Effect of collaborative intervention by medical and dental professionals on adherence to smoking abstinence.

The need for smoking cessation care is widely recognized. It is, however, difficult to achieve continued smoking abstinence, even when cessation has initially been achieved. The aim of this study was to determine the effectiveness of a collaborative smoking cessation program involving both medical and dental professionals on smoking abstinence. A total of 10 patients visiting our Smoking Cessation Outpatient Clinic were followed up and monitored for smoking abstinence. All received smoking cessation care consisting mainly of counseling by dental and medical professionals and pharmacotherapy. They also concurrently received an oral examination, instruction on oral hygiene, and professional tooth cleaning. The 4-week smoking abstinence rate was 90.0% on completion of the program. One patient failed to complete the program. At one month after the program, 8 out of 9 patients remained abstinent (4-month abstinence; 88.9%). At 3 months after the program, 7 patients remained abstinent (6-month abstinence; 77.8%). Follow-up was impossible in one patient. Within the limitations of the present study, it is suggested that such collaborative intervention including subsequent dental care has the potential to promote short-term adherence to smoking abstinence.

Epstein-Barr virus-associated T-cell lymphoproliferative disorder affecting skin and lung in an elderly patient.

A 70-year-old man presented with papular skin lesions and was diagnosed with Epstein-Barr virus (EBV)-associated T-cell lymphoproliferative disorder (T-LPD). The patient showed infiltration of a large number of EBV-encoded RNA-positive T cells in the skin and lung, presence of EBV load in the peripheral blood, and expansion of clonal EBV-infected γδ T cells and CD8(+) T cells in the blood and skin, as assessed by EBV-terminal repeat Southern blot, T-cell receptor polymerase chain reaction and flow cytometric analyses. In the Japanese or East Asian fatal cases of EBV-associated T/natural killer (NK)-LPD, there are two peaks in age at death, approximately 20 years and 60 years. The former age group is associated with chronic active EBV infection (CAEBV), and the latter group typically suffers from extranodal NK/T-cell lymphoma. Our case is characterized not only by the unique skin and lung manifestations but also the late onset age of the disease, indicating that the skin manifestation of CAEBV can be seen even in elderly patients.

Epstein-Barr virus-associated T/natural killer-cell lymphomas in the elderly: the first consensus meeting in Kofu 2013.

From a clinicopathological conference on nine elderly patients with Epstein-Barr virus (EBV)-associated T/natural killer (NK)-cell lymphoma, we have addressed the patients' backgrounds, clinical manifestations, histopathological findings, cytogenesis, complications and prognoses. Among these elderly patients (>65 years old), seven patients had extranodal NK/T-cell lymphoma, nasal type (ENKL) with an NK-cell phenotype, and two patients had EBV(+) T-cell lymphomas or lymphoproliferative disorders (LPD) with cutaneous lesions mimicking pityriasis lichenoides et varioliformis acuta (PLEVA) or hydroa vacciniforme (HV). No patients had a previous episode of EBV-related symptoms such as infectious mononucleosis, chronic active EBV infection, HV or hypersensitivity to mosquito bites. Elderly patients with ENKL may show the centroblastoid variant. EBV(+) CD8(+) CD56(+/-) lymphocytes may be responsible for the development of PLEVA or HV-like cutaneous lesions in the elderly.