Evaluating periodontal conditions in patients with von Willebrand?s disease in Hospital Universitario de Maracaibo (University Hospital, Maracaibo) -Venezuela

Objective: To evaluate the periodontal conditions of patients with von Willebrand?s Disease (vWD) who went for dental examination in the ?Area of attention to patients with systemic disease? of the University Hospital in Maracaibo, Venezuela. Design of the Study: 40 patients (28 female and 12 male), with ages ranging from 10 to 72 years, who regularly attended dental control, were evaluated along with a control group of patients with no hemorrhagic alterations. Periodontal conditions were evaluated using the Löe and Silness Gingival Index (GI) and Greene and Vermillon?s Simplified Oral Hygiene Index (SOHI). The results were analyzed using averages, Standard Deviation, Student?s T-test and the Chi² test, with P<0.0005. Results: 92.5% of the patients had Type 1 vWD and 7.5% had Type 2 or 3. Periodontal Indices: GI (0.70±0.40, slight) and SOHI (1,70±0,80, acceptable). Comparison with the control group showed that there were statistically significant differences in the SOHI (P = 0.02). Conclusions: Periodontal conditions in patients with vWD regularly attending for dental control were within acceptable parameters. Education of the patient with regard to prevention and opportune treatment is of utmost importance, thereby avoiding the oral hemorrhagic complications produced by the periodontal disease. Of equal importance is multidisciplinary teamwork

MANEJO ODONTOLOGICO DEL PACIENTE CON TERAPIA ANTITROMBOTICA

El presente manuscrito tiene como objetivo proporcionar una revisi&oacute;n bibliogr&aacute;fica del manejo odontol&oacute;gico del paciente que recibe terapia antitromb&oacute;tica, debido a que las personas con enfermedad cardiovascular frecuentemente reciben este tipo de terapia y constituyen una amplia poblaci&oacute;n en Venezuela, y junto a la alta prevalencia de caries y enfermedad periodontal, es necesario que los odont&oacute;logos y especialistas est&eacute;n actualizados sobre el manejo de estos pacientes ya que, el tratamiento quir&uacute;rgico y no quir&uacute;rgico de las afecciones bucales pueden desencadenar complicaciones hemorr&aacute;gicas y la suspensi&oacute;n del medicamento puede producir la aparici&oacute;n de un fen&oacute;meno tromb&oacute;tico, por otro lado, la terap&eacute;utica farmacol&oacute;gica empleada com&uacute;nmente en odontolog&iacute;a puede interactuar con el tratamiento m&eacute;dico y provocar complicaciones; para el manejo de estos pacientes, es importante utilizar los agentes hemost&aacute;ticos locales para evitar y controlar el sangrado intraoperatorio y postoperatorio.Palabras claves:&nbsp;Manejo Odontol&oacute;gico, Terapia Antitromb&oacute;tica, Enfermedad Bucal, Enfermedad Cardiovascular.DENTAL MANAGEMENT OF PATIENT WITH ANTITHROMBOTIC THERAPY&nbsp;ABSTRACTThe objective of the present work is to give information related to the dental management of patient receiving antithrombotic therapy, since people with heart disease frequently receive this kind of therapy, and they range a wide population in Venezuela , in addition to the high prevalence of cavities and periodontal disease ; therefore, it is necessary the specialists and dentist to be updated on the management of those patients, because the surgical and non surgical dental treatment may lead to hemorrhagic complications and on one hand, the withdrawal of medication may cause the onset of a thrombotic phenomenon, on the other hand, the pharmacological therapy commonly used in dentistry may interact to the medical treatment and cause complications; for managing those patients, it is important to use the haemostatic agents in order to avoid and control the local bleeding.KEY WORDS:&nbsp;Dental management , antithrombotic therapy, dental disease, heart disease

MANIFESTACIONES BUCALES EN PACIENTES VIH POSITIVOS Y SU RELACION CON VALORES DE LINFOCITOS CD4

Objetivo: Identificar las manifestaciones bucales en pacientes VIH + y establecer la asociaci&oacute;n con el contaje de linfocitos T CD4. Material y M&eacute;todo: Se estudiaron 96 pacientes VIH +, atendidos en la consulta del Servicio de Odontolog&iacute;a del Hospital Universitario de Maracaibo, en el Occidente de Venezuela. . En cada paciente se realiz&oacute; examen cl&iacute;nico bucal y se investigaron los valores de CD4 Resultados: El 87,5% fueron varones; la edad promedio fue de 33,97&plusmn;8,82 a&ntilde;os. Las lesiones bucales se presentaron en el 65,62% de los pacientes, de los cuales el 60,42% estaban bajo tratamiento antirretroviral. Se observ&oacute; que los pacientes con manifestaciones bucales ten&iacute;an valores de CD4 m&aacute;s bajos que los que no la presentaron; adem&aacute;s al comparar los CD4 de los pacientes con y sin manifestaci&oacute;n bucal que recib&iacute;an tratamiento, se encontraron que los primeros mostraron valores m&aacute;s bajos que los segundos (P&lt;0.05). Conclusiones: Los pacientes con VIH con lesiones bucales presentaron valores de CD4 menores a los pacientes VIH + sin lesiones bucales, independientemente del tratamiento antirretroviral.Abstract:Objective: To identify the oral manifestation in HIV+ patients and to establish the association with the CD4 cells. Material and Method: It have been studied 96 HIV+ patients, attended in the consulting room of the Odontology Service in the Universitary Hospital of Maracaibo. In each patient it was made an oral examination and the CD4 values were taken. Results: The 87.5% were male, the average age was 33.97&plusmn; 8.82 years. The oral manifestation were present in the 65.62% of the patients, 60.42% were under medical treatment. It was observed that the patients with oral manifestations had lower values of CD4 cells than the ones that didn't have them; in adittion when the number of CD4 cells of the patients with and without oral manifestations under medical treatment were compared, it was founded that the first ones showed lower values than the second ones (P&lt;0.05). Conclusion: The patients with HIV with oral manifestations presented lower CD4 values than the HIV patients without oral manifestations independently of the antiretroviral treatment

MANIFESTACIONES BUCALES EN PACIENTES VIH POSITIVOS Y SU RELACION CON VALORES DE LINFOCITOS CD4

Objetivo: Identificar las manifestaciones bucales en pacientes VIH + y establecer la asociaci&oacute;n con el contaje de linfocitos T CD4. Material y M&eacute;todo: Se estudiaron 96 pacientes VIH +, atendidos en la consulta del Servicio de Odontolog&iacute;a del Hospital Universitario de Maracaibo, en el Occidente de Venezuela. . En cada paciente se realiz&oacute; examen cl&iacute;nico bucal y se investigaron los valores de CD4 Resultados: El 87,5% fueron varones; la edad promedio fue de 33,97&plusmn;8,82 a&ntilde;os. Las lesiones bucales se presentaron en el 65,62% de los pacientes, de los cuales el 60,42% estaban bajo tratamiento antirretroviral. Se observ&oacute; que los pacientes con manifestaciones bucales ten&iacute;an valores de CD4 m&aacute;s bajos que los que no la presentaron; adem&aacute;s al comparar los CD4 de los pacientes con y sin manifestaci&oacute;n bucal que recib&iacute;an tratamiento, se encontraron que los primeros mostraron valores m&aacute;s bajos que los segundos (P&lt;0.05). Conclusiones: Los pacientes con VIH con lesiones bucales presentaron valores de CD4 menores a los pacientes VIH + sin lesiones bucales, independientemente del tratamiento antirretroviral.Abstract:Objective: To identify the oral manifestation in HIV+ patients and to establish the association with the CD4 cells. Material and Method: It have been studied 96 HIV+ patients, attended in the consulting room of the Odontology Service in the Universitary Hospital of Maracaibo. In each patient it was made an oral examination and the CD4 values were taken. Results: The 87.5% were male, the average age was 33.97&plusmn; 8.82 years. The oral manifestation were present in the 65.62% of the patients, 60.42% were under medical treatment. It was observed that the patients with oral manifestations had lower values of CD4 cells than the ones that didn't have them; in adittion when the number of CD4 cells of the patients with and without oral manifestations under medical treatment were compared, it was founded that the first ones showed lower values than the second ones (P&lt;0.05). Conclusion: The patients with HIV with oral manifestations presented lower CD4 values than the HIV patients without oral manifestations independently of the antiretroviral treatment