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  1. Article ; Online: Oral care and photobiomodulation protocol for the prevention of traumatic injuries and lip necrosis in critically ill patients with COVID-19: an observational study.

    de Paula Eduardo, Fernanda / Gobbi, Marcella Ferreira / Bergamin, Livia Goron / Migliorati, Cesar Augusto / Bezinelli, Leticia Mello

    Lasers in dental science

    2021  Volume 5, Issue 4, Page(s) 239–245

    Abstract: It is well reported that severe cases of COVID-19 frequently need critical care in the ICU to manage respiratory complications, often requiring orotracheal intubation (OTI). Due to complex systemic conditions, the patient may remain intubated for a long ... ...

    Abstract It is well reported that severe cases of COVID-19 frequently need critical care in the ICU to manage respiratory complications, often requiring orotracheal intubation (OTI). Due to complex systemic conditions, the patient may remain intubated for a long period of time and be placed in prone position. This positioning and the pressure of the intubation device on the lips may lead to the development of traumatic injuries. Oral care and the use of photobiomodulation (PBM) can be successfully implemented to promote oral mucosa healing and prevent soft tissue necrosis. We describe the outcomes of the management protocol that was routinely used by the ICU oral medicine team, leading to the implementation of a preventive protocol for the OTI-related oral injuries. We retrospectively analyzed the records of 472 patients with COVID-19 in the ICU from May 2020 to February 2021. 60/472 patients developed traumatic injuries and were managed with the oral care protocol and PBM, to prevent the progress to lip necrosis. When appropriated, in addition to oral care and PBM, other measures were taken to prevent further local trauma (lip hydration, changes in tube fixation). The proposed oral care protocol associated with PBM successfully prevented the progress of traumatic lesions, ulceration, necrosis, and loss of tissue associated with IOT. The quality of life of patients in the ICU and after their recovery was preserved.
    Language English
    Publishing date 2021-11-19
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2367-2587
    ISSN (online) 2367-2587
    DOI 10.1007/s41547-021-00144-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Oral ulcers and sarcoid-like reaction in lymph nodes after cemiplimab therapy for locally advanced cutaneous squamous cell carcinoma: a case report.

    Ferreira, Mariana Henriques / Bezinelli, Letícia Mello / Eduardo, Fernanda de Paula / Gobbi, Marcella Ferreira / Corrêa, Luciana / Schvartsman, Gustavo

    Einstein (Sao Paulo, Brazil)

    2022  Volume 20, Page(s) eRC6367

    Abstract: Cemiplimab is a novel programmed death-1 inhibitor recently approved for advanced cutaneous squamous cell carcinoma. Immune-related adverse events derived from cemiplimab are similar to other anti-PD-1 drugs, including gastrointestinal and cutaneous ... ...

    Abstract Cemiplimab is a novel programmed death-1 inhibitor recently approved for advanced cutaneous squamous cell carcinoma. Immune-related adverse events derived from cemiplimab are similar to other anti-PD-1 drugs, including gastrointestinal and cutaneous toxicities. Oral immune-related adverse events were not reported with cemiplimab in previous studies; thus this case report warns of the fact that the oral cavity may be a site of immune-related adverse events during programmed death-1 block therapy and that this can lead to significant limitations when not properly treated. The present report describes the case of a patient with locally advanced cutaneous squamous cell carcinoma metastatic to cervical lymph nodes who developed dysphagia due to large and painful oral ulcers after a single dose of cemiplimab. The patient also exhibited a sarcoid-like reaction in mediastinal lymph nodes. No immune-related adverse events were found in any other organs. The oral lesions showed significant improvement after topical and short-course systemic corticosteroids, and low-level laser therapy was also performed in the oral lesions. The patient achieved a near-complete response and treatment was discontinued. This article discusses in detail the clinical outcomes and oral toxicity management of cemiplimab therapy for cutaneous squamous cell carcinoma.
    MeSH term(s) Antibodies, Monoclonal, Humanized ; Carcinoma, Squamous Cell/drug therapy ; Humans ; Lymph Nodes ; Oral Ulcer ; Skin Neoplasms/drug therapy
    Chemical Substances Antibodies, Monoclonal, Humanized ; cemiplimab (6QVL057INT)
    Language English
    Publishing date 2022-03-07
    Publishing country Brazil
    Document type Case Reports
    ZDB-ID 2418293-X
    ISSN 2317-6385 ; 2317-6385
    ISSN (online) 2317-6385
    ISSN 2317-6385
    DOI 10.31744/einstein_journal/2022RC6367
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Oral lesions and saliva alterations of COVID-19 patients in an intensive care unit: A retrospective study.

    Eduardo, Fernanda de Paula / Bezinelli, Leticia Mello / Gobbi, Marcella Ferreira / Bergamin, Livia Goron / de Carvalho, Danielle Lima Correa / Corrêa, Luciana

    Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry

    2022  Volume 42, Issue 5, Page(s) 494–502

    Abstract: Aim: To detect the type and frequency of oral lesions and clinical conditions suggestive of saliva alterations in COVID-19 patients in an intensive care unit (ICU), as well as to describe the patient´s management in each case METHODS: Information about ... ...

    Abstract Aim: To detect the type and frequency of oral lesions and clinical conditions suggestive of saliva alterations in COVID-19 patients in an intensive care unit (ICU), as well as to describe the patient´s management in each case METHODS: Information about oral conditions and mechanical ventilation was collected from oral medicine records of COVID-19 patients in an ICU (n = 519) RESULTS: From the total collected, 472 patients (90.9%) were examined by the oral medicine staff. In 242/472 patients (51.3%), alterations in the oral cavity were noted. The most frequent changes were mechanical trauma (18.1%, derived mainly from intubation), vascular/coagulation disturbances (24.1%, petechiae, bruises, varicoses, and oral bleeding), and saliva alterations (24.4%, dry mouth, and sialorrhea). Infectious lesions were mentioned in the oral medicine records (16.9%), most associated with a viral infection (15.7%), mainly herpesvirus. Improved oral change protocols included oral hygiene, use of specific medications, and laser therapy CONCLUSION: COVID-19 patients in the ICU often showed dryness in the oral and mucosa oral lesions related to vascular/coagulation disturbances, and mechanical trauma derived from orotracheal tube. An oral medicine staff must be aligned with the ICU multidisciplinary team to manage COVID-19 patients, as well as to establish diagnoses and oral cavity treatments.
    MeSH term(s) COVID-19 ; Humans ; Intensive Care Units ; Mouth Diseases ; Respiration, Artificial/adverse effects ; Respiration, Artificial/methods ; Retrospective Studies ; Saliva
    Language English
    Publishing date 2022-03-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604118-8
    ISSN 1754-4505 ; 0275-1879
    ISSN (online) 1754-4505
    ISSN 0275-1879
    DOI 10.1111/scd.12705
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Severe oral ulcerative and lichenoid lesions associated with adrenal insufficiency in a patient treated with nivolumab: Report of a case and review of literature.

    Gobbi, Marcella Ferreira / Eduardo, Fernanda de Paula / Bezinelli, Leticia Mello / de Carvalho, Danielle Lima Correa / Monção do Vale, Silvana Kelly / Corrêa, Luciana

    Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry

    2021  Volume 42, Issue 3, Page(s) 286–293

    Abstract: Nivolumab, an antibody against anti-programmed death type 1, has been used for treatment of advanced non-small cell lung cancer with improvement of overall survival. Usually, diarrhea, cutaneous rash, and pruritus are reported as the most common immune- ... ...

    Abstract Nivolumab, an antibody against anti-programmed death type 1, has been used for treatment of advanced non-small cell lung cancer with improvement of overall survival. Usually, diarrhea, cutaneous rash, and pruritus are reported as the most common immune-related adverse effects of nivolumab therapy. Oral lesions and secondary adrenal insufficiency sometimes occur but usually are rare events. We report a case of a patient treated with nivolumab who then showed persistent oral ulcerative and lichenoid lesions, which were refractory to topical corticosteroids. The oral lesions were concomitant to nivolumab-induced adrenal insufficiency. These adverse events led to nivolumab discontinuation, which favored oral lesion healing and adrenal insufficiency remission. Through a brief review of the literature concerning nivolumab toxicity in the oral cavity, we discuss the clinical aspect and management of these lesions.
    MeSH term(s) Adrenal Insufficiency/chemically induced ; Adrenal Insufficiency/drug therapy ; Carcinoma, Non-Small-Cell Lung/chemically induced ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Humans ; Lung Neoplasms/chemically induced ; Lung Neoplasms/drug therapy ; Nivolumab/adverse effects ; Ulcer/chemically induced
    Chemical Substances Nivolumab (31YO63LBSN)
    Language English
    Publishing date 2021-10-30
    Publishing country United States
    Document type Case Reports ; Review
    ZDB-ID 604118-8
    ISSN 1754-4505 ; 0275-1879
    ISSN (online) 1754-4505
    ISSN 0275-1879
    DOI 10.1111/scd.12660
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Dental consensus on HSCT - Part II: dental Care during HSCT.

    Gobbi, Marcella Ferreira / Ferreira, Mariana Henriques / de Carvalho, Danielle Lima Corrêa / Silva, Geisa Badauy Lauria / Macari, Karina Silva Moreira / Neves, Lilian de Jesus / Santos, Paulo Sérgio da Silva / Junior, Luiz Alberto Valente Soares / Melo, Walmyr Ribeiro / Antunes, Héliton Spíndola / De Macedo, Leandro Dorigan / Eduardo, Fernanda de Paula / Bezinelli, Leticia Mello

    Hematology, transfusion and cell therapy

    2023  Volume 45, Issue 3, Page(s) 368–378

    Abstract: During the state of immune vulnerability in hematopoietic stem cell transplantation (HSCT), the patient has an increased risk of developing a vast number of complications, including severe problems in the oral cavity. These situations require ... ...

    Abstract During the state of immune vulnerability in hematopoietic stem cell transplantation (HSCT), the patient has an increased risk of developing a vast number of complications, including severe problems in the oral cavity. These situations require professional oral care to act in the diagnosis and treatment of these conditions, as well as to develop prevention protocols to minimize patient's complications. Oral mucositis, opportunistic infections, bleeding, specific microbiota, taste, and salivary alterations are complications that can occur during HSCT and interfere with various aspects, such as pain control, oral intake, nutrition, bacteremia and sepsis, days of hospitalization and morbidity. Several guidelines have been published to address the role of professional oral care during the HSCT, we describe a consensus regarding these recommendations.
    Language English
    Publishing date 2023-05-30
    Publishing country Brazil
    Document type Journal Article ; Review
    ISSN 2531-1387
    ISSN (online) 2531-1387
    DOI 10.1016/j.htct.2023.04.003
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  6. Article ; Online: Severe acute respiratory syndrome coronavirus 2 and herpesvirus in oral lesions in patients with severe coronavirus disease 2019: Viral interaction?

    Bezinelli, Letícia Mello / Eduardo, Fernanda de Paula / Ferreira, Mariana Henriques / Gobbi, Marcella Ferreira / de Castro, Fabiola Germano / Dos Santos, Gabriela Marcelle Almeida Sant Ana / Pesaventto, Marcele Liliane / Campregher, Paulo Vidal / Corrêa, Luciana

    The Journal of dermatology

    2021  Volume 48, Issue 8, Page(s) e395–e396

    MeSH term(s) COVID-19 ; Herpesviridae ; Humans ; SARS-CoV-2
    Language English
    Publishing date 2021-05-25
    Publishing country England
    Document type Letter
    ZDB-ID 800103-0
    ISSN 1346-8138 ; 0385-2407
    ISSN (online) 1346-8138
    ISSN 0385-2407
    DOI 10.1111/1346-8138.15964
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  7. Article ; Online: Impact of Oral and Gastrointestinal Mucositis on Body Weight Alterations during Hematopoietic Stem Cell Transplantation.

    Eduardo, Fernanda de Paula / Bezinelli, Leticia Mello / Gobbi, Marcella Ferreira / Pereira, Andrea Z / Vogel, Cristina / Hamerschlak, Nelson / Corrêa, Luciana

    Nutrition and cancer

    2017  Volume 70, Issue 2, Page(s) 241–248

    Abstract: The aim of this study was to evaluate whether digestive tract mucositis is a predictive factor for body weight (BW) alterations during hematopoietic stem cell transplantation (HSCT). Data about characteristics of transplantation, initial nutritional ... ...

    Abstract The aim of this study was to evaluate whether digestive tract mucositis is a predictive factor for body weight (BW) alterations during hematopoietic stem cell transplantation (HSCT). Data about characteristics of transplantation, initial nutritional conditions and gastrointestinal mucositis were collected from adult patients (n = 105) who underwent autologous and allogeneic HSCT. Oral mucositis (OM) was not a predictive factor for BW loss, but it was an independent factor for BW gain in autologous HSCT (β = 0.329, P = 0.021). Busulfan-fludarabine conditioning regimen (β = 1.531, P = 0.011) and gender (β = 1.109, P = 0.038) were significant independent risk factors for BW loss in allogeneic HSCT. Overall survival (OS) was significantly affected by the duration of OM in autologous HSCT (HR = 1.243, P = 0.008). In allogeneic HSCT, BW loss (HR = 1.308, P = 0.049) and diarrhea (HR = 1.139, P = 0.012) interfered significantly with OS. In conclusion, OM was not a risk factor for BW loss, but it influenced BW gain and had a negative impact on OS in autologous HSCT patients. Intestinal mucositis explained partially the BW loss and had a negative impact on OS in allogeneic HSCT.
    MeSH term(s) Adult ; Aged ; Body Weight ; Female ; Hematopoietic Stem Cell Transplantation/adverse effects ; Hematopoietic Stem Cell Transplantation/mortality ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Mucositis/etiology ; Multivariate Analysis ; Retrospective Studies ; Transplantation Conditioning/adverse effects ; Transplantation, Autologous/adverse effects ; Transplantation, Homologous/adverse effects
    Language English
    Publishing date 2017-12-26
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 424433-3
    ISSN 1532-7914 ; 0163-5581
    ISSN (online) 1532-7914
    ISSN 0163-5581
    DOI 10.1080/01635581.2018.1412476
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