RESUMEN
AIMS: To examine clinical implications of findings on the relationship between continued alcohol consumption in patients after diagnosis and treatment of upper aerodigestive tract cancer. METHODS: Clinical research literature on the prevalence and effects of alcohol consumption after oral cancer diagnosis was reviewed. Since limited research is currently available on this important clinical topic, all published studies were considered regardless of size and methodology. RESULTS: Between 34 and 57% of oral cancer patients continue to drink alcohol after cancer diagnosis. Continued drinking increases complications from surgery, increases the likelihood of recurrent cancer, and reduces disease-specific survival. Older patients and those with a longer and heavier drinking pattern prior to diagnosis are more likely to continue drinking after diagnosis. CONCLUSIONS: Findings indicate that routine alcohol screening of newly diagnosed oral cancer patients as well as brief intervention and/or treatment referral is warranted. Monitoring of alcohol consumption for the first year after diagnosis and treatment is recommended.
Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Neoplasias Esofágicas/epidemiología , Neoplasias Orofaríngeas/epidemiología , Periodicidad , Enfermedad Crónica , Femenino , Humanos , Masculino , Prevalencia , Encuestas y CuestionariosAsunto(s)
Mucosa Bucal/patología , Candidiasis Bucal/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Cinnamomum zeylanicum/efectos adversos , Condimentos/efectos adversos , Diagnóstico Diferencial , Eritema Multiforme/diagnóstico , Eritema Multiforme/etiología , Eritroplasia/diagnóstico , Humanos , Liquen Plano Oral/diagnóstico , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/diagnósticoRESUMEN
Oral candidosis is the most common opportunistic fungal infection encountered in dentistry. Normally a benign inhabitant of mucous membranes, the fungal organism, Candida albicans, may present serious, even life-threatening infection in specific patient populations. As an opportunistic organism, Candida albicans is extremely responsive to any process resulting in immunosuppression. The clinical manifestations of oral candidosis are variable, occasionally complicating the clinical diagnosis and management. Treatment is often initially rendered based on a provisional clinical diagnosis and supplemented with adjunctive laboratory tests. Specific therapeutic intervention should be tailored to the individual patient, based on the current health status of the patient and the clinical presentation and severity of the infection.
Asunto(s)
Candidiasis Bucal/fisiopatología , Antifúngicos/uso terapéutico , Candida albicans/patogenicidad , Candidiasis Bucal/clasificación , Candidiasis Bucal/diagnóstico , Candidiasis Bucal/tratamiento farmacológico , Queilitis/microbiología , Enfermedad Crónica , Eritema/microbiología , Glositis/microbiología , Humanos , Hiperplasia , Huésped Inmunocomprometido , Infecciones Oportunistas/diagnósticoRESUMEN
A 33-year-old male presented for evaluation of several large, recently discovered white oral lesions of unknown duration. Clinical examination revealed multiple white plaques on the soft palate, uvula, buccal mucosa, and tongue. These lesions could be wiped away, leaving an erythematous base. The lesions were asymptomatic, and the patient did not report difficulty in swallowing. The patient's medical history was noteworthy for several significant diagnoses within the previous 6 months: type 2 diabetes mellitus, mild systolic hypertension, gastroesophageal reflux disease, and adult idiopathic nephrotic syndrome, determined by kidney biopsy to be caused by focal segmental glomerulosclerosis. A provisional diagnosis of pseudomembraneous candidosis was made, and the patient responded to a 14-day course of clotrimazole, administered in 10-mg troches, five times a day. Management of nephrotic syndrome predisposes patients to recurrent fungal infections, and the disease has implications for the selection of systemic antifungal agents.