Role of alcohol and smoking in diagnostic delay of head and neck cancer patients

CONCLUSIONS: This study shows that heavy drinking is a risk factor for prolonged delay in presenting with head and neck cancer and for presenting with a large tumour in the head and neck region. Excessive smoking is only a risk factor for being diagnosed with a large tumour, although there is a weak association between smoking and prolonged diagnostic delay. OBJECTIVE: It is reasonable to assume that prolonged delay in presenting with head and neck cancer is associated with an advanced stage of cancer at diagnosis. In this study we analysed the effects of drinking and smoking habits on diagnostic delay and the T stage of the tumour at diagnosis. MATERIAL AND METHODS: A total of 427 patients with newly diagnosed head and neck carcinomas were eligible for this study. Of these, 306 (72%) actually participated: 134 (77%) with an oral tumour; 117 (69%) with a larynx tumour; and 55 (65%) with a pharynx tumour. Diagnostic delay was defined as a period of >30 days between the appearance of the first tumour-related symptoms and the first visit to a physician. T3 4 tumours were defined as advanced tumours. Drinking behaviour was classified into three types: light (0 2 drinks/day); moderate (3 4 drinks/day); and heavy ( >4 drinks/day). Smoking habits were classified into 4 types: never; stopped; light (0 20 cigarettes/day); and heavy (>20 cigarettes/day). RESULTS: Logistic regression showed that there were significantly more heavy than light drinkers [p = 0.04; odds ratio (OR) 1.8; 95% CI 1.0-3.1] in the delay group than in the non-delay group. Light smokers showed a tendency towards prolonged delay (p = 0.06; OR 2.2; 95% CI 1.0-5.0). Both heavy drinking (p = 0.01; OR 2.0; 95% CI 1.2-3.6) and heavy smoking (p = 0.03; OR 3.1; 95% CI 1.1-8.4) were risk factors for a patient to be diagnosed with a large tumour.     

Treatment of sudden sensorineural hearing loss: II. A Meta-analysis

OBJECTIVE: To pool and meta-analyze the results of all randomized controlled trials (RCTs) on treatment of sudden sensorineural hearing loss (SSHL). DATA SOURCES: A MEDLINE search and hand search were conducted to identify RCTs published between January 1966 and February 2006 in the English language on the treatment of SSHL. Search terms included hearing loss, sensorineural (MeSH term), sensorineural hearing loss (text words), and sudden deafness (text words). STUDY SELECTION: Prospective RCTs on the treatment of patients diagnosed as having sudden sensorineural hearing loss. DATA EXTRACTION: A meta-analysis using the random effects model was conducted when data existed for 2 or more studies. Odds ratios (ORs), 95% confidence intervals (CIs), and tests for heterogeneity were reported. DATA SYNTHESIS: Twenty RCTs were identified, of which 5 met inclusion criteria for meta-analysis. Pooling of data from 2 RCTs that compared steroids with placebo showed no difference between treatment groups (OR, 2.47; 95% CI, 0.89-6.84; P=.08). No difference existed between patients treated with antiviral plus steroid therapy vs placebo plus steroid therapy (OR, 0.92; 95% CI, 0.29-2.92: P=.88). Finally, there was no difference between subjects treated with steroids vs subjects treated with any other active treatment (OR, 1.27; 95% CI, 0.64-2.55; P=.50). CONCLUSIONS: Despite the traditional practice in North America of treating of SSHL with systemic steroids, a meta-analysis revealed no evidence of benefit of steroids over placebo. There was also no difference in the addition of antiviral therapy to systemic steroids, nor was there difference between systemic steroids and other active treatment.     

The risk of hearing loss in a population with a high prevalence of chronic suppurative otitis media

Background

Chronic suppurative otitis media (CSOM) affects 65–330 million people in the developing part of the world and develops in early childhood. Knowledge of the long-term effects on hearing is scarce. Hearing loss (HL) can cause reduced ability to communicate, impair language development and academic skills.

Objective

To estimate the prevalence of HL in a population with a high-risk of CSOM and to identify the risk of permanent hearing loss from CSOM.

Methods

Ten and 15 years follow-up of two Greenlandic population-based children cohorts. Participants underwent otologic examination and audiometric evaluation. HL was defined using both the American Speech-Language-Hearing Association's (ASHA) and the World Health Organizations's (WHO) definition. Risk factors for HL were analyzed, using binomial logistic regression analysis.

Results

A total of 438 individuals aged 11–24 years participated. Using the ASHA definition of HL the prevalence was 50% (95% CI 45.3–54.7). Using the WHO definition of HL the prevalence was 2.5% (95% CI 1.1–3.98). CSOM was the main cause of HL. Co-existing CSOM (OR 16.7, 95% CI 8.29–33.65), spontaneous healing from CSOM (OR 3.75, 95% CI 1.62–8.67), and male gender (OR 2.2, 95% CI 1.28–3.78) were associated with HL. Ninety-one percent of children with CSOM developed a permanent hearing loss >15 dBHL.

Conclusion

CSOM was strongly associated with permanent hearing loss. CSOM was the main reason for HL in this population. The WHO definition of hearing loss is likely to underestimate the burden of hearing loss among children and adolescents in developing countries with a high prevalence of CSOM.     

The increase in incidence of cancer of the tongue in the Nordic countries continues into the twenty-first century

Conclusions This study shows that heavy drinking is a risk factor for prolonged delay in presenting with head and neck cancer and for presenting with a large tumour in the head and neck region. Excessive smoking is only a risk factor for being diagnosed with a large tumour, although there is a weak association between smoking and prolonged diagnostic delay.

Objective It is reasonable to assume that prolonged delay in presenting with head and neck cancer is associated with an advanced stage of cancer at diagnosis. In this study we analysed the effects of drinking and smoking habits on diagnostic delay and the T stage of the tumour at diagnosis.

Material and methods A total of 427 patients with newly diagnosed head and neck carcinomas were eligible for this study. Of these, 306 (72%) actually participated: 134 (77%) with an oral tumour; 117 (69%) with a larynx tumour; and 55 (65%) with a pharynx tumour. Diagnostic delay was defined as a period of >30 days between the appearance of the first tumour-related symptoms and the first visit to a physician. T3–4 tumours were defined as advanced tumours. Drinking behaviour was classified into three types: light (0–2 drinks/day); moderate (3–4 drinks/day); and heavy (>4 drinks/day). Smoking habits were classified into 4 types: never; stopped; light (0–20 cigarettes/day); and heavy (>20 cigarettes/day).

Results Logistic regression showed that there were significantly more heavy than light drinkers [p=0.04; odds ratio (OR) 1.8; 95% CI 1.0–3.1] in the delay group than in the non-delay group. Light smokers showed a tendency towards prolonged delay (p=0.06; OR 2.2; 95% CI 1.0–5.0). Both heavy drinking (p=0.01; OR 2.0; 95% CI 1.2–3.6) and heavy smoking (p=0.03; OR 3.1; 95% CI 1.1–8.4) were risk factors for a patient to be diagnosed with a large tumour.     

Human leukocyte antigen-DQB1 and -DRB1 associations in patients with idiopathic sudden sensorineural hearing loss from a defined population of Northwest Spain

CONCLUSION: The results of this study support the assertion that Southern European individuals have a genetically mediated predisposition to develop idiopathic sudden sensorineural hearing loss (SNHL). OBJECTIVE: To assess the influence of human leukocyte antigen (HLA)-DQB1 and -DRB1 alleles on the susceptibility to and the severity of idiopathic sudden SNHL. MATERIAL AND METHODS: A prospective study of patients diagnosed with idiopathic sudden SNHL between October 2000 and September 2002 was conducted. Patients were included in the study if they were diagnosed with idiopathic sudden SNHL within 1 week after the onset of deafness symptoms and had been followed for at least 12 months. HLA-DQB1 and -DRB1 typing was performed from DNA using molecular-based methods on patients and ethnically matched healthy controls. RESULTS: Thirty-three patients fulfilled the inclusion criteria. No significant differences in HLA-DQB1 phenotype frequencies were found between patients and controls (n = 145). Carriage of HLA-DRB1*0403 was significantly increased in the whole group of patients compared with controls (OR = 11.97; 95% CI 1.99-91.60; p = 0.002; p(corr) = 0.04). In patients without auditory improvement the frequency of the HLA-DRB1*04 phenotype was significantly increased compared with healthy controls (OR = 6.57; 95% CI 1.62-26.70; p = 0.003; p(corr) = 0.04).     

Human papillomavirus and risk of oral cancer

Although human papillomavirus (HPV), a sexually transmitted virus, is established as a necessary cause for more than 95% of cervical carcinomas, the association with oral squamous cell carcinoma is less well delineated. The purpose of this study was to determine the frequency and types of HPV in squamous cells of a group of patients with newly diagnosed oral or pharyngeal cancer (n = 93) compared with an age-and gender-frequency-matched control group of patients with no history of oral cancer (n = 205). HPV was evaluated from a mouth rinse collection of cells in the oral cavity and tested by ³²P-labeled HPV generic probes and DNA sequencing for HPV types. HPV was identified in 15% of the oral cancer cases but in fewer than 5% of the controls (P < .05). The risk of cancer associated with HPV infection was independent of tobacco and alcohol use (adjusted odds ratio [OR] = 3.70; 95% confidence interval [CI]: 1.47–9.32; P < .05). HPV types included similar and other types not identified previously in the genital tract. There was no statistically significant increased risk of cancer among former tobacco users (former vs. never users: adjusted OR = 0.67, 95% CI: 0.31–1.44, P < .05), but the risk was significantly increased for current users (current vs. never: adjusted OR = 2.63; 95% CI: 1.22–5.71; P < .05). Likewise, former alcohol users were not at increased risk of disease (former vs. never: adjusted OR = 1.78; 95% CI: 0.87–3.67), whereas current alcohol users were (current vs. never: adjusted OR = 2.57; 95% CI: 1.22–5.42; P < .05). HPV-related genital lesions (14.3% vs. 10.6%), oral-genital sexual behavior (42.4% vs. 45.2%), and number (11 or more) of sexual partners (23% v. 17%) were not significantly different between cases and controls. These data suggest that in addition to tobacco and alcohol, HPV plays a role in the development of oral cancer.     

The incidence,co-occurrence,and predictors of dysphagia,dysarthria, and aphasia after first-ever acute ischemic stroke

Dysphagia, dysarthria and aphasia occur frequently following stroke. Our purpose was to identify the incidence, co-occurrence, and predictors of these impairments after first-ever ischemic stroke. We used the Registry of the Canadian Stroke Network's database (2003–2008) from one stroke center to identify a random sample of 250 patients with acute ischemic stroke confirmed by MR imaging. We further conducted a retrospective medical chart review. We established reliable data capture and identified the presence of the three impairments. We derived incidence and co-occurrence estimates along with 95% confidence intervals (CI) for dysphagia, dysarthria, and aphasia. We then computed odds ratios (OR) through logistic regression to identify predictors. Twenty-nine patient charts were not available for review. Estimates of the incidence of dysphagia, dysarthria, and aphasia were 44% (95% CI, 38–51), 42% (95% CI, 35–48) and 30% (95% CI, 25–37), respectively. The highest co-occurrence of any two impairments was 28% (95% CI, 23–34) for the presence of both dysphagia and dysarthria. Ten percent of all 221 patients had all three impairments. The highest predictors were non-alert level of consciousness for dysphagia (OR 2.6, CI 1.03–6.5), symptoms of weakness for dysarthria (OR 5.3, CI 2.4–12.0), and right-sided symptoms for aphasia (OR 7.1, CI 3.1–16.6). These findings are a first step toward identifying the incidence and predictors of multiple co-occurring impairments in a homogenous stroke sample.     

有眩晕及无眩晕突聋的纯音听力表现

本文分析病程２周内的特发性突聋１０９例的有眩晕及无眩晕两组病人的听力损失类型及预后。发现；女性合并眩晕多于男性，有眩晕病人平均年龄高于无眩晕病人。１０９例中深度耳聋型占４１例，平坦听力损失型３１例，高频听力损失型２５例，低频听力损失型９例，中应听力损失碟型３例。１０９例中突聋有眩晕者占４５％。     

Hearing loss prevalence and risk factors among older adults in China

Objective: This study aims to investigate the prevalence of hearing loss, and to analyse the major demographics and risk factors that influence the prevalence in older adults of China. Design: Cross-sectional investigation. Study sample: Probability proportionate to size sampling (PPS) was adopted for this survey. Among 45,052 individuals, 6984 older adults (≥60?years) were selected as subjects for this study. Results: The prevalence of hearing loss defined as a speech frequency pure tone average of more than 25?dB HL in the better ear was 58.85%. Age and gender were the factors most strongly associated with hearing loss after multivariate adjustment. Ear disease, diabetes, hypertension, atherosclerosis, noise exposure, and ototoxic drugs were significantly correlated with hearing loss. The largest effects were found for ear disease and noise exposure (OR?=?2.83 [95% CI: 2.43–3.29]; OR?=?2.59 [95% CI: 1.80–3.72]). Conclusions: Hearing loss is prevalent in nearly two thirds of adults aged 60?years and older in China population. Chronic diseases, ear disease, and noise are important factors in adults aged 60?years and older.     

Predictors of Olfactory Dysfunction in Patients With Chronic Rhinosinusitis

Objectives: To measure the prevalence of and identify clinical characteristics associated with poor olfactory function in a large cohort of patients with chronic rhinosinusitis (CRS). Study Design: Multi‐institutional, cross sectional analysis. Methods: An objective measure of olfactory dysfunction, the Smell Identification Test, demographic data, clinical factors, and comorbidity data were collected from a cohort of 367 patients who presented with CRS at three tertiary care centers. Data were analyzed using univariate and multivariate analyses. Results: Sixty‐four percent of men and women aged 18 to 64 had olfactory dysfunction whereas 95% of patients older than or equal to 65 years had olfactory dysfunction (P < .001); no significant difference was noted by gender. By multivariate logistic regression analysis, patients with nasal polyposis [Odds ratio (OR) 2.4, 95% confidence interval (CI) 1.3–4.2, P = .003] and patients older than or equal to 65 years (OR 10.0, 95% CI 2.3–43.7, P = .002) were at increased risk of hyposmia. Patients with nasal polyposis (OR 13.2, 95% CI 5.7–30.7, P < .001), asthma (OR 4.2, 95% CI 1.8–9.8, P = .001), older than or equal to 65 years (OR 15.6, 95% CI 2.3–104.9, P = .005), and smokers (OR 7.6, 95% CI 1.8–31.6, P = .005) were at increased risk of anosmia. Conclusions: Poor olfactory function is common in patients with CRS. Age, nasal polyposis, smoking, and asthma were significantly associated with olfactory dysfunction in patients with CRS. Neither prior endoscopic sinus surgery nor a history of allergic rhinitis was associated with olfactory dysfunction. Septal deviation and inferior turbinate hypertrophy were associated with normal olfactory function.     

Analysis of the vestibular aqueduct development on the risk for suffering from idiopathic sudden sensorineural hearing loss

ObjectiveLarge vestibular aqueduct syndrome (LVAS) is one of the etiology of hearing loss. Clinically, we observed that the VA size of patients with idiopathic sudden sensorineural hearing loss (ISSNHL) did not meet the diagnostic criteria of VA enlargement, but there were individual variations. Through this study, we want to understand the VA development and explore its risk for suffering from ISSNHL.Methods74 patients with ISSNHL were retrospectively reviewed in our department from June 2018 to September 2021. Meanwhile, 57 people with no ear diseases were randomly selected as the control group. All their clinical information were systematically collected. The axial thin-slice CT images of temporal bone were used to observe and measure the VA in ISSNHL and controls. ISSNHL were classified as different types and grades according to pure tone audiometry and the degree of hearing loss, respectively. Logistic regression analysis was adopted to evaluate the risk factors of different types and grades of ISSNHL.ResultsThe operculum morphology could be funnel-shaped, tubular and invisible, but they had no statistical difference in the morbidity of ISSNHL. The operculum width of the affected sides in the case group was significantly wider than that of the matched sides in the control group (0.84±0.35mm vs 0.68±0.34mm, p=0.009), but the midpoint width had no statistical difference (p=0.447). The operculum width was an independent risk factor for the total hearing loss type (p=0.036, OR=4.49, 95% CI=1.10-18.29), moderate (p=0.013, OR=17.62, 95% CI=1.82-170.95) and profound (p=0.031, OR=4.50, 95% CI=1.14-17.67) grade of ISSNHL. Hypertension was an independent risk factor for the severe grade (p=0.004, OR=12.44, 95% CI=2.19-70.64) of ISSNHL. Both the operculum width (p=0.048, OR=7.14, 95% CI=1.02-50.26) and hypertension (p=0.014, OR=6.73, 95% CI=1.46-30.97) were the risk factors for the flat type of ISSNHL. The midpoint width of the VA, gender, age, diabetes mellitus, hyperlipidemia, and plasma fibrinogen concentration had no significant effect on the risk for suffering from ISSNHL.ConclusionThe development of the VA operculum is a risk factor for some types and grades of ISSNHL. Hypertension remained a risk factor for ISSNHL.     

Risk factors for recurrent epistaxis: Importance of initial treatment

Objective

A retrospective study of risk factors for recurrent epistaxis and initial treatment for refractory posterior bleeding was performed. Based on the results, proposals for appropriate initial treatment for epistaxis by otolaryngologists are presented.

Methods

The data of 299 patients with idiopathic epistaxis treated during 2008–2009 were analyzed by multivariate logistic regression analysis. Treatment data for 101 cases of posterior bleeding were analyzed using the chi-square test.

Results

Recurrent epistaxis occurred in 32 cases (10.7%). Unidentified bleeding point (adjusted odds ratio (OR) 5.67, 95% confidence interval (CI) 1.83–17.55, p = 0.003) was predictive of an increased risk of recurrent epistaxis, and electrocautery (adjusted odds ratio (OR) 0.07, 95% confidence interval (CI) 0.03–0.17, p = 0.000) was predictive of a decreased risk of recurrent epistaxis. In terms of initial treatment for posterior bleeding, the rate of recurrent epistaxis was significantly lower for patients who underwent electrocautery as initial treatment compared with those who did not (6.4% vs. 40.7%, p < 0.01), and it was significantly higher for those who underwent endoscopic gauze packing compared with those who did not (39.5% vs. 15.9%, p < 0.01).

Conclusion

In the present study, the risk factors for recurrent epistaxis were unidentified bleeding point. Thus, it is important to identify and cauterize a bleeding point to prevent recurrent epistaxis. The present results also suggest the effectiveness of electrocautery and the higher rate of recurrent epistaxis for patients who underwent gauze packing as initial treatment for posterior bleeding. Electrocautery should be the first-choice treatment of otolaryngologists for all bleeding points of epistaxis, and painful gauze packing may be inadvisable for posterior bleeding. More cases of posterior bleeding are needed for future studies involving multivariate analyses and appropriate analyses of factors related to hospitalization, surgery, and embolization.     

MicroRNA-146a前体区基因多态性与江苏地区汉族人群喉癌遗传易感性的关联性分析

目的 探讨microRNA-146a(miR-146a)前体区基因多态性位点rs2910164 G>C与喉癌的关联性。方法 建立病例-对照研究,选取204例喉癌患者和440例健康对照者,收集一般人口学资料和临床病理学特征,采用TaqMan探针对miR-146a rs2910164位点进行基因分型,logistic回归模型用于评价rs2910164位点与喉癌发病风险的关联性强度。结果 rs2910164多态性位点与增加罹患喉癌风险显著相关(GC/CC vs. CC：OR调整=2.49,95% CI=1.57-3.94)。分层分析显示,与携带GG基因型个体相比,携带C等位基因的吸烟、饮酒以及无肿瘤家族史个体罹患喉癌风险显著增加(P均< 0.05),吸烟、饮酒与miR-146a rs2910164位点的共同作用效应更加显著(吸烟与rs2910164 GC/CC：OR=6.39,95% CI=2.72-15.0;饮酒与rs2910164 GC/CC：OR=4.19,95% CI=2.24-7.83)。结论 miR-146a rs2910164 C等位基因与增加罹患喉癌风险有关,可以作为预测喉癌发病风险的潜在生物标志物。     

Analysis of patient factors associated with hospital visits for allergic rhinitis in Japanese adult patients: A cross-sectional study

ObjectiveAllergic rhinitis (AR) is one of the most common diseases in Japan. However, several AR patients do not seek optimal treatments at clinics/hospitals. This may affect the patient's quality of life and labor productivity. In this study, we assessed the characteristics of the outpatients’ AR and factors associated with their hospital visit, using the dataset obtained from a nation-wide survey in Japan.MethodsIn this cross-sectional study, we used data from the nation-wide 2013 and 2016 Comprehensive Survey of Living Conditions (CSLC) in Japan. We analyzed the data of AR outpatients through logistic regression, using the outcome as the dependent variable, and age groups, sex, household size, educational status, smoking history, alcohol use, household expenditure, psychological distress, quality of sleep, asthma and atopic dermatitis outpatients as explanatory variables.ResultsAmong the data of 317,984 outpatients aged between 20 and 79 years in 2016 CSLC survey, the proportion of AR outpatients was significantly less among current smokers (odds ratio (OR); 0.47, 95% confidence interval (CI); 0.43–0.51, P < 0.001) and those with large household sizes (OR; 0.80, 95% CI; 0.72–0.89, P < 0.001). Conversely, the proportion of AR outpatients was significantly more among subjects with a past smoking habit (OR; 1.19, 95% CI; 1.08–1.31, P < 0.001), insufficient sleep (OR; 2.93, 95% CI; 2.52–3.42, P < 0.001), psychological distress (OR; 1.71, 95% CI; 1.62–1.80, P < 0.001), high household expenditures (OR; 1.68, 95% CI; 1.56–1.80, P < 0.001), and asthma and atopic dermatitis outpatients (OR; 8.97, 95% CI; 8.13–9.89 P < 0.001 for asthma and OR; 7.61, 95% CI; 6.76–8.58 P < 0.001 for atopic dermatitis). We observed the same trend using the dataset of 2013 CLSC survey.ConclusionThis study revealed that smoking habit, psychological distress, insufficient sleep, high household expenditures and outpatients with other allergic diseases are the factors associated with AR outpatient visit.     

Three‐year follow‐up of children with postmeningitic deafness and partial cochlear implant insertion

Objectives: To evaluate the long‐term outcome of children with postmeningitic deafness and partial insertion of the Nucleus electrode array, and to compare their speech perception performance with that of children with full insertion of the electrode array. Design: A battery of seven speech perception tests was administered to 25 children with a cochlear implant (CI). Results were reduced into one score: equivalent hearing loss (EHL). Setting: Tertiary referral centre. Participants: The partial insertion group comprised seven children, mean age at implantation 5.5 years, mean duration of deafness 3.6 years. The full‐insertion control group comprised 18 children. Mean age at implantation: 4.4 years; mean duration of deafness: 2.9 years. All the children became deaf between 0 and 3 years of age. Main outcome measures: Over a 3‐year follow‐up period, the children with partial insertion showed continuing progress, although there was wide variation in performance and the rate of progression. Some open‐set comprehension could even be achieved with the insertion of only eight electrodes of a nucleus device. Results: Three years after implantation, speech perception in the partial insertion children was poorer than that in the control groups with long (P < 0.01; 95% confidence interval 7–43 dB EHL) and short duration of deafness (P < 0.0001; 95% confidence interval 28–53 dB EHL). They showed slower progress and reached a poorer EHL plateau. Four of the seven children acquired open‐set word recognition. Conclusions: Patients with partial insertion of the electrode array benefit from a CI, although less than patients with complete insertion.     

Human leukocyte antigen-DQB1 and -DRB1 associations in patients with idiopathic sudden sensorineural hearing loss from a defined population of Northwest Spain

Conclusion. The results of this study support the assertion that Southern European individuals have a genetically mediated predisposition to develop idiopathic sudden sensorineural hearing loss (SNHL). Objective. To assess the influence of human leukocyte antigen (HLA)-DQB1 and -DRB1 alleles on the susceptibility to and the severity of idiopathic sudden SNHL. Material and methods. A prospective study of patients diagnosed with idiopathic sudden SNHL between October 2000 and September 2002 was conducted. Patients were included in the study if they were diagnosed with idiopathic sudden SNHL within 1 week after the onset of deafness symptoms and had been followed for at least 12 months. HLA-DQB1 and -DRB1 typing was performed from DNA using molecular-based methods on patients and ethnically matched healthy controls. Results. Thirty-three patients fulfilled the inclusion criteria. No significant differences in HLA-DQB1 phenotype frequencies were found between patients and controls (n=145). Carriage of HLA-DRB1*0403 was significantly increased in the whole group of patients compared with controls (OR?=?11.97; 95% CI 1.99–91.60; p=0.002; p_corr=0.04). In patients without auditory improvement the frequency of the HLA-DRB1*04 phenotype was significantly increased compared with healthy controls (OR?=?6.57; 95% CI 1.62–26.70; p=0.003; p_corr=0.04).     

Etiological factors associated with chronic suppurative otitis media in a population of Han adults in China

Objective: Risk factors for chronic suppurative otitis media (CSOM) were not clearly established. The study was to investigate the etiological factors for CSOM from a population of Han adults in China.

Methods: A case-control study was conducted at Second Affiliated Hospital of Xi’an Jiaotong University, School of Medicine in China. A total of 416 individuals participated in this study, which included 206 cases and 210 controls.

Results: Multivariate logistic regression analysis revealed male (OR?=?0.42; 95% CI: 0.21–0.83), BMI increasing (OR?=?0.85; 95% CI: 0.77–0.93), URTI (OR?=?152.85; 95% CI: 34.11–684.93), smoke/passive smoke (OR?=?7.11; 95% CI: 3.36–15.07), residential location (urban area) (OR?=?0.27; 95% CI: 0.13–0.56), serum calcium increasing (OR?=?0.09; 95% CI: 0.01–0.71) were prime risk factors for CSOM. Univariate analysis revealed that low socioeconomic status (OR=?2.33; 95% CI: 1.57–3.45) and hepatitis B (OR?=?4.90; 95% CI: 1.82–13.21) were risk factors together with the above variables.

Conclusion: This study has identified several variables as risk factors for CSOM, suggesting better healthcare, living condition, as well as better nutrition might decrease the development of CSOM. Further studies are necessary to assess the outcome of CSOM after interventions in the etiological factors.     

Parental exposures and risk of nonsyndromic orofacial clefts in offspring: A case-control study in Greece

Objective

To investigate the association between cleft lip and/or palate and nongenetic factors in Greece.

Methods

We designed a case-control study including 35 patients with nonsyndromic cleft lip and/or palate, retrospectively selected, and 35 control patients matched for prefecture of residence, prospectively selected from pediatric population hospitalized for abdominal pain or injury. Parents were interviewed about drug uptake, diseases, habits, non-occupational exposure to pollutants, and occupation. Questions covered the period from one year before until three months after conception.

Results

High-risk paternal occupations (mostly farmers) were significantly more frequent in cleft lip and/or palate than in controls (p = 0.039) and increased significantly the cleft lip and/or palate risk in offspring (OR: 3.00; 95% CI: 1.03-8.70). Maternal occupation did not correlate with cleft lip and/or palate. Parental disease, drugs uptake, hazardous habits, maternal folate supplementation and non-occupational exposure to pollutants did not correlate with cleft lip and/or palate. There was a suggestion of increased risk with maternal passive exposure to tobacco (OR: 1.81; 95% CI: 0.69-4.74) and with residential proximity to industries (OR: 1.70; 95% CI: 0.61-4.74).

Conclusions

Paternal high-risk occupations probably exert a teratogenic effect on spermatogenesis or result in maternal contamination, and deserve specific preventive policies. The relation of smoking and residential proximity to industries with occurrence of cleft lip and/or palate deserves further study.     

Oral status, oral infections and some lifestyle factors as risk factors for oral and oropharyngeal squamous cell carcinoma. A population-based case-control study in southern Sweden

CONCLUSION: Our results show that average and poor oral hygiene and inadequate dental status are independent risk factors for oral and oropharyngeal squamous cell carcinoma (OOSCC), irrespective of tobacco and alcohol consumption. OBJECTIVE: To evaluate a possible relationship between oral cancer, oral hygiene, dental status, oral mucosal lesions and some lifestyle factors in a population-based case-control study. MATERIAL AND METHODS: Between September 2000 and January 2004, 132/165 (80%) of all incident cases of OOSCC and 320/396 (81%) of the intended eligible matched controls participated in the study. Cases and controls were subjected to an identical oral examination. A standardized protocol specially designed for the study was used. RESULTS: After adjusting for tobacco and alcohol consumption, average oral hygiene (OR 2.0; 95% CI 1.1-3.6) and poor oral hygiene (OR 5.3; 95% CI 2.5-11.3) emerged as significant risk factors for OOSCC. More than 20 lost teeth (OR 3.4; 95% CI 1.4-8.5), >5 defective teeth (OR 3.1; 95% CI 1.2-8.2) and poorly fitting or defective complete dentures (OR 3.8; 95% CI 1.3-11.4) were significant risk factors. Regular dental check-ups were associated with a decreased risk of OOSCC (OR 0.4; 95% CI 0.2-0.6).