ABSTRACT
Histoplasmosis is an endemic mycosis. Histoplasma capsulatum, and duboisiï are the pathogenic agents in humans. The disease is reported as endemic in more than 30 countries. Three clinical forms are distinguished; acute, chronic and disseminated. Oral lesions may take on different clinical aspects which are often associated with disseminated histoplasmosis. Disseminated histoplasmosis is frequently diagnosed in immunocompromised hosts. High risk of mortality dictates rapid diagnosis and treatment.
Subject(s)
Histoplasmosis/pathology , Mouth Diseases/microbiology , AIDS-Related Opportunistic Infections/microbiology , Acute Disease , Antifungal Agents/therapeutic use , Chronic Disease , Endemic Diseases , Histoplasmosis/diagnosis , Histoplasmosis/drug therapy , Humans , Immunocompromised Host , Mouth Diseases/diagnosis , Mouth Diseases/drug therapyABSTRACT
INTRODUCTION: We present a prospective clinical study on use of tranexamic acid mouthwashes in patients taking oral anticoagulants and who have to undergo minor ambulatory oral surgery, without modifying their anticoagulant therapy. MATERIAL AND METHODS: Forty patients (18 men and 22 females) aged from 42 to 81 were studied from April 2000 to December 2002. All patients were under the same anticoagulant, vitamin K antagonist, (Sintrom) for different pathologies. The anticoagulant therapy was not modified neither before nor after surgery. More than 70 oral procedures were carried out under local anesthesia. The International Normalized Ratio of prothrombin time (INR) was<=4. Tranexamic acid 5% (Exacyl) mouthwashes were prescribed during and after surgery. RESULTS: All the patients were followed up during 2 weeks after surgery. There were no postoperative bleedings. DISCUSSION: Use of tranexamic acid mouthwashes under a specific protocol is an efficient, reliable and economic method in preventing postoperative bleeding in patients under oral anticoagulant therapy.
Subject(s)
Anticoagulants/administration & dosage , Antifibrinolytic Agents/administration & dosage , Dental Care for Chronically Ill/methods , Oral Hemorrhage/prevention & control , Oral Surgical Procedures , Postoperative Hemorrhage/prevention & control , Tranexamic Acid/administration & dosage , Acenocoumarol/administration & dosage , Administration, Oral , Adult , Aged , Aged, 80 and over , Cardiovascular Diseases , Female , Humans , International Normalized Ratio , Male , Middle Aged , Mouthwashes/therapeutic use , Prospective StudiesABSTRACT
Any general practitioner can be confronted with bleeding complication, the most frequent complication after a dental extraction. As with all complications prevention of bleeding is the best way to manage this problem. The patient's physician plays a crucial role in detection of bleeding risk factors. The goal of this paper is to review the different steps of hemostasis as well as the most frequent anomalies associated to each step. The treatment will be discussed but it's more specific to specialists in odontostomatology.
