Ménétrier disease in an acquired immunodeficiency syndrome patient.

Ménétrier disease is a rare disorder of unknown etiology. An overexpression of TGF-alpha has been proposed to play a role in the pathophysiology. HIV-1 tat gene product has been shown to stimulate TGF-alpha production leading to a positive feedback autocrine loop. The case of a 41-year-old male with AIDS who presented with weight loss, abdominal pain, ascites, edema, nausea, vomiting, and diarrhea is discussed. A computed tomography (CT) scan of the abdomen showed avid enhancement of the stomach mucosa. Magnetic resonance angiography revealed gastric and small bowel distention with diffuse wall thickening. Biopsies of the stomach showed marked foveolar hyperplasia with active inflammation and gland changes consistent with Ménétrier disease

Relationship Between Professional Dental Care in Childhood and Coronary Heart Disease in Adulthood in a Single Urban Dental Clinic

PURPOSE: A growing body of evidence supports an association between coronary heart disease (CHD) and dental diseases, particularly periodontitis (PD). The present study was designed to assess the relationship between childhood dental care and adult CHD in a single community dental clinic. MATERIALS AND METHODS: Consecutive patients (n = 223) at a single urban U.S. dental clinic were asked to complete a questionnaire regarding the details of their childhood and present dental care as well as CHD and PD diagnoses. RESULTS: A significantly greater proportion of patients who reported a lack of prophylactic dental care in childhood also reported a present diagnosis of CHD (54.2% vs 23.6%, P \u3c 0.001). In a multivariate logistic regression model including the traditional CHD risk factors of smoking, family history, age and sex, the relationship between dental care in childhood and reduced CHD remained significant (OR = 0.318, 95% CI = 0.159-0.635, P = 0.001). This association cannot be explained wholly by a mechanism involving the development of PD in patients with poor childhood dental care, as PD was not significantly associated with CHD in the multivariate model (OR = 1.646, 95% CI = 0.836-3.239, P = 0.149). CONCLUSIONS: In our single dental clinic assessment, adequate childhood professional dental prophylactic care was associated with reduced CHD in adulthood, an association independent of traditional risk factors. Further studies are required to better define the magnitude of this association