THE CONSIDERATION OF DIET QUALITY IN HEAD AND NECK CANCER INCIDENCE AND SURVIVAL

The treatment of head and neck squamous cell carcinoma (HNSCC) often results in significant morbidity and healthcare costs. Tobacco use and alcohol consumption along with the human papillomavirus (HPV) are the major risk factors for HNSCC, though HPV is more strongly associated with HNSCC of the oropharynx than with HNSCC of other anatomical sites. Food groups and individual nutrients have been studied with respect to HNSCC, but few have studied the relation between the a priori hypothesis-driven indexes of overall diet quality and HNSCC. We used data from the Carolina Head and Neck Cancer Epidemiology (CHANCE), a large population-based case control study of HNSCC to explore associations between overall diet quality and HNSCC incidence and survival. The self-reported dietary data captured from a validated food frequency questionnaire were used to construct three a priori diet indexes of diet quality: Healthy Eating Index 2005 (HEI-2005), Mediterranean Diet Score (MDS), and a derivative of the MDS, MDS-HNC which we developed and introduced based on the diet-HNSCC literature. Using these measures of diet quality, we aimed to 1) characterize the association between diet quality and HNSCC incidence and 2) characterize the association between diet quality and HNSCC survival. We further sought to explore heterogeneity of the association by anatomic site, HPV tumor positivity, race, body mass index (BMI), alcohol use, and cigarette smoking. In our analysis, we found that diet quality was inversely associated with HNSCC incidence and positively associated with survival. We also observed effect measure modification by BMI and by alcohol for the association between diet quality and HNSCC incidence, as well as the association between diet quality and HNSCC survival. Our findings suggest that diet quality prior to diagnosis is associated with lower HNSCC incidence and prolonged survival.Doctor of Philosoph

Periapical Microsurgery: The Effect of Root Dentinal Defects on Short- and Long-term Outcome

The purpose of this prospective clinical study is to evaluate the clinical outcome of endodontic microsurgery on roots exhibiting the presence or absence of dentinal defects at one year and three-year follow up period

Association of Body Composition with Odds of Breast Cancer by Molecular Subtype: Analysis of the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Nigerian Women (MEND) Study

BACKGROUND: The association between obesity and breast cancer (BC) has been extensively studied among US, European and Asian study populations, with often conflicting evidence. However, despite the increasing prevalence of obesity and associated conditions in Africa, the continent with the highest age-standardized BC mortality rate globally, few studies have evaluated this association, and none has examined in relation to molecular subtypes among African women. The current analysis examines the association between body composition, defined by body mass index (BMI), height, and weight, and BC by molecular subtype among African women. METHODS: We estimated odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between measures of body composition and BC and molecular subtypes among 419 histologically confirmed cases of BC and 286 healthy controls from the Mechanisms for Established and Novel Risk Factors for Breast Cancer in Women of Nigerian Descent (MEND) case-control study. RESULTS: Higher BMI (aOR: 0.79; 95% CI: 0.67, 0.95) and weight (aOR: 0.83; 95% CI: 0.69, 0.98) were associated with reduced odds of BC in adjusted models, while height was associated with non-statistically significant increased odds of BC (aOR: 1.07, 95% CI: 0.90, 1.28). In pre/peri-menopausal, but not post-menopausal women, both higher BMI and weight were significantly associated with reduced odds of BC. Further, higher BMI was associated with reduced odds of Luminal A, Luminal B, and HER2-enriched BC among pre/peri-menopausal women, and reduced odds of triple-negative BC among post-menopausal women. CONCLUSIONS: Higher BMI and weight were associated with reduced odds of BC overall and by molecular subtype among West African women. Larger studies of women of African descent are needed to definitively characterize these associations and inform cancer prevention strategies

Periapical Microsurgery: The Effect of Root Dentinal Defects on Short- and Long-term Outcome

INTRODUCTION: The purpose of this prospective clinical study is to evaluate the clinical outcome of endodontic microsurgery on roots exhibiting the presence or absence of dentinal defects at one year and three-year follow up period. METHODS: 155 teeth were treated with periapical microsurgery using a modern microsurgical protocol in a private practice setting. The root apices were resected and inspected for dentinal defects with a Surgical Operating Microscope and a 0.8mm head diameter LED microscope diagnostic probe light. After inspection, retrograde preparations were performed using ultrasonic tips and retrograde fillings were placed. Follow up visits occurred at one year and three years post-operatively. The primary outcome measure employed was the change in the radiographic apical bone density and the secondary outcome measure used was the absence of clinical symptoms. RESULTS: Out of the 155 treated teeth, a total of 134 teeth were assessed at the one-year follow-up and 127 teeth at the three-year evaluation. The “Intact” group had 94.8% healed at one year and 97.3% healed at three years. The “Dentinal Defect” group had 29.8% healed at one year and 31.5% healed at three years. The baseline root condition of either “Dentinal Defect” or “Intact” showed a statistical difference in the healing outcome at both one year and at three years. CONCLUSIONS: This prospective periapical microsurgery study showed a significant superior clinical outcome for intact roots when compared to roots with dentinal defects at both 1 year and at 3 years post-operatively