Login to your account

Username *
Password *
Remember Me

Blog With Right Sidebar

    Vous êtes ici :  
  1. Accueil
  2. Blog With Right Sidebar

Intraoral metal contact allergy as a possible risk factor for oral squamous cell carcinoma.

OBJECTIVES: Intraoral exposure to dental restorations can cause contact allergy that may induce carcinogenesis. We investigated the relationship of intraoral metal contact allergy to epithelial carcinogenesis.

METHODS: The prevalence of positive patch test reactions to dental restoration metals in 65 prospectively enrolled patients with newly or previously diagnosed oral squamous cell carcinoma (SCC) was compared to that in 48 control patients. The relative risk of oral SCC was estimated by calculating odds ratios for exposure to dental metals resulting in allergy.

RESULTS: Of the 65 patients with oral SCC, 34% were allergic to at least 1 adjacent metal. They were 1.57 times as likely as control patients to have metal contact allergy (odds ratio, 1.57; 95% confidence interval, 0.65 to 3.80) and more than 3 times as likely to react to mercury (odds ratio, 3.20; 95% confidence interval, 0.42 to 33.20).

CONCLUSIONS: Patients with oral SCC who have metal dental restorations should undergo patch testing and possible removal of the restorations if their reactions are positive.

Primary and acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer: an update.

Related Articles

Epidermal growth factor receptor (EGFR) is a critical target in the treatment of nonsmall cell lung cancer (NSCLC). The mutations involving EGFR are more prevalent in patients of Asian ancestry, women, never smokers, and those with adenocarcinoma histology.

Primary mechanism of resistance to EGFR-TKIs includes in frame insertion mutation in exon 20, de novo T790M mutation also on exon 20, activating mutations in KRAS, loss of PTEN, and amplification of c-MET whereas acquired resistance results from development of secondary alteration in ATP domain of T790M. There are many novel targeting agents in development to overcome resistance to EGFR TKIs.

Serum glucose levels for predicting death in patients admitted to hospital for community acquired pneumonia: prospective cohort study.

Related Articles

OBJECTIVE: To examine whether acute dysglycaemia predicts death in people admitted to hospital with community acquired pneumonia.
DESIGN: Multicentre prospective cohort study.
SETTING: Hospitals and private practices in Germany, Switzerland, and Austria.
PARTICIPANTS: 6891 patients with community acquired pneumonia included in the German community acquired pneumonia competence network (CAPNETZ) study between 2003 and 2009.

MAIN OUTCOME MEASURES: Univariable and multivariable hazard ratios adjusted for sex, age, current smoking status, severity of community acquired pneumonia using the CRB-65 score (confusion, respiratory rate >30/min, systolic blood pressure ≤ 90 mm Hg or diastolic blood pressure ≤ 60 mm Hg, and age ≥ 65 years), and various comorbidities for death at 28, 90, and 180 days according to serum glucose levels on admission.

RESULTS: An increased serum glucose level at admission to hospital in participants with community acquired pneumonia and no pre-existing diabetes was a predictor of death at 28 and 90 days. Compared with participants with normal serum glucose levels on admission, those with mild acute hyperglycaemia (serum glucose concentration 6-10.99 mmol/L) had a significantly increased risk of death at 90 days (1.56, 95% confidence interval 1.22 to 2.01; P<0.001), and this risk increased to 2.37 (1.62 to 3.46; P<0.001) when serum glucose concentrations were ≥ 14 mmol/L. In sensitivity analyses the predictive value of serum glucose levels on admission for death was confirmed at 28 days and 90 days. Patients with pre-existing diabetes had a significantly increased overall mortality compared with those without diabetes (crude hazard ratio 2.47, 95% confidence interval 2.05 to 2.98; P<0.001). This outcome was not significantly affected by serum glucose levels on admission (P = 0.18 for interaction).

CONCLUSIONS: Serum glucose levels on admission to hospital can predict death in patients with community acquired pneumonia without pre-existing diabetes. Acute hyperglycaemia may therefore identify patients in need of intensified care to reduce the risk of death from community acquired pneumonia.

Patterns of management and adherence to venous thromboembolism (VTE) treatment guidelines in a national prospective cohort study of VTE management in the Canadian outpatient setting: The Recovery Study.

Documenting patterns and outcomes of venous thromboembolism (VTE) management and degree of adherence by clinicians to treatment guidelines could help identify remediable gaps in patient care. Prospective, clinical practice-based data from Canadian outpatient settings on management of VTE, degree of adherence with treatment guidelines and frequency of recurrent VTE and bleeding during follow-up was obtained in a multicentre, prospective observational study.

From 12 Canadian centres, we assessed 868 outpatients with acute symptomatic VTE who received the low-molecular-weight heparin (LMWH) enoxaparin alone or with vitamin K antagonists (VKA), at baseline and at six months (or at the end of treatment, whichever came first). Index VTE was limb deep venous thrombosis (DVT) in 583 (67.2%) patients, pulmonary embolism (PE) with or without DVT in 262 (30.2%) patients, and unusual site DVT in 23 (2.6%) patients. VTE was unprovoked in 399 (46.0%) patients, associated with cancer in 74 (8.5%) patients, transient risk factors in 327 (37.7%) patients and hormonal factors in 68 (7.8%) patients.

With regard to guideline adherence, 58 (7.3%) patients received <5 days LMWH and 114 (14.5%) had overlap <1 day. Among patients with cancer-related VTE, 59.5% were prescribed LMWH monotherapy and 43.2% received such treatment for >3 months. Only 38.1% of patients with transient VTE risk factors had received thromboprophylaxis.

Our study provides useful information on clinical presentation, management and related outcomes in Canadian outpatients with VTE. Our results suggest there may be important gaps in use of thromboprophylaxis to prevent VTE and use of LMWH monotherapy to treat cancer-related VTE.

Thrombosis and cancer: Retrospective study of 17 cases.

Related Articles

The association cancer and venous thrombosis is almost always an independent criterion of poor prognosis of cancer. Thus, venous thromboembolic disease is with infection and organ failure, one of the leading causes of death in patients with malignant disease.

Aim: To identify the characteristics of the association between cancer and venous thrombosis in any patient with deep vein thrombosis of lower limbs seemingly unexplained.

Methods: This is a retrospective study from January 1994 to December 2008, concerning 17 cases of patients with deep vein thrombosis of lower limbs associated with neoplasia, hospitalized in internal medicine department at Habib Thameur hospital between a total of 290 patients with deep vein thrombosis of lower limbs. Only patients hospitalized for deep vein thrombosis of lower limbs complicated or not by a pulmonary embolism were included.

Results: Our study concerned 17 patients. There were 10 women and 7 men with a sex ratio (Female / Male) at 1, 42. The average age was 68.7 years, with extreme ages ranging from 40 to 90 years. Cancer has formed 6% of the causes of deep venous thrombosis of lower limbs. Eight of our patients were known to suffer from a cancerous disease. Six cases of cancers were discovered at an advanced stage of evolution with multiple metastases. In seven cases the etiological could not be achieved. Deep venous thrombosis was complicated by pulmonary embolism in four inaugural events, five patients had recurrent thrombosis, and two cases of bleeding complications were noted.

Conclusion: Venous thromboembolism is common in cancer patients. It can be the first manifestation of cancer completely silent. The course and prognosis depend on the stage of cancer combined.

Search

Search