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1.
Eur J Surg Oncol ; 43(8): 1494-1502, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28336186

RESUMEN

BACKGROUND: To explore variation in numbers and treatment between hospitals that treat head and neck cancer (HNC) in the Netherlands. MATERIAL AND METHODS: Patient, tumor and treatment characteristics were collected from the Netherlands Cancer Registry, while histopathological features were obtained by linkage to the national pathology record register PALGA. Inter-hospital variation in volume, stage, treatment, pathologically confirmed loco-regional recurrence and overall survival rate was evaluated by tumor site. RESULTS: In total, 2094 newly diagnosed patients were included, ranging from 65 to 417 patients in participating hospitals treating HNC in 2008. Oral cavity cancer was mainly treated by surgery only, ranging from 46 to 82% per hospital, while the proportion of surgery with (chemo)radiotherapy ranged from 18 to 40%. Increasing age, male sex, and high stage were associated with a higher hazard of dying. In oropharynx cancer, the use of (chemo)radiotherapy varied from 31 to 82% between hospitals. We found an indication that higher volume was associated with a lower overall hazard of dying for the total group, but not by subsite. Low numbers, e.g. for salivary gland, nasopharynx, nasal cavity and paranasal sinus, did not permit all desired analyses. CONCLUSION: This study revealed significant interhospital variation in numbers and treatment of especially oropharyngeal and oral cavity cancer. This study is limited because we had to rely on data recorded in the past for a different purpose. To understand whether this variation is unwanted, future research should be based on prospectively collected data, including detailed information on recurrences, additional case-mix information and cause of death.


Asunto(s)
Neoplasias de Cabeza y Cuello/terapia , Pautas de la Práctica en Medicina/estadística & datos numéricos , Femenino , Neoplasias de Cabeza y Cuello/epidemiología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Países Bajos/epidemiología , Calidad de la Atención de Salud , Sistema de Registros , Estudios Retrospectivos , Tasa de Supervivencia , Resultado del Tratamiento
2.
Int J Oral Maxillofac Surg ; 45(8): 945-50, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27055978

RESUMEN

For cT1/2N0 oral squamous cell carcinoma (OSCC), treatment of the neck is a matter of debate. Two treatment strategies were evaluated in this study: selective neck dissection (SND) and watchful waiting (WW). One hundred and twenty-three SND patients and 70 WW patients with cT1/T2N0M0 OSCC of the tongue, floor of mouth, or buccal mucosa were analysed retrospectively. Extracapsular spread (ECS), 3-year overall survival (OS), and disease-specific survival (DSS) were determined. Twenty-nine percent of SND patients and 13% of WW patients had occult nodal disease. WW-N+ patients showed thicker tumours as compared to WW-N0 patients (5mm vs. 2mm, P=0.02). WW-N+ patients showed significantly more ECS as compared to SND-N+ patients (56% vs. 14%, P=0.016) and had a significantly worse 3-year DSS than SND-N+ patients (56% vs. 82%, P=0.02). For T1 OSCCs, a watchful waiting policy is acceptable if tumour thickness proves to be <4mm. Otherwise, an additional treatment of the neck is advised, since WW-N+ patients show more ECS, with a worse DSS than SND-N+ patients.


Asunto(s)
Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Neoplasias de la Boca/patología , Neoplasias de la Boca/cirugía , Disección del Cuello , Espera Vigilante , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Retrospectivos
3.
Ned Tijdschr Tandheelkd ; 117(7-8): 387-90, 2010.
Artículo en Holandés | MEDLINE | ID: mdl-20726498

RESUMEN

A 90-year old woman attended a department of Oral and Maxillofacial Surgery with a tongue that had been painful for at least 3 months. Clinical examination revealed extensive bullous and ulcerative lesions located on the tongue, the oral vestibule and the buccal mucosa on both sides. A variety of diseases may be causative of ulcerative stomatitis: autoimmune diseases (like Pemphigus vulgaris, Erosive Lichen Planus, SLE or M. Crohn), or a viral, bacterial or mycotical infection, vitamin deficiency, a toxic reaction to medication or an immune deficiency. After an extensive, clinical examination, a definitive diagnosis still had not been achieved. The patient suffered from osteoporosis, for which she used alendronate (Fosamax). A study of the literature described a possible relationship between the occurrence of oral ulcers and the use of oral biphosphonates. Since a toxic reaction to alendronate was suspected, the use of Fosamax tablets was suspended. Three months later a complete recovery of the oral mucosa was observed.


Asunto(s)
Alendronato/efectos adversos , Mucosa Bucal/efectos de los fármacos , Mucosa Bucal/patología , Anciano de 80 o más Años , Alendronato/uso terapéutico , Femenino , Humanos , Osteoporosis/tratamiento farmacológico
4.
Int J Oral Maxillofac Surg ; 39(10): 962-7, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20615664

RESUMEN

In this study the authors evaluate and quantify the residual bony defect in the mandibular symphysis and its effect on the soft tissue contour a minimum of 1 year after harvesting chin bone. 59 ASA I cleft lip and palate patients, aged 8-19 years were included. In all patients an autologous bone graft from the mandibular symphysis was harvested for transplantation to the alveolar cleft. Lateral cephalograms were used to measure the donor site defects, and the effects on the soft tissue contour. An evident residual defect was measured at the donor site 1 year after harvesting chin bone. A significant relation was seen between age at time of surgery and size of the defect 1 year postoperatively. In older patients a larger defect remained. Using the current surgical technique of harvesting chin bone, complete bony repair of the defect was not achieved. This study shows postoperatively persisting defects that comprise on average 14% of the original peroperative defects. A significant increase in soft tissue thickness was seen at the mandibular symphysis at a minimum of 1 year postoperatively. These changes in the soft tissue chin contour 1 year after harvesting bone are similar to normal growth changes.


Asunto(s)
Alveoloplastia/métodos , Trasplante Óseo/métodos , Mentón/patología , Fisura del Paladar/cirugía , Mandíbula/patología , Recolección de Tejidos y Órganos/métodos , Adolescente , Factores de Edad , Vendajes , Cefalometría/métodos , Niño , Mentón/cirugía , Labio Leporino/cirugía , Femenino , Espuma de Fibrina/uso terapéutico , Estudios de Seguimiento , Hemostáticos/uso terapéutico , Humanos , Masculino , Mandíbula/cirugía , Técnicas de Sutura , Recolección de Tejidos y Órganos/efectos adversos , Trasplante Autólogo , Adulto Joven
5.
Med Tr Prom Ekol ; (4): 8-13, 2000.
Artículo en Ruso | MEDLINE | ID: mdl-10870343

RESUMEN

Considering possibility of waste materials use in building materials production, the authors evaluated toxicity of ash and clinker waste of electric power stations in Ulan-Ude city. The ash dust and its tincture in water, when injected even in maximal amounts, induced no intoxication symptoms and death in experimental animals, therefore bear no toxicity. Using toxicity indexes to compare ash and clinker waste dust with nontoxic dust proved the studied waste to be nontoxic and acceptable for use in building industry.


Asunto(s)
Contaminación Ambiental/estadística & datos numéricos , Residuos Industriales/efectos adversos , Centrales Eléctricas , Animales , Femenino , Humanos , Masculino , Ratas , Federación de Rusia
6.
J Forensic Sci ; 37(4): 984-90, 1992 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-1506839

RESUMEN

The impact of high temperatures (24 to 39 degrees C) and low to moderately high humidities (20 to 70%) on the applicability of TLC systems for drug identification was studied during a 6 month climatologic cycle in Burkina Faso (West Africa). In general, the Rf values as observed on the plates were found to be substantially affected as compared with values obtained at temperate climates. Some TLC systems were more affected than others and the largest deviations of up to 30 Rf units were at low humidities. Tropical conditions also had a negative effect on the reproducibility of Rf values. However, when an Rf-correction procedure was applied, using reference mixtures of known drugs on each plate, accuracy as well as reproducibility of the resulting Rfc values were drastically improved and data thus corrected were found to be compatible with existing TLC data bases developed under moderate climatological conditions. The impact of high to extremely high humidities (70 to 100%) remains to be investigated.


Asunto(s)
Cromatografía en Capa Delgada/normas , Calor , Humedad , Drogas Ilícitas/análisis , Clima Tropical , Burkina Faso , Estándares de Referencia , Reproducibilidad de los Resultados
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