Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-08-01T16:54:22Z No. of bitstreams: 1 DIS_JULIANA_JASPER_PARCIAL.pdf: 388351 bytes, checksum: 6af0aff0490b73b53ede7bf4fe93485c (MD5) / Made available in DSpace on 2016-08-01T16:54:22Z (GMT). No. of bitstreams: 1 DIS_JULIANA_JASPER_PARCIAL.pdf: 388351 bytes, checksum: 6af0aff0490b73b53ede7bf4fe93485c (MD5) Previous issue date: 2016-04-18 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Radiation-induced oral mucositis (OM) is a highly debilitating side effect, which affects almost all patients with head and neck malignancies undergoing radiotherapy (RT). The severity of this injury is directly related to factors associated with the therapy itself and the individual characteristics of each patient. To date, there is no standard treatment protocol for this condition. Therefore, the present study aimed to evaluate clinically and histologically the effect of granulocyte colony-stimulating factor (G-CSF) on the healing of traumatic ulcers produced in the tongue of Wistar rats undergoing RT. The animals were randomly divided into 4 groups: 1) RT + traumatic ulcer + Filgrastim; 2) RT + traumatic ulcer + saline; 3) no RT + traumatic ulcer + Filgrastim; 4) no RT + traumatic ulcer. Filgrastim (r-metHuG-CSF), a recombinant G-CSF, was injected subcutaneously into the animals once daily, beginning 1 day after a single-dose radiation protocol (30 Gy), immediately after the traumatic ulcer was made. At the end of a 7-day experimental period, animals were euthanized and had their tongue surgically removed, processed, and stained with hematoxylin and eosin (HE). Clinically, all groups differed significantly in presence and size of traumatic ulcers, and the irradiated groups also differed significantly in severity of radiation-induced OM. Filgrastim-treated groups, submitted or not to RT, showed a better performance in this aspect. Histologically, there was an increased inflammatory response in the nonirradiated groups, with no statistically significant difference between the study drug and the respective control groups. Based on the present clinical results, we conclude that the use of Filgrastim reduced the manifestation and severity of trauma-induced ulcers and radiation-induced OM. This condition has a complex pathogenesis, which requires further detailed investigations on the actual role of G-CSF in its management before a formal recommendation regarding its use for this purpose can be made. / A mucosite oral (MO) radioinduzida ? um efeito colateral altamente debilitante, que afeta a quase totalidade dos indiv?duos portadores de neoplasias malignas na regi?o de cabe?a e pesco?o, submetidos ? radioterapia (RT). A gravidade desta inj?ria est? diretamente relacionada a fatores pertinentes ? terapia em si e ?s caracter?sticas individuais de cada paciente. N?o h?, at? o momento, um protocolo padr?o para o tratamento desta enfermidade. Sendo assim, o presente estudo objetivou analisar clinica e histologicamente a a??o do fator estimulador de col?nias de granul?citos (G-CSF) em ?lceras traum?ticas confeccionadas na l?ngua de ratos Wistar submetidos ? RT. Os animais foram alocados randomicamente em quatro grupos distintos: 1) RT + ?lcera traum?tica + Filgrastim; 2) RT + ?lcera traum?tica + soro fisiol?gico; 3) sem RT + ?lcera traum?tica + Filgrastim; 4) sem RT + ?lcera traum?tica. O Filgrastim (r-metHuG-CSF), um G-CSF recombinante, foi injetado diariamente nos animais pela via subcut?nea, iniciando um dia depois do protocolo ?nico de irradia??o (30 Gy), imediatamente ap?s a confec??o da ?lcera traum?tica. Uma vez conclu?do o tempo experimental de sete dias, os animais foram eutanasiados e tiveram a l?ngua excisada, processada e corada com hematoxilina e eosina (HE). A avalia??o cl?nica diferiu significativamente entre todos os grupos quanto ? presen?a e ao tamanho da ?lcera traum?tica, al?m do grau de severidade da MO radioinduzida, entre os grupos irradiados. Os grupos tratados com Filgrastim, submetidos ou n?o ? RT, apresentaram uma melhor performance neste quesito. Histologicamente, houve maior resposta inflamat?ria nos grupos n?o irradiados, sem diferen?a estatisticamente significante entre a medica??o estudada e os respectivos grupos controle. Baseado nos resultados cl?nicos encontrados, pode-se concluir que o uso do Filgrastim reduziu a manifesta??o e o grau de severidade da ?lcera confeccionada e da MO radioinduzida. Esta ? uma doen?a de patogenia complexa, a qual necessita investiga??es mais detalhadas sobre o real papel do G-CSF no seu manejo, para que uma indica??o formal do seu uso possa ser recomendada com esta finalidade.

Submitted by Jadson Francisco de Jesus SILVA (jadson@uefs.br) on 2018-01-23T22:40:05Z No. of bitstreams: 1 ANA PAULA EUFR?ZIO.pdf: 1790027 bytes, checksum: 4b9b469a85fd902129536275d6da931f (MD5) / Made available in DSpace on 2018-01-23T22:40:06Z (GMT). No. of bitstreams: 1 ANA PAULA EUFR?ZIO.pdf: 1790027 bytes, checksum: 4b9b469a85fd902129536275d6da931f (MD5) Previous issue date: 2016-08-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Malignant neoplasms represent one of the main causes of morbi-mortality in Brazil and worldwide. Radiotherapy, whether associated or not with chemotherapy, is the therapeutic modality most often used for cancer of the head and neck. However, it can trigger reactions at the oral level, such as oral mucositis, the most limiting side effect, with intense pain and difficulty eating, which may require the suspension of oncologic treatment for the patient. Polyhexanide has been used effectively and safely in the treatment of acute and chronic wounds. Objectives: To describe the clinical-epidemiologic profile and investigate the efficacy of polyhexanide in the treatment of oral mucositis and pain relief, in the period of 8-15 days, among patients with cancer of the head and neck undergoing treatment with radiotherapy (whether associated or not with chemotherapy). Methods: A randomized clinical trial was conducted, parallel and double-blind, among patients with cancer of the head and neck undergoing radiotherapy treatment with or without chemotherapy, in the High Complexity Oncology Unit of Feira de Santana, Bahia, who developed oral mucositis, were 18 years of age or older and consented to participation and signed informed consent forms in the period of July 2015 to May 2016. Two equal groups were formed by random allocation?an intervention group (polyhexanide gel) and a control group (gel without polyhexanide). These groups were reevaluated after 8 and 15 days of use of the gels. Clinical exams, evaluations of the medical records, and interviews with the application of a survey instrument used in the study were approved by the Committee for Ethics in Human Subjects Research of the State University of Feira de Santana, under the number 1.074.479/2015. Statistical analysis consisted of relative and absolute frequencies, averages, medians, and standard deviation, and the p-value?considered statistically signification when <0.05?were obtained by non-parametric Friedman tests, Wilcoxon the posts with signs and Wilcoxon-Mann-Whitney. Results: The findings were presented as an article. The mean age was 59.68 years; 58.8% men; 67.6% Brown/Black, and 79.4% with an elementary school education or less. The majority of tumors (64.7%) already presented in advanced stage, and the most frequent were those of the pharynx (23.5%) and the oral cavity (20.4%). Radiotherapy associated with chemotherapy was the most used therapy. Grades III and IV of oral mucositis were the most frequent in the third and fourth weeks of radiotherapy treatment. A total of 34 individuals were accompanied, 17 in the intervention group and 17 in the control group. After a period of 8 to 15 days, statistically significant differences were observed (p<0.05) in relation to the reduction in severity of the oral mucositis and pain, between the time points of gel use in the intervention group. Conclusions: Knowledge of the clinical-epidemiologic profile of patients undergoing oncology treatment with oral mucositis is important to establish potentially effective treatments. In this study polyhexanide represented an effective therapy in the treatment of oral mucositis and relief of pain, with positive results in the first 8 days of use. / As neoplasias malignas representam uma das principais causas de morbimortalidade no Brasil e no mundo. A Radioterapia, associada ou n?o a quimioterapia, ? a modalidade terap?utica mais empregada para o c?ncer de cabe?a e pesco?o. Todavia, pode desencadear rea??es em n?vel bucal, como a mucosite oral, o efeito mais limitante, com dor intensa e dificuldades na alimenta??o, podendo requerer at? a suspens?o do tratamento oncol?gico do paciente. A polihexanida tem sido empregada no tratamento de feridas agudas e cr?nicas, com efic?cia e seguran?a. Objetivos: Descrever o perfil cl?nico-epidemiol?gico e investigar a efic?cia da polihexanida no tratamento da mucosite oral e do al?vio da dor, no per?odo de 8 e 15 dias, em pacientes com c?ncer de cabe?a e pesco?o, sob tratamento com radioterapia associada ou n?o a quimioterapia. M?todos: Realizou-se um ensaio cl?nico randomizado, paralelo e duplo cego, com todos os pacientes com c?ncer de cabe?a e pesco?o sob tratamento com radioterapia associada ou n?o a quimioterapia, na Unidade de Alta Complexidade em Oncologia de Feira de Santana, Bahia, que desenvolveram mucosite oral, tinham 18 anos ou mais de idade e aceitaram participar assinando o termo de consentimento livre e esclarecido, no per?odo de julho de 2015 a maio de 2016. Dois grupos foram igualmente formados por aloca??o aleat?ria, o de interven??o (gel de polihexanida) e o grupo controle (gel sem polihexanida), e reavaliados nos intervalos de 8 e 15 dias de uso dos g?is. Avalia??es cl?nicas, de prontu?rios e entrevistas com aplica??o de formul?rio foram aplicadas neste estudo aprovado pelo Comit? de ?tica em Pesquisa com Seres Humanos da Universidade Estadual de Feira de Santana sob o n?mero 1.074.479/2015. Para a an?lise estat?stica empregaram-se as frequ?ncias relativas e absolutas, m?dias, medianas e desvio-padr?o, e o valor de p, considerado estatisticamente significativo quando ? 0,05 foi obtido por meio dos testes n?o param?tricos de Friedman, Wilcoxon dos postos com sinais e Wilcoxon-Mann-Whitney. Resultados: Os achados foram apresentados em forma de artigo. A m?dia de idade foi de 59,68 anos; 58,8% homens; 67,6% de cor parda e 79,4% analfabetos ou com baixo grau de escolaridade. A maioria (64,7%) dos tumores j? se apresentava em est?dio avan?ado, sendo os mais frequentes os da faringe (23,5%) e cavidade oral (20,4%). A Radioterapia associada ? quimioterapia foi a terap?utica mais empregada. Graus III e IV de mucosite oral foram mais frequentes nas 3? e 4? semanas de tratamento radioter?pico. Um total de 34 indiv?duos foi acompanhado, sendo 17 do grupo de interven??o e 17 do grupo controle. Ap?s um per?odo de 8 e 15 dias, observaram-se diferen?as estatisticamente significativas (p<0,05) em rela??o a redu??o da gravidade da mucosite oral e da dor, entre os tempos de uso do gel no grupo de interven??o. Conclus?es: O conhecimento do perfil cl?nico-epidemiol?gico de pacientes em tratamento oncol?gico com mucosite oral faz-se importante para se estabelecer terap?uticas potencialmente eficazes. Neste estudo a polihexanida apresentou-se como uma terap?utica eficaz no tratamento da mucosite oral e controle da dor, com resultados positivos ainda nos primeiros 8 dias de uso.