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

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          Abstract

          Abstract Objective: To verify differences between salivary flow in pediatric cancer patients before starting antineoplastic treatment and in healthy pediatric patients. Material and Methods: This is an observational, cross-sectional, paired study with sample of 120 children and adolescents (3-18 years). Thirty pediatric cancer patients were selected for convenience at “Napoleão Laureano” Hospital (G1). Another group was composed of 90 individuals attended at the School of Dentistry Clinics of the Federal University of Paraíba, matched by age (G2). Data collection was performed in two steps for both groups. Information regarding pediatric cancer patients was obtained by interview with parents / guardians and searching medical records, while in the other group by interview with parents / guardians. Saliva collection was performed using standard method in both groups: unstimulated salivary flow rate (USFR) being the mean volume expelled in 1 minute. Data were analyzed by the Shapiro-Wilk, Kolmogorov-Smirnov and Mann-Whitney tests (α = 5%) Results: Mean USFR for G1 and G2 was 0.52 mL / min and 0.66 mL / min, respectively (p>0.05) and, in both groups, significant difference was observed (p <0.05) between the mean USFR values of its subgroups, and values of adolescents being higher than those of children Conclusion: There is no difference in unstimulated salivary flow of pediatric cancer patients before starting antineoplastic treatment compared with healthy pediatric patients.

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          Effect of stress, anxiety and depression on unstimulated salivary flow rate and xerostomia

          Background. Unstimulated salivary flow rate can be influenced by different factors. This study was undertaken to evaluate the effect of stress, anxiety and depression on unstimulated salivary flow rate in adults. Methods. A total of 247 adult subjects, randomly selected from patients referring to Zanjan Dental School, were included in this investigation. The study procedures consisted of collecting salivary samples (in 5 minutes), completing a form for feeling of xerostomia and completing Depression Anxiety Stress Scale (DASS) Questionnaire to assess the severity of stress, anxiety and depression. Based on the results, the patients were categorized in four groups: Low salivary flow rate plus xerostomia (group 1, n=60), normal salivary flow rate plus xerostomia (group 2, n=59), low salivary flow rate without xerostomia (group 3, n=60) and normal salivary flow rate without xerostomia (control group, n=68). Results. The frequencies of subjects with severe and major depression in groups 1, 2 and 3 were 31.4%, 11.7% and 8.5%, respectively, with 4.4% in the control group. The frequencies of subjects with severe stress in groups 1, 2 and 3 were 21.7%, 3.3% and 11.9%, respectively, with 1.5% in the control group. The frequencies of patients with severe anxiety in groups 1, 2 and 3 were 50%, 30% and 61.1%, respectively, with 4.4% in the control group. Stress, anxiety and depression exhibited a statistically significant relationship with unstimulated salivary flow rate and xerostomia (P<0.05). Conclusion. Stress, anxiety and depression can influence unstimulated salivary flow rate and lead to xerostomia.
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            Cesarean Section and Risk of Childhood Acute Lymphoblastic Leukemia in a Population-Based, Record-Linkage Study in California

            The relationship of mode of delivery to risk of childhood acute lymphoblastic leukemia (ALL) is uncertain. After linking birth records and cancer registry data from California, we conducted a population-based case-control study to investigate the role of delivery by cesarean section (C-section) in the etiology of childhood ALL. This study included 5,081 cases and 18,927 matched controls born in 1978–2009; more detailed data were available on type of C-section (i.e., elective vs. emergency) for a subset of 1,552 cases and 5,688 controls. No association was observed between C-section overall and childhood ALL risk (<15 years of age), but elective C-section was associated with a significantly elevated risk of ALL (odds ratio (OR) = 1.17, 95% confidence interval (CI): 1.01, 1.36). At the peak ages of ALL incidence (2–4 years), C-section was associated with an 11% higher risk of ALL (OR = 1.11, 95% CI: 1.01, 1.22) compared with vaginal delivery, and the magnitude of the association was larger for elective C-section (OR = 1.38, 95% CI: 1.11, 1.70). Emergency C-section was not associated with childhood ALL. Because of design features minimizing nonparticipation and inaccurate recall, this record linkage–based study is less prone to bias. Our results suggest that delivery by elective C-section was associated with a higher risk of childhood ALL, especially at the peak ages of incidence. It is important to evaluate possible mechanisms, because this potential risk factor is modifiable.
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              Measurement of saliva flow rate in healthy young humans: influence of collection time and mouthrinse water temperature.

              The aim of the current study was to determine if unstimulated saliva flow (measured in μl min-1 ) is affected by different durations of sample collection and by temperatures of mouthrinse water used before sample collection. In randomized order, participants provided 10 samples of unstimulated saliva at time points ranging from 1 to 6 min after rinsing with different temperatures of water (10, 20, and 30°C). Data were analysed by one-way anova with post-hoc tests. Test-retest reliability was assessed using Bland-Altman plots and correlation coefficients. A larger volume of saliva was obtained over a longer collection time. No significant difference in saliva flow rate was observed between collection times [mean: 364 (95% CI: 332-397) μl min-1 ]. Although rinsing with different temperatures of mouthrinse water resulted in no significant difference in saliva flow rates as a result of the mouthrinse water temperatures, 60% of the participants had a higher saliva flow rate after rinsing with mouthrinse water at a temperature of 10°C compared with mouthrinse water at 20 and 30°C, suggesting large individual variation (range: 24-420 μl min-1 ). These findings provide justification for using saliva collection times of 1-6 min during sampling of unstimulated saliva. The large individual variations in saliva flow rate in response to different mouthrinse water temperatures suggest that standardization, control, and reporting of mouthrinse water temperature is warranted.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                pboci
                Pesquisa Brasileira em Odontopediatria e Clínica Integrada
                Pesqui. Bras. Odontopediatria Clín. Integr.
                Associação de Apoio à Pesquisa em Saúde Bucal (João Pessoa, PB, Brazil )
                1519-0501
                1983-4632
                2019
                : 19
                : e4630
                Affiliations
                [2] Campinas São Paulo orgnameUniversidade Estadual de Campinas orgdiv1Piracicaba Dental School orgdiv2Postgraduate Program in Clinical Dentistry Brazil
                [6] João Pessoa PB orgnameFederal University of Paraíba orgdiv1Department of Clinical and Social Dentistry Brazil
                [4] João Pessoa PB orgnameFederal University of Paraíba orgdiv1Department of Clinical and Social Dentistry Brazil
                [1] João Pessoa PB orgnameFederal University of Paraíba orgdiv1Postgraduate Program in Dentistry Brazil
                [3] Ribeirão Preto São Paulo orgnameUniversidade de São Paulo orgdiv1Post-Doctoral Fellow Brazil
                [5] João Pessoa PB orgnameFederal University of Paraíba orgdiv1Department of Clinical and Social Dentistry Brazil
                Article
                S1983-46322019000100401 S1983-4632(19)01900000401
                10.4034/pboci.2019.191.141
                5e771f97-8e8a-4552-852a-299aa23a9c7b

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 03 September 2019
                : 25 March 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 0
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                SciELO Brazil

                Categories
                Original Article

                Neoplasms,Dental Care for Children,Saliva
                Neoplasms, Dental Care for Children, Saliva

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