Patient Generated-Subjective Global Assessment (PG-SGA) was used to evaluate nutritional status of cancer patients as described [ 17]. It is divided into two components, i.e., the medical history and the physical examination. The presence of nutrition-related signs and symptoms and short-term weight loss. Nutrition status was categorized as A (well-nourished), B (moderately malnourished), and C (severely malnourished). Nutrition triage scores were categorized to needs for nutrition therapy as (0-1) no interventions required, (2-3) patients and family education required, (4-8) interventions by dietitians required, and (≥ 9) nutrition therapy critically needed [ 17]. Body weight and body mass index Hotjar sets this cookie to identify a new user’s first session. It stores a true/false value, indicating whether it was the first time Hotjar saw this user. Dalodom S, Lam-Ubol A, Jeanmaneechotechai S, Takamfoo L, Intachai W, Duangchada K, Hongsachum B, Kanjanatiwat P, Vacharotayangul P, Trachootham D (2016) Influence of oral moisturizing jelly as a saliva substitute for the relief of xerostomia in elderly patients with hypertension and diabetes mellitus. Geriatr Nurs 37:101–109 A validated Eating Assessment Tool (EAT-10) was used to evaluate the degree of each swallowing problem [ 15]. Details of the EAT-10 questions and scoring were described in Electronic supplementary material. Objective swallowing ability score Nevertheless, there are limitations of this study. First, we advised the participant to swallow OMJ but apply GC topically in the mouth. Since the participant who used GC did not spit it out, they may swallow some GC gel. This may explain the equal effect between GC and OMJ to improve swallowing time. Therefore, future studies should consider other kinds of saliva substitutes which really cannot be swallowed such as mouth wash. Second, this study included all patients who had dry mouth problems regardless of the radiation dose they received. Nevertheless, we tried to balance the radiation dose in both groups to achieve equal average of 33 fractions of radiation (66 Gy). Future studies should include stratification of radiation dose and compare the effect of saliva substitutes in various doses of radiation. Third, this study had no placebo control. Thus, the effect of saliva substitutes cannot be completely distinguished from self-recovery effect. Last, other factors such as self-compliance and social support were not included in data collection and analysis. Since this is considered the first study exploring the effect of saliva substitutes on nutrition, further large-scale studies with better design to manage the above-mentioned confounders are warranted.

We provide a superb range of classic and flavoured hot chocolate products too, for an extra special treat. Oral examination by a dentist specialized in oral medicine was performed to determine signs of dry mouth by using Challacombe Scale [ 14]. Details of scale and scoring were described in Electronic supplementary material. Subjective swallowing problem score

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Capra S, Ferguson M, Ried K (2001) Cancer: impact of nutrition intervention outcome--nutrition issues for patients. Nutrition 17:769–772 Grab all of the drinks on your shopping list for the lowest possible price when you explore our range of cheap drinks. Soft Drinks Emilien C, Hollis JH (2017) A brief review of salient factors influencing adult eating behaviour. Nutr Res Rev 30(2):233–246B&M provides instant coffee from top brands like Nescafe, Costa, Kenco and Azera, along with Yorkshire Tea, PG Tips, Typhoo and Tetleys for tea. You’ll also find green teas, decafs and even delectable coffee syrups to create your perfect hot drink. McCullough G, Pelletier C, Steele C (2003) National dysphagia diet: what to swallow? ASHA Leader. November 4:16, 27. Available at: www.asha.org/about/publications/leader-online/archives/2003/ q4/f031104c.htm. Accessed 6 April 2007 A validated questionnaire was used to assess dry mouth symptoms as previously described [ 13]. There are six questions for symptoms of dry mouth, oral discomfort, awake at night to drink water, speech problem, swallowing difficulty, and ill-fitting dentures. Each participant described the magnitude of each problems in visual analog scale between 0 and 10 (no problems = 0, extremely troublesome = 10). The average of all scores (sum of total scores divided by number of questions) was used for interpretation. Score ≥ 3 indicates dry mouth symptoms. Objective dry mouth score Adverse events were observed only in the GC group but not in OMJ group. In this study, five flavors of GC dry mouth gels were available including lemon, orange, mint, raspberry, and fruit-salad. In contrast, OMJ had only one flavor of strawberry. In fact, a previous study reported that a flavoring agent peppermint was associated with burning mouth and oral ulceration [ 28]. Interestingly, we observed that all participants with adverse events were those who used mint flavored GC gel. Therefore, the mouth pain and mouth ulcer were likely results of allergic reaction to mint flavor. Taken together, mint flavor should not be used for saliva substitute products. Strawberry flavored product seemed to be non-allergenic and more suitable for patients with xerostomia.

Body weight was measured by using a body composition monitor machine (TANITA BC-730, Tanita Corporation, Tokyo, Japan). Body mass index was calculated from body weight/height 2. Height was measured by using height meter. Energy intake Shiboski CH, Hodgson TA, Ship JA, Schidt M (2007) Management of salivary gland hypofunction during and after radiotherapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 103:S66.e1–S66.e19 After 1 and 2 months of interventions, subjective and objective dry mouth scores, subjective swallowing problem scores, swallowing times, and clinical nutritional status in both groups were significantly improved ( p< 0.0001). Compared to GC, OMJ group had higher percent improvement in all outcome measures ( p< 0.001) except swallowing time and clinical nutritional status. Interestingly, subjective dry mouth scores were significantly correlated with subjective swallowing problem scores ( r = 0.5321, p< 0.0001). ConclusionsThe main objective of this work was to compare percent baseline of subjective dry mouth scores after 2 months of interventions between two groups. Thus, the sample size was calculated using non-centrality parameter of unpaired t test. Mean and SD from pilot data of 30 post-radiotherapy cancer patients ( n = 15 each group) were used to obtain the effect size of 0.8. Level of significance was set as 0.05, power of 0.8. The calculated total sample size was 60 (at least 30 each group). To account for possible 15% drop-out, at least 70 participants needed to be recruited (35 each group). Intervention and materials Records the default button state of the corresponding category & the status of CCPA. It works only in coordination with the primary cookie.

Whatever you need - from multibuy beers for a big gathering to a soothing cup of cocoa alone in the evening - you’ll find everything for the best possible price at B&M. Mortazavi H, Baharvand M, Movahhedian A et al (2014) Xerostomia due to systemic disease: a review of 20 conditions and mechanisms. Ann Med Health Sci Res 4(4):503–510 The protocol of this work can be accessed at https://clinicaltrials.gov/ct2/show/NCT03035825?term=NCT03035825&rank=1 Ethics

Since the complete data from 62 participants provided adequate power of over 0.9, per protocol analysis was used with no needs for imputation. All statistical analyses were performed by a researcher who was blinded to randomization. Graphing and statistical analyses were performed using GraphPad Prism v. 7. Power analysis and sample size calculation were performed using G-power v.3.0.10. A significance level of 5% ( p< 0.05) was used for all analyses. Normality of data distribution was assessed by D’Agostino and Pearson normality test. Participant characteristics with numerical scale were compared between groups by using unpaired t test. Comparison of baseline categorical data was analyzed by using Fisher’s exact test and Chi-square test as specified. Repeated measure ANOVA with Greenhouse-Geisser correction followed by Tukey’s multiple comparison test was used to compare changes in numerical outcome measures among 0, 1, and 2 months in the same group. Changes in objective dry mouth scores, subjective swallowing problem scores, and swallowing times after intervention were compared and categorized as same (similar scores to baseline), better (lower scores than baseline), or worse outcomes (higher scores than baseline). Comparison of outcome measures between OMJ and GC groups at the same time point was analyzed by using unpaired t test and chi-square test for numerical and categorical data, respectively. Correlation between subjective dry mouth score and subjective swallowing difficulty score were analyzed by using Pearson correlation analysis. Water swallowing test (WST) was used to evaluate swallowing ability [ 16]. Each participant was asked to swallow 30 ml of room temperature water and the swallowing time was recorded. Normal swallowing time for adult age below 60 is between 0 and 5 s, while that of elderly age above 60 is between 0 and 7 s. Swallowing time longer than the normal range suggests abnormal swallowing [ 16]. Clinical nutritional status Osailan SM, Pramanik R, Shirlaw P, Proctor GB, Challacombe SJ (2012) Clinical assessment of oral dryness: development of a scoring system related to salivary flow and mucosal wetness. Oral Surg Oral Med Oral Pathol Oral Radiol 114:597–603 This study had been approved by the Ethics Committee of Chonburi Cancer Hospital (COA. No. 7/2016), the Mahidol University Central Institutional Review Board (COA. No. 2017/163.0809), and the Ethics committee of Faculty of Dentistry, Srinakharinwirot University (COA. No. DENTSWU-EC26/2560). Study design, blinding, random allocation, and concealment Bauer J, Capra S, Ferguson M (2002) Use of the scored patient-generated subjective global assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56:779–785