ABSTRACT
PURPOSE: Candidates and recipients of kidney transplants are at high risk for oral infections due to systemic co-morbidities, and disease and drug-induced immunosuppression. Developing oral infections while on the waiting list can jeopardize candidacy for receiving a kidney, and post-operatively increases the chance for organ rejection. Therefore, it is imperative to minimize oral disease risks in this population. A comprehensive, oral preventive care protocol is presented to guide dental professionals with patient management throughout the process of care. Proper dental and dental hygiene care can help to prevent oral infections, optimize oral health, and enhance overall health and quality of life for the renal transplant population.
Subject(s)
Graft Rejection/prevention & control , Kidney Transplantation , Mouth Diseases/prevention & control , Patient Care Planning , Humans , Mouth Diseases/drug therapy , Oral Health/standards , Oral Hygiene/standards , Patient Care Management , Quality of Life , Risk FactorsABSTRACT
INTRODUCTION: Detection of gastric atrophy could be used for early diagnosis of gastric cancer in Perú. It was determined the pepsinogens I and II (PGI, PGII) and Gastrin-17 (G17) serum levels, and the PGI/PGII ratio as a non-invasive diagnostic test for gastric atrophy in Peruvian patiens. METHODS: Dyspeptic adults undergoing endoscopy and gastric biopsies were studied.For each case with atrophy two controls without atrophy were selected. Differences were evaluated and ROC curves constructed. A serologic profile was produced combining PGI and PGI/PGII ratio. Sensitivity and specificity were calculated. RESULTS: 22 cases and 44 controls were included. Areas under ROC curves were 0.599, 0.546 and 0.534 for PGI, PGII and PGI/PGII ratio, respectively. None of these allowed for discrimination between cases and controls. The serological profile did not reach appropriate sensitivity and specificity. DISCUSSION: This first study of pepsinogen, gastrin and atrophy in Peru showed none of these tests to be useful. Their potential impact in early detection and prevention of prevalent cancer justify further investigation. Recruiting more patients, excluding those previously treated for Helicobacter pylori, and processing independently the antrum and corpus biopsies, could reveal findings not seen in present study.
Subject(s)
Gastrins/blood , Gastritis, Atrophic/blood , Pepsinogen A/blood , Pepsinogen C/blood , Adult , Biomarkers , Biopsy , Case-Control Studies , Dyspepsia/etiology , Gastritis, Atrophic/diagnosis , Gastritis, Atrophic/epidemiology , Gastroscopy , Humans , Peru/epidemiology , ROC Curve , Sensitivity and Specificity , Stomach Neoplasms/prevention & controlABSTRACT
INTRODUCCIÓN: La detección de atrofia gástrica podría ser utilizada en el diagnóstico precoz de cáncer gástrico en Perú. Se evaluó la determinación de niveles séricos de pepsinógenos I y II (PGI, PGII), gastrina-17 (G17), y la relación PGI/PGII como posible prueba de diagnóstico no invasivo de atrofia en pacientes peruanos. MATERIAL Y MÉTODOS: Se estudiaron adultos con dispepsia sometidos a endoscopía con biopsia gástrica, considerando dos controles sin atrofia por cada caso con atrofia. Se evaluaron las diferencias y se confeccionaron curvas ROC, así como el perfil serológico combinando PGI y PGI/PGII. Se calculó su sensibilidad y especificidad. RESULTADOS: Se analizaron 22 casos y 44 controles. El área bajo la curva ROC fue 0.599, 0.546 y 0.534 para PGI, PGII, y PGI/PGII respectivamente. Ninguna prueba discriminó entre casos y controles. El perfil serológico no alcanzó sensibilidad y especificidad adecuadas. DISCUSIÓN: Este primer estudio de pepsinógeno, gastrina y atrofia en Perú, no mostró utilidad de estos métodos. El impacto potencial en la detección y prevención de una neoplasia prevalente justifica mayor investigación. Incluir más pacientes, excluir a los tratados previamente contra Helicobacter pylori, y procesar separadamente las biopsias de antro y cuerpo, podrían revelar asociaciones no vistas en este estudio.
INTRODUCTION: Detection of gastric atrophy could be used for early diagnosis of gastric cancer in Perú. It was determined the pepsinogens I and II (PGI, PGII) and Gastrin-17 (G17) serum levels, and the PGI/PGII ratio as a non-invasive diagnostic test for gastric atrophy in Peruvian patiens. METHODS: Dyspeptic adults undergoing endoscopy and gastric biopsies were studied. For each case with atrophy two controls without atrophy were selected. Differences were evaluated and ROC curves constructed. A serologic profile was produced combining PGI and PGI/PGII ratio. Sensitivity and specificity were calculated. RESULTS: 22 cases and 44 controls were included. Areas under ROC curves were 0.599, 0.546 and 0.534 for PGI, PGII and PGI/PGII ratio, respectively. None of these allowed for discrimination between cases and controls. The serological profile did not reach appropriate sensitivity and specificity. DISCUSSION: This first study of pepsinogen, gastrin and atrophy in Peru showed none of these tests to be useful. Their potential impact in early detection and prevention of prevalent cancer justify further investigation. Recruiting more patients, excluding those previously treated for Helicobacter pylori, and processing independently the antrum and corpus biopsies, could reveal findings not seen in present study.
