Early detection of oral cancers: current status and future prospects.

Purpose of review: This article reviews the current literature and summarizes the latest developments in screening and early detection of oral cancers and looks at the future possibilities. Recent findings: Oral cancer is the best model for screening and prevention. The screening for oral cancer can be population based, opportunistic, or targeted. A long-term 15-year follow-up data of a randomized controlled study from a developing country setting indicated a sustained reduction in oral cancer mortality in high-risk individuals. Visual oral examination remains the mainstay in the screening. Several adjunctive techniques have been described to aid in the clinical examination of these lesions. A Cochrane review revealed that there is no evidence to recommend these adjuncts in clinically visible lesions. Salivary biomarkers seem to be promising as a tool for screening in the future. A Targeted Evidence Update for the US Preventive Services Task Force found no evidence on screening either in the general or selected high-risk population for oral cancer in the United States or on benefit of any adjunctive device affecting the performance of the screening examination. Summary: Current evidence shows that community based screening has a value in reducing the oral cancer mortality in high-risk group of population. But this evidence may not be universally applicable. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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T Cell Response in Patients with Implanted Biological and Mechanical Prosthetic Heart Valves

The study was aimed at assessing T cell subsets of peripheral blood from recipients of long-term functioning (more than 60 months) biological and mechanical heart valve prostheses. The absolute and relative number of CD4 and CD8 T cell subsets was analyzed: naïve (N, CD45RA+CD62L+), central memory (CM, CD45RA−CD62L+), effector memory (EM, CD45RA−CD62L−), and terminally differentiated CD45RA-positive effector memory (TEMRA, CD45RA+CD62L−) in 25 persons with biological and 7 with mechanical prosthesis compared with 48 apparently healthy volunteers. The relative and absolute number of central memory and naïve CD3+CD8+ in patients with biological prosthesis was decreased (). Meanwhile the number of CD45RA+CD62L−CD3+CD8+ and CD3+CD4+ was increased (). Patients with mechanical prosthesis had increased absolute and relative number of CD45RA+CD62L−CD3+CD8+ cells (). Also the relative number of CD3+CD4+ cells was reduced (). We assume that altered composition of T cell subsets points at development of xenograft rejection reaction against both mechanical and biological heart valve prostheses.

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Diode endovascular laser treatment in venous malformations of the upper aerodigestive tract

Diode endovascular laser treatment in venous malformations of the upper aerodigestive tract

via ScienceDirect Publication: Journal of Cranio-Maxillofacial Surgery

Publication date: Available online 15 February 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): François Simon, Nicolas Le Clerc, Didier Salvan, Elisabeth Sauvaget, Benoît Faucon, Michel Borsik, Philippe Herman, Annouk Bisdorff
PurposeVenous malformations of the upper aerodigestive tract can cause pain, dysphagia, obstructive sleep apnea, and rarely bleeding. We studied 980-nm diode endovenous laser therapy.Material and MethodsThis is a 2007–2014 retrospective study in our vascular anomalies center. Data on patients' clinical history, polysomnography, magnetic resonance imaging, and treatment were collected. Patients were contacted for Epworth Sleepiness Scale and Eating Assessment Tool (EAT-10) scores to evaluate sleepiness and dysphagia before and after laser therapy.ResultsWe included 32 patients (mean age 41 years) presenting with obstructive sleep apnea (n = 18) and dysphagia (n = 13). With a mean follow-up of 39 months, average Epworth Sleepiness Scale score fell from 17.3 to 10.4 (p = 0.015), EAT-10 score from 8.2 to 3.5 (p=0.002) and apnea–hypopnea index from 47.5 to 24.7 (p = 0.01). Of the sleep apnea patients, 89% required continuous positive airway pressure before and 50% afterward (p = 0.016).ConclusionsDiode endovascular laser treatment seems to be a safe and effective treatment option in venous malformations of the upper airways.

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Oral diseases in pediatric HIV-infected populations

The global burden of oral diseases in pediatric HIV-infected populations: a workshop report:

Objectives

To achieve a comprehensive understanding about the global burden of oral diseases in HIV-infected children and to identify research needs.

Materials and methods

A literature search was conducted in PubMed (2009–2014) to address five questions: (i) prevalence of oral diseases in HIV-infected compared with uninfected children, (ii) impact of oral diseases on quality of life, (iii) effect of antiretroviral exposure in utero on craniofacial and dental development, (iv) important co-infections and antiretroviral complications, and (v) value of atraumatic restorative treatment.

Results

Studies showed a high prevalence of dental caries in HIV-infected children but the relationship between HIV infection and dental caries remains unclear. Also quality of life needs further investigation supported by better study designs and improvement of the instruments used. Up-to-date evidence suggested long-term harms associated with in utero antiretroviral exposure were minor but would require long-term follow-up through National Registries. The reviews also revealed the wide spectrum of metabolic disease due to antiretroviral therapy and co-infections such as tuberculosis. Finally, atraumatic restorative technique appears to be a simple and safe technique to treat dental caries but outcomes need further evaluation.

Conclusions

The impact of antiretroviral therapy in HIV-infected children has raised novel challenging questions in the field of oral health warranting future research.

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Human papilloma virus and other biologic markers in nasopharyngeal cancer

Clinical implications of human papilloma virus and other biologic markers in nasopharyngeal cancer: Human papilloma virus (HPV) is associated with both the occurrence and prognosis of oropharyngeal cancer. However, few studies have examined the relationship between HPV and nasopharyngeal cancer (NPC). This study investigated the clinical implications of HPV and other molecular markers, including p16, p53, and epidermal growth factor receptor (EGFR), for NPC patients.

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Infraorbital necrotising fasciitis

Infraorbital necrotising fasciitis: importance of rehabilitation in vulnerable patients: A 31-year-old woman presented to the accident and emergency department after a blunt force injury to the right side of her face from an alleged assault. She had mental health problems and a history of substance misuse. There was periorbital swelling, but all investigations were within normal limits. The next day her right eye swelled with pus and she had signs of acute sepsis (Fig. 1). She was diagnosed with necrotising fasciitis by the maxillofacial team, and immediately taken to the operating theatre for debridement.

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Natural position of the head

: review of two-dimensional and three-dimensional methods of recording

via British Journal of Oral and Maxillofacial Surgery

Publication date: Available online 16 February 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): D. Cassi, C. De Biase, I. Tonni, M. Gandolfini, A. Di Blasio, M.G. Piancino
Both the correct position of the patient's head and a standard system for the acquisition of images are essential for objective evaluation of the facial profile and the skull, and for longitudinal superimposition. The natural position of the head was introduced into orthodontics in the late 1950s, and is used as a postural basis for craniocervical and craniofacial morphological analysis. It can also have a role in the planning of the surgical correction of craniomaxillofacial deformities. The relatively recent transition in orthodontics from 2-dimensional to 3-dimensional imaging, and from analogue to digital technology, has renewed attention in finding a versatile method for the establishment of an accurate and reliable head position during the acquisition of serial records. In this review we discuss definition, clinical applications, and procedures to establish the natural head position and their reproducibility. We also consider methods to reproduce and record the position in two and three planes.

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