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1.
Epidemiol Psychiatr Sci ; 29: e125, 2020 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-32370818

RESUMO

AIMS: More than one-half of betel-quid (BQ) chewers have betel-quid use disorder (BUD). However, no medication has been approved. We performed a randomised clinical trial to test the efficacy of taking escitalopram and moclobemide antidepressants on betel-quid chewing cessation (BQ-CC) treatment. METHODS: We enrolled 111 eligible male BUD patients. They were double-blinded, placebo-controlled and randomised into three treatment groups: escitalopram 10 mg/tab daily, moclobemide 150 mg/tab daily and placebo. Patients were followed-up every 2 weeks and the length of the trial was 8 weeks. The primary outcome was BQ-CC, defined as BUD patients who continuously stopped BQ use for ⩾6 weeks. The secondary outcomes were the frequency and amount of BQ intake, and two psychological rating scales. Several clinical adverse effects were measured during the 8-week treatment. RESULTS: Intention-to-treat analysis shows that after 8 weeks, two (5.4%), 13 (34.2%) and 12 (33.3%) of BUD patients continuously quit BQ chewing for ⩾6 weeks among placebo, escitalopram, moclobemide groups, respectively. The adjusted proportion ratio of BQ-CC was 6.3 (95% CI 1.5-26.1) and 6.8 (95% CI 1.6-28.0) for BUD patients who used escitalopram and moclobemide, respectively, as compared with those who used placebo. BUD patients with escitalopram and moclobemide treatments both exhibited a significantly lower frequency and amount of BQ intake at the 8th week than those with placebo. CONCLUSIONS: Prescribing a fixed dose of moclobemide and escitalopram to BUD patients over 8 weeks demonstrated treatment benefits to BQ-CC. Given a relatively small sample, this study provides preliminary evidence and requires replication in larger trials.


Assuntos
Antidepressivos/uso terapêutico , Areca , Citalopram/uso terapêutico , Mastigação , Moclobemida/uso terapêutico , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Adolescente , Adulto , Idoso , Areca/efeitos adversos , Grupo com Ancestrais do Continente Asiático , Método Duplo-Cego , Humanos , Análise de Intenção de Tratamento , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/etnologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Resultado do Tratamento
2.
Anticancer Res ; 39(12): 6515-6521, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31810916

RESUMO

BACKGROUND/AIM: Oral cancer is of the highest incidence worldwide in Taiwan, and a better marker for personalized therapeutic strategies such as immunotherapies is urgently needed. Interleukin-12 (IL12) is a cytokine that has been reported to exhibit potent tumoricidal effects, however, its genotypic contribution to oral cancer is still largely unknown. The current study aimed at investigating whether IL12B rs3212227 genotype is associated with oral cancer in Taiwan. MATERIALS AND METHODS: Genotypic characteristics of IL12B rs3212227 were determined among 958 oral cancer cases and age- and gender-matched individuals via typical polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methodology. RESULTS: The AA, AC and CC genotypes of IL12B rs3212227 were 38.2, 38.9 and 22.9% in the case group and 36.2, 41.5 and 22.3% in the control group (p=0.5189), respectively. CONCLUSION: IL12B rs3212227 genotype was associated with oral cancer risk only in betel quid chewers.


Assuntos
Areca/efeitos adversos , Subunidade p40 da Interleucina-12/genética , Neoplasias Bucais/genética , Polimorfismo de Nucleotídeo Único , Idoso , Estudos de Casos e Controles , Feminino , Estudos de Associação Genética , Testes Genéticos , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/induzido quimicamente , Taiwan
3.
Hum Genet ; 138(11-12): 1379-1389, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31679052

RESUMO

Betel quid (BQ) chewing is a prevailing risk for oral squamous cell carcinoma (OSCC) in Southeast Asia. Yet, the detailed mechanisms by which BQ chewing damages the genome are still not fully understood. Through exome sequencing of tumor-normal pairs from 196 male patients with OSCC, including 95 habitual BQ chewers and 101 non-BQ users, we conducted a quantitative survey of mutational signatures and genomic aberrations and explored their association with BQ chewing. We found that BQ-associated elevation in mutation rate was seen in cancers of the tongue, but not in overall OSCC. Additionally, we identified a mutational signature that is enriched in tumors from BQ users. Moreover, the numbers of small insertions and deletions (INDELs) and breakpoints derived from structural variations (SV) were increased, whereas the extent of loss of heterozygosity was decreased in BQ-related OSCC genomes. However, neither the number of base substitutions and microsatellite instability events nor the extent of copy-number alterations differed between BQ-related and -unrelated OSCC. In conclusion, consistent with the proposition that BQ chewing increases OSCC risk as a mutagen, our results unveil a BQ-associated mutational signature and indicate mutagenic impacts of BQ chewing on preferentially eliciting INDELs and SV-related breakpoints in OSCC genomes.


Assuntos
Areca/efeitos adversos , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/genética , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Mastigação , Neoplasias Bucais/genética , Mutação , Adulto , Idoso , Carcinoma de Células Escamosas/induzido quimicamente , Carcinoma de Células Escamosas/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/induzido quimicamente , Neoplasias Bucais/epidemiologia
4.
Int J Gynaecol Obstet ; 147(3): 292-300, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31520411

RESUMO

BACKGROUND: Betel nut is the fourth most commonly abused substance worldwide and has been associated with significant adverse health outcomes. Little is known about its effects on the fetus. OBJECTIVE: To perform a systematic review of studies investigating prenatal betel nut use and adverse perinatal outcomes. SEARCH STRATEGY: Pubmed, Embase, and Cochrane databases were searched from inception until July 2018 using the terms areca, betel nut, pregnancy, pregnancy complications, and infection. SELECTION CRITERIA: Eligible studies included case-control, cohort, and randomized control studies involving pregnant women. DATA COLLECTION AND ANALYSIS: Where appropriate, bivariate meta-analysis was performed, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. MAIN RESULTS: In total, 28 studies were screened and eight studies (including 15 270 women) were included in the review and meta-analysis. Preterm birth, low birthweight, and anemia were most commonly investigated. Meta-analysis revealed a significant association between betel nut use and low birthweight, with a pooled OR of 1.75 (95% CI, 1.35-2.27). CONCLUSIONS: The review identified only eight eligible studies, all based in the Asia-Pacific region. There was a significant association between low birthweight and betel nut exposure in pregnancy. Further prospective studies are needed to confirm this association.


Assuntos
Areca/efeitos adversos , Nascimento Prematuro/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/etiologia , Transtornos Relacionados ao Uso de Substâncias , Adulto , Feminino , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Gravidez , Complicações na Gravidez/etiologia , Resultado da Gravidez , Nascimento Prematuro/etiologia , Estudos Prospectivos
5.
Gulf J Oncolog ; 1(30): 13-21, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31242977

RESUMO

BACKGROUND: Chewing Betel (areca-nut) can cause oral cancer. This happens when its components are in direct contact with the oral epithelium. The aim of this study is to understand this mechanism by analyzing salivary mucins, in vitro, during and after betel chewing. METHODS: The in vivo analysis would necessarily involve subtraction of betel to understand its effects. This study analyzed the interaction between mucins and betel in vitro. We added increasing amounts of areca powder, and for comparison an equal amount of pure vine tannin to saliva samples provided by a first volunteer. This study analyzes salivary mucins in two volunteers, one of whom is a regular betel consumer, after chewing the areca-nut, on six saliva samples taken at half-hour intervals. RESULTS: In vitro, total precipitation of the salivary mucins occurs after we added 1g of Areca nut (50 mg Tannin equivalent), a concentration five times lower than what is actually present during the chewing period; in vivo, in the first volunteer, there is a statistically significant increase in the mucins after chewing two and half hours: p-value = 0.02034, while for the regular betel consumer there is a significant decrease: p-value = 0.00512. DISCUSSION: In vitro, we conclude that the polyphenol content in betel causes total precipitation of mucins and causes poor defense of the oral epithelium. The increase of mucins in the non-routine consumers, show a transient (up to two hours after the end of chewing) inflammatory process. Inflammation can cause keratinization of the oral epithelium because the saliva increases its viscosity for the higher amount of mucins, with its lower adherence and protection of the oral cavity. Subsequent and regular consumption of betel nut, as in the regular betel consumer, can cause chronic fibrosis in the oral epithelium and cut the salivary mucins.


Assuntos
Areca/química , Mastigação , Neoplasias Bucais/diagnóstico , Mucinas/análise , Saliva/metabolismo , Adulto , Areca/efeitos adversos , Humanos , Técnicas In Vitro , Masculino , Neoplasias Bucais/etiologia , Neoplasias Bucais/metabolismo , Mucinas/química , Saliva/química
6.
Adv Otorhinolaryngol ; 83: 1-14, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30943510

RESUMO

Hypopharyngeal cancer is uncommon in the developed world; it is mostly diagnosed in men who smoke tobacco and consume excessive alcohol and uncommon in women. However, recent trends in the developed world show that there has been an annual increase in the percentage of women with hypopharyngeal cancer. In France, there has been a significant annual percentage change in the incidence of this form of cancer - a decrease in men and a greater increase in women since the 1980s. In the developing world, India, Taiwan and other countries, the incidence of hypopharyngeal cancer has increased in both men and women. These populations indulge widely in the social habit of tobacco usage at an earlier age, both smoking and chewing, excessive alcohol drinking, along with the chewing of the areca nut. Recent research has proven that areca nut alone is carcinogenic. The combination of tobacco and alcohol has a greater multiplicative impact on increasing the risk of cancer, while the involvement of areca nut remains to be proven. The World Health Organisation has commenced a Global Mission on the cessation of smoking and reduction of alcohol intake. The effect of this work has been credited with a reduction of hypopharyngeal and other head and neck cancers. While the younger aged should be the targeted population to avoid tobacco usage, the middle and older age of the population must be targeted for quitting smoking tobacco.


Assuntos
Neoplasias Hipofaríngeas/epidemiologia , Adulto , Idoso , Consumo de Bebidas Alcoólicas/efeitos adversos , Areca/efeitos adversos , Feminino , Saúde Global , Humanos , Neoplasias Hipofaríngeas/etiologia , Incidência , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , Distribuição por Sexo , Fumar/efeitos adversos , Tabaco sem Fumaça/efeitos adversos
7.
PLoS One ; 14(3): e0213729, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30865709

RESUMO

Tobacco use and oral sex (OS) are important risk factors for oral and oropharyngeal Human papillomavirus (HPV) infection. Little is known about the prevalence of OS practice in South Africa. This study aimed to determine the prevalence of OS practice and tobacco use in a South African patient population. This cross-sectional study used a structured questionnaire to collect socio-demographic characteristics, tobacco use, betel nut use and OS practice data from consenting adults (≥18 years; n = 850). Oral sex practices were recorded for patients 18-45 years-old (n = 514). Data analysis included chi-square and multiple logistic regression analyses. Of the study population, 55.2% (n = 468) were female, 88% (n = 748) self-identified as black Africans and 45.1% (n = 383) were unemployed. Furthermore, 19.7% (n = 167), 6.4% (n = 54) and 2.1% (n = 18) were current smokers, snuff users and betel nut users, respectively. Out of the 514 who answered the questionnaire in relation to OS, 22.8% (n = 115) reported to practice it. Oral sex practice in the age group 18-45 years was most common among the self-identified white participants (41.9%); and among tobacco users than among non-tobacco users (30.9% vs. 20.5%; p = 0.022). A multivariable-adjusted regression model showed that white South Africans were more likely to use tobacco than black Africans (OR = 5.25; 95% CI = 2.21-12.47). The practice of OS was more likely among those 18-35 years-old (OR = 1.67; 95% CI = 1.01-2.74), but had no significant association with tobacco use (OR = 1.06; 95% CI = 0.62-1.83). The observed age and ethnic differences in both risk behaviours suggest a need for targeted population intervention in order to reduce the risk for oral HPV infection.


Assuntos
Clínicas Odontológicas , Infecções por Papillomavirus/complicações , Comportamento Sexual , Tabaco sem Fumaça/efeitos adversos , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Areca/efeitos adversos , Estudos Transversais , Grupo com Ancestrais do Continente Europeu , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/etnologia , Prevalência , Análise de Regressão , Fatores de Risco , África do Sul/epidemiologia , África do Sul/etnologia , Inquéritos e Questionários , Uso de Tabaco/efeitos adversos , Tabagismo/complicações , Tabagismo/etnologia , Adulto Jovem
8.
Asian Pac J Cancer Prev ; 20(2): 411-415, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30803200

RESUMO

Background: Oral potentially malignant disorders (OPMDs) and oral cancer (OC) are preventable oral mucosal diseases prevalent in Asian region. This epidemiological study aims to identify oral potentially malignant disorders (OPMDs) and oral cancer (OC), confirm histopathologically, and treat or refer these cases among the population of Eastern Development Region (EDR) of Nepal. It also attempts to assess the risk factors associated in order to compare dose­response measurements of oral habits in these patients. Methods: Cross-sectional epidemiological study was conducted over a period of 2 years in 16 districts of EDR. A total of 3,200 people were screened. A brief history was taken and visual screening examination was conducted in two phases as described by British Columbia Oral Cancer Prevention Program. Suspicious oral lesions were biopsied either by punch or scalpel after toluidine blue staining. Tissue specimen was transported to the institutional lab for histopathological processing. The reports were sent to the patients through the local leaders or organizations. Results: More than 40% of the study population either chewed areca nut and/or tobacco. Eighteen percent were smokers. OPMDs were prevalent among 468 study population with male-female ratio of 3:1. Tobacco pouch keratosis (50.4%) was the most prevalent OPMD, followed by OSF (29.1%). Fifty-two had squamous cell carcinoma and 8 had verrucous carcinoma. Conclusion: Chewing areca nut, tobacco, commercial areca nut/tobacco preparation and smoking being the major risk factors, there is high prevalence of oral cancer and OPMDs in the EDR of Nepal.


Assuntos
Carcinoma de Células Escamosas/epidemiologia , Detecção Precoce de Câncer , Neoplasias Bucais/epidemiologia , Lesões Pré-Cancerosas/epidemiologia , Tabaco sem Fumaça/efeitos adversos , Adulto , Areca/efeitos adversos , Carcinoma de Células Escamosas/etiologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/etiologia , Nepal/epidemiologia , Lesões Pré-Cancerosas/etiologia , Prevalência , Prognóstico , Medição de Risco , Fatores de Risco
9.
Asian Pac J Cancer Prev ; 20(2): 451-455, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30803207

RESUMO

Aim: Correlation of habit duration and frequency with clinical grading and histopathologic grouping of oral submucous fibrosis (OSMF). Materials and methods: 48 patients with OSMF were included in the study. Detailed history of each patient, clinical profile and habit history were recorded. Biopsy was performed for histopathological correlation. All the findings were correlated with Kerr et al and Khanna and Andrade classification. Statistical Analysis: Kruskal-wallis test was performed to assess the correlation between the study findings. Results: Out of 48 OSMF cases majority were males. Maximum cases were in clinically and histopathologically respectively. Mouth opening was directly proportional with histopathological grouping as per Khanna et al. No correlation between frequency and habit duration with respect to different stages or severity of the OSMF was noted. Conclusion: Disease staging of OSMF clinically and histopathologically is not directly impacted by habit duration and frequency. Rather than habit centered history and management accordingly, more focus should be given to genetics and susceptibility of patient for OSMF development and progression.


Assuntos
Areca/efeitos adversos , Fibrose Oral Submucosa/etiologia , Fibrose Oral Submucosa/patologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Transtornos Relacionados ao Uso de Substâncias/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Adulto Jovem
11.
PLoS One ; 14(1): e0210901, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30657779

RESUMO

A number of genetic variants were suggested to be associated with oral malignancy, few variants can be replicated. The aim of this study was to identify significant variants that enhanced personal risk prediction for oral malignancy. A total of 360 patients diagnosed with oral squamous cell carcinoma, 486 controls and 17 newly diagnosed patients with OPMD including leukoplakia or oral submucous fibrosis were recruited. Fifteen tagSNPs which were derived from somatic mutations were genotyped and examined in associations with the occurrence of oral malignancy. Environmental variables along with the SNPs data were used to developed risk predictive models for oral malignancy occurrence. The stepwise model analysis was conducted to fit the best model in an economically efficient way. Two tagSNPs, rs28647489 in FAT1 gene and rs550675 in COL9A1 gene, were significantly associated with the risk of oral malignancy. The sensitivity and specificity were 85.7% and 85.5%, respectively (area under the receiver operating characteristic curve (AUC) was 0.91) for predicting oral squamous cell carcinoma occurrence with the combined genetic variants, betel-quid, alcohol and age. The AUC for OPMD was only 0.69. The predictive probability of squamous cell carcinoma occurrence for genetic risk score without substance use increased from 10% up to 43%; with substance use increased from 73% up to 92%. Genetic variants with or without substance use may enhance risk prediction for oral malignancy occurrence in male population. The prediction model may be useful as a clinical index for oral malignancy occurrence and its risk assessments.


Assuntos
Caderinas/genética , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/genética , Colágeno Tipo IX/genética , Neoplasias Bucais/etiologia , Neoplasias Bucais/genética , Adulto , Idoso , Consumo de Bebidas Alcoólicas/efeitos adversos , Areca/efeitos adversos , Estudos de Casos e Controles , Feminino , Interação Gene-Ambiente , Humanos , Leucoplasia Oral/etiologia , Leucoplasia Oral/genética , Masculino , Pessoa de Meia-Idade , Fibrose Oral Submucosa/etiologia , Fibrose Oral Submucosa/genética , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Fumar/efeitos adversos
12.
J Investig Clin Dent ; 10(1): e12379, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30499194

RESUMO

AIM: The aim of the present study was to investigate the awareness of oral cancer among adults in Jakarta, Indonesia, and explore the factors influencing it. METHODS: A previously-tested questionnaire on 1000 adults in Jakarta was used in the present study. The data included sociodemographic factors and answers to assess the awareness of oral cancer, early signs and symptoms, risks factors, lifestyles, and history of dental visits. RESULTS: Only 53.2% of participants were aware of oral cancer. The level of awareness significantly differed by level of education, occupation, and experience of dental visits. Only 30% of patients had been asked about their tobacco and alcohol habits, and had been informed about the hazards of these by their dentists. All of the smokers knew that tobacco increased the risk for oral cancer. However, only a few participants considered alcohol, betel quid chewing, UV light exposure, poor diet, and genetics to play role in the development of oral cancer. Health warnings were the main source of information about oral cancer; the role of health professionals is still quite low and needs to be emphasized. CONCLUSION: Oral cancer awareness is still low among adults in Jakarta; this finding was consistent with other studies conducted in Asia. Educational material suited to particular communities is warranted.


Assuntos
Conscientização , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Bucais , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/efeitos adversos , Areca/efeitos adversos , Estudos Transversais , Educação , Feminino , Hábitos , Humanos , Indonésia , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Ocupações , Saúde Bucal , Fatores de Risco , Gestão de Riscos , Fumar/efeitos adversos , Inquéritos e Questionários , Tabaco/efeitos adversos , Tabaco sem Fumaça/efeitos adversos , Adulto Jovem
13.
Community Dent Oral Epidemiol ; 47(1): 58-64, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30238494

RESUMO

OBJECTIVES: Betel quid (BQ) chewing is extremely prominent in South and Southeast Asia because it considered by users to be of social, cultural and religious importance. BQ chewing has been recognized as a risk factor for oral premalignant lesions and oral cancer. Because BQ chewing has become a severe health risk in Taiwan, the development of prevention and cessation programmes is essential. The purpose of this study was to explore the attitudes and perceptions associated with BQ consumption and its oral health implications in an attempt to inform the development of health promotion initiatives and BQ cessation efforts in Taiwan, where the dental profession could have a pivotal role in preventing and controlling BQ use among persons at risk. METHODS: This qualitative study used data gathered from focus groups and individual interviews. A convenience sample of 41 adults from Jhushan and Lugu Townships (Nantou County) and Taichung City, Taiwan, participated in this study (27 men, 14 women; 31 Han, 10 aboriginals from the Paiwan tribe; mean age 40.3, SD 9.2 years). RESULTS: Among the seven themes that emerged from the original study, five (Initiation, Health Risk Perception, Health Consequences, Withdrawal Symptoms and Help from Healthcare Providers) had oral/dental implications. CONCLUSIONS: Our study highlights research areas relevant to further investigation, such as incorporating brief BQ prevention and cessation counselling when early oral and dental signs associated with BQ consumption are detected. Undertaking behavioural interventions in dental settings might help to reduce the prevalence of BQ chewing in Taiwan.


Assuntos
Areca , Neoplasias Bucais/epidemiologia , Saúde Bucal , Adulto , Areca/efeitos adversos , Atitude , Feminino , Humanos , Masculino , Mastigação , Lesões Pré-Cancerosas/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Taiwan
14.
Brain Imaging Behav ; 13(4): 1135-1145, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30051327

RESUMO

The World Health Organization regards betel quid (BQ) as a human carcinogen. The current study analyzes whether the BQ cues can elicit activity in the chewers' craving-related brain areas. We adopted a cue-reactivity paradigm to examine the changes in the brain activities. The urge intensity was also included to examine whether it can moderate the brain areas stimulated by BQ cues. Sixteen male BQ chewers and 16 healthy male controls were recruited and analyzed. Four types of cues were adopted: BQ cues, matched food cues, visual control cues, and resting crosshair cued. The most direct and important comparison was between the brain activities elicited by the BQ cues versus those by the food cues. Furthermore, to test the current urge intensity effect, we compared BQ chewers with a strong urge versus those with a weak urge. All of the three-dimension anatomical and multi-slice task-based functional images were acquired using 3 T MRI. We found that (1) the BQ chewers and the healthy controls had similar brain activation patterns when comparing any two cue types, (2) the high-urge (not the low-urge) chewers showed craving-related activations (e.g., anterior cingulate cortex, medial orbitofrontal gyrus, and superior frontal gyrus) in the critical BQ cues vs. the food cue comparisons. (3) The high-urge chewers had larger contrast activations (BQ - Food) in many craving-related brain areas than low-urge chewers did (e.g., frontal gyrus). The urge states endorsed by the chewers can moderate the neural responses to BQ cues. Multisensory cues should be considered to elicit more intense and consistent cravings.


Assuntos
Areca/efeitos adversos , Mapeamento Encefálico/métodos , Fissura/fisiologia , Adulto , Encéfalo/fisiopatologia , Córtex Cerebral/fisiologia , Sinais (Psicologia) , Lobo Frontal/fisiologia , Giro do Cíngulo/fisiologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Mastigação/fisiologia , Córtex Pré-Frontal/fisiologia
15.
J Diet Suppl ; 16(2): 207-214, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29624459

RESUMO

Oral submucous fibrosis (OSMF) is one of the "diseases of civilization" because of the large differences in prevalence among races, geographic areas, and individuals at different socioeconomic levels. It is a premalignant condition strongly associated with the habit of chewing areca nuts. This study is to compare the scoring system in relation to the burning sensation of mouth and dysphagia using the visual analog scale (VAS) and Dakkak and Bennett grading system for Indian food, respectively, in OSMF patients. This study was a randomized clinical trial incorporating a total of 50 cases of OSMF divided into a control group (antioxidant therapy) and pentoxifylline test cases. Values for burning sensation of the mouth using the VAS and modified Dakkak and Bennett grading system for Indian food were recorded. Statistical analyses were done using t test, Mann -Whitney U test, and one-way analysis of variance (ANOVA) test. Patients subjected to pentoxifylline when compared to the control group showed significant reduction in dysphagia for Indian food. Burning sensation was recorded according to the visual analogue scale. Significant reduction in burning sensation was seen in the pentoxifylline group when compared to the control group. This grading system provides quantitative and qualitative parameters in patients with OSMF.


Assuntos
Transtornos de Deglutição/etiologia , Alimentos/efeitos adversos , Alimentos/classificação , Fibrose Oral Submucosa/fisiopatologia , Pentoxifilina/uso terapêutico , Antioxidantes/uso terapêutico , Areca/efeitos adversos , Feminino , Humanos , Índia , Masculino , Nozes/efeitos adversos , Fibrose Oral Submucosa/complicações , Fibrose Oral Submucosa/tratamento farmacológico , Medição da Dor
16.
J Formos Med Assoc ; 118(1 Pt 1): 203-208, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29636296

RESUMO

BACKGROUND: The incidence of HPV positive oropharyngeal cancer is increasing in Taiwan. Given this, it is critical to understand the prevalence of oral HPV infection since this cancer is potentially preventable. A community-based study was conducted to evaluate the prevalence of oral HPV infection and sexual behavior changes. METHODS: Between January and December 2016, 100 subjects between 20 and 70 years-old with current/ever betel nut chewing or current cigarette smoking visited the Department of Health, New Taipei City. Subjects with cancer history or known HIV/AIDS were excluded. Sexual behavior information was collected through a questionnaire. Oral rinse samples and oropharyngeal swabs were obtained for HPV genotyping using the EasyChip HPV genotyping array (King-Car, Taiwan). RESULTS: 92 men and 8 women were recruited. The prevalence of oral HPV infection was 3%, present between 60 and 70 (11%) and between 30 and 40 years old (4%). The prevalence of the first sexual contact at younger than 20 years old were 71.4%, 53.6%, 15.4% and 44% in <40, 40-49, 50-59 and 60+ years old, respectively (p for trend = 0.0036). The prevalence of 3 or more lifetime sexual partners were 60.7%, 57.1%, 23.1% and 16.7%, respectively for <40, 40-49, 50-59 and 60+ years old (p for trend = 0.0005). CONCLUSION: The prevalence of oral HPV infection is 3%, in current/ever betel nut chewers or current cigarette smokers in Northern Taiwan. Younger generation have more lifetime sexual partners and younger first sexual contact. This could explain the rising incidence of HPV positive oropharyngeal cancer in Taiwan.


Assuntos
Areca/efeitos adversos , Fumar Cigarros/efeitos adversos , Neoplasias Orofaríngeas/virologia , Infecções por Papillomavirus/epidemiologia , Adulto , Fatores Etários , Idoso , Alphapapillomavirus/genética , Diagnóstico Bucal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/epidemiologia , Prevalência , Fatores de Risco , Amostragem , Taiwan/epidemiologia , Adulto Jovem
17.
J Cancer Educ ; 34(2): 309-314, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29164494

RESUMO

Betel nut (BN) is a psychoactive oral carcinogen that is commonly used among Asian communities. This study aims to investigate BN usage patterns and the effectiveness of a visually guided educational initiative in a high-risk refugee population. All adult patients presenting to a private practice clinic, free community clinic, or health fair in the refugee community of Clarkston, Georgia during days when survey staff were present were approached for the study. Participants were first categorized into a familiar and unfamiliar cohort depending on participant-reported familiarity with BN. Depending on familiarity, subjects were then administered a pre-intervention test surveying health awareness for BN and usage patterns where relevant; subsequently, a visually guided educational brochure was reviewed, and a post-intervention test was administered. Results were statistically analyzed (STATA 12). Forty-eight participants were surveyed for the familiar cohort and 25 for the unfamiliar cohort. Among the familiar cohort, South and Southeast Asians comprised 91% of participants. On frequency of use, 42.8% reported social, 28.6% reported usage during celebrations only, and 28.6% reported daily. The most common reasons for use were for taste (40.9%), enjoyment (38.6%), and addiction (25%). Among the familiar cohort, 75% believed BN was harmful for health compared to 8% among the unfamiliar (p < 0.0001). In the familiar cohort, 52.3% believed BN alone could cause cancer compared to 4% among the unfamiliar (p < 0.0001). Following the educational intervention, 100% of participants believed BN mastication is harmful in both cohorts (p < 0.01), while 87.5% of participants in both cohorts recognized that BN alone could cause cancer (p < 0.0007). This study illustrates gaps in understanding regarding oral cancer and the health consequences of chronic BN mastication, as well as the efficacy of a visually guided educational brochure to improve participant knowledge among a high-risk refugee population.


Assuntos
Areca/efeitos adversos , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias Bucais/etiologia , Refugiados , Adulto , Ásia/etnologia , Estudos de Coortes , Feminino , Georgia , Humanos , Masculino , Mastigação , Folhetos , Fatores de Risco
18.
Perspect Public Health ; 139(1): 44-48, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29957144

RESUMO

AIM:: Areca nut (AN) is consumed globally by 600 million people, and 10%-20% of the world population uses betel quid, a preparation containing areca nut. India and other South-east Asian countries are the largest consumers of AN in the world. The aim of this article is to review the economic impact and oral health effects of the consumption of AN. It will also discuss the role of dentists and auxiliary healthcare providers for increasing public awareness and the need for a strong public health policy. METHOD:: To address the concerned area, PubMed, Scopus and Google Scholar databases were explored from the year 1965 until 2017. Studies focusing on various aspects of AN only, and articles published in English were included. Anecdotal reports, case reports and unpublished data were excluded. RESULTS AND DISCUSSION:: This narrative review suggests India is the world's largest producer of AN along with the largest AN consuming population followed by other South-east Asian countries. AN chewing causes oral submucous fibrosis (OSF) and it is most commonly observed in people of India and South-east Asia. AN use is associated with various social and unsocial aspects. Dentists and dental auxiliaries can increase the knowledge and awareness of a health issue (OSF) among the target audience as well as the detrimental effects of AN chewing. CONCLUSION:: There is a need for more aggressive public health measures and dentists and dental auxiliaries should be employed to bring awareness to the general public regarding AN use.


Assuntos
Areca , Fibrose Oral Submucosa/etiologia , Areca/efeitos adversos , Ásia Sudeste/epidemiologia , Comércio/estatística & dados numéricos , Educação em Saúde , Política de Saúde , Humanos , Índia/epidemiologia , Internacionalidade , Fibrose Oral Submucosa/epidemiologia
20.
Oral Oncol ; 87: 58-63, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30527244

RESUMO

OBJECTIVES: To elucidate the risk of malignant transformation to invasive oral cancer by subtypes of oral potentially malignant disorders (OPMD) and to examine the independent effects of risk factors, particularly alcohol drinking, by subtype based on a nationwide oral cancer screening program targeting at general population with habits of smoking and/or betel quids chewing. MATERIALS AND METHODS: The total of 8501 subjects diagnosed as different subtypes of OPMDs from the Taiwanese screening program between 2004 and 2009 were followed up over time to ascertain the occurrence of invasive oral cancer. The hazard ratios of malignant transformation were estimated by using Cox proportional hazards regression model. RESULTS: The overall malignant rate (per 1000 person-years) to oral cancer was 8.4 (407 incident cases with an average of 5.7 years of follow-up). The highest rate was noted in exophytic verrucous hyperplasia (33), followed by erythroplakia (11.8), erythroleukoplakia (10.7), oral submucous fibrosis (OSF) (8.6), and leukoplakia (5.4). After adjusting for confounders, exophytic verrucous hyperplasia still had a 5.69 (4.47-7.24) times risk compared with leukoplakia. The corresponding figures for erythroplakia, erythroleukoplakia, and OSF were 2.25 (1.31-3.89), 2.00 (1.13-3.53), and 1.63 (1.29-2.06), respectively. Alcohol drinking elevated the overall risk of malignant transformation by 23% (1-52% and also triggered a higher risk in OSF (aHR = 1.62 (1.06-2.47)). The higher risk attributed to betel quids chewing was noted for exophytic verrucous hyperplasia (aHR = 4.23 (1.55-11.55)). CONCLUSIONS: The risk of malignant transformation to oral cancer varied with the subtypes of OPMD and was elevated in OSF and verrucous hyperplasia attributed to alcohol drinking and betel quids, respectively.


Assuntos
Transformação Celular Neoplásica/patologia , Detecção Precoce de Câncer/estatística & dados numéricos , Leucoplasia Oral/patologia , Neoplasias Bucais/epidemiologia , Lesões Pré-Cancerosas/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Areca/efeitos adversos , Feminino , Seguimentos , Humanos , Hiperplasia/epidemiologia , Hiperplasia/etiologia , Hiperplasia/patologia , Incidência , Leucoplasia Oral/epidemiologia , Leucoplasia Oral/etiologia , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/etiologia , Estudos Prospectivos , Fatores de Risco , Taiwan/epidemiologia , Adulto Jovem
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