
DOI: 10.1111/jgh.14305 -
Radiotherapy and Oncology : Journal of... Sep 2015A significant reduction of radiation-induced oral mucositis by systemic application of pentoxifylline has been demonstrated in a mouse tongue model. However, the...
PURPOSE
A significant reduction of radiation-induced oral mucositis by systemic application of pentoxifylline has been demonstrated in a mouse tongue model. However, the underlying mechanisms remain unclear. The present study focuses on the development of local hypoxia in mouse tongue during daily fractionated irradiation and a potential modulation by pentoxifylline.
MATERIALS AND METHODS
Daily fractionated irradiation with 5×3Gy/week (days 0-4, 7-11) was given to the snouts of mice. Groups of 3 animals per day were sacrificed between day 0 and 14. Pentoxifylline (15mg/kg, s.c.) was administered daily from day -5 to the day before the mice were sacrificed. The expression of intrinsic hypoxia markers HIF-1α and GLUT1 in the epithelium of the lower tongue surface was analysed by immunohistochemistry in 3 animals per day; the percentage of positive epithelial cells and the staining intensity were analysed as endpoints.
RESULTS
Compared to untreated control tissue, fractionated irradiation resulted in a progressive increase in the expression of both hypoxia markers. This effect was significantly reduced by pentoxifylline.
CONCLUSION
An early onset of local hypoxia occurs during fractionated irradiation in mouse tongue epithelium. The effect is markedly reduced by the mucoprotective agent pentoxifylline, suggesting a mucositis-promoting role of hypoxia; this, however, deserves further investigation.
Topics: Analysis of Variance; Animals; Cell Count; Demulcents; Disease Models, Animal; Dose Fractionation, Radiation; Hypoxia; Hypoxia-Inducible Factor 1, alpha Subunit; Male; Mice, Inbred C3H; Mouth Mucosa; Pentoxifylline; Radiation-Protective Agents; Stomatitis; Tongue
PubMed: 25890574
DOI: 10.1016/j.radonc.2015.03.024