Declining incidence of esophageal cancer in the Turkmen Plain, eastern part of the Caspian Littoral of Iran: A retrospective cancer surveillance

Background: Previous studies have shown that upper gastrointestinal cancers are the most common cancers in Caspian Littoral, and rate of esophageal cancer (EC) in Iranian Turkmens residing in the Eastern part of littoral are among the highest in the world. Our aim was to reassess the rate 30 years later and following socioeconomic changes in the region. Methods: A comprehensive retrospective search was undertaken to find all new cancer cases during the 1996-2000 period. Diagnosis of cancer was based on histopathological reports in 68.2, clinical and/or radiological evidence in 29.7 and death certificate only (DCO) in 2.1 of the cases. Results: A total of 5143 new cancer cases were registered of whom 3063 (59.6) were males. The median (IQR) age was 60 (44-69) years. Age-standardized rates (ASR) for all cancers in males and females were 134.7 and 104.5 per 100,000, respectively. Based on ASR, the top five common cancers in males (excluding skin cancer) were cancers of esophagus (43.4), stomach (27.8), colorectal (10.7), bladder (7.8) and oral cavity (6.3), while in females cancer of esophagus (36.3) was followed by cancers of breast (15.7), stomach (8.3) colorectal (6.6) and cervix (3.6). Conclusion: We conclude that EC incidence rate has decreased to less than half the rate reported 30 years ago, while the incidence rates of colorectal and breast cancers have increased significantly. © 2006 International Society for Preventive Oncology. Published by Elsevier Ltd. All rights reserved

Prognostic factors for esophageal squamous cell Carcinoma-A Population-Based study in Golestan province, Iran, a high incidence area

Golestan Province in northern Iran is an area with a high incidence of esophageal squamous cell carcinoma (ESCC). We aimed to investigate prognostic factors for ESCC and survival of cases in Golestan, on which little data were available. We followed-up 426 ESCC cases participating in a population-based case-control study. Data were analyzed using the Kaplan-Meier method and the Cox proportional hazard models. Median survival was 7 months. Age at diagnosis was inversely associated with survival, but the association was disappeared with adjustment for treatment. Residing in urban areas (hazard ratio, HR = 0.70; 95 CI 0.54-0.90) and being of non-Turkmen ethnic groups (HR = 0.76; 95 CI 0.61-0.96) were associated with better prognosis. In contrast to other types of tobacco use, nass (a smokeless tobacco product) chewing was associated with a slightly poorer prognosis even in models adjusted for other factors including stage of disease and treatment (HR = 1.38; 95 CI 0.99-1.92). Opium use was associated with poorer prognosis in crude analyses but not in adjusted models. Almost all of potentially curative treatments were associated with longer survival. Prognosis of ESCC in Golestan is very poor. Easier access to treatment facilities may improve the prognosis of ESCC in Golestan. The observed association between nass chewing and poorer prognosis needs further investigations; this association may suggest a possible role for ingestion of nass constituents in prognosis of ESCC. © 2011 Aghcheli et al

Effect of a 16% Carbamide Peroxide Bleaching Gel on Enamel Staining Susceptibility

Statement of Problem: Due to the growing popularity of vital bleaching by CarbamidePeroxide it is imperative to understand the effect of such agents on enamel and dentine.Purpose: The purpose of this study was to evaluate the effect of a 16% carbamide peroxide bleaching gel; Vivastyle on enamel staining susceptibility.Materials and Methods: Thirty bovine specimens were selected and randomly divided into two groups of fifteen. The experimental group was subjected to Vivastyle gel and then was immersed in coffee, for half an hour daily for three weeks. The control group was only immersed in coffee. The teeth were evaluated by colorimeter readings to measure L*, a*, b* of each tooth. Total color differences between two colors (ΔE) were calculated using the following formula: ΔE= [(ΔL*) 2 + (Δa*) 2+ (Δb*) 2].ΔE1 represent color difference after bleaching; ΔE2: bleached and immersed in coffee,and ΔE3 immersed in coffee.Results: Mean color difference were: 9.478, 13.808, and 7.230 for ΔE1, ΔE2, and ΔE3 respectively. Paired comparison by Duncan test showed that there was a significant difference between ΔE1 and ΔE2 (P0.000). t-test showed that there was no significant difference between ΔE3 and ΔE1. (P=0.08), however, ΔE3 had significant difference with ΔE2 (P0.000).Conclusion: After vital bleaching, the enamel staining susceptibility is significantly increased

A Histopathologic Study on Pulp Response to Glass Ionomer Cements in Human Teeth

Statement of Problem: Despite the wide range of new dental materials, there is still a need for biomaterials demonstrating high biocompatibility, antimicrobial effects and ideal mechanical properties.Purpose: The aim of this study was to histologically evaluate the pulpal response to a conventional glass ionomer, a resin modified glass ionomer and a calcium hydroxide in human teeth.Materials and Methods: Fifty five deep class V cavities were prepared in premolars of 31 patients and were divided into 3 groups based on application of the following liners:resin modified glass ionomer (Vivaglass Liner), conventional glass ionomer (ChembondSuperior) and calcium hydroxide (Dycal). After applying varnish, teeth were filled with amalgam. Each group was further divided into three subgroups according to time intervals of 7, 30 and 60 days. Teeth were then extracted and their crowns were fixed in formalin. Each sample was assessed microscopically for odontoblastic changes,inflammatory cell infiltration, reactionary dentin formation, remaining dentinal thickness and presence of microorganisms. Statistical analysis including Kruskal Wallis and Mann Whitney was carried out for comparison of mean ranks. (P=0.05).Results: In the Vivaglass Liner group, pulpal response was significantly higher on day 7 as compared to days 30 and 60 (P<0.05). Reactionary dentin production was significantly lower after 7 days than after 60 days for all materials (P<0.05). There wasno statistically significant difference in pulpal responses among the three groups during the same time intervals (P>0.05). There was no correlation between pulpal responses with micro-organisms and remaining dentin thickness (P>0.05).Conclusion: According to the results of this study, light-cured glass ionomer as well as the other tested lining materials were determined to be biologically compatible with vital pulps in deep cavities of sound human teeth

A Histopathological Study of Direct Pulp Capping with Adhesive Resins

Statement of Problem: Recently, it has been proposed that different adhesive materials can be used for direct pulp capping. Previous studies have demonstrated that multi steps dentin adhesives could form reparative dentin similar to calcium hydroxide (CH).Purpose: The aim of this study was to evaluate the histological pulp response of ninety mechanically exposed cat pulps to two adhesive resins (Scotch Bond MP and Single Bond 3M) were compared with a calcium hydroxide cement (Dycal, Dentsply).Materials and Methods : Class V facial cavities with similar pulpal exposures were prepared in canines. In the experimental groups phosphoric acid was used to etch the enamel and dentin and pulp exposure, and after it dentin adhesives was applied. The exposure point of the control group was capped with Dycal then the remainder of the cavities was etched and a dentin adhesive (single bond) was applied. All of the cavities were restored with a composite resin (Z 100) in usual manner. The animals were scarified after 7, 30 and 60 days (n=30), and the pulp evaluated histologically, statistical analysis was carried out with Kruskal- Wallis test (a=0.05).Results: The data showed that most of the cases had mild inflammation of pulp tissue.There was no significant difference in inflammatory reaction of pulp by Dycal and two adhesive systems, severe inflammatory reaction of pulp was observed only in most of the 30- day Single Bond group. Soft tissue organization of dentin bridge was less than ScotchBond and Dycal groups, the differentiation of dentin bridge was less than Scotch Bond group after 7 days.Conclusion: Slight inflammatory cell infiltration was the main reaction of exposed pulp when two commercially available adhesive resins were placed directly on the exposed pulp.There was no significant difference in inflammatory reaction of pulp between Dycal and two adhesive systems after 7 days and 60 days. After 7 days most of the specimens showed an amount of predentin deposition

A clinical evaluation on adhesive posts in extensive composite restorations

Problem: A few studies have been conducted about bioglass posts.&quot;nAim: The aim of this study was to compare bioglass posts with prefabricated metallic posts in clinical performance of extensive composite restorations for anterior endodontically treated teeth. Materials and Methods: Sixty endodontocally maxillary anterior teeth, with horizontally or vertically destruction, were selected. Teeth were divided into two groups based on the kind of post: Metallic prefabricated parapost and bioglass post. Each group was divided into three subgroups based on anterior bite: normal, deep bite and edge to edge. Gutta-percha was removed from 2/3 of canal length for parapost and 1/3 for bioglass post. After etching with phosphoric-acid (37%) and applying dentine bonding syntac, Duo cement was used for the adhesion of bioglass post and a self cured composite (Degufil) for parapost. Restoration was done with a hybrid composite (Heliomolar). Follow up studies, radio-graphically and clinically, were done every three months for a 1.5-year period. Exact Fisher and Pearson tests were used for data analysis.&quot;nResults: Apical lesion was not observed in any of the radiographs. Post seal was increased by resin cement and dentin bonding agent. Post type did not significantly affect on the clinical success rate of the restorations. The retention of restoration, for both posts, was the same. Crown destruction had no significant effect on success rate. The type of anterior bite had a significant effect on success rate, as the total 6.6% failure rate was related to the patients with anterior deep bite.&quot;nConclusion: It is suggested to use metallic paraposts and bioglass posts, in extensive composite restorations for patients with deep-bite, more conservatively

Current and Future Challenges of Radiation Oncology in Iran: A Report from the Iranian Society of Clinical Oncology

Aims: Growth of the cancer incidence rate in Iran has been very high in recent years. Therefore, the Iranian health care system should be prepared for the treatment of a huge number of patients in the foreseeable future. One of the most important treatment options for cancer is radiation. However, there is no comprehensive information on infrastructure for radiation oncology in this country. Materials and methods: In 2015, a questionnaire was designed by the Iranian Society of Clinical Oncology (ISCO) and all radiation oncology centres in the country were visited to determine four important components of radiation oncology services, including facilities, equipment, personnel and patients. Results: In 2015, 94 radiotherapy centres were identified in Iran. Sixty-one centres were fully operational, six centres were commissioning, 26 centres were under construction and one was inactive. Among the fully operational radiotherapy centres, 54 offered three-dimensional conformal radiotherapy and two-dimensional radiotherapy, eight offered brachytherapy, two intensity-modulated radiotherapy, two intraoperative radiotherapy, ostereotactic radiosurgery, two hyperthermia and 59 chemotherapy. Moreover, the survey identified 110 linear accelerators, 25 cobalt-60, one gamma knife, 21 remote brachytherapy afterloaders and six orthovoltage units. Treatment planning equipment included 15 graphy simulators, 19 dedicated computed tomography simulators, 22 multileaf collimator and 12 electronic portal imaging devices. Moreover, in 2015, 243 clinical oncologists participated in the treatment of 42 350 cancer patients in need of radiotherapy, which is about one radiation oncologist for 175 patients. During 2010�2015, number of cobalt-60 reduced 70, from 25 units to 8 units. Conclusions: There is a significant gap between Iran's available facilities for radiation therapy and international standards. Moreover, during international economic sanctions against Iran this gap widened. © 2017 The Royal College of Radiologist

Current and Future Challenges of Radiation Oncology in Iran: A Report from the Iranian Society of Clinical Oncology

Aims: Growth of the cancer incidence rate in Iran has been very high in recent years. Therefore, the Iranian health care system should be prepared for the treatment of a huge number of patients in the foreseeable future. One of the most important treatment options for cancer is radiation. However, there is no comprehensive information on infrastructure for radiation oncology in this country. Materials and methods: In 2015, a questionnaire was designed by the Iranian Society of Clinical Oncology (ISCO) and all radiation oncology centres in the country were visited to determine four important components of radiation oncology services, including facilities, equipment, personnel and patients. Results: In 2015, 94 radiotherapy centres were identified in Iran. Sixty-one centres were fully operational, six centres were commissioning, 26 centres were under construction and one was inactive. Among the fully operational radiotherapy centres, 54 offered three-dimensional conformal radiotherapy and two-dimensional radiotherapy, eight offered brachytherapy, two intensity-modulated radiotherapy, two intraoperative radiotherapy, ostereotactic radiosurgery, two hyperthermia and 59 chemotherapy. Moreover, the survey identified 110 linear accelerators, 25 cobalt-60, one gamma knife, 21 remote brachytherapy afterloaders and six orthovoltage units. Treatment planning equipment included 15 graphy simulators, 19 dedicated computed tomography simulators, 22 multileaf collimator and 12 electronic portal imaging devices. Moreover, in 2015, 243 clinical oncologists participated in the treatment of 42 350 cancer patients in need of radiotherapy, which is about one radiation oncologist for 175 patients. During 2010�2015, number of cobalt-60 reduced 70, from 25 units to 8 units. Conclusions: There is a significant gap between Iran's available facilities for radiation therapy and international standards. Moreover, during international economic sanctions against Iran this gap widened. © 2017 The Royal College of Radiologist