Mouth self-examination as a screening tool for oral cancer in a high-risk group of patients with Fanconi anemia

Background In 2014, a screening tool was implemented at Medical University of South Carolina (MUSC) Health to identify patients who are at risk for medication-related events. Patients are classified as high-risk if they meet one of the following criteria: receiving anticoagulation therapy, taking more than 10 scheduled medications upon admission, or readmission within the past 30 days. The goal of this study was to determine risk criteria specific to the malignant hematology (MH) and bone marrow transplant (BMT) patients. Methods A retrospective chart review of 114 patients admitted and discharged from the MH/BMT services between 1 September 2015 and 31 October 2015 was performed. A pharmacist-conducted medication history was completed and documented, and all interventions at admission and throughout hospitalization were categorized by severity and by value of service. The primary objective was to evaluate if patients in the MH/BMT services have more medication-related interventions documented upon admission compared with patients who are not screened as high risk. The secondary objectives were to evaluate the different types and severities of interventions made by pharmacists during the entire hospital stay, and to determine if there are certain characteristics that can help identify hematology/oncology high-risk patients. Results More interventions documented upon admission in the high-risk group as a whole when compared with the not high-risk group (73 vs. 31), but when normalized per patients in each group, there was an equal number of interventions (1.0). The most common interventions were to modify regimen (36%) and discontinue therapy (16%). The patient characteristics associated with high-risk included neutropenia, lower average platelet counts on admission, and longer length of stay. Conclusion The screening tool does not further differentiate an already complex MH/BMT patient population. Pharmacists may be more useful at capturing errors or changes during a patient’s hospital stay instead of upon admission. Thrombocytopenia, neutropenia, and active infections may correlate with higher-risk status.

Download Full-text

Mouth Self-Examination (MSE) As a Screening Tool for Oral Potentially Malignant Disorders Among a High-Risk Indigenous Population With a Low Socioeconomic Status

Journal of Global Oncology ◽

10.1200/jgo.18.37700 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 48s-48s

Author(s):

I.A. Razak ◽

W.M.N. Ghani ◽

J.G. Doss ◽

A. Ramanathan ◽

Z. Tahir ◽

...

Keyword(s):

High Risk ◽

Oral Cancer ◽

Screening Tool ◽

Oral Potentially Malignant Disorders ◽

Betel Quid Chewing ◽

Oral Mucosal Lesions ◽

Potentially Malignant Disorders ◽

Potentially Malignant ◽

Mucosal Lesions ◽

Self Examination

Background: Oral cancer can be preceded by a group of conditions termed oral potentially malignant disorders (OPMDs). Oral cancers are associated with a 5-year survival of less than 50%, largely attributed to diagnoses at advanced stages. As pain associated with oral cancer manifests only at late stages, delay in detection often occurs. Screening has been found to aid in detection at an early stage, however it is only feasible if targeted toward high risk individuals. Mouth self-examination (MSE) is a relatively quick, inexpensive and simple to perform method of screening. Aim: To evaluate the efficacy of MSE as a screening tool for detection of oral mucosal lesions and OPMDs in a high risk indigenous population with a high prevalence of tobacco and betel quid chewing habit. Methods: Two villages were selected as the sampling frame based on prevalence of tobacco and betel quid chewing habit. Respondents were asked to check their mouth for presence of lesion or abnormalities. Education on oral cancer, including MSE was provided. Subsequently, respondents were asked to perform MSE. Finally, a comprehensive oral examination (COE) was done by a specialist and the presence of oral mucosal lesions was recorded. Results: Almost 64.5% of respondents exhibited high levels of difficulty and low mucosal visualization and retracting ability, whereas 3.0% demonstrated high attention level when performing MSE. Prevalence of oral mucosal lesions was 59.0%, whereas the prevalence of oral potentially malignant disorders (OPMDs) was 9.0%. Detection of oral lesions by respondents using MSE was lower than detection by the gold standard. Sensitivity and specificity of MSE for detection of all types of lesions were 8.6% and 95.0% respectively. When analyzing each lesion type separately, MSE was found to be most sensitive in detection of swellings (10.0%), and most specific in identifying red lesions (100.0%). For detection of OPMDs, MSE yielded a high specificity of 98.9%, with an accuracy rate of 91.8%. Conclusion: MSE is a potentially good screening tool for OPMDs and oral cancer; however, awareness level of the public on oral cancer and its associated signs and symptoms needs to be improved.

Download Full-text

Baseball Players, a High Risk Group of Men for the Development of Oral Cancer

Gender Medicine ◽

10.1016/j.genm.2011.09.016 ◽

2012 ◽

Vol 9 (1) ◽

pp. S98

Author(s):

Michele Follen

Keyword(s):

High Risk ◽

Oral Cancer ◽

Risk Group ◽

High Risk Group ◽

Baseball Players

Download Full-text

Acromegaly and Obstructive Sleep Apnea: Identifying the High-Risk Group

10.1055/s-0039-1679596 ◽

2019 ◽

Author(s):

Xiaojun Zhan ◽

Chandala Chitguppi ◽

Ethan Berman ◽

Gurston Nyquist ◽

Tomas Garzon-Muvdi ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

High Risk ◽

Risk Group ◽

High Risk Group ◽

Obstructive Sleep

Download Full-text

Recommendations from male students help shape mental health support for this high-risk group

10.3310/alert_42077 ◽

2020 ◽

Keyword(s):

Mental Health ◽

High Risk ◽

Risk Group ◽

High Risk Group ◽

Male Students ◽

Mental Health Support ◽

Health Support

Download Full-text

Anamnestic factors that shape reproductive health of women with repeated unsuccessful popygamy in vitro fertilization

HEALTH OF WOMAN ◽

10.15574/hw.2016.114.140 ◽

2016 ◽

pp. 140-143

Author(s):

N.V. Cotsabin ◽

◽

O.M. Makarchuk ◽

Keyword(s):

High Risk ◽

Risk Group ◽

Polycystic Ovary ◽

High Risk Group ◽

Stress Factors ◽

Control Group ◽

Fertilization In Vitro ◽

Infertile Women ◽

Group I

The proportion of patients with multiple unsuccessful attempts of assisted reproductive technology (ART) is about 30% of all patients treated with the use of ART. Women with history of unsuccessful ART attempts - a special category of patients who require emergency attention and a thorough examination at the stage of preparation for superovulation stimulation,the selection of embryos and endometrium preparation for embryo transfer. The objective: to distinguish high-risk group of unsuccessful attempts based on a detailed analysis of anamnestic and clinical data of infertile women with repeated unsuccessful ART attempts that requires more in-depth study of hormonal features, ovarian reserve and condition of the endometrium. Materials and methods. For better understanding of the problem of repeated unsuccessful ART attempts and сreation of efficient infertility treatment algorithms for these couples we conducted a thorough analysis of anamnestic data of three groups of infertile women (105 patients), which were distributed by age: group I – younger than 35, the II group – from 35 to 40, the III group - over 40 years. These groups of patients were compared with each other and with the control group of healthy women (30 persons). Results. Leading stress factors in the percentage three times prevailed in the group of infertile women and had a direct connection with the fact of procedure «fertilization in vitro» and chronic stressors caused by prolonged infertility. Primary infertility was observed significantly more frequent in patients younger than 35 years (p <0.05), secondary infertility - mostly in the second and third experimental groups (p <0.05). Noteworthy significant percentage of wellknown causes of infertility and idiopathic factor in all groups, and the prevalence of tubal-peritoneal factor in the second and third experimental groups, and endocrine dysfunction in the I experimental group. The most common disorder among this category of woman was polycystic ovary syndrome. Frequency of usual miscarriage among patients of I ana II groups was two times higher than in the third group (p <0.05). Among the experimental groups the leading place belongs urinary tract infection, respiratory tract diseases, pathologies of the cardiovascular system. Data of the stratified analysis show an increase likelihood of repeated unsuccessful ART attempts under the influence of constant chronic stress (odds ratio OR=2.06; 95% CI: 0.95–3.17; p<0.05). Conclusions. Among infertile patients with repeated unsuccessful ART attempts must be separated a high risk group of failures. The identity depends on the duration of infertility, female age and leading combination of factors. Key words: repeated unsuccessful ART attempts, anamnesis, infertility, high risk.

Download Full-text