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Journal of Gastroenterology - Small bowel cancer is not a single entity. Population-based studies taking into account histological diversity are scarce. The aim of this study was to report on their...  相似文献   
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Purpose

To analyze trends in second primary cancer (SPC) incidence by using a case-mix approach to standardize on first cancer site distribution.

Methods

Cases registered by 13 French cancer registries between 1989 and 2010 and followed-up until June 2013 were included. The person-year approach was used to compute standardized incidence ratios (SIRs) of metachronous SPC. Usual SIRs and cancer site–specific weighted SIRs called “case-mix SIRs” (cmSIRs) were estimated by sex and calendar period of first cancer diagnosis. Calendar trends in SIRs and cmSIRs were compared.

Results

More than 2.9 million person-years at risk were included. Among males, SIRs dropped from 1.49 to 1.23 between 1989–1994 and 2005–2010, while cmSIRs decreased from 1.40 to 1.27. This difference seems mainly related to a stronger representation of prostate cancers (at lower risk of SPC) and a weaker contribution of bladder and head and neck cancers (at higher risk of SPC) in recent periods of diagnosis. Among females, both SIRs and cmSIRs have remained stable at around 1.22 and 1.21, respectively.

Conclusions

The cmSIR is an indicator that is not influenced by changes in first cancer site distribution. Its use should be encouraged to assess second cancer incidence control.  相似文献   
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Background

Patient navigation programs to increase colorectal cancer (CRC) screening adherence have become widespread in recent years, especially among deprived populations.

Objectives

To evaluate the cost-effectiveness of the first patient navigation program in France.

Methods

A total of 16,250 participants were randomized to either the usual screening group (n = 8145) or the navigation group (n = 8105). Navigation consisted of personalized support provided by social workers. A cost-effectiveness analysis of navigation versus usual screening was conducted from the payer perspective in the Picardy region of northern France. We considered nonmedical direct costs in the analysis.

Results

Navigation was associated with a significant increase of 3.3% (24.4% vs. 21.1%; P = 0.003) in participation. The increase in participation was higher among affluent participants (+4.1%; P = 0.01) than among deprived ones (+2.6%; P = 0.07). The cost per additional individual screened by navigation compared with usual screening (incremental cost-effectiveness ratio) was €1212 globally and €1527 among deprived participants. Results were sensitive to navigator wages and to the intervention effectiveness whose variations had the greatest impact on the incremental cost-effectiveness ratio.

Conclusions

Patient navigation aiming at increasing CRC screening participation is more efficient among affluent individuals. Nevertheless, when the intervention is implemented for the entire population, social inequalities in CRC screening adherence increase. To reduce social inequalities, patient navigation should therefore be restricted to deprived populations, despite not being the most cost-effective strategy, and accepted to bear a higher extra cost per additional individual screened.  相似文献   
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Background  

Squamous cells carcinoma is the most important malignant tumor with primary site in the oral cavity and, given the great exposure of mucosa and lips to the etiologic factors of this neoplasm, its incidence is high. Investigation of the prognostic determinants is significant for the expectations of treatment proposal and cure of the patient. The local immune response represented by peritumoral inflammatory infiltrate is a possible prognostic factor.  相似文献   
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The aim of the present study was to clinically evaluate fissure sealants on the occlusal fissures and buccal pits of permanent first and second molars after 20 and 15 years, respectively. The population consisted of 72 children, each of whom had had their four first molars sealed between 1977 and 1980. At the annual examinations, all caries-free, newly erupted second molars were sealed. When sealant was applied to the second molars, the first molars were checked and sealant was reapplied to those that had deficient sealants. At the follow-up, when the subjects were 26–27 years of age, 27 in the original group had moved from the community. Thus, the present result is based on 45 subjects. One hundred and fifty-three sealed first molars and 161 sealed second molars were available for inspection. At the follow-up examination of the first molars 20 years after sealant had been applied, 65% showed complete retention, 22% partial retention without caries, and 1306 caries or restoration in the occlusal fissures or buccal pits. At the 15-year follow-up of the second molars, the corresponding figures were 65%, 30% and 5%, respectively. Of the restored or carious molars, significantly more were found in the mandible than in the maxilla ( P  < 0.001). This longitudinal study showed that pit and fissure sealants, applied during childhood, have a long-lasting, caries-preventive effect.  相似文献   
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This study evaluates the healing of the rabbit temporomandibular joint (TMJ) following discectomy in four groups of animals fed a ground diet for 3 consecutive months (group 1), a ground diet for 1 month followed by 2 months of a coarse diet (group 2), a ground diet for 6 consecutive months (group 3), or a ground diet for 3 months followed by a coarse diet for 3 months (group 4), in order to evaluate the effects of changing the diet texture following discectomy. After 3 and 6 months, histologic evaluation demonstrated that 1) an early hyperplastic response in the fibrocartilage regressed in the later period regardless of diet, and 2) switching the ground diet to a hard diet caused degenerative scores to increase after both 1 and 3 months.  相似文献   
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In vitro adherence of bacteria to bleached or unbleached enamel surfaces   总被引:1,自引:0,他引:1  
summary The purpose of this in vitro study was to evaluate the effects of three 10% carbamide peroxide bleaching agents on adherence of bacteria to tooth enamel surface. Enamel specimens were subjected to one of three carbamide peroxide solutions for 8 h per day for 30 days. Control specimens were kept in saline solution. Profilometer evaluation of surface roughness was performed on all specimens. The adherence of Streptococcus mutans was determined bacteriologically. There was no significant difference in surface roughness between the untreated and treated enamel specimens but a statistically significant difference was found in the adherence of S. mutans to bleached and unbleached enamel specimens. Specimens treated with Opalescence° showed the highest adherence.  相似文献   
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