RESUMEN
BACKGROUND: We conducted an independent analysis of metallothionein 1 (MT-1) rs8052394, rs11076161, rs8052334, rs964372, rs7191779, and rs708274 in 587 individuals who were either healthy controls or subjects with oral squamous cell carcinoma (OSCC). METHODS: All participants provided a nucleic acid sample (blood) as well as epidemiologic information on covariates or "risk factors" for OSCC, including tobacco, alcohol, and areca quid use. The genotyping result was used in a logistic regression model that examined main effects as well as statistical interactions while controlling for confounders. RESULTS: MT-1 is involved in regulation of zinc and copper homeostasis. It also is a potent antioxidant and its polymorphisms correlate with the risk for OSCC. Rs11076161 A, rs964372 C, and rs7191779 C alleles were protective against OSCC (adjusted OR = 0.53, 0.49, 0.36, respectively; p < 0.05), whereas rs8052394 A alleles were associated with increased risk. Areca quid chewing and tobacco use were strong risk factors for developing the disease and were associated with 20- and 8-fold increases in adjusted risk (p < 0.05), respectively. CONCLUSIONS: Controlling for the effects of age, gender, areca quid, tobacco, and alcohol use, individuals with inherited the MT-1 rs11076161 AA, rs964372 CC, and rs7191779 GC genotypes may experience significant protection against OSCC, whereas individuals carrying the MT-1 rs8052394 A allele seem exposed to higher risk.
Asunto(s)
Carcinoma de Células Escamosas/etiología , Metalotioneína/genética , Mucosa Bucal/metabolismo , Neoplasias de la Boca/etiología , Polimorfismo Genético/genética , Consumo de Bebidas Alcohólicas , Areca , Carcinoma de Células Escamosas/patología , Estudios de Casos y Controles , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Mucosa Bucal/patología , Neoplasias de la Boca/patología , Reacción en Cadena de la Polimerasa , Pronóstico , Factores de RiesgoRESUMEN
UNLABELLED: In the developed world, intraoral malignancies are more frequent in males than females. Recent observations from Greece suggest that the number of females is increasing. AIM: The present study investigates gender and age statistics among subjects with cancers of the mouth or leukoplakia. METHODS: Five hundred and twelve subjects of Greek origin participated in this analysis. Chi-square and logistic regression statistics were used to compare if there are differences in participants' gender and age, stratified by histological type. RESULTS: Epithelial cancers and leukoplakia exhibited equal distributions among men and women. Men were diagnosed at a much younger age than women. Our data also indicates a progression in the process of epithelial cancer development, as benign leukoplakia was diagnosed 2-4 years earlier than epithelial dysplasia and 8 years earlier than squamous cell carcinoma (SSC). The same age difference was observed in non-Hodgkin's lymphoma, although the male to female ratio was 3:1. In regards to anatomy, 47% of SSC appeared in the tongue. The most prevalent site for the development of non-Hodgkin's lymphoma was the gingival (50%), followed by the palate (40%). CONCLUSION: Although oral cancer occurs earlier in men than women, the risk of females tends to be similar to that of males.
Asunto(s)
Leucoplasia Bucal/epidemiología , Neoplasias de la Boca/epidemiología , Factores de Edad , Carcinoma de Células Escamosas/epidemiología , Carcinoma Verrugoso/epidemiología , Distribución de Chi-Cuadrado , Femenino , Grecia/epidemiología , Humanos , Modelos Logísticos , Linfoma no Hodgkin/epidemiología , Masculino , Persona de Mediana Edad , Factores Sexuales , Factores de TiempoRESUMEN
Early detection and treatment improve the prognosis for oral cancer. Delays from the onset of symptoms to clinical diagnosis are common. Our aim is to identify factors associated with this delay. Between 1995 and 1998, we interviewed 105 consecutive patients with histologically confirmed oral cancer in Greece. If 21 or more days elapsed from the time the patient noticed major symptoms to a definitive diagnosis, we called it a delay (52% of cases). We used logistic and linear regression to estimate odds ratios of delayed diagnosis and to identify correlates of length of delay, respectively. Former smokers had a 4.3 times greater risk of delayed diagnosis compared with current smokers (95% confidence interval: 1.1-17.1). The length of delay was greater among single patients, non-smokers, or those with stage IV tumors. Clinicians should be advised that delay in the diagnosis of oral cancer occurs frequently, even in individuals who do not smoke heavily.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Neoplasias de la Boca/diagnóstico , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas , Peso Corporal , Carcinoma de Células Escamosas/genética , Estudios de Casos y Controles , Intervalos de Confianza , Empleo , Femenino , Grecia , Humanos , Modelos Lineales , Modelos Logísticos , Masculino , Estado Civil , Persona de Mediana Edad , Neoplasias de la Boca/genética , Estadificación de Neoplasias , Oportunidad Relativa , Salud Bucal , Neoplasias Faríngeas/diagnóstico , Neoplasias Faríngeas/genética , Factores de Riesgo , Factores Sexuales , Fumar , Estadísticas no Paramétricas , Factores de TiempoRESUMEN
Oral and pharyngeal cancer (OC) mortality is very low in Greece, especially among men, compared to other European countries. We conducted a case-control study of OC in Athens, and obtained information on tobacco, alcohol use and other potential risk factors and confounding variables for 110 incident cases and 115 hospital-based controls. We used multivariate logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Tobacco smoking (pack years, P(trend)=0.01) and alcohol use (drinks/week, P(trend)=0.07) were independent risk factors, with a multiplicative effect for combined exposures (OR, 8.3; 95% CI, 2.4-29.1, for >28 alcohol drinks/week and >50 pack years of cigarette smoking). The type of alcoholic beverage also seemed important: drinking ouzo and tsipouro (liquors of high ethanol concentration) was associated with greater increased OC risk than drinking comparable amounts of wine, beer or dark spirits. While alcohol drinking is more common for male cases versus controls, few men reported regularly consuming large quantities of ethanol associated with highest risk of OC in other studies. This may partially explain the low rates of male OC mortality in Greece. Among the 38% of our cases who were women, however, neither smoking nor alcohol drinking frequencies were significantly elevated compared to controls, and so the etiology of OC risk in females requires further investigation.
Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Neoplasias de la Boca/etiología , Neoplasias Faríngeas/etiología , Fumar/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Bebidas Alcohólicas/efectos adversos , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Distribución por Sexo , Factores SexualesRESUMEN
OBJECTIVES: Modeling new biomedical technologies and determining their expected cost is necessary before initiating formal clinical trials. This paper estimates an economic model for the potential cost impact of microbiological screening of toddlers for caries risk compared to the traditional method of managing pediatric caries. METHODS: Potential cost savings were calculated based on screening test properties (sensitivity and specificity) derived from a population of 1,180 children aged 1 to 3 years with a caries prevalence of 15 percent. An algorithm was then developed to allocate prevalent and anticipate incident caries, treatment effectiveness assumptions, and existing regional treatment costs. RESULTS: The cost analysis model conservatively predicts savings of 7.3 percent from screening and early intervention. Cumulative dental treatment costs for a child at age 4 years are $367.90 if the child has been screened and $396.70 otherwise. The model further predicts that cost savings increase significantly as caries prevalence increases. CONCLUSIONS: Microbiologic risk assessment for pediatric caries may be an example of a preventive public health screening technique that results in both clinical benefits and cost savings. If the model is validated by randomized clinical trials, microbiologic screening could be used by pediatric primary care providers to identify toddlers who require early referral to dentists for further risk assessment and early caries management.
Asunto(s)
Bacterias/crecimiento & desarrollo , Atención Dental para Niños/economía , Susceptibilidad a Caries Dentarias , Caries Dental/microbiología , Tamizaje Masivo/economía , Modelos Económicos , Medición de Riesgo , Algoritmos , Preescolar , Ahorro de Costo , Costos y Análisis de Costo , Índice CPO , Caries Dental/prevención & control , Caries Dental/terapia , Predicción , Necesidades y Demandas de Servicios de Salud , Humanos , Lactante , Prevalencia , Sensibilidad y Especificidad , Resultado del TratamientoRESUMEN
BACKGROUND: One of the responsibilities of the dental profession is to protect and advance the well-being of the public through research of new pharmaceuticals and devices. The objective of this article is to present information about the scientific and regulatory process involved in the design and execution of randomized clinical trials. CONCLUSIONS: Dentists willing to serve as investigators in clinical trials--from Phase 1 to Phase 2 or Phase 3--need to be aware of the two main documents that contain the majority of guidelines and regulations governing clinical research: Title 21 of the U.S. Code of Federal Regulations and the guidelines for good clinical practice put forth by the International Conference on Harmonisation. CLINICAL IMPLICATIONS: Advancements in the frontiers of oral health science and the development of safe, innovative and effective treatment modalities are often the result of high-quality clinical research that is conducted by dental professionals. Knowledge of the research process, professionalism, scientific integrity and a detailed execution of the research plan are all required elements for a successful outcome.
Asunto(s)
Investigación Dental , Ensayos Clínicos Controlados Aleatorios como Asunto , American Dental Association , Materiales Dentales/normas , Investigación Dental/educación , Investigación Dental/métodos , Investigación Dental/normas , Aprobación de Recursos , Aprobación de Drogas , Comités de Ética , Guías como Asunto , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto/legislación & jurisprudencia , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Estados Unidos , United States Food and Drug AdministrationRESUMEN
The purpose of this study was to assess the nasal volume and the cross-sectional areas of the nose in 7 to 12 year old children, and to identify factors that may influence those parameters. Specifically we investigated the effect of passive smoking at home, body mass, presence of allergies, and history of removal of the tonsils, controlling for the age, gender and race of the child. Fifty-four children participated in the study. Five consecutive nasal measurements were taken from each nostril in one visit, using the acoustic reflection technique (acoustic rhinometry). The nasal volume and the cross-sectional area were computed from the nasal readings. We observed that the minimal cross sectional area is located at the laminal valve, which has been considered one of the main anatomical structures that affect the regulation of breathing in the anterior part of the nose. We also concluded that body mass and exposure to environmental tobacco by-products play a significant role in determining reductions in a child's nasal volume. The clinical significance of such a finding and its effect to the normal craniofacial development of a growing child may force parents to reconsider smoking while at home.
Asunto(s)
Desarrollo Maxilofacial , Obstrucción Nasal/etiología , Nariz/anatomía & histología , Contaminación por Humo de Tabaco/efectos adversos , Obstrucción de las Vías Aéreas , Constitución Corporal , Niño , Femenino , Humanos , Modelos Lineales , Masculino , Respiración por la Boca/etiología , Factores de RiesgoRESUMEN
The purpose of this study was to determine if there are any differences in the nasal geometry of children with nasal respiration or predominantly oral respiration (mouth breathing). The technique utilized was the acoustic reflection technique or acoustic rhinometry. Acoustic rhinometry is a non-invasive method, which can be easily applied to young children. Twenty children participated and both nostrils were evaluated. Statistically significant differences were found in the total nasal volumes between the two groups, with the mouth breathers presenting with reduced nasal volumes. No differences were observed in the nasal cross sectional areas.
Asunto(s)
Respiración por la Boca/diagnóstico , Cavidad Nasal/fisiopatología , Obstrucción Nasal/diagnóstico , Pruebas de Función Respiratoria/instrumentación , Acústica , Adolescente , Resistencia de las Vías Respiratorias , Niño , Femenino , Humanos , Masculino , Manometría , Respiración por la Boca/etiología , Respiración por la Boca/fisiopatología , Cavidad Nasal/patología , Obstrucción Nasal/complicaciones , Obstrucción Nasal/fisiopatología , Encuestas y CuestionariosRESUMEN
Proper diagnosis, surgical management and application of biomechanics have paramount clinical significance in order to prevent potential mucogingival problems and to ensure the outcome of treatment in cuspid impaction cases.