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Previous studies on smokeless tobacco use and head and neck cancer (HNC) have found inconsistent and often imprecise estimates, with limited control for cigarette smoking. Using pooled data from 11 US case-control studies (1981-2006) of oral, pharyngeal, and laryngeal cancers (6,772 cases and 8,375 controls) in the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, we applied hierarchical logistic regression to estimate odds ratios and 95% confidence intervals for ever use, frequency of use, and duration of use of snuff and chewing tobacco separately for never and ever cigarette smokers. Ever use (versus never use) of snuff was strongly associated with HNC among never cigarette smokers (odds ratio (OR) = 1.71, 95% confidence interval (CI): 1.08, 2.70), particularly for oral cavity cancers (OR = 3.01, 95% CI: 1.63, 5.55). Although ever (versus never) tobacco chewing was weakly associated with HNC among never cigarette smokers (OR = 1.20, 95% CI: 0.81, 1.77), analyses restricted to cancers of the oral cavity showed a stronger association (OR = 1.81, 95% CI: 1.04, 3.17). Few or no associations between each type of smokeless tobacco and HNC were observed among ever cigarette smokers, possibly reflecting residual confounding by smoking. Smokeless tobacco use appears to be associated with HNC, especially oral cancers, with snuff being more strongly associated than chewing tobacco. [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficacy and safety of modified standard chemotherapy in the treatment of spinal tuberculosis, and clarify the common side effects as well as corresponding treating measures. Methods From 2008 January to 2012 December, cases of spinal tuberculosis were collected in our hospital, received the modified standard chemotherapy (2HRZE/4HRE/12-18HR;H 300mg R dose, 450 mg, Z 750 mg, E 750mg, meal served in morning), and followed up for at least 2 years. The chemotherapy efficacy was evaluated using the clinical cure rate and recurrence rate. Meanwhile, the chemotherapy safety was evaluated through the drug side effect incidence and severity. The drug side effects were analyzed by statistics according to the types, duration, severity, and treatment measures. Results A total of 67 patients were included in the study, including 32 cases of male, 35 cases of female; aged 15-68 years (mean, 40. 6 years) . 21 patients were treated with modified standard chemotherapy, the remaining 46 cases were treated with preoperative chemotherapy + operation + chemotherapy after surgery. The clinical healing rate within 2 years was 95. 52%, and the recurrence rate after 2 years was 1. 50% . In the whole period of chemotherapy, drug side effects occurred mainly in intensive treatment period in the first 2 months, mainly related to the gastrointestinal reaction (about 28.36%), hyperuricemia (about 31.34%) and abnormal liver function (about 31.34%), but most drugs had mild side effects. In some cases with serious liver injury, liver protecting drugs (such as polyene phosphatidyl choline, glyphosate acid two sodium or glutathione etc.), sodium bicarbonate and drinking more water measures were verified as effective. The removal of pyrazinamide might reduce the incidence of hyperuricemia. Conclusion The use of modified standard chemotherapy for the treatment of spinal tuberculosis has a good clinical curative effect with high security. [ABSTRACT FROM AUTHOR]

Background Seasonal associations of cardiovascular mortality have been noted in most populations of European origin years ago, but are not well evaluated in Asian populations recently. Methods Utilizing the electronic Hospitalization Summary Reports (HSRs) from 32 top-ranked hospitals in Beijing, China, we evaluated the association between winter season and the risk of cardiovascular death among hospitalized individuals. General additive models and logistic regression models were adjusted for confounding factors. Results Older patients who were admitted to the hospital in the winter months (January, February, November and December) had a death risk that was increased by approximately 30% to 50% (P < 0.01) over those who were admitted in May. However, younger patients did not seem to experience the same seasonal variations in death risk. The excess winter deaths among older patients were associated with ischemic heart disease (RR = 1.22; 95% CI 1.13 to 1.31 ), pulmonary heart disease (RR = 1.42; 95% CI 1.10 to 1.83), cardiac arrhythmias (RR = 1.67 ; 95% CI 1.36 to 2.05), heart failure (RR = 1.30 ; 95% CI 1.09 to 1.54), ischemic stroke (RR = 1.30 ; 95% CI 1.17 to 1.43), and other cerebrovascular diseases (RR = 1.78 ; 95% CI 1.40 to 2.25). The risks of mortality were higher in winter months than in the month of May, regardless of the presence or absence of respiratory disease. Conclusions Winter season was associated with a substantially increased risk of cardiovascular death among older Chinese cardiovascular inpatients. [ABSTRACT FROM AUTHOR]

Objectives. To examine the associations between cardiovascular disease (CVD) and hip fracture and to determine if these associations are attributable to hypertensive disease. Methods. Data were obtained from 2006-2010 hospitalization summary reports of 31 tertiary hospitals in Beijing, China. This study included 864,408 inpatients aged ≥55 years. Occurrence rate of hip fracture was based on the first-listed ICD-10 codes (S72.0, S72.1, and S72.2) and of CVD as comorbidities were based on the secondto the eighth-listed ICD-10 codes (I00-I99). Results. The occurrence rate of hip fracture is 53% higher among older inpatients with a diagnosis of CVD than those without (RR = 1.53, 95% CI 1.47-1.60). Those with hip fracture were more likely to have hypertensive or cerebrovascular disease, with the risk ranging from 1.34 to 1.70. Compared with those without hip fracture, the occurrence rate of overall CVDs increased by 80%, 83%, and 16% among hip fracture patients aged 55-64, 65-79, and ≥80 years. In addition, hypertensive disease did not modify the association between cerebrovascular disease and hip fracture. Conclusion. CVD was positively associated with hip fracture, and the associations observed in this sample of Chinese inpatients were similar to those reported from cohort studies conducted in the European populations. [ABSTRACT FROM AUTHOR]

Objective: To study non-cancer-related mortality rates over time and examine the possible causes for several major deaths in patients with oral cavity and oropharyngeal (OC/OP) cancer. Design: Retrospective cohort analysis using the Surveillance, Epidemiology, and End Results (SEER) cancer registry data of the National Cancer Institute. Main Outcome Measure: Cause-specific mortality rates during the first year after diagnosis of OC/OP cancer were calculated for 4 cohorts (1980-1984, 1990-1994, 2000- 2003, and 2004-2007). The percentage changes over time were calculated. Standardized mortality ratios (SMRs) for suicide, cardiovascular disease, and pneumonia were calculated and compared with patient demographic and clinical characteristics. Results: We analyzed data for 32 487 patients in 4 cohorts. From 1980-1984 to 2004-2007, mortality from suicide increased by 406.2% (P=.01), cardiovascular disease-related and pneumonia-related mortality decreased by 45.9% (P<.001) and 42.9% (P=.009), respectively, and rates of other non-cancer-related deaths did not change. Compared with the general population, patients diagnosed as having OC/OP cancer were at a significantly higher risk of mortality from suicide (SMR, 7.8; 95% CI, 4.6-12.4; P<.001), cardiovascular disease (SMR, 2.4; 95% CI, 2.1-2.7; P<.001), and pneumonia (SMR, 8.9; 95% CI, 6.8-11.5; P<.001) during the first year after cancer diagnosis. Risk factors for increased mortality included age of 55 to 64 years, marital status (including never married, divorced, or separated), advanced tumor stage (including regional and distant disease), treatment with radiotherapy alone, and pharyngeal tumor location. Conclusions: Suicide rates have significantly increased in patients with OC/OP cancer since 1980 to 1984. Although cardiovascular disease- and pneumonia-related deaths have significantly decreased over time, they remain higher than the general US population. Increased knowledge of risk factors associated with non-cancerrelated mortality in OC/OP cancer may lead to early intervention and enhanced overall survival. [ABSTRACT FROM AUTHOR]

Objective: To collaborate with multiple centers to identify representative epidemiological, clinical, and pathologic characteristics of melanoma of the iris. This international, multi center, Internet-assisted study in ophthalmic oncology demonstrates the collaboration among eye cancer specialists to stage and describe the clinical and pathologic characteristics of biopsy-proven melanoma of the iris. Methods: A computer program was created to allow for Internet-assisted multicenter, privacy-protected, online data entry. Eight eye cancer centers in 6 countries performed retrospective chart reviews. Statistical analysis included patient and tumor characteristics, ocular and angle abnormalities, management, histopathology, and outcomes. Results: A total of 131 patientswith iris melanoma (mean age, 64 years [range, 20-100 years]) were found to have blue-gray (62.2%), green-hazel (29.1%), or brown (8.7%) irides. Iris melanoma color was brown (65.6%), amelanotic (9.9%), and multicolored (6.9%). A mean of 2.5 clock hours of iris was visibly involved with melanoma, typically centered at the 6-o'clock meridian. Presentations included iritis, glaucoma, hyphema, and sector cataract. High-frequency ultrasonography revealed a largest mean tumor diameter of 4.9 mm, a mean maximum tumor thickness of 1.9 mm, angle blunting (52%), iris root disinsertion (9%), and posterior iris pigment epithelium displacement (9%). Using the American Joint Commission on Cancer-International Union Against Cancer classification, we identified 56% of tumors as T1, 34% of tumors as T2, 2% of tumors as T3, and 1% of tumors as T4. Histopathologic grades were G1-spindle (54%), G2-mixed (28%), G3-epithelioid (5%), and undetermined (13%) cell types. Primary treatment involved radiation (26%) and surgery (64%). Kaplan-Meier analysis found a 10.7% risk of metastatic melanoma at 5 years. Conclusions: Iris melanomas were most likely to be brown and found in the inferior quadrants of patients with light irides. Typically small and unifocal, melanomas are commonly associated with angle blunting and spindle cell histopathology. This multi center, Internet-based, international study successfully pooled data and extracted information on biopsy-proven melanoma of the iris. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: To examine demographic, histologic, and survival trends of oral cavity and oropharyngeal (OC/OP) squamous cell carcinoma (SCCA) patients over the past 3 decades. To test the hypothesis that decreased histologic differentiation and increased disease-specific survival is related to a decline in smoking rates and an increased percentage of human papillomavirus (HPV)-related tumors. Study Design: Retrospective cohort analysis was done using the Surveillance, Epidemiology, and End-Results (SEER) database of the national cancer institute. Methods: SEER data were used to design seven cohorts: 1975-1979, 1980-1984, 1985-1989, 1990- 1994, 1995-1999, 2000-2004, and 2005-2006. Incidence rates, histologic tumor grade. and 5-year survival rates were analyzed over time. Further subgroup analysis was performed according to subsite, age, gender, and stage. Results: In both OC and OP, well-differentiated (grade I) tumors decreased significantly over time, from 33% to 16% between 1975 and 2006 (P < .001). In contrast, poorly differentiated tumors (grade III) significantly increased from 23% to 34% (P < .001). Over time, 5-year survival rates of less differentiated tumors improved 57%, whereas survival of well-differentiated tumors improved only 15.5%. Tonsil, posterior oropharynx and tongue subsites showed the greatest improvement in survival over time. Conclusions: Comprehensive population-based analysis of oral cavity and oropharyngeal carcinoma from 1975 to 2006 demonstrated significant trends toward decreased tumor differentiation and increased survival over time. These findings support the influence of HPV in OC/OP carcinoma and may have implications for treatment, prognosis, and possibly prevention. [ABSTRACT FROM AUTHOR]

The article presents a pooled analysis of data regarding coffee and tea intake and the risks of head and neck cancer. The researchers gathered data from nine case-control studies of head and neck cancers including 5,139 cases and 9,028 controls. The analysis supports the hypothesis of an inverse association between caffeinated coffee drinking and the risk of cancer of the oral cavity and pharynx.

Background:Thyroid cancer incidence has continuously increased for decades and the causes of this increase are still controversial. The objective of this study was to examine if the increased trend is different among the different National Cancer Institute (NCI) Race/Ethnicity Groups (REGs) within the NCI surveillance epidemiology and end results database for the United States.Methods:Using recent 13-year surveillance epidemiology and end results data, we described the specific incidence trend of thyroid cancer for the REGs by tumor size, tested the statistical significance of the trend of incidence, and estimated the annual percentage change (APC) and 95% confidence interval. In addition, we compared the difference of 5-year survival rate among the REGs.Results:Papillary thyroid cancer incidence significantly increased over 13 years from 1992 to 2004 among the five major REGs. The estimated APC was 5.6% (95% confidence interval = 5.1%–6.1%, p< 0.01) for the non-Hispanic whites group, 4.3% (3.0–5.5, p< 0.01) for the Blacks group, 2.8% (1.5–4.2, p< 0.01) for the Hispanic whites group, 1.5% (0.5–2.5, p< 0.01) for the Asians group, and 1.1% (−2.2–4.6, p= 0.477) for the American Indians/Alaska Natives group, respectively. The APCs among the REGs were significantly different (Z= 7.89, p< 0.001). The upward incidence trend could be seen in all small or large tumors as well as in women or in men. The proportion of local staged thyroid cancer increased by 24% in the Blacks group, 14.4% in the Hispanic whites group, 14.3% in the non-Hispanic whites group, and only 4.0% in the Asians group between two periods of 1992–1996 and 2000–2004. Five-year survival rates of patients with papillary tumor were about 95%, but that of anaplastic tumor ranged from 5.6% to 11.4% among REGs.Conclusion:The time trend of incidence of thyroid cancer is different among the different NCI REGs. Differences in diagnostic scrutiny may explain the differences in the REG-related trend, but this cannot easily explain the relatively small degree of increase in the trend in the Asian and the Indians/Alaska Natives groups nor can it explain the increase in the trend of large tumors that are likely to be discovered by self-palpation by patients. [ABSTRACT FROM AUTHOR]

Objectives: To provide comprehensive temporal trend analysis of 5-year relative survival rates of laryngeal cancer using the Surveillance, Epidemiology, and End Results database; and to expand on prior reports by including inclusion of laryngeal tumor location, stage, age at diagnosis, treatment strategy, and histologic grade. Design: Retrospective cohort analysis using the Surveillance, Epidemiology, and End Results database of the National Cancer Institute. The Surveillance, Epidemiology, and End Results data were used to design 5 cohorts of patients with laryngeal cancer: 1977-1978, 1983-1984, 1989-1990, 1995-1996, and 2001-2002. Five-year survival rates were analyzed according to tumor site, stage, and grade; age at diagnosis; and treatment strategy. The joinpoint regression model was used to assess survival trends and their statistical significance. Results: Among patients with supraglottic cancer, 5-year relative survival rates for distant disease worsened over time while rates for local and regional disease did not change (P = .01 and P > .05, respectively). For localized glottic cancer, survival remained stable from 1977-1978 to 2001-2002. However, patients with regional and distant glottic cancer demonstrated a significant decrease in survival in the past 3 decades (P < .001). This trend was independent of treatment strategy. Finally, the proportion of well-differentiated tumors in patients with regional laryngeal cancer decreased over time (P < .001 for supraglottic and P = .007 for glottic). Conclusions: A decreasing 5-year survival trend was found among patients with glottic cancer who had regional disease and in all patients with distant disease. Histopathologic trends not previously reported in those with laryngeal cancer seem to parallel those seen in other tobacco-related cancers. These trends may reflect the effect of birth cohorts and implicate the relationship between carcinogenic exposure and host factors, rather than the influence of treatment. [ABSTRACT FROM AUTHOR]

Objectives: This study was performed to assess the overall incidence and duration of alterations in tongue sensation and taste after operative microlaryngoscopy, and the relation of these symptoms to operative time. Methods: We performed a retrospective review of information regarding tongue symptoms in patients who completed standard post-microlaryngoscopy follow-up at 1 week, 1 month, and 3 months. Results: One hundred patients (54 male and 46 female; mean age, 46 years; age range, 14 to 83 years) met the inclusion criteria. Eighteen patients had positive findings at 1 week: 15 complained of paresthesia and 3 of dysgeusia. The symptoms decreased over time without treatment (4% of patients at 1 month and 1% of patients at 3 months). Only 1 case of dysgeusia persisted past 3 months. Gender was found to be a significant independent risk factor for the development of symptoms (odds ratio, 5.63; 95% confidence interval, 1.36 to 31.29; p = .013). Patients whose operations lasted longer than 1 hour were almost 4 times more likely to develop tongue-related symptoms than those with an operative time less than 30 minutes, although these findings did not achieve statistical significance (odds ratio, 3.91; 95% confidence interval, 0.62 to 30.95; p =. 182). Conclusions: Alterations in tongue sensation and taste, most likely due to lingual nerve injury, are common after microlaryngoscopy, especially in female patients. They also tend to be associated with longer operative times. Although transient in nearly every case, lingual paresthesia and dysgeusia should form part of the preoperative discussion with the patient. [ABSTRACT FROM AUTHOR]

Objectives To assess the differences in facial proportions between Korean American (KA) women and North American white (NAW) women and to quantitatively describe aesthetic facial features in the KA women. Design Anthropometric survey and facial aesthetic evaluation. Participants Volunteer sample of KA women (n = 72) who served as models for part 1 of the study and a different sample of KA women (n = 5) and men (n = 5) who served as judges for part 2 of the study. All subjects were between ages 18 and 35 years and had Korean parents and no previous facial surgery or trauma. Intervention For part 1 of the study, standardized and referenced frontal and lateral photographs were taken of the models, and 26 standard anthropometric measurements were determined. Results were compared with published NAW standards. For part 2 of the study, 10 judges evaluated frontal views of the models for facial aesthetics using a visual analog scale. Quantitative analysis was done of the faces of attractive KA women (>90th percentile in aesthetic scores) and comparisons were made with the faces of NAW women and average KA women. Results The KA woman's face did not fit the neoclassical facial canons. Compared with NAW women, 24 of the 26 facial measurements in KA women were significantly different. Only 9 of the 26 facial measurements were significantly different when the attractive KA women were compared with the NAW women. Nine of the 17 nonsignificant facial measurements were very similar to those of the NAW women; many of these facial features centered around the midface. Conclusions Although the average KA woman's facial anthropometric measurements were very different from those of the NAW woman, attractive KA women reflected many of the facial features of NAW women. These findings support the need for ethnically sensitive facial canons and further research into transcultural aesthetics. [ABSTRACT FROM AUTHOR]

Objective: To present the design for a novel, resorbable, drug-eluting Eustachian-tube stent and to ascertain its tolerability and resorption in a chinchilla animal model. Materials and Methods: In a prospective, controlled animal study, a poly-l-lactide stent was implanted via a transbullar approach in one Eustachian tube (ear implanted was randomly selected) of five adult female chinchillas. The other ear served as a matched control. Otoendoscopy was performed at baseline to rule out pre-existing disease. Animals were sacrificed at varying times up to 26 weeks post implantation. Blinded histological sectioning was performed to determine degree of inflammatory response and stent resorption. All adverse events were recorded. Results: Follow-up data were available for three animals at the time of sacrifice. The histologic findings were similar for the test and control ears. The stents did not appreciably resorb over the 6-month period of follow-up. Conclusions: The poly-l-lactide Eustachian tube stent generally was well tolerated by the chinchillae without untowards effects. A follow-up larger sample animal study using another animal model with a larger Eustachian tube (a healthy Eustachian tube in one ear and a non-opening Eustachian tube in the other ear) is planned to further establish a safety profile, to investigate efficacy outcomes, and to follow gas-sterilized stents over time towards complete resorption. [ABSTRACT FROM AUTHOR]