Exogenous hormone use and cutaneous melanoma risk in women: The European Prospective Investigation into Cancer and Nutrition

Evidence suggests an influence of sex hormones on cutaneous melanoma risk, but epidemiologic findings are conflicting. We examined the associations between use of oral contraceptives (OCs) and menopausal hormone therapy (MHT) and melanoma risk in women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in 1992 in 10 European countries. Information on exogenous hormone use at baseline was derived from country-specific self-administered questionnaires. We used Cox proportional hazards regression models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Over 1992–2015, 1,696 melanoma cases were identified among 334,483 women, whereof 770 cases among 134,758 postmenopausal women. There was a positive, borderline-significant association between OC use and melanoma risk (HR = 1.12, 95% CI = 1.00–1.26), with no detected heterogeneity across countries (p_homogeneity = 0.42). This risk increased linearly with duration of use (p_trend = 0.01). Among postmenopausal women, ever use of MHT was associated with a nonsignificant increase in melanoma risk overall (HR = 1.14, 95% CI = 0.97–1.43), which was heterogeneous across countries (p_homogeneity = 0.05). Our findings do not support a strong and direct association between exogenous hormone use and melanoma risk. In order to better understand these relations, further research should be performed using prospectively collected data including detailed information on types of hormone, and on sun exposure, which may act as an important confounder or effect modifier on these relations.     

Transverse displacement of the proximal segment after bilateral sagittal osteotomy.

PURPOSE: The aim of the present investigation was to evaluate the transverse displacement of the proximal segment and ramus rotation after a bilateral sagittal osteotomy (BSO) with rigid internal fixation (RIF) using bicortical LAG screws. PATIENTS AND METHODS: We conducted a retrospective review of 37 patients (14 males and 23 females, age range of 14 to 55 years) who underwent a mandibular advancement with BSO and RIF. Posteroanterior and lateral cephalometric radiographs were obtained 1 to 8 weeks before and 1 to 4 weeks after surgery. The transverse displacement and angulation of the proximal segments after surgery were measured on posteroanterior radiographs, using the best-fit method. The amount of mandibular advancement was compared with the amount of transverse displacement of the proximal segments. RESULTS: In the 1 to 4-week postoperative period after a BSO, 36 of 37 subjects showed an increased transverse intergonion distance (5.6 mm) (P <.0001) and 35 of 37 patients showed an increased transverse interramus width (3.3 mm) (P <.0001). No correlation was found between mandibular advancement and transverse displacement of the proximal segment. CONCLUSIONS: The study results indicate that transverse displacements of the proximal segments occur with BSO and RIF. The clinical impact on temporomandibular joint symptomatology or surgical relapse with such displacement was not assessed in the study. Future studies that address these issues may help to determine whether there is an association between proximal segment displacement and surgical relapse, temporomandibular dysfunction, or both.     

The necessity of a test reading after 1 week to detect late positive patch test reactions in patients with oral lichen lesions

Objectives

Establishing the clinical relevance of contact allergy to dental materials in patients with oral lichen lesions (OLL) may be difficult, and tests are often read only on day 3 or day 4; also, concentration of the tested allergens may vary. Several studies on dermatitis patients have shown that additional positive patch test reactions can be found after day 4. Therefore, the aim of the present study was to analyse the frequency of late positive reactions to potential allergens in patients with OLL.

Material and methods

Eighty-three of 96 consecutive patients with biopsy-verified OLL were patch-tested with a recently developed lichen series. The patches were removed after 48 h and reactions read 3 and 7 days after application.

Results

A total of 129 contact allergies were found, and 26 (20.2 %) of the allergic reactions in 23 patients were seen on day 7 only. The 25.2 % increase in positive test reactions with an additional reading on day 7 in addition to day 3 was statistically significant. Metals were the substances with the highest frequency of late positive reactions.

Conclusions

Patients with OLL cannot be considered properly investigated with regard to contact allergy, unless the testing has been performed with mandatory readings on day 3 (or day 4) and day 7.

Clinical relevance

Late patch test readings are crucial in order to elucidate the role of contact allergy to dental materials in the aetiology of OLL.