Search

Objective(s): There has been a disproportionate increase in the incidence of young patients with squamous cell carcinoma of the oral tongue (SCCOT). The purpose of this study was to compare young patients to older patients with SCCOT without prior drinking or smoking history as this population is poorly characterized in the literature. Methods: A retrospective review of patients presenting to our institution with SCCOT was performed. The clinical and pathologic characteristics, as well as, outcomes were compared between younger patients (age ≤45) and older patients (age >45). Outcome analysis was performed using Kaplan Meier method. Multivariable Cox proportional hazard models were performed for age and stage. Results: Eighty‐two patients (38 young, 44 old) were included in this study. Median follow‐up was 29.4 months. When compared to the older cohort (age >45), the younger cohort (age ≤45) demonstrated lower rates of 5‐year locoregional control (LC) (79.6% vs. 52.5%, p = 0.043) and distant metastasis‐free survival (88.1% vs. 61.8%, p = 0.006). Both cohorts demonstrated similar overall survival rates (55.5% vs. 58.1%) and disease‐specific survival (66.2% vs. 58.1%). Of patients experiencing locoregional failure with available radiation therapy plans and PET scans in younger cohorts (n = 7), 100% demonstrated in‐field failures. Multivariable Cox proportional hazards demonstrated age was an independent predictor of DMFS (p = 0.004) and the advanced stage was a predictor of DSS (p = 0.03). Conclusions: Young, nondrinker, nonsmokers with SCCOT demonstrate high rates of locoregional recurrence, distant metastasis, and in‐field failures. Future studies are warranted to determine underlying mechanisms driving pathogenesis in this unique cohort. Level of Evidence: 3 Laryngoscope, 133:1110–1121, 2023 [ABSTRACT FROM AUTHOR]

ABSTRACT Background and objective Bronchiectasis manifests as recurrent respiratory infections and reduced lung function. Airway dilation, which is measured as the ratio of the diameters of the bronchial lumen (B) and adjacent pulmonary artery (A), is a defining radiological feature of bronchiectasis. A challenge to equating the bronchoarterial ( BA) ratio to disease severity is that the diameters of airway and vessel in health are not established. We sought to explore the variability of BA ratio in never-smokers without pulmonary disease and its associations with lung function. Methods Objective measurements of the BA ratio on volumetric computed tomography ( CT) scans and pulmonary function data were collected in 106 never-smokers. The BA ratio was measured in the right upper lobe apical bronchus ( RB1) and the right lower lobe basal posterior bronchus. The association between the BA ratio and forced expiratory volume in 1 s ( FEV1 ) was assessed using regression analysis. Results The BA ratio was 0.79 ± 0.16 and was smaller in more peripheral RB1 bronchi ( P < 0.0001). The BA ratio was >1, a typical threshold for bronchiectasis, in 10 (8.5%) subjects. Subjects with a BA ratio >1 versus ≤1 had smaller artery diameters ( P < 0.0001) but not significantly larger bronchial lumens. After adjusting for age, gender, race and height, the BA ratio was directly related to FEV1 ( P = 0.0007). Conclusion In never-smokers, the BA ratio varies by airway generation and is associated with lung function. A BA ratio >1 is driven by small arteries. Using artery diameter as reference to define bronchial dilation seems inappropriate. [ABSTRACT FROM AUTHOR]

Background and objective An estimated 25-40% of patients with chronic obstructive pulmonary disease ( COPD) have never smoked. We investigated the prevalence and patient characteristics of COPD in non-smokers from Vietnam and Indonesia. Methods This population-based cross-sectional survey of participants from urban and rural Vietnam and Indonesia used a stratified multistage cluster sampling design, with sample and population weights applied to ensure representativeness. Participants were female or male (recruited in the ratio 2:1) non-smokers, 40 years or older and able to perform a spirometry test. Spirometry was performed at a single study visit. Other clinical information was collected via standardized questionnaires. Results The 1506 evaluable participants were approximately equally distributed between Vietnam and Indonesia, and rural and urban areas. Overall prevalence of COPD was found to be 6.9% (95% confidence interval ( CI): 5.7-8.3), with almost three times higher prevalence in men than women (12.9% (95% CI: 9.1-18.0) vs 4.4% (95% CI: 3.0-6.5)). We found higher rates of COPD in Vietnam than Indonesia (8.1% (95% CI: 5.8-11.3) vs 6.3% (95% CI: 4.8-8.3)), with a particularly high prevalence in urban Vietnam (11.1% (95% CI: 8.1-15.1)). Very few participants (6%) diagnosed to have COPD during the study had been previously diagnosed with COPD. Respiratory symptoms and lower health-related quality of life were more common in participants with COPD. Conclusions The prevalence of COPD in non-smoking individuals from rural and urban Vietnam and Indonesia was 6.9%, of which a significant proportion (94%) were previously undiagnosed. [ABSTRACT FROM AUTHOR]

Aim To evaluate the compliance of cigarette smokers with scheduled visits for supportive periodontal therapy ( SPT). Materials and Methods Qualitative and quantitative analyses of compliance with scheduled SPT visits were performed using retrospective data from patients undergoing dental hygiene treatment at the Medi School of Dental Hygiene ( MSDH), Bern, Switzerland 1985-2011. Results A total of 1336 patients were identified with 32.1% ( n = 429) being smokers, 23.1% ( n = 308) former smokers and 44.8% ( n = 599) non-smokers. Qualitatively, significantly less smokers returned for SPT than non-smokers or former smokers ( p = 0.0026), whereas 25.9% ( n = 346) never returned for SPT. Further quantitative analysis of patients returning twice or more ( n = 883) revealed that the overall mean %-compliance was 69.8% ( SD ±22.04),whereas smokers complied with 67.0% ( SD ±22.00), former smokers with 69.7% ( SD ±22.03), and non-smokers with 71.7% ( SD ±21.92) reaching statistical significance ( p = 0.0111). Confounder adjusted analysis, however, revealed that older age ( p = 0.0001), female gender ( p = 0.0058), longer SPT intervals ( p < 0.0001) and higher severity of periodontal disease ( p < 0.0001) had a much greater impact on %-compliance than smoking ( p = 0.7636). Conclusions This study suggests that qualitatively, smokers return less likely for SPT than non-smokers or former smokers while quantitatively, a lower mean %-compliance of smokers attending scheduled SPT visits may be attributed to confounders. [ABSTRACT FROM AUTHOR]

ABSTRACT Chronic obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality worldwide, and it has been strongly correlated to tobacco smoking. While a number of studies have concentrated on smokers only, recent published data demonstrate that at least one fourth of patients with COPD are non-smokers, and that the burden of COPD in non-smokers is also higher than previously believed. Risk factors of COPD in non-smokers may include genetic factors, long-standing asthma, outdoor air pollution (from traffic and other sources), environmental smoke exposure (ETS), biomass smoke, occupational exposure, diet, recurrent respiratory infection in early childhood, tuberculosis and so on. In Asian region, indoor/outdoor air pollution and poor socioeconomic status may play important roles in the pathogenesis of non-smoking-related COPD. The prevalence of COPD among never smokers varies widely across nations. Such a variation may arise from several aspects, including study design, definition of COPD, diagnostic criteria, age and gender distribution of the studied population, local risk factors and socioeconomic status. More investigations and efforts are required to elucidate the involved factors and their shared contributions to non-smoking-related COPD so as to achieve better estimation and reduction of the burden of this neglected entity worldwide. [ABSTRACT FROM AUTHOR]

Objective: To recognize specific clinicopathological characteristics of non-smoking and non-drinking (NSND) head and neck squamous cell carcinoma (HNSCC) patients. This can increase our knowledge regarding a potentially different carcinogenesis in these patients. Study design/methods: Retrospective analysis of data for 195 NSND patients with HNSCC and comparison with data for patients with HNSCC obtained from the Netherlands Cancer Registry. Results: Compared with all HNSCC patients in the Netherlands, our NSND patients with HNSCC were typically female ( n = 142; 73% vs 26%), old at disease presentation (mean 73 years vs 64 years), and had tumors mainly of the oral cavity ( n = 130; 66% vs 25%). Most tumors were stage I ( n = 67; 34%) and stage IVA ( n = 59; 30%). The incidence of second primary tumors (SPTs) was high ( n = 32; 16%), mainly occurring in the oral cavity ( n = 26; 13%). Discussion/conclusion: Our study confirms that NSND HNSCC patients have different clinicopathological characteristics from those of the overall HNSCC population; however, the frequency of SPTs is as high in NSND patients as in patients who smoke and drink alcohol. More research, and particularly molecular data are needed to obtain a better understanding of head and neck cancer in NSND patients. [ABSTRACT FROM AUTHOR]