Purpose
To investigate the impact of sleep on the development of early childhood caries (ECC).
Methods
Seven electronic databases and grey literature were searched with various keyword combinations. Two reviewers independently selected studies, extracted data, and assessed the risk of bias using the Newcastle–Ottawa Scale. The studies were included if they evaluated the impact of sleep parameters on the caries experience or severity of ECC in children under 6 years of age.
Results
Four cross-sectional studies and two longitudinal studies were included. Children who had irregular bedtimes had a 66–71% higher chance of developing ECC. Children who slept after 11 pm might have a 74–85% higher chance of developing ECC. Children who slept less than 8 h during the night had a 30% increased risk of caries than children who slept more than 11 h.
Conclusion
Irregular or late bedtime and fewer sleeping hours could be an independent risk factor for ECC. The risk of ECC might be related inversely in a dose–response manner to the number of sleep hours.
Background. Between August 1984 and November 1989, the Hoosier Oncology Group conducted a Phase III study comparing cyclophosphamide (CTX) with cyclophosphamide, doxorubicin, and methotrexate (CAM) in patients with hormone‐refractory metastatic prostatic cancer to determine whether the addition of doxorubicin and methotrexate to the cyclophosphamide regimen conferred any survival advantage.
Methods. One hundred three patients were registered and randomized, 99 were evaluable for response, and all were evaluable for survival results. All had histologically confirmed metastatic prostatic cancer and had not responded to hormonal therapy. Fifty‐three patients received CTX alone, and 50 received CAM. Seventy‐one patients (69%) had evaluable disease, and 32 (31%) had measurable disease.
Results. There were no complete responses and only four (13%) partial responses in the patients with measurable disease. There was no difference in overall survival time between the two treatment arms in either patients with a Karnofsky performance status (KPS) of 80‐100 (median survival, 9.0 versus 9.5 months; P = 0.93) or in those with a KPS of 50‐70 (median survival, 5.0 versus 6.0 months; P = 0.51). There was no difference in overall time to progression between the two treatment arms (median time to progression; 4.4 versus 6.2 months; P = 0.07). Toxicity was tolerable in both regimens.
Conclusions. It was concluded that there was no survival advantage to CAM over CTX alone. New chemo‐therapeutic agents with greater activity against prostatic cancer must be identified.
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