scholarly journals Tooth Extraction in Patients on Oral Anticoagulants: Prospective Study Conducted in 108 Brazilian Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Claudio Maranhão Pereira ◽  
Patrícia Freire Gasparetto ◽  
Danilo Santos Carneiro ◽  
Maria Elvira P. Corrêa ◽  
Cármino Antônio Souza
Keyword(s):  
Acetic Acid ◽  
Tooth Extraction ◽  
Dental Treatment ◽  
Oral Anticoagulants ◽  
Postoperative Bleeding ◽  
International Normalized Ratio ◽  
Hemorrhagic Complications ◽  
Anticoagulant Drug ◽  
Dental Offices ◽  
And Control

Introduction. Dental treatment performed in patients receiving continuous oral anticoagulant drug therapy is becoming increasingly common in dental offices. For these patients it is imperative to carry out careful anamnesis, as well as a multiprofessional clinical evaluation with regard to the risk and control of hemorrhagic or thromboembolic episodes. Objectives and Material and Methods. The aim is to evaluate postextraction hemorrhagic or thromboembolic episodes in patients who have been on anticoagulant medications for an uninterrupted period of 48 months. Results. Among the 108 patients evaluated, 215 extractions were performed in which there was only one case of postoperative bleeding. Warfarin was used by 98 patients; Warfarin associated with salicylic acetic acid by 9 patients and salicylic acetic acid in only 1 patient. As regards the serologic tests performed, International Normalized Ratio (INR) ranged from 0.8 to 4.9, with a mean of 3.15. Conclusion. Extractions in patients on oral anticoagulants must be performed in the least traumatic manner possible. It is not necessary to stop anticoagulant therapy to perform extractions. Local hemostasis techniques, such as obliterative sutures alone are sufficient to prevent hemorrhagic complications.

scholarly journals CIRURGIAS ORAIS EM PACIENTES EM USO DE VARFARINA: REVISÃO DE LITERATURA

2016 ◽  
Vol 7 (2) ◽  
Author(s):  
Marlus Da Silva Pedrosa ◽  
Jézlia Chris Da Silva Galdino ◽  
Flávia Ennes Dourado Ferro ◽  
José Guilherme Férrer Pompeu ◽  
Marcia Socorro da Costa Borba
Keyword(s):  
Drug Therapy ◽  
Anticoagulant Therapy ◽  
Dental Treatment ◽  
Oral Surgery ◽  
Thromboembolic Events ◽  
Risk Of Bleeding ◽  
Dental Procedures ◽  
Therapy Interruption ◽  
Anticoagulant Drug ◽  
Dental Offices

Introduction: Dental treatment performed in patients on anticoagulant drug therapy is becoming increasingly common in dental offices. Thus, questions concerning thromboembolic and bleeding risks relative to invasive dental procedures, are frequently raised. Aim: To review the scientific evidences regarding anticoagulant therapy interruption in patients taking warfarin undergoing oral surgeries. Methods: It was carried out a literature review in the electronic SciELO, PubMed, Lilacs and Oviatt Library databases from January to March of 2016, using as descriptors: Anticoagulants, Warfarin, Oral Surgery, and Oral Hemorrhage. Results and Discussion: Anticoagulant therapy is extremely important in patients at high risk for development of thromboembolic events. Most studies show that the risk of bleeding oral surgery in patients taking warfarin is relatively insignificant and it can be controlled by simple measures such as hemostasis. Conclusion: It is highly recommended to not interrupt anticoagulant in minor oral surgeries.

scholarly journals A gyógyszer indukálta vérzékeny betegek fogorvosi, szájsebészeti ellátása: a 2015-ös hazai szakmai ajánlás alkalmazása és értékelése

2016 ◽  
Vol 157 (43) ◽  
pp. 1722-1728
Author(s):  
Dénes Lukács ◽  
Nóra Stáczer ◽  
László Vajta ◽  
Lajos Olasz ◽  
Árpád Joób-Fancsaly ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Vitamin K ◽  
Dental Treatment ◽  
Oral Anticoagulant Therapy ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Postoperative Bleeding ◽  
Bleeding Risk ◽  
Night Duty ◽  
Anticoagulated Patients

Introduction: In 2015 a new Hungarian guideline was published regarding dental treatment and management of anticoagulated patients in agreement of the Hungarian Association of Oral and Maxillofacial Surgeons and the Dental Implantology Association of Hungarian Dentists. Aim: The aim of the authors was to evaluate the efficiency and safety of local hemostatic measures recommended by the guideline in anticoagulated patients. Method: In these patients, postoperative bleeding episodes were examined after dental and oral surgical treatments, retrospectively. Results: Overall 263 bleeding risk cases were treated; 138 patients with vitamin K antagonists, 97 patients with antiplatelet therapy and 6 patients with novel oral anticoagulants. Six patients (2.3%) had minor postoperative bleeding after the “one hour control”, while one patient needed a night duty support (0.5%). In contrast, 86 patients who were treated in rural practices neglecting the guideline attended the night duty with postoperative bleeding (3 patients treated with vitamin K antagonists, 24 patients taking low molecular weight heparin, 30 patients receiving antiplatelet therapy and one patient on novel oral anticoagulant therapy. Conclusions: The Hungarian guideline can be applied safely, without increasing the risk of postoperative bleeding, however, rural dental practices are frequently unprepared for these treatments. Orv. hetil., 2016, 157(43), 1722–1728.

scholarly journals SOCIO-PSYCHOLOGICAL ASPECTS IN THE PREVENTION OF DENTAL DISEASES

2019 ◽  
Vol 72 (5) ◽  
pp. 769-772
Author(s):  
Yevhen Ya. Kostenko ◽  
Volodymyr S. Melnyk ◽  
Liudmyla F. Horzov
Keyword(s):  
Medical Care ◽  
Dental Treatment ◽  
Main Role ◽  
Preventive Dental Care ◽  
Medical Institutions ◽  
Gradual Evolution ◽  
Prophylactic Measures ◽  
Dental Diseases ◽  
Dental Offices ◽  
And Control

Introduction: Measures to prevent dental diseases are included in the list of medical care provided by dentists. Modern socio-economic transformations, including in health care, have contributed to the gradual evolution of the patient from the recipient of medical care to the consumer of services. The aim: To study the position of patients regarding the need and effectiveness of preventive dental care. Materials and methods: Study was conducted among 310 patients who were admitted in various municipal and state medical institutions, dental clinics and private dental offices in Uzhhorod. The average age of respondents is 26 years. The survey was conducted using questionnaires. Results: 90% of respondents are willing to pay for dental treatment based on the use of innovative technologies; 64% of people refer to paid services aesthetic therapeutic treatment; 87% of patients agree to pay for orthopedic treatment and 48% - for surgical intervention. Only 16% of respondents consider additional professional hygiene services and ready to pay for it themselves. Survey data show that 43.2% of patients give a doctor the main role in the treatment process. 42.8% of respondents need medical help in the form of advice or counseling for a decision on treatment. 14% of patients prefer to choose their own medical care and control the treatment. Conclusions: Dental prophylactic measures that are implemented in the practice of regulating social and labor relations, the presence of relationships between the physician and the patient develop by socio-psychological laws.

scholarly journals Tooth extraction in patients on chronic anticoagulant treatment – preliminary results of a clinical prospective study

2015 ◽  
Vol 61 (4) ◽  
pp. 285-291
Author(s):  
Rareş C. Roman ◽  
◽  
Andreea Miron ◽  
Horaţiu Rotaru ◽  
Mădălina-Ana Văleanu ◽  
...  
Keyword(s):  
Experimental Study ◽  
High Risk ◽  
Prospective Study ◽  
Tooth Extraction ◽  
Oral Anticoagulants ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Special Focus ◽  
International Literature ◽  
Anticoagulant Treatment

Patients under anticoagulant treatment which needs dental extractions have a significant high risk of postoperative bleeding, in consequence they need either hospitalization or ambulatory postextractional monitoring. The objective of this study was while using Surgicel® as a socket local hemostat for extractions at patients under anticoagulants to prove his efficacy during a clinical prospective experimental study. We followed three groups of patients under anticoagulant treatment with single or multiple dental extractions: one group under oral anticoagulants (warfarin) and socket meshing with Surgicel®, one group under i.v. anticoagulants (heparin) and one control group under antithrombotics. Many parameters were observed and studied with special focus on postextractional hemorrhage. Results were statistically analyzed and they were compared with the latest findings on international literature. The study conclusions suggest using Surgicel® as viable intraalveolar hemostat which can reduce many postoperative bleeding accidents and avoid thrombotic risks associated with suppression of oral anticoagulant or heparin treatment.

Multi-Center Study of Thromboplastin Calibration Precision – Influence of Reagent Species, Composition, and International Sensitivity Index (ISI)

1993 ◽  
Vol 69 (01) ◽  
pp. 035-040 ◽  
Author(s):  
A M H P van den Besselaar ◽  
R M Bertina
Keyword(s):  
Oral Anticoagulants ◽  
International Normalized Ratio ◽  
The Other ◽  
World Health ◽  
Rabbit Brain ◽  
Sensitivity Index ◽  
Bovine Plasma ◽  
Significant Difference ◽  
The Mean ◽  
International Sensitivity Index

SummaryFour thromboplastin reagents were tested by 18 laboratories in Europe, North-America, and Australasia, according to a detailed protocol. One thromboplastin was the International Reference Preparation for ox brain thromboplastin combined with adsorbed bovine plasma (coded OBT/79), and the second was a certified reference material for rabbit brain thromboplastin, plain (coded CRM 149R). The other two thromboplastin reagents were another rabbit plain brain thromboplastin (RP) with a lower ISI than CRM 149R and a rabbit brain thromboplastin combined with adsorbed bovine plasma (RC). Calibration of the latter two reagents was performed according to methods recommended by the World Health Organization (W. H. O.).The purpose of this study was to answer the following questions: 1) Is the calibration of the RC reagent more precise against the bovine/combined (OBT/79) than against the rabbit/plain reagent (CRM 149R)? 2) Is the precision of calibration influenced by the magnitude of the International Sensitivity Index (ISI)?The lowest inter-laboratory variation of ISI was observed in the calibration of the rabbit/plain reagent (RP) against the other rabbit/plain reagent (CRM 149R) (CV 1.6%). The highest interlaboratory variation was obtained in the calibration of rabbit/plain (RP) against bovine/combined (OBT/79) (CV 5.1%). In the calibration of the rabbit/combined (RC) reagent, there was no difference in precision between OBT/79 (CV 4.3%) and CRM 149R (CV 4.2%). Furthermore, there was no significant difference in the precision of the ISI of RC obtained with CRM 149R (ISI = 1.343) and the rabbit/plain (RP) reagent with ISI = 1.14. In conclusion, the calibration of RC could be performed with similar precision with either OBT/79 or CRM 149R, or RP.The mean ISI values calculated with OBT/79 and CRM 149R were practically identical, indicating that there is no bias in the ISI of these reference preparations and that these reference preparations have been stable since their original calibration studies in 1979 and 1987, respectively.International Normalized Ratio (INR) equivalents were calculated for a lyophilized control plasma derived from patients treated with oral anticoagulants. There were small but significant differences in the mean INR equivalents between the bovine and rabbit thromboplastins. There were no differences in the interlaboratory variation of the INR equivalents, when the four thromboplastins were compared.

The use of dilute acetic acid for butyl acetate production in a reactive distillation: Simulation and control studies

2008 ◽  
Vol 25 (6) ◽  
pp. 1252-1266 ◽  
Author(s):  
Amornchai Arpornwichanop ◽  
Chantarawadee Wiwittanaporn ◽  
Suthida Authayanun ◽  
Suttichai Assabumrungrat
Keyword(s):  
Acetic Acid ◽  
Butyl Acetate ◽  
Reactive Distillation ◽  
Acetate Production ◽  
Simulation And Control ◽  
Distillation Simulation ◽  
And Control

Life-Threatening Non-Allergic Drug Hypersensitivity Reaction as a Very Rare Side Effect of Rivaroxaban Administration in the Netherlands

2021 ◽  
pp. 153857442110047
Author(s):  
Nadia A. G. Hakkenbrak ◽  
Maarten Truijers
Keyword(s):  
The Netherlands ◽  
Hypersensitivity Reaction ◽  
Anaphylactic Reaction ◽  
Side Effect ◽  
Drug Hypersensitivity ◽  
Oral Anticoagulants ◽  
Clinical Signs ◽  
Hemorrhagic Complications ◽  
Drug Hypersensitivity Reaction ◽  
Life Threatening

Background: Anticoagulant therapy is indicated for the prevention and treatment of thromboembolic disease. Direct oral anticoagulants (DOACs) are frequently prescribed and Rivaroxaban is the most frequently administered DOAC in the Netherlands. Most side effects relate to hemorrhagic complications, however, also non-hemorrhagic side effect may be potentially life threatening. Case presentation: A 74-year-old man presented at the emergency department with a ruptured infrarenal abdominal aortic aneurysm for which open aneurysm repair was performed. Postoperatively, the patient developed neurological deficit, respiratory and circulatory failure following rivaroxaban administration, initiated for atrial fibrillation. Even though, the clinical signs resembled an anaphylactic reaction, the skin-prick test was negative and complications most likely resulted from a non-allergic drug hypersensitivity reaction. Conclusion: This case report shows that non-allergic drug hypersensitivity reactions may mimic an anaphylactic reaction and can be potentially life threatening. In addition, severe non-hemorrhagic complications after rivaroxaban administration do occur and should be considered in case of acute clinical deterioration.

Levosimendan administration is not associated with increased risk of bleeding and blood transfusion requirement in patients undergoing off-pump coronary artery bypass grafting: a retrospective study from single center

Perfusion ◽  
2021 ◽  
pp. 026765912110490
Author(s):  
Li-hong Wang ◽  
Xiao-hong Wang ◽  
Jie-chao Tan ◽  
Li-xian He ◽  
Run-qiao Fu ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Transfusion Requirement ◽  
Artery Bypass ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Chest Drainage ◽  
Off Pump ◽  
Blood Transfusion Requirement ◽  
Pump Coronary Artery Bypass ◽  
And Control

Background: Levosimendan (LEVO) is a positive inotropic drug which could increase myocardial contractility and reduce the mortality rate in cardiac surgical patients. However, Whether LEVO is associated with postoperative bleeding and blood transfusion in cardiac surgical patients is controversial. Therefore, the current study was designed to investigate the impact of LEVO administration on bleeding and blood transfusion requirement in off-pump coronary artery bypass grafting (OPCAB) patients. Methods: In a retrospective analysis, a total of 292 patients, aged 40–87 years, undergoing elective OPCAB between January 2019 and July 2019, were divided into LEVO group ( n = 151) and Control group ( n = 141). Patients in LEVO group continuously received LEVO at a rate of 0.1–0.2 μg kg−1 min−1 after anesthesia induction until 24 hours after OPCAB or patients in Control group received no LEVO. The primary outcome was postoperative chest drainage volume. The secondary outcomes were reoperation for postoperative bleeding, transfusion requirement of red blood cells (RBCs), fresh frozen plasma (FFP) and platelet concentrate (PC), etc. Comparisons of two groups were performed with the Student’s t-test or Wilcoxon-Mann-Whitney test. Results: There was no significant difference with respect to chest drainage volume ((956.29 ± 555.45) ml vs (1003.19 ± 572.25) ml, p = 0.478) and the incidence of reoperation for postoperative bleeding (1.32% vs 1.42%, p = 0.945) between LEVO group and Control group. The transfusion incidence and volume of allogeneic RBCs, FFP, and PC were comparable between two groups. Conclusions: LEVO administration was neither associated with more postoperative blood loss nor increased allogeneic blood transfusion requirement in OPCAB patients.

scholarly journals Changes in Prescribing Antithrombotic Therapy in Patients with Atrial Fibrillation in the Multidisciplinary Hospital in Volgograd from 2012 to 2020

2022 ◽  
Vol 17 (6) ◽  
pp. 831-836
Author(s):  
A. S. Gerasimenko ◽  
O. V. Shatalova ◽  
V. S. Gorbatenko ◽  
V. I. Petrov
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Practice ◽  
Clinical Guidelines ◽  
Antithrombotic Therapy ◽  
Heart Valves ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
International Normalized Ratio ◽  
Prosthetic Heart Valves ◽  
Discharge From Hospital

Aim. To study the frequency of prescribing antithrombotic agents in patients with non-valvular atrial fibrillation (AF) in real clinical practice, to evaluate changes of prescriptions from 2012 till 2020.Material and methods. The medical records of inpatients (Form 003/y) with the diagnosis AF, hospitalized in the cardiological department were analyzed. According to the inclusion criteria, the patients were over 18 years of age, established diagnosis of non-valvular AF. There were two exclusion criteria: congenital and acquired valvular heart disease and prosthetic heart valves. In retrospective analysis we have included 263 case histories in 2012, 502 ones in 2016 and 524 in 2020. CHA2DS2-VASc score was used for individual stroke risk assessment in AF. The rational use of the antithrombotic therapy was evaluated according with current clinical practice guidelines at analyzing moment.Results. During period of observation the frequency of antiplatelet therapy significantly decreased from 25,5% to 5,5% (р<0.001), decreased the frequency of administration of warfarin from 71,9% to 18,3% (р<0.001). The frequency of use of direct oral anticoagulants increased in 2020 compared to 2016 (р<0.001). For patients with a high risk of stroke anticoagulant therapy was administered in 71.8% of cases in 2012, 88.5% in 2016 and 92.5% in 2020. Before discharge from hospital majority of patients (72%) achieved a desired minimum international normalized ratio (INR) from 2.0 to 3.0 in 2012. In 2016 and 2020 an only 33% and 40.6% of patients achieved INR (2.0-3.0).Conclusion. Doctors have become more committed to following clinical guidelines during the period of the investigation. In 2020 antithrombotic therapy for atrial fibrillation was suitable according to current clinical guidelines.

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