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Innovative intraoral cooling device better tolerated and equally effective as ice cooling.

ABSTRACT: Most of the patients who receive myeloablative therapy prior to stem cell transplantation develop oral mucositis (OM). This adverse reaction manifests as oral mucosal erythema and ulcerations and may require high doses of morphine for pain alleviation. OM may also interfere with food intake and result in weight loss, a need for parenteral nutrition, and impaired quality of life. To date, there have been very few studies of evidence-based interventions for the prevention of OM. Cryotherapy, using ice chips, has been shown to reduce in an efficient manner the severity and extent of OM, although clinical applications are still limited due to several shortcomings, such as adverse tooth sensations, problems with infectious organisms in the water, nausea, and uneven cooling of the oral mucosa. The present proof-of-concept study was conducted to compare the tolerability, temperature reduction, and cooling distribution profiles of an intra-oral cooling device and ice chips in healthy volunteers who did not receive myeloablative treatment, and therefore, did not experience the symptoms of OM.Twenty healthy volunteers used the cooling device and ice chips for a maximum of 60 min each, using a cross-over design. The baseline and final temperatures were measured at eight intra-oral locations using an infra-red thermographic camera. The thermographic images were analysed using two digital software packages. A questionnaire was used to assess the tolerability levels of the two interventions.The intra-oral cooling device was significantly better tolerated than the ice-chips (p?=?0.0118). The two interventions were equally effective regarding temperature reduction and cooling distribution.The intra-oral cooling device shows superior tolerability in healthy volunteers. Furthermore, this study shows that temperature reduction and cooling distribution are achieved equally well using either method.

SUBMITTER: Walladbegi J

PROVIDER: S-EPMC5676821 | biostudies-other | 2017 Nov

REPOSITORIES: biostudies-other

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Innovative intraoral cooling device better tolerated and equally effective as ice cooling.

Walladbegi Java J Gellerstedt Martin M Svanberg Anncarin A Jontell Mats M

Cancer chemotherapy and pharmacology 20171003 5

<h4>Purpose</h4>Most of the patients who receive myeloablative therapy prior to stem cell transplantation develop oral mucositis (OM). This adverse reaction manifests as oral mucosal erythema and ulcerations and may require high doses of morphine for pain alleviation. OM may also interfere with food intake and result in weight loss, a need for parenteral nutrition, and impaired quality of life. To date, there have been very few studies of evidence-based interventions for the prevention of OM. Cr ...[more]

PMID: 28975429

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Project description:BackgroundThe aim of the study was to assess whether an inexpensive tablet-based box trainer (TBT) is at least equally effective compared with a standard box trainer (SBT) to learn basic laparoscopic skills (BLS). BLS training outside the operating room has been shown to be beneficial for surgical residency. However, simulation trainers are expensive and are not consistently available in all training centers. Therefore, TBT and other homemade box trainers were developed.MethodsMedical students were randomized to either a TBT or an SBT and trained 4 fundamentals of laparoscopic surgery (FLS) tasks for 1 hour twice a week for 4 weeks. A baseline test before the training period and a posttraining test were performed. All students then completed a questionnaire to assess their assigned box trainer. The primary outcome measure was the improvement in total test scores. Improvement in the scores for the 4 individual FLS tasks was chosen as a secondary outcome measure.ResultsThirty-two medical students were recruited. Baseline test scores did not differ significantly between the groups. BLS improved significantly in both groups for the total score and for all 4 tasks separately. Participants in the TBT group showed a greater improvement of total scores than those in the SBT group, although this did not reach statistical significance; noninferiority of the TBT compared with the SBT concerning the improvement of total scores could be demonstrated. Regarding the individual FLS tasks, noninferiority of the TBT could be shown for the pattern cutting and the suturing with intracorporeal knot-tying task. The acceptance of the TBT by the trainees was very good.ConclusionLearning BLS on a homemade TBT is at least equally effective as on an SBT, with the advantage of being very cost saving. Therefore, this readily available box trainer may be used as an effective, flexible training device outside the operating room to improve accessibility to simulation training.

Project description:OBJECTIVE::To evaluate the exposure parameters, radiation protection, absorbed dose and radiographic image quality of the DIOX® intraoral portable radiography device. METHODS::The exposure parameters were measured using the Xi UNFORS detector. Operator exposure to secondary radiation was measured using the 1800cc ionization chamber coupled to the electrometer. The absorbed dose (D) in the patient was calculated using TLD-100H positioned in the Alderson RANDO anthropomorphic simulator. The quality of the radiographic digital image was assessed by comparing radiographic images obtained from two conventional devices (CS 2200®, Carestream Health; Heliodent plus®, Sirona Dental Systems GMbH) with the radiological simulator of the upper molar region RMI (Radiation Measurements Instruments), using three acquisition sensors: Kodak RVG 5000® and Kodak PSP®, Eastman Kodak Company, Rochester, NY; EVO Micro Image®, Brazil. RESULTS::The DIOX intraoral portable radiographic device demonstrated reliability in relation to the performance of the standard evaluated parameters, except for the diameter of the radiation field (5.8 ?mm) less or greater. No evidence of device head radiation was detected. The Pb lead protection of the apparatus attenuates the secondary radiation, thus protecting the operator. However, it was observed that the region of the operator's gonads was the most exposed during the measurements. In the Alderson RANDO anthropomorphic simulator, the highest value of D was in the region corresponding to the submandibular and lingual glands of the left side (0.568 mGy). The image quality of the DIOX portable radiographic apparatus presented quality standards equivalent to those produced by the two conventional radiographic devices. CONCLUSION::The DIOX intraoral portable radiography device demonstrated reliability in relation to the quality control and radioprotection criteria, according to international standards. Results obtained demonstrated the safe use of the DIOX intraoral portable radiography device and indicated the need for debate and change in international sanitary oversight standards regarding the use of portable XR devices in dentistry.

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Innovative intraoral cooling device better tolerated and equally effective as ice cooling.

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Innovative intraoral cooling device better tolerated and equally effective as ice cooling.

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