Smokeless tobacco - a substantial risk for oral potentially malignant disorders in South Asia

Data sources: Medline, the Science Citation Index (SCI) via Web of Science, Scopus, CINAHL, Global Index Medicus, Google Scholar and SLT-related reports of the International Agency for Research on Cancer and the National Cancer Institute of the United States. Study selection: Observational studies on the use of SLT and the risk of developing OPMDs in South Asian Populations. Data extraction and synthesis: Duplicate selection of studies was undertaken with two reviewers undertaking data abstraction and quality assessment independently. Risk and odds ratios were extracted or calculated for studies where possible. Meta odds ratios (mOR) were calculated using a random effects analysis. Results: Fifteen papers reporting 18 studies were included. The majority (12) were from India. All the studies were case-control designs. MOR for any OPMD with the use of any SLT product was 15.5 (95% CI; 9.9–24.2). Risk was higher in women; mOR = 22.2 (95% CI, 9.1–54.1) than men; mOR = 8.7 (95% CI, 2.1–34.8). Betel quid with tobacco carried the highest risk for OPMD, mOR = 16.1 (95% CI, 7.8–33.5). Conclusions: The findings of our study point towards a strong association between some forms of OPMDs and SLT use in South Asia. The risk estimates are high, irrespective of controlling for confounders such as smoking and alcohol or stratification by sex, country or source of controls. There is also an exposure-response relationship between OPMDs and SLT use

Oral Cancer Development in Patients with Leukoplakia – Clinicopathological Factors Affecting Outcome

Oral leukoplakia (OL) is the best-known potentially malignant disorder. The objective of the current study was to evaluate the clinicopathological factors predictive of outcome in a large cohort of patients with OL, and report our experience in the early detection of malignant events.A total of 320 patients with biopsy-proven OL were retrospectively reviewed from the study institution who had a mean follow-up of 5.1 years. Data on patient and lesion at initial diagnosis and patient underwent sequential biopsies were reviewed. Multiple biopsies indicates > = 3 times sequential biopsies. Oral cancer-free survival rate (OCFS) was determined by the Kaplan-Meier method and significant factors were identified by Cox regression analysis.<0.001), especially during the first 2–3 years of follow-up. Multivariate analysis revealed that the 4 factors including patient aged >60 years, lesion located at lateral/ventral tongue, non-homogenous lesion, high-grade dysplasia were independent significant indicators for OL malignant transformation. In addition, significant positive correlation between the multiple biopsies and these 4 factors and malignant outcome was established.Elderly patients with OL located at lateral/ventral tongue and who had non-homogenous lesion with high-grade dysplasia correlated much higher risk of transformation. This high-risk subpopulation was suggested to undergo sequential biopsies and histologic examination contributing to early detection of malignant event

Derivation and validation of a risk-factor model for detection of oral potentially malignant disorders in populations with high prevalence

Background:Oral and pharyngeal cancers constitute the sixth most common type of cancer globally, with high morbidity and mortality. In many countries, most cases of oral cancer arise from long-standing, pre-existing lesions, yet advanced malignancies prevail. A new approach to early detection is needed. We aimed to validate a model for screening so that only high-risk individuals receive the clinical examination.Methods:A community-based case-control study (n1029) in rural Sri Lanka assessed risk factors and markers for oral potentially malignant disorders (OPMD) by administering a questionnaire followed by an oral examination. We then developed a model based on age, socioeconomic status and habits of betel-quid chewing, alcohol drinking and tobacco smoking, with weightings based on odds ratios from the multiple logistic regression. A total, single score was calculated per individual. Standard receiver-operator characteristic curves were plotted for the total score and presence of OPMD. The model was validated on a new sample of 410 subjects in a different community.Results:A score of 12.0 produced optimal sensitivity (95.5%), specificity (75.9%), false-positive rate (24.0%), false-negative rate (4.5%), positive predictive value (35.9%) and negative predictive value (99.2%).Conclusion:This model is suitable for detection of OPMD and oral cancer in high-risk communities, for example, in Asia, the Pacific and the global diaspora therefrom. A combined risk-factor score of 12.0 was optimal for participation in oral cancer/OPMD screening in Sri Lanka. The model, or local adaptations, should have wide applicability

Incidence rates and trends of lip, oral and oro-pharyngeal cancers in Portugal

Objectives: To analyse the trends and patterns of lip, oral and oro‐pharyngeal cancer incidence in Portugal between 1998 and 2007. Patients and Methods: Data on lip, oral and oro‐pharyngeal cancers was collected from the databases maintained at the three main Regional Cancer Registries of Portugal (1998–2007). The data were analysed by gender, age and by site. Incidence rates were age standardized by the direct method, and joinpoint regression was used to estimate trends in incidence. Results: During this 10‐year period, a total of 9623 cases of lip, oral and oropharynx cancers were reported, 7565 (78.6%) in males and 2058 (21.4%) in females. There was an increase in the age‐standardized incidence of oral cancers by 1.96% per year for both sexes grouped together and an increase of 4.34% per year for the female group. Oro‐pharyngeal cancer showed an increase incidence trend of 3.49% per year for both sexes grouped together and an increase of 3.49% per year for male group among the sites analysed. Lip cancer showed a decrease in its incidence rate. Conclusion: In view of rising trends, it is necessary to implement policies on oral cancer control by initiating campaigns on oral cancer awareness and screening and to harness political measures on tobacco and alcohol control for the Portuguese population

The potential synergistic behaviour of inter- and intra-genus probiotic combinations in the pattern and rate of short chain fatty acids formation during fibre fermentation

This study compared the rate of short chain fatty acid (SCFA) production by different probiotic combinations of Lactobacillus and Bifidobacterium to determine any synergistic effects. Six different fibre fractions were fermented with nine combinations of Lactobacillus rhamnosus (LR), Lactobacillus acidophilus (LA), Bifidobacterium longum (BL) and Bifidobacterium breve (BB) for 0, 6, 24 and 48 h. SCFAs were quantified by gas chromatography. Inter-genus combinations of bacteria produced more SCFA, especially BB + BL + LR, compared to intra-genus that yielded the lowest SCFA production. Acetate was the most abundant, while propionate and butyrate were the most utilised. The SCFA formation was as acetate \u3e propionate \u3e butyrate and the total dietary fibre produced most of the SCFA. Most combinations utilised 60–80% of the fibre; BB + BL + LR digested the fibre completely. The quantity, pattern and the time of release of SCFA depends on the genus, but the combination of pre and probiotics is of great importance for the outcome

Primary care surgical skills course in otorhinolaryngology designed for medical students of faculty of medicine and health science

МЕТОДИЧЕСКИЕ РЕКОМЕНДАЦИИОТОРИНОЛАРИНГОЛОГИЯДИАГНОСТИЧЕСКИЕ МЕТОДЫ ОТОЛОГИЧЕСКИЕПРАКТИЧЕСКИЕ НАВЫКИИНТЕРНЫКЛИНИЧЕСКИЕ ОРДИНАТОРЫИНОСТРАННЫЕ СТУДЕНТЫOTORHINOLARYNGOLOGYSURGICAL SKILLSСодержатся краткие анатомические сведения, перечень используемого инструментария, пошаговые алгоритмы выполнения наиболее распространенных практических навыков в оториноларингологии. Описаны методы обследования пациента, а также наиболее простые и часто выполняемые диагностические и лечебные манипуляции. Для студентов медицинских университетов (лечебный, педиатрический и стоматологический факультеты), использующих английский язык в качестве языка-посредника, при подготовке к дифференцированному зачету по оториноларингологии. Может быть полезно врачам-интернам и клиническим ординаторам-оториноларингологам, а также врачам общей практики. It contains brief anatomical information, a list of tools used, step-by-step algorithms for performing the most common practical skills in otorhinolaryngology. The methods of examination of the patient are described, as well as the simplest and most frequently performed diagnostic and therapeutic manipulations

Primary structure and comparative sequence-analysis of an insect apolipoprotein: apolipophorin-Iii from Manduca-sexta

The amino acid sequence of an insect apolipoprotein, apolipophorin-III from Manduca sexta, was determined by a combination of cDNA and protein sequencing. The mature hemolymph protein consists of 166 amino acids. The cDNA also encodes for an amino-terminal extension of 23 amino acids which is not represented in the mature hemolymph protein. The existence of a precursor protein was confirmed by in vitro translation of fat body mRNA. Computer-assisted comparative sequence analysis revealed the following points: 1) the protein is composed of tandemly repeating tetradecapeptide units with a high potential for forming amphiphilic helical structures. Compared to mammalian apolipoproteins the repeat units in the insect apolipoprotein show considerable length variability; 2) the sequence has a striking resemblance to several human apolipoproteins including apoE, AIV, AI, and CI. However, the homology seems to be entirely functional since, although the insect and mammalian apoproteins contain very similar types of amino acid residues, the actual degree of sequence identity is quite low. Whether the mammalian and insect apoproteins are derived from a common ancestral amphiphilic helix forming, lipid-binding protein, or arose by convergent evolution can not be determined at present. This represents the first complete amino acid sequence for an insect apolipoprotein

Gottron’s Carcinoid Papillomatosis: Case Report

Introduction. Gottron’s papillomatosis is a rare benign type of dermatosis with pseudoepitheliomatous hyperplasia of the epidermis, first described as an independent disease by the German dermatologist H.A. Gottron. Invasive epidermal growth and hyperkeratosis reveal no signs of malignancy. Chronic venous insufficiency and lymphedema can be associated with various secondary skin lesions: the formation of ulcers, hyperkeratosis and skin papillomatosis, as well as infectious complications. Skin papillomatosis may be a manifestation of paraneoplastic syndrome, which requires a careful differential diagnosis. Timely treatment of complications in a patient with concomitant somatic pathology performed by a multidisciplinary team of specialists is necessary to improve the prognosis. Considering the relative rarity of Gottron’s papillomatosis and the lack of awareness among practicing physicians regarding the differential diagnosis of this disease, we present this clinical analysis.Description of a clinical case. Patient L., 42 years old (body mass index — 76.5 kg/m2) with chronic lymphovenous insufficiency, lymphedema, erysipelas of the right lower limb associated with unspecified skin papillomatosis, was urgently hospitalized in a health care institution “City Clinical Hospital No. 3” of Grodno (Republic of Belarus), consulted by a multidisciplinary team of clinicians including a therapist, a cardiologist, a dermatologist, an endocrinologist, an infectious disease specialist, and a surgeon. Taking into account the clinical status of the patient and the retrospective analysis of archival records of previous examinations performed on the patient in the health care institution “Grodno University Clinic”, the type of dermatosis was determined as Gottron’s papillomatosis of both lower extremities. In terms of the clinical diagnosis of the patient, complex therapy was initiated in a hospital setting, which was then continued at the outpatient stage.Conclusion. Adequate long-term treatment of morbid obesity and chronic lymphovenous insufficiency is necessary to prevent serious complications. According to the academic literature, timely diagnosis of such a rare dermatosis as Gottron’s papillomatosis, as well as the prescription of adequate therapy determine the possibility of regression in the early stages of the disease