Under the influence: informing oral health care providers about substance abuse.

Unlabelled: Treating the drug addicted dental patient is different than treating the non-addicted patient due to differences related to the emotional/behavioral/personality issues of the addict, the addict's often poor general health and poor nutrition, ongoing problems of oral hygiene and the effects of drugs on the oral mucosa, gingiva and dentition

Background: Oral health care providers need to be aware of the emerging trends in substance abuse, able to recognize patient's addicted to drugs and to be knowledgeable about the effects of substance abuse to provide the most efficacious treatment to avoid the consequences of contraindicated dental procedures and therapy. This article defines the scope of the problem of drug abuse and provides an overview of commonly abused substances and their effects on health and oral health.

Methods: A review of the literature combined with the authors' extensive experience in the substance abuse field explains parameters of oral health care treatment of the drug addicted individual for patient and provider safety.

Atypical autoerotic death: part II.

Autoerotic fatalities encompass a wide array of means and mechanisms used to attain sexual gratification. The most commonly encountered autoerotic practice, specifically, autoerotic asphyxia, denotes death resulting from failure of a release mechanism of the apparatus designed to attain cerebral hypoxia for heightened arousal. Historically, the majority of victims of autoerotic death are Caucasian males under the age of 30.

Limitations of EBV-PCR monitoring to detect EBV associated post-transplant lymphoproliferative disorder.

Post-transplant lymphoproliferative disorder (PTLD) represents a significant threat to the survival of pediatric transplant recipients. Epstein-Barr (EBV) viral load monitoring using polymerase chain reaction (PCR) has been reported to have a variable sensitively with relatively higher specificity as in an indicator of the development of PTLD. We report two cases of pathologically confirmed PTLD in children who failed to develop sustained increases in their EBV-PCR determined viral loads.

Long-term survival after liver transplantation in children with metabolic disorders.

Background: Liver transplantation for inherited metabolic disorders aims to save the patient's life when the disorder is expected to progress to organ failure, and to cure the underlying metabolic defect.

Methods: We retrospectively analyzed 146 pediatric liver transplants (28 metabolic; 118 non-metabolic) performed between 1986 and 2000.

Results: Twenty-eight transplants were performed in 24 children with metabolic disease (8 females; 16 males; age range 3 months to 17 yr).

Response of elevated Epstein-Barr virus DNA levels to therapeutic changes in pediatric liver transplant patients: 56-month follow up and outcome.

Background: Posttransplant lymphoproliferative disease (PTLD) is a serious complications after liver transplantation. Epstein-Barr virus (EBV) load measured by quantitative competitive polymerase chain reaction (PCR) has been used as an early marker for the development of PTLD and a guide for initiating preemptive therapy. The aim of this study is to report the results of EBV DNA PCR screening in a transplant population and to examine the risk factors for developing elevated EBV DNA PCR and the effect of interventions for reducing EBV DNA levels.