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1.
J Family Med Prim Care ; 11(4): 1573-1579, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35516693

RESUMO

Tongue acts as a mirror of our body. Diagnosis of tongue lesions is challenging to primary physicians as they might be the first sign or may be a part of underlying systemic diseases. Knowledge on the lesions of tongue is necessary for oral and overall health planning and education. Hence, this article illustrates a clinical case series of tongue lesions among a rural population in south Chennai, thus imparting a higher awareness of the specific tongue pathology-related etiology and management to increase the awareness on thorough oral screening including detailed assessment of tongue and provide a holistic care to patients to improve the Oral health related and Overall quality of life of patients (OHRQOL/QOL).

2.
Am Fam Physician ; 105(4): 369-376, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35426641

RESUMO

Familiarity with common oral conditions allows clinicians to observe and treat patients in the primary care setting or refer to a dentist, oral surgeon, otolaryngologist, or other specialist. Recurrent aphthous stomatitis (canker sores) is the most common ulcerative condition of the oral cavity. Recurrent herpes simplex labialis and stomatitis also commonly cause oral ulcers. Corticosteroids, immunocompromise, antibiotics, and dentures can predispose patients to oral candidiasis. Benign migratory glossitis (geographic tongue) occurs in up to 3% of the population but generally lacks symptoms, although some people experience food sensitivity or a burning sensation. Hairy tongue is associated with a low fiber diet, tobacco and alcohol use, and poor oral hygiene in older male patients. Generally, hairy tongue is asymptomatic except for an unattractive appearance or halitosis. Tobacco and alcohol use can cause mucosal changes resulting in leukoplakia and erythroplakia. These can represent precancerous changes and increase the risk of squamous cell carcinoma. Mandibular and maxillary tori are common bony cortical outgrowths that require no treatment in the absence of repeat trauma from chewing or interference with dentures. Oral lichen planus occurs in up to 2% of individuals and can present as lacy reticulations or oral erosions and ulcerations. Traumatic buccal mucosal fibromas and labial mucoceles from biting can be excised.


Assuntos
Glossite Migratória Benigna , Doenças da Boca , Úlceras Orais , Estomatite Aftosa , Língua Pilosa , Idoso , Glossite Migratória Benigna/patologia , Humanos , Masculino , Doenças da Boca/diagnóstico , Doenças da Boca/etiologia , Doenças da Boca/terapia , Mucosa Bucal/patologia , Úlceras Orais/diagnóstico , Úlceras Orais/etiologia , Estomatite Aftosa/complicações , Estomatite Aftosa/etiologia , Língua Pilosa/complicações , Língua Pilosa/patologia
3.
J Oral Maxillofac Pathol ; 26(Suppl 1): S17-S21, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35450243

RESUMO

Migratory stomatitis (MS) is an uncommon inflammatory condition with unclarified etiology, which despite its benign nature, may raise concerns for patients and diagnostic difficulties for professionals. This case report aims to describe the clinical features of a patient who presented with MS in conjunction with benign migratory glossitis (BMG), and its diagnostic process and management. The patient, a 25-year-old man, sought diagnosis of an oral condition, with cyclic behavior, which had been causing him great discomfort for a year. The patient presented erythematous patches on his lower lips and right side of the buccal mucosa, surrounded by a slightly elevated halo with a concomitant classical picture of BMG. After analysis of his entire symptomatology, the diagnosis of MS associated with BMG was concluded. The patient received clear explanations and symptomatic treatment. The diagnosis of MS may be challenging, even to oral medicine practitioners, especially if it occurs alone. MS with concurrent manifestation of BMG may make the conditions easier to diagnose, but it does not exclude the need to apply a complete process of differential diagnosis to rule out other similar possibilities.

4.
Sci Rep ; 12(1): 6888, 2022 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-35477968

RESUMO

Epizootic hemorrhagic disease (EHD) and bluetongue (BT) are vector-borne viral diseases that affect wild and domestic ruminants. Clinical signs of EHD and BT are similar; thus, the syndrome is referred to as hemorrhagic disease (HD). Syndromic surveillance and virus detection in North America reveal a northern expansion of HD. High mortalities at northern latitudes suggest recent incursions of HD viruses into northern geographic areas. We evaluated the occurrence of HD in wild Illinois white-tailed deer from 1982 to 2019. Our retrospective space-time analysis identified high-rate clusters of HD cases from 2006 to 2019. The pattern of northward expansion indicates changes in virus-host-vector interactions. Serological evidence from harvested deer revealed prior infection with BTV. However, BTV was not detected from virus isolation in dead deer sampled during outbreaks. Our findings suggest the value of capturing the precise geographic location of outbreaks, the importance of virus isolation to confirm the cause of an outbreak, and the importance of expanding HD surveillance to hunter-harvested wild white-tailed deer. Similarly, it assists in predicting future outbreaks, allowing for targeted disease and vector surveillance, helping wildlife agencies communicate with the public the cause of mortality events and viral hemorrhagic disease outcomes at local and regional scales.


Assuntos
Vírus Bluetongue , Bluetongue , Cervos , Vírus da Doença Hemorrágica Epizoótica , Transtornos Hemorrágicos , Infecções por Reoviridae , Doenças Transmitidas por Vetores , Animais , Illinois/epidemiologia , Infecções por Reoviridae/epidemiologia , Infecções por Reoviridae/veterinária , Estudos Retrospectivos , Ovinos
5.
Cancer Epidemiol ; 78: 102140, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35303618

RESUMO

BACKGROUND: Oropharynx is the anatomical site with the highest human papillomavirus (HPV) infection in head and neck. Many studies on HPV prevalence and p16INK4a positivity in oropharyngeal cancer have been published in recent years. We aimed to update the global burden estimates of oropharyngeal cancer attributable to HPV with the latest data and estimate global burden of tonsillar cancer and base of tongue cancer attributable to HPV by region and country. METHODS: We calculated the number of new cancer cases using the Cancer Incidence in Five Continents Volume XI (CI5XI) and country-specific population in 2012 issued by the United Nations. Estimates of HPV prevalence and p16INK4a positivity were obtained from literature search and pooled analyses where necessary. RESULTS: Globally the number of oropharyngeal cancer and tonsillar cancer attributable to HPV were 42,000 and 20,000 in 2012, corresponding to AFs of 42.7% and 52.7%. The number of cancer cases attributable to HPV among males was about 4-fold greater than that among females. For both oropharyngeal cancer and tonsillar cancer, AFs were higher in more developed countries. Among HPV positive oropharyngeal cancer cases, 86.7%, 87.8%, and 92.5% could have been prevented by bivalent (2v), quadrivalent (4v), and nonavalent (9v) HPV vaccines. CONCLUSIONS: It is worth considering the inclusion of HPV immunization in males, especially in the regions where oropharyngeal cancer is highly prevalent.


Assuntos
Alphapapillomavirus , Neoplasias Orofaríngeas , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias Tonsilares , Inibidor p16 de Quinase Dependente de Ciclina , Feminino , Humanos , Masculino , Neoplasias Orofaríngeas/epidemiologia , Papillomaviridae , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle
6.
Actas Dermosifiliogr ; 113(2): T183-T186, 2022 Feb.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35244581

RESUMO

The aim of this study was to describe oral lesions in a group of patients with COVID-19. We recruited 55 patients, 25 women (45.5%) and 30 men (54.5%), aged between 1 and 89 years with confirmed COVID-19 at different stages of severity. After obtaining informed consent, we examined their mouths and recorded clinical findings. Forty percent of the patients had at least 1 oral lesion. The most common lesions were candidiasis and ulcers (7 patients each); 2 patients had enanthems. Geographic tongue and caviar tongue were also observed. Altered taste, dry mouth, and painful/burning mouth were noted in 60%, 27.3%, and 36.4% of patients, respectively. Oral mucosal alterations and lesions were prevalent in this series of COVID-19 patients. Altered taste and a painful/burning mouth were common symptoms.

7.
Head Neck Pathol ; 2022 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-35316511

RESUMO

Oral squamous cell carcinoma (OSCC) commonly affects older patients; however, several studies have documented an increase in its incidence among younger patients. Therefore, it is important to investigate if this trend is also found in different geographic regions. The pathology files of diagnostic and therapeutic institutions from different parts of the globe were searched for OSCC cases diagnosed from 1998 to 2018. Data regarding the sex, age, and tumor location of all cases, as well as the histologic grade and history of exposure to risk habits of cases diagnosed as OSCC in young patients (≤ 40 years of age) were obtained. The Chi-square test was used to determine any increasing trend. A total of 10,727 OSCC cases were identified, of which 626 cases affected young patients (5.8%). Manipal institution (India) showed the highest number of young patients (13.2%). Males were the most affected in both age groups, with the tongue and floor of the mouth being the most affected subsites. OSCC in young individuals were usually graded as well or moderately differentiated. Only 0.9% of the cases occurred in young patients without a reported risk habit. There was no increasing trend in the institutions and the period investigated (p > 0.05), but a decreasing trend was observed in Hong Kong and the sample as a whole (p < 0.001). In conclusion there was no increase of OSCC in young patients in the institutions investigated and young white females not exposed to any known risk factor represented a rare group of patients affected by OSCC.

8.
Preprint em Inglês | medRxiv | ID: ppmedrxiv-22269712

RESUMO

Introduction & ObjectivesThe COVID-19 pandemic has been raging across the globe since early January 2020. India has reported over 27 million cases and more than 3, 00,000 deaths. This study was planned to analyze the differences in demographic, clinical features and oral manifestations of COVID 19 patients hospitalized during COVID-19 pandemic. MethodsThis observational pilot study had total 36 participants, 12 each of mild, moderate and severe RT-PCR positive COVID cases hospitalized during COVID 19 pandemic. All demographic, clinical features, treatment details and oral manifestations were noted from first day of admission to hospital till treatment completion with follow up of minimum 7 days. ResultsMean age of the patients was 39.44 {+/-}9.13 years with M: F ratio of 5:4. Most common clinical presentation was fever, shortness of breath and treatment involved was symptomatic with supplemental oxygen & mechanical ventilation. Most common oral site involved was tongue & oral lesions observed were herpes labialis, mucositis, burning sensation, dryness of oral cavity, angular chelitis, aphthous ulcers, geographic tongue, fissuring of tongue, candidiasis, coated tongue, sublingual varicosity, & scalloped tongue. Interpretation and ConclusionAll demographic, clinical and oral manifestations were significantly different in mild, moderate and severe cases of covid hospitalized patients. Though clinical symptoms were improved, oral lesions were worsened. Oral Lesions seen in covid patients were associated with multiple drug therapy for illness along with poor oral hygiene, but further etiology for lesions needs to be evaluated. Sublingual varicosity was observed in our hospitalised covid patients, but large sample observation is required for confirmation of findings and may be an early oral feature for covid detection. Prevention is always better than cure, so all patients positive for Covid should have a full mouth examination. Oral health should be priority during overall management of COVID patients and dentists should be a part of Covid management team.

9.
Artigo em Inglês | MEDLINE | ID: mdl-35156217

RESUMO

OBJECTIVES: Obtaining robust evidence about the local mortality levels, trends and impact of oral cavity/base of tongue cancers and lip cancer, especially for women, is imperative in the fight against cancer. This descriptive retrospective ecological time-series study explored trends in oral cavity/base of tongue cancers and lip cancer mortality rates for women in Brazil from 1980 to 2018, by geographic region and anatomical location. METHODS: The crude and age-adjusted annual mortality rates were obtained by sex, anatomical location and macro-regions of Brazil. The number of deaths from oral cavity/base of tongue cancers and lip cancers in Brazil was based on official population counts and estimates. The annual percentage change was calculated based on age-adjusted rates. Data set were analysed using the Joinpoint Regression program. RESULTS: A total of 81,918 individuals died of oral cavity/base of tongue cancers and lip cancer between 1980 and 2018 in Brazil. The age-adjusted mortality rate for women was 0.47 and 0.57 per 100,000 in 1980 and 2018, respectively. The cumulative female mortality rates standardized by age were 0.01/100,000 for lip cancer and 0.5/100,000 for oral cavity and base of tongue cancers. A decrease in deaths related to oral cavity and base of tongue cancers was identified in the 1980s; however, over the last two decades, there has been an increase in the number of deaths of women with cancer at the base of tongue and neighbouring areas and on the floor of mouth. Importantly, Brazilian regions showed wide variability in trends of oral cavity, base of tongue and lip cancers rate and, in 2018, the regions with the highest rates were the Southeast, South and Northeast for both sexes and specifically for women. The North region showed the greatest recent significant upward trend. CONCLUSIONS: During the last 38 years, Brazil has shown a significant increase in the trend of the mortality rate due to oral cavity/base of tongue and lip cancers in women. Preventive strategies with control of risk factors should be strongly emphasized in order to improve the survival rates of individuals with oral cavity/base of tongue and lip cancers.

11.
Sci Rep ; 12(1): 2111, 2022 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-35136124

RESUMO

Alterations in the three chemosensory modalities-smell, taste, and chemesthesis-have been implicated in Coronavirus Disease 2019 (COVID-19), yet emerging data suggest a wide geographic and ethnic variation in the prevalence of these symptoms. Studies on chemosensory disorders in COVID-19 have predominantly focused on Caucasian populations whereas Asians remain understudied. We conducted a nationwide, multicentre cross-sectional study using an online questionnaire on a cohort of RT-PCR-confirmed adult COVID-19 patients in Malaysia between 6 June and 30 November 2020. The aim of our study was to investigate their presenting symptoms and assess their chemosensory function using self-ratings of perceived smell, taste, chemesthesis, and nasal blockage. In this cohort of 498 patients, 41.4% reported smell and/or taste loss when diagnosed with COVID-19, which was the commonest symptom. Blocked nose, loss of appetite, and gastrointestinal disturbances were independent predictors of smell and/or taste loss on multivariate analysis. Self-ratings of chemosensory function revealed a reduction in smell, taste, and chemesthesis across the entire cohort of patients that was more profound among those reporting smell and/or taste loss as their presenting symptom. Perceived nasal obstruction accounted for only a small proportion of changes in smell and taste, but not for chemesthesis, supporting viral disruption of sensorineural mechanisms as the dominant aetiology of chemosensory dysfunction. Our study suggests that chemosensory dysfunction in COVID-19 is more widespread than previously reported among Asians and may be related to the infectivity of viral strains.Study Registration: NMRR-20-934-54803 and NCT04390165.


Assuntos
Teste de Ácido Nucleico para COVID-19 , Transtornos do Olfato , SARS-CoV-2 , Autorrelato , Inquéritos e Questionários , Distúrbios do Paladar , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/fisiopatologia , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/etiologia , Transtornos do Olfato/fisiopatologia , Distúrbios do Paladar/diagnóstico , Distúrbios do Paladar/epidemiologia , Distúrbios do Paladar/etiologia , Distúrbios do Paladar/fisiopatologia
14.
Actas Dermosifiliogr ; 113(2): 183-186, 2022 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-34545255

RESUMO

The aim of this study was to describe oral lesions in a group of patients with COVID-19. We recruited 55 patients, 25 women (45.5%) and 30 men (54.5%), aged between 1 and 89 years with confirmed COVID-19 at different stages of severity. After obtaining informed consent, we examined their mouths and recorded clinical findings. Forty percent of the patients had at least 1 oral lesion. The most common lesions were candidiasis and ulcers (7 patients each); 2 patients had enanthems. Geographic tongue and caviar tongue were also observed. Altered taste, dry mouth, and painful/burning mouth were noted in 60%, 27.3%, and 36.4% of patients, respectively. Oral mucosal alterations and lesions were prevalent in this series of COVID-19 patients. Altered taste and a painful/burning mouth were common symptoms.

15.
Environ Sci Pollut Res Int ; 29(15): 22237-22250, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34780014

RESUMO

Fritillariae Cirrhosae Bulbus (FCB) is a famous traditional Chinese medicine, mainly used for relieving cough and resolving phlegm. According to Chinese Pharmacopoeia (2020), the medicine comes from dried bulbs of five species and one variety in Fritillaria. Due to climate change and human disturbance, the wild resources have become critically endangered in recent years. Following three climate change scenarios (SSP1-2.6, SSP2-4.5, and SSP5-8.5) under 2050s and 2070s, geographic information technology (GIS) and maximum entropy model (MaxEnt) were used to simulate the ecological suitability of FCB, a third-grade rare and endangered medicinal plant species. The results showed that the key environmental variables affecting the distribution of FCB were altitude, human activity intensity, and mean temperature of coldest quarter. Under current climate situation, the highly suitable areas were mainly located in the east of Qinghai Tibet Plateau, including Western Sichuan, southeastern Tibet, southern Gansu, Northwestern Yunnan, and Eastern Qinghai, with a total area of 31.47×104 km2, the area within the nature reserve was 7.13×104 km2, indicating that there was a large protection gap. Under the future climate change scenarios, the areas of the highly and poorly suitable areas of FCB showed a decreasing trend, while the areas of the moderately and total suitable areas showed an increasing trend. The geometric center of the total suitable area of the medicine will move to the northwest. The results could provide a strategic guidance for protection,development, and utilization of FCB though its prediction of potential distribution based on the key variables of climate change.


Assuntos
Fritillaria , Plantas Medicinais , China , Mudança Climática , Ecossistema , Humanos , Medicina Tradicional Chinesa
16.
Phytochem Anal ; 33(1): 72-82, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34114292

RESUMO

INTRODUCTION: Citri Sarcodactylis Fructus (CSF) is widely used as a food ingredient and a traditional Chinese medicine. In China, CSF is cultivated in many places, including Sichuan, Guangdong, Zhejiang, and Fujian provinces. The types and chemical contents of CSF from different origins may vary greatly due to the difference in climate and environmental conditions. Therefore, comparing the chemical composition of CSF from various places is vital. OBJECTIVE: To rapidly select potential characteristic compounds for differentiating CSF from different origins. MATERIAL AND METHODS: Thirty-one batches of CSF samples from different regions were analysed using ultra-performance liquid chromatography with hybrid quadrupole-orbitrap high-resolution mass spectrometry. Thereafter, chemometric methods, including principal component analysis (PCA) and orthogonal partial least squares discrimination analysis (OPLS-DA), were employed to find differential metabolites among the CSF samples from various origins. RESULTS: PCA revealed 77.9% of the total variance and divided all CSF samples into three categories corresponding to their origins. OPLS-DA displayed better discrimination of CSF from different sources, with R2 X, R2 Y, and Q2 of 0.801, 0.985, and 0.849, respectively. Finally, 203 differential metabolites were obtained from CSF from different origins using the variable importance in projection of the OPLS-DA model, 30 of which were identified, and five coumarin compounds were selected as marker compounds discriminating CSF from different origins. CONCLUSION: This work provides a practical strategy for classifying CSF from different origins and offers a research foundation for the quality control of CSF.


Assuntos
Citrus/química , Medicamentos de Ervas Chinesas , Cromatografia Líquida de Alta Pressão , Medicamentos de Ervas Chinesas/análise , Frutas , Geografia , Espectrometria de Massas , Medicina Tradicional Chinesa , Análise de Componente Principal
17.
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1363379

RESUMO

Introducción: la glositis migratoria benigna, también conocida como lengua geográfica, es una variante normal, que presenta zonas superficiales circulares. Según la literatura revisada, dentro de sus causas figuran los procesos alérgicos, en los que están las alergias alimentarias. Se decidió realizar esta investigación para determinar la prevalencia de las alergias alimentarias frecuentes en estos pacientes mediante pruebas cutáneas. Materiales y métodos: se realizó un estudio descriptivo, longitudinal y prospectivo. La muestra estuvo compuesta por 27 pacientes en el período de enero hasta agosto de 2018 en portadores de glositis migratoria benigna, a los cuales se les realizaron pruebas alérgicas de tipo cutáneas para la determinación de alergias alimentarias. Resultados: el 59,3 % fue mujer y el antecedente alérgico más frecuente fue la rinitis alérgica. El antecedente de alergia alimentaria más frecuente fue los lácteos. Respecto a los resultados de las pruebas para la leche y los mariscos, estas dieron positivas en la mayoría de los pacientes, seguidos por el pescado, los huevos y los frutos secos. La prevalencia de positividad para por lo menos una prueba fue de 85,2%. Discusión: actualmente no existe suficiente literatura que hable sobre las posibles etiologías de la glositis migratoria benigna. Dentro de los antecedentes alérgicos, la rinitis alérgica fue la más frecuente, seguida de la alergia alimentaria. Hasta ahora existen pocas investigaciones que estudien esta prevalencia de alergias alimentarias en los pacientes de forma específica. Conclusión: la lengua geográfica no tiene factor epidemiológico predominante. El antecedente alérgico puede ser un factor predisponente, la alergia alimentaria puede ser desencadenante de la presentación de la lengua geográfica.


Introduction: The benign migratory glossitis, also known as geographic tongue, is a normal variant, which presents circular or irregular depapillated superficial areas. According to the literature reviewed, its causes include allergic processes, among these are food allergies. It was decided to carry out this investigation to determine the prevalence of frequent food allergies in these patients using skin tests. Materials and methods: A descriptive, longitudinal, prospective study was carried out. The sample consisted of 27 patients in the period January-August 2018, carriers of geographic tongue who underwent skin-type allergic tests to determine food allergies. Results: 59.3% were women without statistically significant predominance, the most frequent allergic history was allergic rhinitis. The most frequent history of food allergy was to dairy. Regarding the results of the tests for milk and shellfish, they were positive in 55.6%, followed by fish 14.8%, eggs and nuts with 11.1% respectively. The prevalence of positivity for at least one test was 85.2% with a statistically significant predominance over the negative result. Discussion: There is currently not enough literature that discusses the possible etiologies of benign migratory glossitis. Within the allergic history, allergic rhinitis was the most frequent, followed by food allergy. Until now there are few investigations that study this prevalence of food allergies in patients in a specific way. Conclusion: Geographic tongue does not have a predominant epidemiological factor, an allergic history can be a predisposing factor, food allergy can be a trigger for presentation of geographic language.


Assuntos
Humanos , Glossite Migratória Benigna , Língua Fissurada , Hipersensibilidade , Anormalidades da Boca
18.
Am J Otolaryngol ; 43(1): 103243, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34583290

RESUMO

OBJECTIVE: To evaluate the role of social and geographic factors on the likelihood of receiving transoral robotic surgery (TORS) or non-robotic transoral endoscopic surgery treatment in early stage oropharyngeal squamous cell carcinoma (OPSCC). MATERIALS AND METHODS: The National Cancer Database was queried to form a cohort of patients with T1-T2 N0-N1 M0 OPSCC (AJCC v.7) who underwent treatment from 2010 to 2016. Demographics, tumor characteristics, treatment type, social, and geographic factors were all collected. Univariate analysis and multivariate logistic regression were then performed. RESULTS: Among 9267 identified patients, 1774 (19.1%) received transoral robotic surgery (TORS), 1191 (12.9%) received transoral endoscopic surgery, and 6302 (68%) received radiation therapy. We found that lower cancer stage, lower comorbidity burden and HPV- positive status predicted a statistically significant increased likelihood of receiving surgery. Patients who reside in suburban or small urban areas (>1 million population), were low-to- middle income, or rely on Medicaid were less likely to receive surgery. Patients that reside in Medicaid-expansion states were more likely to receive TORS (p > .0001). Patients that reside in states that expanded Medicaid January 2014 and after were more likely to receive non-robotic transoral endoscopic surgery (p > .0001). CONCLUSIONS: Poorer baseline health, lower socioeconomic status and residence in small urban areas may act as barriers to accessing minimally invasive transoral surgery while residence in a Medicaid-expansion state may improve access. Barriers to accessing robotic surgery may be greater than accessing non-robotic surgery.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Cirurgia Endoscópica por Orifício Natural/estatística & dados numéricos , Neoplasias Orofaríngeas/cirurgia , Procedimentos Cirúrgicos Robóticos/estatística & dados numéricos , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Idoso , Bases de Dados Factuais , Feminino , Geografia , Humanos , Masculino , Pessoa de Meia-Idade , Cirurgia Endoscópica por Orifício Natural/métodos , Estadiamento de Neoplasias , Neoplasias Orofaríngeas/patologia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/métodos , Fatores Socioeconômicos , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Estados Unidos
19.
Am J Chin Med ; 50(1): 91-131, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34931589

RESUMO

Machine learning (ML), as a branch of artificial intelligence, acquires the potential and meaningful rules from the mass of data via diverse algorithms. Owing to all research of traditional Chinese medicine (TCM) belonging to the digitalization of clinical records or experimental works, a massive and complex amount of data has become an inextricable part of the related studies. It is thus not surprising that ML approaches, as novel and efficient tools to mine the useful knowledge from data, have created inroads in a diversity of scopes of TCM over the past decade of years. However, by browsing lots of literature, we find that not all of the ML approaches perform well in the same field. Upon further consideration, we infer that the specificity may inhere between the ML approaches and their applied fields. This systematic review focuses its attention on the four categories of ML approaches and their eight application scopes in TCM. According to the function, ML approaches are classified into four categories, including classification, regression, clustering, and dimensionality reduction, and into 14 models as follows in more detail: support vector machine, least square-support vector machine, logistic regression, partial least squares regression, k-means clustering, hierarchical cluster analysis, artificial neural network, back propagation neural network, convolutional neural network, decision tree, random forest, principal component analysis, partial least squares-discriminant analysis, and orthogonal partial least squares-discriminant analysis. The eight common applied fields are divided into two parts: one for TCM, such as the diagnosis of diseases, the determination of syndromes, and the analysis of prescription, and the other for the related researches of Chinese herbal medicine, such as the quality control, the identification of geographic origins, the pharmacodynamic material basis, the medicinal properties, and the pharmacokinetics and pharmacodynamics. Additionally, this paper discusses the function and feature difference among ML approaches when they are applied to the corresponding fields via comparing their principles. The specificity of each approach to its applied fields has also been affirmed, whereby laying a foundation for subsequent studies applying ML approaches to TCM.


Assuntos
Inteligência Artificial , Medicina Tradicional Chinesa , Algoritmos , Aprendizado de Máquina , Controle de Qualidade
20.
J Clin Med ; 10(23)2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34884195

RESUMO

Geographic tongue (GT) is a chronic condition of unknown aetiology, with no defined parameters to establish the protocol for evidence-based management. Validation of a newly developed and proposed clinical index to assess the severity of GT could assist in its diagnosis, especially in cases associated with systemic dermatological diseases in the form of psoriasis. OBJECTIVE: To verify the applicability of the geographic tongue area and severity index (GTASI). This involved healthcare professionals from different specialties to evaluate the usefulness of the GTASI in supporting GT classification, as well as the follow-up process. METHODS: One hundred cases of previously diagnosed GT were initially evaluated by three independent, experienced researchers/clinicians to obtain a standardised classification baseline. Subsequently, nine cases of GT were selected, three cases for each category-mild, moderate and severe. These stages were professionally evaluated by 51 healthcare professionals from three groups: 17 dentists (33%), 22 oral medicine specialists (43%) and 12 specialist dermatologists (24%) during a cross-sectional survey. RESULTS: The quantitative and qualitative assessment based on experts' opinions in the cross-sectional survey demonstrated an acceptable, similar level of GT clinical diagnosis (p > 0.05), with coherence between the various groups of professionals critically appraising the GTASI. An apparent divergence was observed for the moderate GT category, as well as in the group of less experienced evaluators. CONCLUSION: Whilst the validation of GTASI applicability was successfully executed, the general dental practitioners, specialists in oral medicine and dermatologists were equally capable of correct GT diagnosis and appropriately rating its severity. These coherent results were especially replicated among the experienced clinicians. The validation of the newly proposed index confirmed its reliability as a feasible instrument in oral medicine, with the prospect of its wider implementation in clinical practice.

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