Atención estomatológica a pacientes en protocolo para trasplante de órgano / Stomatological care for patients with organ transplantation protocol

El trasplante es el reemplazo con propósitos terapéuticos de órganos, tejidos, material celular para un humano, donado usualmente de otro humano vivo o muerto. En recientes años, el trasplante de órganos se ha desarrollado por la tecnología quirúrgica médica y los medicamentos inmunosupresores. Debido a la frecuencia de trasplantes que se realizan, es común atender a pacientes trasplantados en el consultorio dental para recibir tratamiento estomatológico. Objetivo: Revisión de literatura con respecto a las manifestaciones bucales en pacientes trasplantados y el tratamiento estomatológico antes y después del trasplante. Material y métodos: Se revisaron artículos de la literatura que se obtuvieron de la base de datos de PubMed y MedLine. Resultados y conclusión: Describimos las manifestaciones bucales más comunes debido a los medicamentos en pacientes trasplantados (infecciones virales, bacterianas, fúngicas, alteraciones gingivales y xerostomía); además del tratamiento estomatológico que deben recibir los pacientes trasplantados antes y después de ser trasplantado (AU)

Transplantation is the replacement for therapeutic purposes of organs, tissues, cellular material for a human, usually donated from another living or dead human. In recent years organ transplantation has been developed by medical surgical technology and immunosuppressive drugs. Due to the frequency of transplants that are performed it is common to treat transplant patients in the dental office to receive stomatological treatment. Objective: Review of literature regarding oral manifestations in transplant patients and stomatological treatment before and after transplantation. Material and methods: Literature articles that were obtained from the PubMed and MedLine databases were reviewed. Results and conclusion: We describe the most common oral manifestations due to drugs in transplant patients (viral, bacterial, fungal infections, gingival alterations, xerostomia, and the stomatological treatment that transplant patients should receive before and after being transplanted (AU)

In the (sub)tropics allergic rhinitis and its impact on asthma classification of allergic rhinitis is more useful than perennial-seasonal classification.

BACKGROUND: Two different allergic rhinitis (AR) symptom phenotype classifications exist. Treatment recommendations are based on intermittent-persistent (INT-PER) cataloging, but clinical trials still use the former seasonal AR-perennial AR (SAR-PAR) classification. This study was designed to describe how INT-PER, mild-moderate/severe and SAR-PAR of patients seen by allergists are distributed over the different climate zones in a (sub)tropical country and how these phenotypes relate to allergen sensitization patterns. METHODS: Six climate zones throughout Mexico were determined, based on National Geographic Institute (Instituto Nacional de Estadística y Geografía) data. Subsequent AR patients (2-68 years old) underwent a blinded, standardized skin-prick test and filled out a validated questionnaire phenotyping AR. RESULTS: Five hundred twenty-nine subjects participated in this study. In the tropical zone with 87% house-dust mite sensitization, INT (80.9%; p < 0.001) and PAR (91%; p = 0.04) were more frequent than in the subtropics. In the central high-pollen areas, there was less moderate/severe AR (65.5%; p < 0.005). Frequency of comorbid asthma showed a clear north-south gradient, from 25% in the dry north to 59% in the tropics (p < 0.005). No differences exist in AR cataloging among patients with different sensitization patterns, with two minor exceptions (more PER in tree sensitized and more PAR in mold positives; p < 0.05). CONCLUSION: In a (sub)tropical country the SAR-PAR classification seems of limited value and bears poor relation with the INT-PER classification. INT is more frequent in the tropical zone. Because PER has been shown to relate to AR severity, clinical trials should select patients based on INT-PER combined with the severity cataloging because these make for a better treatment guide than SAR-PAR.