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A problem swallowing
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Other pre-malignant conditions include: oesophageal web/ring (Plummer-Vinson syndrome)coeliac disease (see p. 202).
Update on Oral Lichen Planus: Etiopathogenesis and Management
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
Cameron M Herbert, Esther A Hullah
Given the premalignant potential of OLP, it is recommended that patients should be reviewed on a regular basis. Patients should be advised on how to monitor and contact their health-care provider should they notice any change to their OLP.
DRCOG MCQs for Circuit B Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Vulvar dystrophy:Presents with pruritus.Can be premalignant.Only occurs in the postmenopausal woman.Diagnosis is made by careful history and physical examination.Lichen sclerosus presents as white premalignant lesions on the vulva.
Lies of Omission and Commission, Providing and Withholding Treatment, Local and Global Autonomy – There Are Reasons for Clinical Ethicists to Attend to All of These Distinctions
Published in The American Journal of Bioethics, 2021
One such feature is whether deception is being employed in the context of providing or withholding treatment. Meyer’s example of failing to disclose side-effects of a medical treatment in order to prevent a nocebo effect is an example of the former. Yet, reasons of beneficence and/or non-maleficence may also support deception in the context of withholding treatment. Suppose a biopsy confirms that a patient has developed a premalignant tumor, but one that is very unlikely to spread, and which can be closely monitored and quickly treated if necessary. If the patient will be unduly terrified upon receiving any sort of “cancer diagnosis,” and will likely want to immediately pursue aggressive, risky and probably unnecessary treatment, it might be argued that there are ethical reasons to deceive the patient about the precise nature of their diagnosis.2
Outcome after endoscopic treatment for dysplasia and superficial esophageal cancer – a cohort study
Published in Scandinavian Journal of Gastroenterology, 2020
Tobias Hauge, Isabel Franco-Lie, Else Marit Løberg, Truls Hauge, Egil Johnson
Barrett’s esophagus is a premalignant condition where the normal squamous epithelium of the lower esophagus is altered into columnar epithelium by metaplasia. The main risk factor is chronic reflux and it is estimated that 10–15% of all patients with reflux will develop Barrett’s esophagus [1]. Patients with Barrett’s esophagus without dysplasia, will have an estimated yearly incidence of about 0.33% for progression into cancer, while in case of low-grade dysplasia (LGD) or high-grade dysplasia (HGD) the incidence rates vary from 0.4 to 13% and 6 to 19%, respectively [2]. With confirmed LGD, the SURF study from 2014, in which 68 patients with LGD were randomized to either radiofrequency ablation (RFA) or surveillance, showed that active treatment reduced the progression to HGD or adenocarcinoma by 25% (p<.001) [3]. Recently, a long-term follow-up study has been presented in which 96% of the patients treated with RFA experienced a sustained clearance after a median follow-up of 74 months [4]. RFA for confirmed LGD is now an integral part in most national [5] and international [6] guidelines.
Effective early detection of oral cancer using a simple and inexpensive point of care device in oral rinses
Published in Expert Review of Molecular Diagnostics, 2018
Elizabeth J Franzmann, Michael J. Donovan
From a clinical use perspective, the data suggest that a patient with a negative POC and lab test result, in conjunction with clinical judgment, has a lower likelihood of oral/oropharyngeal cancer and while a positive test result would require further evaluation including repeating the POC test or utilizing the quantitative lab test or both to improve specificity. The assays are designed to address a clinical unmet need by providing simple, accurate, and cost-effective adjunctive early detection assays. The POC test is an easy to use lateral flow device with results reported in 10 min without expensive equipment while the laboratory-based ELISA algorithmic assay provides probability risk scores for predicting the presence of oral or oropharyngeal cancer. Both assays provide the treating physician tools to assist in the identification of this disease, possibly in an early, more preinvasive stage for optimal health outcomes. More research is needed to further understand the accuracy of the test for detecting premalignant disease. The health-care provider is advised to perform an internal and external visual and bimanual palpation head and neck examination to determine if there are any visible or palpated abnormalities. It is important to note that the assay results are meant to be supportive to the diagnostic decision process and are not considered diagnostic.