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Journal of Perinatal Medicine Oct 2020Objectives The objectives of this study were to quantify the prescription of oral methergin tablets in a busy Women's Hospital, assess the stated indications for such...
Objectives The objectives of this study were to quantify the prescription of oral methergin tablets in a busy Women's Hospital, assess the stated indications for such prescription and highlight the issues and safety profile of Methergin use especially in the postpartum patient. Methods Review of prescription data for oral Methergin and the corresponding annual figures on primary and secondary postpartum hemorrhage. Results Over a period of 5 years, oral Methergin prescriptions for delayed and secondary postpartum hemorrhage constituted less than 1% of the overall prescription in Obstetrics and Gynaecology, which ranged between 1214 and 2085 per year. The numbers were too few to ascertain any relationship with both types of postpartum hemorrhage. Although stated on the relevant Patient Information leaflet, no local or regional guideline on its use exist. Conclusions Specific and random trend monitoring of medications for continuing safety profile, risk benefit issues, or unapproved indication, may help in identifying, preventing and mitigating any medication safety matters. Clinical pharmacists in collaboration with physicians are well placed in conducting such pharmacovigilance activities to improve medication safety.
Topics: Administration, Oral; Adult; Female; Health Services Needs and Demand; Humans; Methylergonovine; Oxytocics; Pharmacovigilance; Postnatal Care; Postpartum Hemorrhage; Practice Guidelines as Topic; Practice Patterns, Physicians'; Pregnancy; Qatar; Risk Assessment; Safety Management
PubMed: 32809964
DOI: 10.1515/jpm-2020-0128 -
Oral Anticoagulation in the Elderly: New Oral Anticoagulants-Innovative Solution for an Old Problem?American Journal of Therapeutics 2019Direct oral anticoagulants emerge as the most innovative and promising drug toward preventing and treating cardiovascular disease, raising great interest among the... (Review)
Review
Direct oral anticoagulants emerge as the most innovative and promising drug toward preventing and treating cardiovascular disease, raising great interest among the scientific community. Numerous studies and meta-analysis generated much data clarifying clinicians' doubts; however, uncertainties remain regarding their use in particular groups such as patients with prosthetic valves, in valvular atrial fibrillation (defined as atrial fibrillation related to mitral rheumatic heart disease or prosthetic heart valves), among the elderly, in paraneoplastic thromboembolism, in pulmonary embolism with hemodynamic compromise, and scarcity of specific antidotes. This review article intends to condense the vast scientific production addressing new oral anticoagulants by focusing on their advantages and disadvantages when used on the elderly.
Topics: Administration, Oral; Age Factors; Aged; Aging; Anticoagulants; Antifibrinolytic Agents; Blood Coagulation; Cardiovascular Diseases; Drug Interactions; Drug Substitution; Hemorrhage; Humans
PubMed: 27574927
DOI: 10.1097/MJT.0000000000000452 -
The Chinese Journal of Dental Research 2018To understand the oral health knowledge, attitude, behaviour and oral health status of Chinese diabetic patients so as to facilitate the development of oral health...
OBJECTIVE
To understand the oral health knowledge, attitude, behaviour and oral health status of Chinese diabetic patients so as to facilitate the development of oral health education programmes for diabetic patients in China.
METHOD
A face-to-face questionnaire was conducted for 1,024 diabetic patients and 8,030 non-diabetic people aged 55 to 74 years old in order to understand their oral health knowledge, attitudes, and behaviour. Oral health examination was implemented including caries, gingival bleeding, dental calculus, periodontal attachment loss, etc. according to the Oral Health Surveys Basic Methods 5th Edition.
RESULTS
Compared with non-diabetic patients, those with diabetes had more oral health knowledge and more positive attitudes. The proportion of people who formed toothbrushing habits was higher in diabetic patients, but that of regular scaling and flossing is as low as that in non-diabetic people. The detection rate of deep periodontal pockets in diabetic patients was higher than that in non-patients, while the caries situation was better than that in non-patients.
CONCLUSION
This study has shown that the oral health knowledge, attitude, behaviour and oral health status of the 55 to 64-year-old diabetic population are not optimistic. There is a great need for a systematic oral health education programme in China. The contradiction between a large number of diabetes patients and limited health resources requires us to give priority to the improvement of oral health behaviours, such as educating patients to develop toothbrushing and flossing habits.
Topics: Aged; Case-Control Studies; China; Dental Calculus; Dental Caries; Dental Devices, Home Care; Diabetes Mellitus; Female; Gingival Hemorrhage; Health Education, Dental; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Oral Health; Oral Hygiene; Toothbrushing
PubMed: 30264043
DOI: 10.3290/j.cjdr.a41085 -
International Journal of Dental Hygiene Aug 2023This study aimed to evaluate the biological and clinical effect of professional toothbrushing on the periodontal health of patients with gingivitis.
OBJECTIVES
This study aimed to evaluate the biological and clinical effect of professional toothbrushing on the periodontal health of patients with gingivitis.
METHODS
We enrolled 21 university students with gingivitis in Jinju City in this study between April 24 and October 28, 2014. A dental hygienist performed a professional toothbrushing routine on the participants twice, once at baseline and after 3 months. Oral examinations were performed at baseline, 3, and 6 months to assess the periodontal health. The patient hygiene performance index, gingival bleeding rate, periodontal pocket depth, amount of gingival sulcus fluid, and number of bacterial colonies in the gingival sulcus (CFU/mL) were evaluated during the oral examination.
RESULTS
The patient hygiene performance index, gingival bleeding rate, pocket depth, amount of gingival sulcus fluid, and CFU/mL within the gingival sulcus significantly decreased after professional toothbrushing (p < 0.05), indicating an improvement in the periodontal health. The patient hygiene performance index, gingival bleeding rate, pocket depth, amount of gingival sulcus fluid, and CFU/mL within the gingival sulcus decreased more among those whose pocket depth was 4-5 mm than among those whose PD was ≤3 mm (p < 0.05).
CONCLUSIONS
Professional toothbrushing improved the periodontal health in patients with gingivitis in respect of both biological and clinical results.
Topics: Humans; Toothbrushing; Dental Plaque; Gingivitis; Oral Hygiene; Periodontal Pocket; Gingival Hemorrhage; Dental Plaque Index
PubMed: 37369915
DOI: 10.1111/idh.12709 -
Medicina Clinica Jan 2021Major bleeding is a common complication of anticoagulant treatment. Risk assessment tools are relevant in the management of patients with atrial fibrillation and venous... (Review)
Review
Major bleeding is a common complication of anticoagulant treatment. Risk assessment tools are relevant in the management of patients with atrial fibrillation and venous thromboembolism. The combination of clinical, biological and genetic markers is incorporated to build predictive scores to help in the decision process about intensity and duration of treatment. The optimal management of bleeding involves the application of predictive scores in combination with anticoagulant reversal strategies.
Topics: Administration, Oral; Anticoagulants; Atrial Fibrillation; Hemorrhage; Humans; Venous Thromboembolism
PubMed: 33218693
DOI: 10.1016/j.medcli.2020.06.065 -
BMC Oral Health Jun 2021Gingivitis is the most prevalent form of periodontal disease in children and adolescents, being strongly associated to some socioeconomic factors and oral health...
BACKGROUND
Gingivitis is the most prevalent form of periodontal disease in children and adolescents, being strongly associated to some socioeconomic factors and oral health behaviours. This study aimed to assess the prevalence of gingivitis and its association with socio-demographic factors and oral health-related behaviours in children aged 12-15 years in Guangdong, Southern China.
METHODS
A total of 7680 children were sampled using an equal-sized, stratified, multistage, random sampling method and clinically examined between December 2015 and April 2016. A questionnaire on socio-demographic factors and oral health-related behaviours related to gingivitis was completed by each of the selected children. Gingival bleeding was recorded using the Community Periodontal Index probe, and children with a gingival bleeding positive score ≥ 10% were defined as having gingivitis. A multivariate logistic regression analysis was performed to assess the association between socio-demographic factors and gingivitis. All statistical tests were performed at a two-sided significance level of 0.05.
RESULTS
The weighted prevalence of gingivitis among 12-15-year-old children was 29.6%, with 22.6% having localised gingivitis and 7.0% having generalised gingivitis. Age differences were observed in the prevalence of gingivitis, whereas urban-rural differences were not. According to the multivariate logistic regression analysis results, factors such as increasing age, being the only child, lack of regular annual dental check-up, and heavy dental calculus were significantly associated with higher prevalence of gingivitis. In addition, the association of gingivitis with these factors was inconsistent among the urban and rural areas.
CONCLUSIONS
Dental calculus and oral health behaviour were found to be important factors for maintaining the gingival health of children aged 12-15 years in Guangdong. Maintaining gingival health in children requires promoting positive oral health behaviours and regular dental prophylaxis.
Topics: Adolescent; Child; China; Cross-Sectional Studies; Dental Calculus; Gingival Hemorrhage; Gingivitis; Humans; Oral Health; Prevalence
PubMed: 34134691
DOI: 10.1186/s12903-021-01666-1 -
Haemophilia : the Official Journal of... Mar 2020Due to the global prevalence of oral disease, tooth extraction is the most common surgical procedure required in general population thus likely to be similarly common in... (Review)
Review
Due to the global prevalence of oral disease, tooth extraction is the most common surgical procedure required in general population thus likely to be similarly common in patients with haemophilia, especially those in older age and those living in countries with restricted resources. There are little or no consensus about optimal level and duration of factor replacement (FRP) therapy required to prevent bleeding complication following surgery and low levels of evidence to inform protocols and guidelines. The goal of this article was to review the literature regarding haematological treatment protocols and to assess their effectiveness in prevention of bleeding complications during and after tooth extractions in people with haemophilia. A total number of 29 articles were identified. Only two of the studies were randomized controlled trials, and meta-analysis was not possible. Significant heterogeneity regarding haematological regimes, dental surgical procedures, disease severity and sample size of published studies which are unable to reliably inform the provision of safe dental surgery was noted. Based on the haematological regimens, all studies were classified into one of three groups: pre- and postoperative FRP or DDAVP, single preoperative FRP or DDAVP, and no FRP treatment. The overall reported bleeding rate in case of both pre- and postoperative FRP and single dose FRP preoperative is similar, 11.9% and 11.4%, respectively, indicating that minimizing the use of clotting factor concentrate is possible if proper local haemostatic measures are provided. Strictly designed prospective studies with higher number of patients are necessary to get firm conclusions about optimal FRP treatment required to prevent bleeding complications during and after oral surgery in patients with haemophilia.
Topics: Consensus; Evidence-Based Medicine; Hemophilia A; Humans; Tooth Extraction
PubMed: 31962377
DOI: 10.1111/hae.13928 -
BMC Oral Health Nov 2014The current oral health status and possible dental risk factors among children in rural Shaanxi Province, western China are unreported. This study aimed to describe the...
BACKGROUND
The current oral health status and possible dental risk factors among children in rural Shaanxi Province, western China are unreported. This study aimed to describe the oral health status and to analyze the possible risk factors for the oral health status in this population.
METHODS
A multi-stage cluster sampling method was used to survey 12- to 15-year-olds and 4- to 6-year-olds in villages in Shaanxi Province. The structured questionnaires were provided to the 12- to 15-year-olds and to the caregivers of the 4- to 6-year-olds to collect information on the subjects' oral health knowledge, attitudes and behavior. A clinical examination was performed to assess dental caries and gingival bleeding (only 12- to 15-year-olds). SPSS 17.0 statistical software was used to analyze the data.
RESULTS
The decayed, missing, filled teeth (DMFT) index scores of 12- to 15-year-olds and 4-to 6-year-olds averaged 0.45 and 3.05, respectively. The caries prevalence was 23.9% in 12- to 15-year-olds and 67% in 4-to 6-year-olds. Additionally, 45.2% of the 12- to 15-year-olds had gingival bleeding and 62.8% had calculus. The oral health knowledge of the subjects was generally poor, whereas they held very positive attitudes toward oral health. A low number of participants reported that they brushed their teeth at least twice daily. Moreover, a statistically significant relationship was found between oral health knowledge scores, tooth brushing frequency and DMFT scores as well as gingival bleeding in the 12- to 15-year-olds. Frequency of sweets consumption was strongly related to dmft scores in the 4- to 6-year-olds.
CONCLUSION
The oral health status, oral health knowledge and behaviors among village children in Shaanxi Province are poor. Oral health education to improve oral health knowledge and to increase the frequency of tooth brushing should be undertaken in the rural schools in western China.
Topics: Adolescent; Attitude to Health; Child; Child, Preschool; China; Cross-Sectional Studies; DMF Index; Dental Calculus; Dental Caries; Dietary Sucrose; Female; Gingival Hemorrhage; Health Behavior; Health Knowledge, Attitudes, Practice; Health Status; Humans; Male; Oral Health; Prevalence; Risk Factors; Rural Health; Rural Population; Toothbrushing
PubMed: 25433658
DOI: 10.1186/1472-6831-14-144 -
CJEM Dec 2022Elderly patients on oral anticoagulation are commonly seen in emergency departments (EDs). Oral anticoagulation, particularly warfarin, is associated with an increased...
INTRODUCTION
Elderly patients on oral anticoagulation are commonly seen in emergency departments (EDs). Oral anticoagulation, particularly warfarin, is associated with an increased risk of intracranial hemorrhage after head trauma. Data on delayed bleeds in anticoagulated patients are limited. The objective of this study was to examine risk of delayed intracranial hemorrhage in patients presenting to the ED with a head injury anticoagulated with warfarin or a direct oral anticoagulant, compared to patients not anticoagulated.
METHODS
Cohort study using administrative data from Ontario of patients ≥ 65 years presenting to the ED with a complaint of head injury between 2016 and 2018. The primary outcome was delayed intracranial hemorrhage, defined as a new ICD-10 code for intracranial hemorrhage within 90 days of the initial ED visit for a head injury where no intracranial hemorrhage was diagnosed. The main exposure variable was oral anticoagulation use, which was a three-level variable (warfarin, direct oral anticoagulants, or no oral anticoagulation). We used multivariable logistic regression to determine the odds of delayed intracranial hemorrhage based on anticoagulation status.
RESULTS
69,321 patients were included: 58,233 (84.0%) had not been prescribed oral anticoagulation, 3081 (4.4%) had a warfarin prescription, and 8007 (11.6%) had a direct oral anticoagulant prescription. Overall, 718 (1.0%) patients had a delayed intracranial hemorrhage within 90 days of ED visit for head injury. Among patients not anticoagulated, 586 (1.0%) had a delayed intracranial hemorrhage, 54 (1.8%) patients on warfarin, and 78 (1.0%) patients on a direct oral anticoagulant had a delayed intracranial hemorrhage. There was an increased odds of delayed intracranial hemorrhage with warfarin use compared with no anticoagulation (OR 1.5, 95% CI 1.1-2.1). There was no association between delayed intracranial hemorrhage and direct oral anticoagulant use compared to no anticoagulation (OR 0.9, 95% CI 0.6-1.1).
CONCLUSIONS
There was an increased odds of delayed intracranial hemorrhage within 90 days in older ED head injured patients prescribed warfarin compared to patients not on anticoagulation. direct oral anticoagulant use was not associated with increased risk of delayed intracranial hemorrhage.
Topics: Humans; Aged; Warfarin; Cohort Studies; Anticoagulants; Intracranial Hemorrhages; Craniocerebral Trauma; Hemorrhage; Emergency Service, Hospital; Retrospective Studies
PubMed: 36242733
DOI: 10.1007/s43678-022-00392-z -
International Dental Journal Jun 2018In recent years, there have been dramatic changes in anti-thrombotic treatment as a result of new anti-thrombotic agents, as well as changes in the indications for their... (Review)
Review
BACKGROUND
In recent years, there have been dramatic changes in anti-thrombotic treatment as a result of new anti-thrombotic agents, as well as changes in the indications for their use. As a consequence, dentists are encountering larger numbers of patients who are undergoing anti-thrombotic treatment and who have increased risk for bleeding. The current paper aims to review the literature regarding up-to-date anti-thrombotic treatment and provide information regarding their implications on dentistry.
METHODS
An online search was performed of the literature published between 2000 and 2016. Articles dealing with evidence-based clinical guidelines for anti-thrombotic treatments, as well as literature reporting the use of anti-thrombotic medications were included. The manuscripts were screened according to their relevance to dentistry as well as their treatment protocol guidelines.
RESULTS
In total, 5,539 publications were identified: 56 of 554 evidence-based clinical guidelines were found that dealt with treatment protocols with anti-thrombotic agents; and 132 of 5,539 articles describe direct anti-thrombotic medications.
CLINICAL IMPLICATIONS
Dental treatment includes a risk for bleeding. As a result of the increasing number of patients taking new-generation anti-thrombotic drugs, dentists must be up to date regarding the implications of such drugs on dental treatment as well as the practical means to achieve haemostasis.
Topics: Clinical Protocols; Dental Care; Fibrinolytic Agents; Hemostatic Techniques; Humans; Oral Hemorrhage; Pharmaceutical Research; Practice Guidelines as Topic
PubMed: 28921533
DOI: 10.1111/idj.12322