Patient communication protocols for sexually transmitted infections: A systematic review

AIMS

We conducted a systematic review of post-test communication protocols and observational studies regarding counseling for a positive sexually transmitted infection (STI) result and also discuss the role of dental specialist (e.g., oral medicine) in this sense.

METHODS AND RESULTS

The search process followed the parameters of PRISMA 2020 guidelines. MEDLINE/PubMed, Web of Science, Scopus, EMBASE, and LILACS were consulted with a specific search strategy for each one. Additionally, the references of the included studies, grey literature, and experts were consulted. Four protocols and 18 observational studies were included in this systematic review, published between 1997 and 2022 in the Americas and Europe. The communication protocols emphasized the importance of conducting personal and private discussions with patients to address their fears and questions. Among the observational studies, 56% indicated that post-test counseling was either ineffective or absent. Furthermore, 22% of the studies used telephone communication to deliver results to patients.

CONCLUSIONS

Our study showed that the communication process of a positive STI result affects the patients in several aspects, as treatment adherence and their relationship with the community. Nevertheless, this process of STI post-test communication seems to be flawed, which brings potential negative effects to patients.

What is the effect of lactoferrin on oral and jawbone tissue repair? A systematic review

Currently, there is growing interest in the potential use of lactoferrin (LTF), a member of the transferrin family, for the improvement of tissue healing. In this sense, a literature search was conducted to integrate data published on the effect of LTF on jawbone repair. PubMed/MEDLINE, Scopus, Embase, Web of Science, LILACS, and Cochrane databases were retrieved according to the PRISMA 2020 statement. Articles in English, Spanish, and Portuguese were recovered, with no year restriction. In vitro, in vivo, and clinical studies were selected. A total of 742 articles were retrieved, 11 of which met the inclusion criteria (5 in vitro and 5 in vivo studies, and one clinical trial). The included data demonstrated wide variations in study design and LTF therapy protocols. Cell proliferation and viability were the primary outcomes evaluated in the in vitro studies, all of which reported a potential effect of LTF on the repair process. Of three in vivo studies, one reported a reduction in the overall healing rate, whereas the other two showed that LTF inhibited bone resorption and increased bone formation. The clinical trial's findings showed that LTF is a potential promoter of wound repair in patients with medication-related osteonecrosis of the jaws. Overall, data from the studies support a potential effect of LTF therapy on the process of jawbone repair.

ORAL MUCOSAL LESIONS IN A COVID-19 PATIENT: A CASE REPORT

Because the oral health of patients with COVID-19 can be affected by the infection, there is doubt whether these manifestations could be a typical pattern resulting from the direct viral infection or result from systemic deterioration. A 24-year-old woman was referred to the general clinical doctor complaining about fever, headache, and shortness of breath lasting around 5 days. Medical history was unremarkable. A nasopharyngeal swab (reverse transcriptase polymerase chain reaction) for SARS-CoV-2 was positive. Azithromycin and supportive treatment were prescribed. On the fifth day after the onset of symptoms (2 days after the start of antibiotic) the patient complained about sores in the mouth. Intraoral examination showed several painful, red ulcers with irregular margins and varying sizes and a nonhemorrhagic background in the oropharyngeal region. Topical anesthetic mouthrinse was prescribed. Two weeks after the initial signs, the patient is symptom free with no evidence of local or systemic disease.

CLINICAL AND HISTOPATHOLOGIC FEATURES OF COVID-19 IN ORAL MUCOSA: A SYSTEMATIC REVIEW

Objectives

To investigate the demographic, clinical, and histologic features of patients with COVID-19 who present oral lesions.

Study design

An electronic search was conducted by 2 reviewers in 6 databases. Absolute and relative frequencies were obtained by descriptive analysis.

Results

Three publications comprising 4 cases were included. Mean patient age was 54.75 (±14.7) years, and males (n = 3, 75.0%) were more often affected. All patients (100%) were White. All individuals presented comorbidities, with the most common being diabetes (n = 2, 28.6%), hypertension (n = 2, 28.6%), and coronary heart disease (n = 2, 28.6%). All lesions presented as symptomatic ulcers (n = 4, 100%). The mean evolution time was 5 days. Hard palate (n = 2, 28.6%), tongue (n = 2, 28.6%), buccal mucosa (n = 2, 28.6%), and lip (n = 1, 14.2) were the affected sites. Regarding histologic features, the most frequent were the following: koilocytes (n = 4, 100.0%), ulcer (n = 3, 75.0%), exocytosis (n = 3, 75.0%), acute inflammation (n = 3, 75.0%), chronic inflammation (n = 2, 50.0%), and thrombus (n = 1, 25.0%). Of informed immunohistochemical markers, HSV 1 /2, CD20, CD68, CD163, CD163, CD4, CD34, CD3, and CD8 showed positivity. The mean follow up was 11.7 days with total remission of 3 (75.0%) lesions.

Conclusions

There is still doubt as to whether intraoral manifestations of COVID-19 patients could be a typical pattern resulting from direct viral infection or from systemic deterioration. Further investigation is needed.

Is teriparatide therapy effective for medication-related osteonecrosis of the jaw? A systematic review and meta-analysis

Considering the lack of studies determining the real TPTD efficacy in individuals who develop MRONJ, our objective was to combine the available data on MRONJ cases treated with TPTD. The findings demonstrated that TPTD in combination with another therapy, especially antibiotic therapy, can be considered an effective protocol for MRONJ.

PURPOSE

To integrate the data published on the effect of teriparatide (TPTD) therapy on cases of medication-related osteonecrosis of the jaws (MRONJ) into a comprehensive analysis of clinical features.

METHODS

An electronic search was undertaken in six databases. Descriptive analyses of clinicodemographic data of MRONJ were carried out. Poisson regression was also run to evaluate predictors of total resolution of MRONJ treated with TPTD.

RESULTS

Twenty-six publications comprising 111 cases were included. Most reported cases affected female individuals (82.0%) with a mean age of 76.54 years. Osteoporosis (76.5%) represented the main reason for using antiresorptive drugs, with bisphosphonates (98.1%) as the most frequently reported. Comorbidities were commonly present. The most related trigger factor of MRONJ was dental extraction (61.7%). Mandible (75.8%) was the most commonly affected site, with a mean evolution time of 5 months. MRONJ stage 2 (61.3%) was the most prevalent. Regarding TPTD treatment, in 45.1% cases, TPTD was used alone, with the total resolution being observed in 59.5% of the individuals. Associated therapy (54.9%) included surgery, antibiotic therapy, and laser therapy. Mean follow-up was 8.7 months. Poisson regression demonstrated that individuals with MRONJ stage 1 were 1.21 times more likely to present total resolution of osteonecrosis than individuals with MRONJ stage 3 (CI = 1.02-1.43; p < 0.023). Individuals who had undergone treatment with TPTD in association with another therapeutic modality were 1.21 times more likely to present total resolution of osteonecrosis than those who had undergone treatment with TPTD alone (CI = 1.40-1.39; p < 0.010).

CONCLUSION

TPTD in combination with another therapy, especially antibiotic therapy, should be considered an effective therapeutic modality for MRONJ.

Oral pigmented lesions in syndromic individuals: A systematic review

OBJECTIVE

To systematically integrate the available data published in the literature on oral pigmented lesions (OPL) associated with syndromes, summarizing the clinical and demographic features of the individuals.

MATERIALS AND METHODS

An electronic search was undertaken in six databases. Eligibility criteria were articles in English, Spanish, and Portuguese describing case reports or case series of OPL associated with syndromes. Data were aggregated and statistically evaluated.

RESULTS

About 108 articles reporting 149 cases of individuals with syndromes were identified. Among the affected individuals, nine syndromes were reported. The mean age at diagnosis was 35.93 years (0.41 to 83 years), with a predilection for white (n = 85/85.86%) female (n = 102/68.46%) individuals. As regards the number of lesions, 109 (73.15%) were multiple and 40 (26.85%) were single. Lip represented the anatomical location more affected (122 cases/38.01%), followed by the buccal mucosa (100 cases/31.15%). Brownish lesions accounted for 82 (69.49%) cases. The mean time of evolution was 10.52 years (0.16 to 56 years). OPL preceding diagnosis of the syndrome was observed in 111 (74.50%) cases.

CONCLUSIONS

Although these syndromes are uncommon, dentists should be able to recognize their manifestations, since oral manifestations can represent an important aspect in early diagnosis.