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Role of Antioxidants in Minor Salivary Glands Cancer in the Elderly.
Oteri, G, Lentini, M, Cicciù, M, Peditto, M, Rey, EO, Carrión, AB, Marciano, A
The Journal of craniofacial surgery. 2019;(3):823-828
Abstract
BACKGROUND Minor salivary gland tumors (MSGTs) are infrequent, representing 10% to 15% of all salivary neoplasms. Despite this low frequency, a significant increase in the incidence of these tumors has been reported in the lasts 30 years. While tumors of the salivary glands can appear at any age, different authors consider the peak of incidence to be associated with old age (60+). The etiopathogenesis of MSGTs remains unclear. In this context, the aim of this study was to explore the hypothesis that age-related changes in salivary antioxidant capacity are involved in the pathogenesis of minor salivary glands tumors to identify possible preventive measures.Furthermore the study aimed to describe the clinico-pathological features of a multi-institutional case series of MSGTs which results are consistent with data in the literature. METHODS An electronic search of the English language literature was performed using PubMed and Google scholar (). Databases were screened for papers using a number of search strings constructed using relevant terms (minor salivary glands tumors, elderly, diet, antioxidant, saliva, salivary glands). RESULTS According to the world literature, the peak of incidence of MSGTs is between the fifth and seventh decades of life. To date, the only confirmed risk factor for salivary gland tumors is the exposure to ionizing radiation. The significantly reduced salivary antioxidant capacity in old people may explain the higher prevalence of these tumors in the elderly population. CONCLUSIONS Further investigation is required to determine the real etiopathogenesis of MSGTs and why these tumors result more frequent in elderly patients.
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2.
Scurvy mimicking osteomyelitis: case report and review of the literature.
Harknett, KM, Hussain, SK, Rogers, MK, Patel, NC
Clinical pediatrics. 2014;(10):995-9
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3.
Immediate bonding to bleached enamel treated with 10% sodium ascorbate gel: a case report with one-year follow-up.
Garcia, EJ, Mena-Serrano, A, de Andrade, AM, Reis, A, Grande, RH, Loguercio, AD
The European journal of esthetic dentistry : official journal of the European Academy of Esthetic Dentistry. 2012;(2):154-62
Abstract
It is generally not recommended that bonded restoration treatment should be carried out immediately after bleaching treatment. However, the use of antioxidants such as sodium ascorbate can be useful to avoid a waiting period. This article is a brief review about in vitro proposals to overcome low bond strength values to bleached dental surfaces. It shows a one-year follow-up case report of a young female presenting agenesis of maxillary lateral incisors reshaped with direct resin composite immediately after dental bleaching. Teeth were bleached with a combination of in-office and at-home whitening protocols, followed by the application of a 10% sodium ascorbate gel for one hour, to allow the immediate reshaping with direct resin composite restoration. After one year, the clinical performance of the restoration was successful. The use of sodium ascorbate gel can help the clinician to perform bonding procedures immediately after bleaching treatments.
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4.
Alpha-lipoic acid may improve symptomatic diabetic polyneuropathy.
Tang, J, Wingerchuk, DM, Crum, BA, Rubin, DI, Demaerschalk, BM
The neurologist. 2007;(3):164-7
Abstract
OBJECTIVE In patients with symptomatic diabetic polyneuropathy, is oral alpha-lipoic acid (ALA) effective in improving neuropathic symptoms compared with placebo? METHODS The question was addressed with a structured evidence-based clinical neurologic practice review via videoconferencing between 3 academic institutions. Participants included consultant and resident neurologists, clinical epidemiologists, medical librarians, and clinical content experts. A critically appraised topic format was employed, with a clinical scenario, structured question, search strategy, appraisal, results, summary of evidence, commentary, and bottom-line conclusions. RESULTS A single modestly valid randomized controlled trial demonstrated that oral ALA in doses of 600 mg, 1200 mg, and 1800 mg was effective in reducing neuropathic symptoms of diabetic distal symmetric polyneuropathy (DSP) at 5 weeks, as assessed by the Total Symptom Score (>or=50% reduction), with number needed to treat (NNT) (95% CI) of 2.7 (1.8 to 5.8), 4.1 (2.3 to 20.2), and 3.2 (2.0 to 8.6), respectively. Adverse events, including nausea, vomiting, and vertigo, were identified but occurred most frequently with ALA doses of 1200 mg and 1800 mg. Overall, treatment emergent adverse events for ALA 600 mg were not significantly different than placebo, but ALA 1200 mg and 1800 mg had number needed to harm (95% CI) of 4.5 (2.4 to 31.0) and 3.0 (1.9 to 7.1), respectively. CONCLUSION Oral ALA may improve neuropathic symptoms in diabetic DSP. A single modestly valid RCT demonstrated that 600 mg was an effective and well-tolerated dose, with NNT 2.7 to significantly reduce neuropathic pain symptoms over a 5-week period. ALA's role and place in an algorithm among other commonly prescribed oral treatments for symptomatic relief of neuropathic pain in diabetic DSP remains unclear.
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5.
Case report: resolution of symptomatic epidural fibrosis following treatment with combined pentoxifylline-tocopherol.
Georges, C, Lefaix, JL, Delanian, S
The British journal of radiology. 2004;(922):885-7
Abstract
Epidural fibrosis (EF) is a major cause of failed back surgery syndrome (FBSS), which induces disabling radiculopathy for which no effective medical treatment exists. Our understanding of the fibrosis mechanisms and our clinical and experimental results for the treatment of radiation-induced fibrosis prompted us to postulate that EF might respond to treatment with combined pentoxifylline (PTX)-tocopherol (Vit.E). 6 weeks after lumbar spine surgery, a 28-year-old man presented with recurrent left L5 sciatica without disc herniation on MRI in December 1993. From 1993 to 1997, he had unrelieved back and leg pain, which became increasingly resistant to intensive medical treatment and to a spinal cord stimulator, and confined him to bed as from December 1997. In 1998, a lumbar CT-scan showed an area of left L4-L5 EF measuring 12 mm x 12 mm, without disc herniation. From April 1998, oral PTX (800 mg day(-1)) and Vit.E (1000 IU day(-1)) were administered daily for 3.5 years and well tolerated. Clinical improvement began during the third month of treatment and continued until total regression of clinical symptoms April 2001. Lumbar MRI in November 2001 showed a surface area of residual EF half the size of the initial area. This is the first report to indicate that antifibrotic treatment using combined PTX-Vit.E may be of potential benefit in the treatment of post-operative EF. Additional studies are required to confirm this potential.
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6.
Radical scavengers for Ménière's disease after failure of conventional therapy: a pilot study.
Takumida, M, Anniko, M, Ohtani, M
Acta oto-laryngologica. 2003;(6):697-703
Abstract
OBJECTIVE To perform a trial to assess the efficacy of radical scavengers, i.e. rebamipide, vitamin C and glutathione, for the treatment of Ménière's disease (MD). MATERIAL AND METHODS Rebamipide (300 mg/day), vitamin C (600 mg/day) and/or glutathione (300 mg/day) were given orally for at least 8 weeks to 25 patients with poorly controlled MD. RESULTS Of 22 patients, 21 showed marked improvement of vertigo; 12/27 ears showed improvement of hearing disorders; 17/27 ears showed improvement of tinnitus; and 18/25 patients showed improvement of disability. CONCLUSION This study suggests that treatment using radical scavengers has the potential to become an effective new therapy for MD.
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7.
The use of antioxidants with first-line chemotherapy in two cases of ovarian cancer.
Drisko, JA, Chapman, J, Hunter, VJ
Journal of the American College of Nutrition. 2003;(2):118-23
Abstract
OBJECTIVE Because of poor overall survival in advanced ovarian malignancies, patients often turn to alternative therapies despite controversy surrounding their use. Currently, the majority of cancer patients combine some form of complementary and alternative medicine with conventional therapies. Of these therapies, antioxidants, added to chemotherapy, are a frequent choice. METHODS For this preliminary report, two patients with advanced epithelial ovarian cancer were studied. One patient had Stage IIIC papillary serous adenocarcinoma, and the other had Stage IIIC mixed papillary serous and seromucinous adenocarcinoma. Both patients were optimally cytoreduced prior to first-line carboplatinum/paclitaxel chemotherapy. Patient 2 had a delay in initiation of chemotherapy secondary to co-morbid conditions and had evidence for progression of disease prior to institution of therapy. Patient 1 began oral high-dose antioxidant therapy during her first month of therapy. This consisted of oral vitamin C, vitamin E, beta-carotene, coenzyme Q-10 and a multivitamin/mineral complex. In addition to the oral antioxidant therapy, patient 1 added parenteral ascorbic acid at a total dose of 60 grams given twice weekly at the end of her chemotherapy and prior to consolidation paclitaxel chemotherapy. Patient 2 added oral antioxidants just prior to beginning chemotherapy, including vitamin C, beta-carotene, vitamin E, coenzyme Q-10 and a multivitamin/mineral complex. Patient 2 received six cycles of paclitaxel/carboplatinum chemotherapy and refused consolidation chemotherapy despite radiographic evidence of persistent disease. Instead, she elected to add intravenous ascorbic acid at 60 grams twice weekly. Both patients gave written consent for the use of their records in this report. RESULTS Patient 1 had normalization of her CA-125 after the first cycle of chemotherapy and has remained normal, almost 3(1/2) years after diagnosis. CT scans of the abdomen and pelvis remain without evidence of recurrence. Patient 2 had normalization of her CA-125 after the first cycle of chemotherapy. After her first round of chemotherapy, the patient was noted to have residual disease in the pelvis. She declined further chemotherapy and added intravenous ascorbic acid. There is no evidence for recurrent disease by physical examination, and her CA-125 has remained normal three years after diagnosis. CONCLUSION Antioxidants, when added adjunctively, to first-line chemotherapy, may improve the efficacy of chemotherapy and may prove to be safe. A review of four common antioxidants follows. Because of the positive results found in these two patients, a randomized controlled trial is now underway at the University of Kansas Medical Center evaluating safety and efficacy of antioxidants when added to chemotherapy in newly diagnosed ovarian cancer.
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8.
[Successful treatment of an elderly patient with idiopathic thrombocytopenic purpura accompanied with chronic subdural hematoma, using a Chinese herbal medicine, EK-49, and ascorbic acid].
Hirano, A, Ueoka, H
Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics. 2001;(2):224-8
Abstract
An 88 year-old woman was admitted complaining of headache. CT scan of the head revealed a right subdural hematoma. She had been followed by a local physician because of chronic thrombocytopenia. Her peripheral platelet count on admission was 0.5 x 10(4)/microliter, with a high serum level of PAIgG. Bone marrow examination revealed marked increase of megakaryocyte. Idiopathic thrombocytopenic purpura(ITP) accompanied with chronic subdural hematoma was diagnosed. Transient increase of platelet count and improvement of subdural hematoma was obtained by administration of prednisolone. However, platelet count decreased with tapering of prednisolone. Then combined administration of a Chinese herbal medicine, EK-49, and ascorbic acid was started. Platelet count gradually increased and no adverse effects were experienced. These results indicated that elderly patients with chronic subdural hematoma can be treated non-invasively, and that a combination of EK-49 and ascorbic acid may be effective in the treatment of refractory ITP.
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9.
Acute renal failure, oxalosis, and vitamin C supplementation: a case report and review of the literature.
Mashour, S, Turner, JF, Merrell, R
Chest. 2000;(2):561-3
Abstract
With the increased use of nonprescription vitamin supplementation, physicians involved in critical care must be aware of the potential complications of these medications. We report the case of a 31-year-old African-American man presenting to the emergency department with acute renal failure. He had previously been well and initially denied the use of any drugs except for vitamin C tablets obtained at a local health food store. This case report and review of the literature is utilized to illustrate the importance of historical data in patients presenting with acute renal failure to a critical care service.