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.68) from 24 datasets. For vital staining, sensitivity was 0.86 (CI 0.79-0.90) and specificity 0.68 (CI 0.58-0.77) from 22 datasets. For combined tests, sensitivity was 0.78 (CI 0.45-0.94) and specificity 0.71 (CI 0.53-0.84) from nine datasets.Conclusion None of the adjunctive tests can presently be recommended in lieu of tissue biopsy and histological assessment. Of the modalities, oral cytology showed the greatest potential based on the high summary estimate values for sensitivity and specificity. Further research is needed into the utility of these alternative diagnostic tests.Data sources Four electronic databases (PubMed, Web of Science, Scopus and PLOS) were queried to identify studies that investigated the effects of probiotics against oral cancer, published in the English language between January 2015 and February 2020.Study selection Randomised controlled trials (RCT) including in vivo and in vitro studies that evaluated the effects of probiotics against oral cancer were included.Data extraction and synthesis The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-P) 2015 guidelines were followed to conduct this systematic review. Screening of titles, abstracts and full texts was done independently by four authors with disagreements resolved by mutual discussion. Individual studies' year, author, country, as well as strain of probiotics, type of sample, mechanisms of probiotics and outcomes, were analysed by two authors. The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools (Chec showed 95% reduction of risk in oral cancer development (OR = 0.05, 95% CI 0.01-0.23; p less then 0.05).Conclusions Within the limitations of in vivo (animal) and in vitro (cell lines) studies, the authors concluded that the probiotics analysed in this review, especially L. salivarius Ren, seem to play a role in oral cancer inhibition.Aim This study aimed to investigate periodontal disease as a non-genetic risk factor for oral cancer.Design Case-control study.Patient population Two hundred patients, regardless of periodontal and adverse habits (smoking and alcohol) status, in the age group of 18-90 years were included in this institutional study. One hundred patients with histologically confirmed oral squamous cell carcinoma (OSCC) were included in the case group, while the control group had 100 patients without any oral cancer.Methods Multivariable examination to obtain socioeconomic and lifestyle risk factors was performed with a questionnaire for both the groups and compared statistically. Additionally, oral status (periodontal stage, clinical attachment loss, periodontal pocket depth, bleeding on probing, Silness-Loe plaque index, and decayed, missing, and filled teeth [DMFT] index) of both the groups was recorded and compared statistically.Results A significant correlation was found between age, gender and development of oral cancer. There was a significant co-relation between alcohol intake and oral cancer development. Surprisingly, there was no correlation between smoking habits and passive smoking with oral cancer development in the case group. Overall, 72.1% of case group patients had Stage 4 periodontitis, whereas 51.6% of control group patients had Stage 2 periodontitis. A significant correlation was found between the incidence of oral cancer and the stage of periodontitis.Conclusion The findings of the study support the hypothesis that periodontitis is an independent risk factor for oral cancer.Design Systematic review looking at published studies which aimed to identify human tissue biomarkers which could predict malignant transformation of oral leukoplakia (OL) lesions.Case/control selection Articles were identified from PubMed, EBSCO and Cochrane library databases using combinations of keywords. Randomised clinical trials, case-control studies and prospective and retrospective cohort studies were included. All studies had to include follow-up data. There were no restrictions regarding gender, age groups, geographic origin, or year of publication. The selection process involved two of the researchers independently analysing titles and abstracts to identify articles for full-text reading. The same authors then read the articles identified for full-text reading, applying the eligibility criteria. If there was a disagreement with regards to the selection, a discussion was had until a consensus was reached.Data analysis Qualitative data was presented as reported from the primary studies. Quantitative analysis was not carried out due to the high heterogeneity across the studies.Results Forty-six studies were included within the systematic review. These studies identified a total of 3,783 patients with OL, of which 1,047 went on to develop oral cancer, giving an average malignant transformation incidence of 27.6%. Forty-nine different tissue biomarkers were evaluated among the included studies, with the p53 and podoplanin proteins and loss of heterozygosity the most frequently discussed.Conclusions Of the biomarkers studied, podoplanin and chromosomal loci abnormalities (such as loss of heterozygosity) would appear the most promising in being able to predict malignant transformation of OL lesions; however, further research is required.Study selection Two electronic databases (Medline/PubMed and Embase) were searched up to 30 August 2020. Selected papers fitted the following criteria human studies published in the English language that assessed adult patients over the age of 18 with a presumptive diagnosis of an oral potentially malignant disorder, oral cancer or oropharyngeal cancer. The studies compared either visual inspection or light-based tests with diagnostic biopsy of the lesions. The outcome measures identified were sensitivity, specificity, summary receiver operating characteristic curve (SROC), positive predictive value (PPV) and negative predictive value (NPV).Data extraction and synthesis The extraction of data followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline process. Two independent reviewers selected articles via PubMed search, and a further two independent reviewers selected articles via an Embase search. The quantitative data obtained from each study was used to create a datad the lowest sensitivity (0.63-95% CI [0.45-0.78]) of actually diagnosing sinister lesions. Autofluorescence more accurately identified premalignant and malignant changes (sensitivity = 0.86 95% CI [0.77-0.91]) compared with chemiluminescence (sensitivity = 0.67 95% CI [0.38-0.87]) and visual examination (sensitivity = 0.63 95% CI [0.45-0.78]). Autofluorescence was also faster and simpler to use compared with chemiluminescence.Conclusions This review and meta-analysis concludes that autofluorescence has greater accuracy in identifying premalignant and early neoplastic changes compared with clinical examination and chemiluminescence. Biopsy remains the gold standard for definitive diagnosis of oropharyngeal and oral premalignant and malignant conditions.Design Retrospective cohort study.Cohort selection OroGrams is a nomogram designed to better predict survival patterns in patients with oropharyngeal squamous cell carcinoma (OPSCC) by incorporation of both HPV-DNA and p16 status. The aim of this study was to evaluate the external validity of OroGrams in a Scottish population. The study population was noted to have a higher smoking status than the four European cohorts among which Orograms was originally developed and established.Data analysis Retrospective analysis was undertaken of health records and death certificates of patients with OPSCC in Glasgow, Scotland between 2012 and 2017. Required baseline characteristics were compared to the original study cohorts to assess comparability. OroGrams was implemented to produce Kaplan Meier curves for overall and progression-free survival at one, three and five years. Brier scores were produced to compare these to the actual observed outcomes.Results Compared to the UK study group, significantly more of the Scottinded to enhance outcome understanding and better inform treatment planning.Data Sources Electronic search on PubMed, Cochrane, Scopus, Embase, Google Scholar, Saudi Digital Library and Web of Science, and hand searching carried out for studies published January 2000-March 2021. Language was restricted to English.Study selection Original research studies involving artificial intelligence technology for oral cancer diagnosis and prognosis prediction were considered. The studies had to provide quantitative data of their evaluation analysis. The exclusion criteria were reported. No limit was set on study design.Data extraction and synthesis The initial search yielded 628 articles. Following deduplication, 340 full-text articles were screened. QUADAS-2 tool was used to assess the quality of the included studies regarding diagnostic accuracy.Results A total of 16 studies were included with various study designs 14 cross-sectional, one cohort and one retrospective study. Six studies reviewed the diagnosis aspect. All studies indicate an overall positive trend of artificial intelligence technology.Conclusions Artificial intelligence appears to have good accuracy in oral cancer diagnosis and its prediction.Data sources The online databases of Medline, Web of Science, Embase and Cochrane Library were systematically searched to identify articles published (up to October 2021) on the accuracy of microRNAs (miRNAs) in the diagnosis of oral squamous cell carcinoma (OSCC).Study selection Primary research studies involving human participants with the presence of healthy controls and sufficient data for statistical analysis were included. Exclusion criteria included review articles, letters, case reports and non-human trials. Two reviewers independently assessed the studies, and any conflicts were resolved by consulting a third reviewer. From 326 initially identified articles, 20 articles (all case-control studies) were included in the meta-analysis involving 1,106 cases and 732 controls.Data extraction and synthesis Data extracted included sensitivity, specificity, likelihood ratios and diagnostic odds ratios for blood and salivary miRNAs. A combined category of body fluid miRNAs was also synthesised. Heterogeneity beonclusions Body fluid miRNAs may provide moderate accuracy in diagnosing OSCC; however, the significant heterogeneity between studies and the lack of large-scale high-quality studies limits their diagnostic value.Significant clinical improvement is often observed in patients who receive placebo treatment in randomized double-blind placebo-controlled trials. While a proportion of this "improvement" reflects experimental design limitations (e.g., reliance on subjective outcomes, unbalanced groups, reporting biases), some of it reflects genuine improvement corroborated by physiological change. see more Converging evidence across diverse medical conditions suggests that clinically-relevant benefits from placebo treatment are associated with the activation of brain reward circuits. In parallel, evidence has accumulated showing that such benefits are facilitated by clinicians that demonstrate warmth and proficiency during interactions with patients. Here, we integrate research on these neural and social aspects of placebo effects with evidence linking oxytocin and social reward to advance a neurobiological account for the social facilitation of placebo effects. This account frames oxytocin as a key mediator of treatment success across a wide-spectrum of interventions that increase social connectedness, thereby providing a biological basis for assessing this fundamental non-specific element of medical care.
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