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2.
PLoS One ; 17(4): e0266011, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35390010

RESUMO

OBJECTIVE: Few studies have compared the frequency of hemorrhages after tooth extraction between patients taking direct oral anticoagulants (DOACs) and those taking warfarin or no anticoagulants. Further, the effects of the timing of DOAC administration and tooth extraction on the frequency of post-extraction hemorrhage have not been demonstrated. Therefore, we compared the frequency of post-extraction hemorrhages in patients in these different conditions and examined the effects of the timing of DOAC administration and tooth extraction on the frequency. DESIGN: Prospective multicenter study. SETTING: Eighty-six Japanese hospitals. PARTICIPANTS: In total, 182 teeth extracted from 145 individuals (119 teeth from adult males) receiving dabigatran and 88 teeth from individuals (62 teeth from adult males) receiving rivaroxaban were included. INTERVENTION: Tooth extraction was followed by a 7-day observational period between November 1, 2008 and December 31, 2015. Dabigatran was administered twice daily; rivaroxaban was administered once a day. PRIMARY OUTCOME MEASURE: Hemorrhage after tooth extraction. RESULTS: The frequency of hemorrhage after tooth extraction was 1.65%, 3.41%, and 3.63% in those treated with dabigatran, rivaroxaban, and warfarin, respectively, and 0.39% in those who did not receive anticoagulants. Hemorrhages after tooth extraction were significantly higher in the rivaroxaban group than in patients who did not receive anticoagulants (P = 0.008). These frequencies did not differ significantly in the dabigatran and rivaroxaban groups compared to the warfarin group (P = 0.221 and P = 1.000, respectively). CONCLUSIONS: The frequency of hemorrhaging after tooth extraction appeared to be similar in patients receiving continuous dabigatran or rivaroxaban and in those receiving continuous warfarin.


Assuntos
Fibrilação Atrial , Dabigatrana , Administração Oral , Adulto , Anticoagulantes/efeitos adversos , Fibrilação Atrial/tratamento farmacológico , Estudos Transversais , Dabigatrana/efeitos adversos , Hemorragia/induzido quimicamente , Hemorragia/tratamento farmacológico , Humanos , Masculino , Estudos Prospectivos , Piridonas/uso terapêutico , Rivaroxabana/efeitos adversos , Extração Dentária/efeitos adversos , Varfarina/efeitos adversos
3.
Medical Education ; : 363-366, 2016.
Artigo em Japonês | WPRIM (Pacífico Ocidental) | ID: wpr-379296

RESUMO

<p> The education program in all medical schools in Japan has been studied and analyzed every 2 years since 1974 by the curriculum committee of the Association of Japan Medical Colleges. Based on the most recent analysis in 2015, the marked innovation of medical education, such as an integrated curriculum, active learning, and clinical clerkship, was recognized.</p>

4.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-176669

RESUMO

This review represents the clinical significance of home blood pressure (BP) and its possible practical application. Home BP is highly reproducible and its reproducibility is better than ambulatory BP. According to this feature home BP has a greater prognostic value at least than clinic BP and is extremely effective for the evaluation of drug effects and their duration. The introduction of home BP to the diagnosis and treatment of hypertension facilitates long-term BP control. Home BP is particularly important for the diagnosis and treatment of hypertension in diabetes mellitus, pregnancy, children and renal diseases. Home BP measurements improve the adherence to medications and medical consultations, and are indispensable for diagnosis of white coat hypertension and masked hypertension. Such efficiency of home BP improves medical economy. Home BP can detect minimal charge in BP mediated by medication, and intrinsic and extrinsic stimuli and detect long-term change in BP. Thus, home BP is now indispensable for improvement in the management of hypertension in medical practice as well as for the recognition of hypertension in the general population. Standardization of the measurement procedure may elevate the position of home BP in the practice of diagnosing and treating hypertension.


Assuntos
Criança , Humanos , Gravidez , Pressão Sanguínea , Diabetes Mellitus , Honorários e Preços , Hipertensão , Hipertensão Mascarada , Farmacologia Clínica , Encaminhamento e Consulta , Hipertensão do Jaleco Branco
5.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-133722

RESUMO

We studied 1809 oral cancer patients who visited and were treated in 2002 at the 148 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons, which is composed of 39 dental university hospitals, 44 medical university hospitals, 64 general hospitals, and 1 unknown institution. The patients consisted of 1071 (59.2 %) males and 738 (40.8 %) females (male:female ratio, 1.45:1), who had a mean age of 65.2 years old. The tongue (40.2 %) was the most common site affected, followed by the gingiva (32.7 %), buccal mucosa (10.1 %), and oral floor (9.0 %). There were 6 cases of intraoral multiple cancer. In histopathological examinations, squamous cell carcinoma (88.7 %) was the most common type found, followed by adenoid cystic carcinoma (2.1 %), and mucoepidermoid carcinoma (1.7 %). In addition, non-epithelial tumors comprised 1.8 % , among which malignant melanoma was the most common type. Cases classified as T2N0 were the most common (32.1 %), followed by T1N0 (21.4 %), T4N0 (8.0 %), and T2N1 (7.6 %). Distant metastasis occurred in 17 patients (1.0 %). The sizes of the non-epithelial malignant tumors ranged from 1.0 to 7.0 cm, with a mean size of 3.7 cm.


Assuntos
Feminino , Humanos , Masculino , Povo Asiático , Carcinoma Adenoide Cístico , Carcinoma Mucoepidermoide , Carcinoma de Células Escamosas , Estudos Epidemiológicos , Pisos e Cobertura de Pisos , Gengiva , Hospitais Gerais , Hospitais Universitários , Melanoma , Mucosa Bucal , Neoplasias Bucais , Metástase Neoplásica , Cirurgia Bucal , Língua
6.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-133719

RESUMO

We studied 1809 oral cancer patients who visited and were treated in 2002 at the 148 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons, which is composed of 39 dental university hospitals, 44 medical university hospitals, 64 general hospitals, and 1 unknown institution. The patients consisted of 1071 (59.2 %) males and 738 (40.8 %) females (male:female ratio, 1.45:1), who had a mean age of 65.2 years old. The tongue (40.2 %) was the most common site affected, followed by the gingiva (32.7 %), buccal mucosa (10.1 %), and oral floor (9.0 %). There were 6 cases of intraoral multiple cancer. In histopathological examinations, squamous cell carcinoma (88.7 %) was the most common type found, followed by adenoid cystic carcinoma (2.1 %), and mucoepidermoid carcinoma (1.7 %). In addition, non-epithelial tumors comprised 1.8 % , among which malignant melanoma was the most common type. Cases classified as T2N0 were the most common (32.1 %), followed by T1N0 (21.4 %), T4N0 (8.0 %), and T2N1 (7.6 %). Distant metastasis occurred in 17 patients (1.0 %). The sizes of the non-epithelial malignant tumors ranged from 1.0 to 7.0 cm, with a mean size of 3.7 cm.


Assuntos
Feminino , Humanos , Masculino , Povo Asiático , Carcinoma Adenoide Cístico , Carcinoma Mucoepidermoide , Carcinoma de Células Escamosas , Estudos Epidemiológicos , Pisos e Cobertura de Pisos , Gengiva , Hospitais Gerais , Hospitais Universitários , Melanoma , Mucosa Bucal , Neoplasias Bucais , Metástase Neoplásica , Cirurgia Bucal , Língua
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