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Aim: This study is to investigate the effect of Reflexology as an add-on treatment in patients with Fibromyalgia, receiving pregabalin as treatment. Method: The study was conducted from September 2017 to February 2020. 79 patients (74 women and 5 men) with a mean age of 54.6 years were included. Inclusion criteria:-Diagnosis of Fibromyalgia >1 year-Duration of pain >1 year-Pain intensity >6 on VAS scale-Not using Reflexology in the past Results:-Primary endpoint: Reduction of pain scores more than 30% in 3 months.-Secondary endpoints: Functionality (in terms of rigidity and workability) in 3 months. In all patients, the diagnosis of Fibromyalgia was made by completing the FIRST (Fibromyalgia Rapid Screening Tool) questionnaire (Greek version). The evaluation of the results was done with the pain intensity questionnaire in scale VAS as well as with observation, interviews, diaries. All patients received Pregabalin medication at a recommended dose of 75–600 mg daily. 44 patients (56%) received normal medication. A mean reduction in pain of >50% was recorded. 35 patients (44%) did not reach the maximum dose due to side effects and the drug was stopped at 450 mg daily. These patients received 14, 20-min Reflexology sessions, in 12 weeks, in order to achieve the desired analgesic effect. There was a reduction of pain >65% and a significant improvement in the secondary endpoints of functionality (significantly reduced morning stiffness, increased ability to work). Conclusions: Reflexology may be beneficial as add-on treatment in patients with Fibromyalgia who are unable to receive the recommended dosages of their medication. © 2021, Pharmamed Mado Ltd. All rights reserved.

Current therapies for Head and Neck cancer treatment are extremely advanced. Though, they cause oral complications which have deleterious effects on basic life functions, affect oral and overall health, may lead to significant morbidity and treatment discontinuation and have an impact on survivorship and quality of life. As new therapies are introduced, a new spectrum of oral complications is rising, compromising the mucosal integrity and the salivary function, that may not be recognized, reported and treated properly. Oral complications, often permanent and extremely painful, may include mucositis, xerostomia, dysgeusia, infections, trismus and fibrosis, risk of dental disease and necrosis of the jaw, neurosensory disorders and when targeted therapies and immunotherapy are involved, aphthoid and lichenoid lesions can also be reported. Increased awareness is required for the prevention and management of these complications, which can be best provided by a multidisciplinary team. © 2021 Maria Kouri et al., published by Sciendo 2021.

Objective: We reported the alveolar bone histology prior to dental extractions in cancer patients, who received bone-targeting agents (BTA). Subjects and Methods: Fifty-four patients were included. Patients underwent extractions, and bone biopsies were taken. Results: Extractions were performed due to pain, swelling, purulence, fistula, and numbness, not responding to treatment, in 40 patients (group A); extractions due to asymptomatic, non-restorable teeth, were performed in 14 patients (group B). Complete alveolar jaw bone histological necrosis was observed in 28 of 40 (70%) patients of group A and none of group B (p 1 year and concurrent targeted therapy were also significantly associated with MRONJ (p =.016 and p =.050). Conclusion: Pain, swelling, purulence, fistula, and numbness were significantly associated with complete bone histological necrosis prior to extractions and increased MRONJ development. Research is justified to explore whether histological necrosis represents an early stage of osteonecrosis. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved

Substantial knowledge is available on the association of the indoor school environment and its effect among schoolchildren. In the same context, the SINPHONIE (School indoor pollution and health: Observatory network in Europe) conducted a study to collect data and determine the distribution of several indoor air pollutants (IAPs), physical and thermal parameters and their association with eye, skin, upper-, lower respiratory and systemic disorder symptoms during the previous three months. Finally, data from 115 schools in 54 European cities from 23 countries was collected and included 5175 schoolchildren using a harmonized and standardized protocol. The association between exposures and the health outcomes were examined using logistic regression models on individual indoor air pollutants (IAPs); a VOC (volatile organic compound) score defined as the sum of the number of pollutants to which the children were highly exposed (concentration > median of the distribution) in classroom was also introduced to evaluate the multiexposure – outcome association, while adjusting for several confounding factors. Schoolchildren exposed to above or equal median concentration of PM2.5, benzene, limonene, ozone and radon were at significantly higher odds of suffering from upper, lower airways, eye and systemic disorders. Increased odds were also observed for any symptom (sick school syndrome) among schoolchildren exposed to concentrations of limonene and ozone above median values. Furthermore, the risks for upper and lower airways and systemic disorders significantly increased with the VOCs score. Results also showed that increased ventilation rate was significantly associated with decreased odds of suffering from eye, skin disorders whereas similar association was observed between temperature and upper airways symptoms. The present study provides evidence that exposure to IAPs in schools is associated with allergic and respiratory symptoms in children. Further investigations are needed to confirm our findings. © 2020 Elsevier B.V.

Introduction: The reporting of osteonecrosis of the jaw (ONJ) related to anticancer agents without known antiresorptive properties (non-antiresorptives), such as antiangiogenics, tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors, immune checkpoint inhibitors, and cytotoxic chemotherapy is increasing. Objective: To review characteristics of ONJ in cancer patients receiving non-antiresorptives. Methods: A systematic review of the literature between 2009 and 2017 was conducted by the Bone Study Group of MASCC/ISOO. Results: Of 6249 articles reviewed and from personal communication, 42 ONJ cases related to non-antiresorptives were identified. No gender predilection was noted. Median age was 60 years and ONJ stage 2 was most common, with predilection for posterior mandible. Exposed bone, pain, and infection were common at diagnosis. In comparison to bone targeting agents (BTAs), radiology, histology, and management were similar, with medication often discontinued. Delayed diagnosis (median 8 weeks) was noted. Important differences included earlier time to ONJ onset (median 20 weeks), absence of trigger event (40%), and greater likelihood of healing and shorter healing time (median 8 weeks) as compared to BTA-related ONJ. Gastrointestinal cancers predominated, followed by renal cell carcinomas compared to breast, followed by prostate cancers in BTA-related ONJ, reflecting different medications. Conclusions: Data about non-antiresorptive-related ONJ is sparse. This type of ONJ may have better prognosis compared to the BTA-related ONJ, suggested by greater likelihood of healing and shorter healing time. However, the delay in diagnosis highlights the need for more education. This is the first attempt to characterize ONJ associated with different non-antiresorptives, including BRAF and immune checkpoint inhibitors. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

no. MSCC8-0753

Background: Patients, who receive radiotherapy (RT) for head and neck cancer, develop chronic functional abnormalities and survive with reduced quality of life. Purpose: We aimed to study patients with oral cancer, who received post-operative radiotherapy or chemoradiotherapy. Patients: Ten patients (mean age 63.8 years) were included. Methods: Oral mucositis, pain and xerostomia, maximum mouth opening (MMO) and functional abnormalities before and after RT were recorded. The 35 mm MMO or less was accepted as trismus. Patients completed the EORTC QLQ C-30 and Head/Neck35 questionnaires. Results: Mean RT dose was 64.3 Gray. Six patients received chemoradiotherapy. Severe mucositis, pain and xerostomia were recorded in 6 and 5 patients respectively. MMO was reduced in all patients. The mean MMO (34 mm) reached the level of trismus. The total number of symptoms increased from 3.1 to 6.3 in C-30 and from 3.1 to 8.8 per patient in the H/N35. Severe fatigue, pain, limitations at work, weakness, sad feelings, family problems, sleeping problems, anorexia, financial difficulties, tense/irritable, constipation, nausea, vomiting and depression were most often reported with C-30. Most patients reported low to moderate quality of life. Severe oral, jaw and neck pain, swallowing problems, taste alterations, sticky saliva, dry mouth, coarseness, dental problems, feeling sick and reduced interest in life/sex were the most common symptoms reported with N/H35. Conclusions: The observed trismus, 2-to 3-fold increase of symptoms and poorer quality of life highlighted the need for support of oral cancer patients, who receive postoperative radiotherapy or chemoradiotherapy. © De Gruyter Open.

Zinc (Zn) and selenium (Se) exert regulatory activities on immune functions, while cadmium (Cd) is an immunotoxic agent. The object of this study was to detect effects of 10(-4), 10(-5), and 10(-6) M Cd sulphate, Zn sulphate, and sodium selenite, and their combinations on human peripheral blood mononuclear cell (PBMC) proliferation and IFN-gamma and TNF-alpha production. Only 10(-5) M Zn sulphate significantly enhanced spontaneous PBMC proliferation, which was unaffected by the other salts. At 10(-4) and 10(-5) M, Cd sulphate exerted a dose-response inhibitory action on phytohemagglutinin- (PHA-) stimulated PBMC proliferation and cytokine release, while 10(-4) M and 10(-5) M Zn sulphate and 10(-5) M sodium selenite induced a stimulatory effect on both proliferation and cytokine release; 10(-4) M sodium selenite enhanced only the PBMC proliferation; at 10(-6) M, none of the salts changed the PHA-stimulated immune activity. Moreover, 10(-4) and 10(-5) M Zn and 10(-5) M Se strongly upregulated IFN-gamma (a Th1 cytokine) release, even in presence of 10(-5) M Cd, and reduced the inhibitory effects of Cd on PBMC proliferation and TNF-alpha release. This study confirms that Zn and Se both strongly enhance cytokine release induced by mitogenic stimulation, showing also that Zn acts with a broader range of concentrations than Se. This suggests that dietary excess of Se may not have beneficial effects.