Care pathways in forensic mental health services in New Zealand.

On entering forensic mental health services (FMHS) patients progress along forensic care pathways (FCP) that aim to maximise well-being and reduce risk of reoffending. They progress through high-, medium-, and low-secure psychiatric units with changing care and security needs. There is minimal literature examining FCP or their efficacy. This retrospective study describes the characteristics of patients admitted to an acute FMHS and explores the clinical, sociodemographic, and legal factors that influence FCP progression. Most patients were referred from prison (65.1%) and presented with violent index offending (62.4%) and psychotic disorder (80.6%). Young Maori men with psychosis predominated the forensic population. Logistic regression revealed violent index offending and diagnosis were determinants of following FCP, while violent offending and longer duration of stay were predictive of FCP progression. This study found no reduction in re-hospitalisation rates or inpatient length of stay over a three year follow-up for patients that completed the FCP.

Registro de datos sobre riesgo quirúrgico en historias clínicas de Estomatología General Integral / Recording surgical risk data in comprehensive dental care medical records

Introducción: La atención estomatológica integral al paciente de riesgo quirúrgico resulta un reto en la actualidad. El profesional de la estomatología necesita herramientas que permita profundizar en los riesgos quirúrgicos, entre esas herramientas puede contarse la correcta confección de historia clínica. Objetivo: Describir el comportamiento de la confección de historia clínica en los pacientes de riesgo quirúrgico en la Clínica Estomatológica "Salvador Allende". Métodos: Se revisaron 108 historias clínicas de todos los pacientes de riesgo quirúrgico ingresados en la consulta de estomatología general integral en el archivo de la Clínica "Salvador Allende" del municipio Cerro, La Habana, correspondientes a un periodo de tres meses. Resultados: Un 41,6 por ciento de pacientes presentó hipertensión arterial, seguidos de pacientes con dos o más enfermedades (37,0 por ciento). El 56,4 por ciento de las historias clínicas abordó sobre el uso de medicamentos para la enfermedad de base, los restantes acápites tuvieron bajos porcentajes en relación con el completamiento de la información. El 79,6 por ciento de los pacientes de riesgo recibieron tratamiento quirúrgico. Conclusiones: La enfermedad de riesgo más frecuente es la hipertensión arterial seguida por los pacientes con dos o más enfermedades. No se recogen los datos necesarios en la atención del paciente de riesgo quirúrgico y las propuestas plasmadas permitirán realizar cualquier ejercicio de la profesión de manera más eficaz y con menor riesgo(AU)

Introduction: Comprehensive dental care of surgical risk patients is a current challenge. Dental care professionals should have access to tools allowing them to expand their knowledge about possible surgical risks. Appropriately developed medical records are an example of such tools. Objective: To describe the process of development of medical records of surgical risk patients at Salvador Allende dental clinic. Methods: A total 108 medical records were reviewed, corresponding to all the surgical risk patients admitted to the general comprehensive dental care service of Salvador Allende dental clinic in the municipality of Cerro, Havana, in a three months' period. Results: Of the patients studied, 41.6 percent had arterial hypertension, followed by patients with two or more conditions (37.0 percent). It was found that 56.4 percent of the medical records contained information about the use of drugs for the underlying condition. The remaining items exhibited low percentages of data completion. 79.6 percent of the risk patients received surgical treatment. Conclusions: The most common risk condition is arterial hypertension, followed by patients with two or more diseases. The data required for the care of surgical risk patients are not recorded. The proposals put forth will make it possible to perform any professional practice in a more effective manner and with a lower level of risk(AU)

El paciente de riesgo quirúrgico en la carrera de Estomatología / The surgical-risk patient in the Dental Medicine Major

Introducción: La atención estomatológica integral se realiza a través de grupos priorizados. Entre estos se encuentran los pacientes con enfermedades crónicas, que constituyen un riesgo durante los tratamientos estomatológicos quirúrgicos. Por diversas razones, la atención a estos pacientes se dificulta y muchas deficiencias pueden originarse durante el proceso docente. Objetivo: Evaluar los contenidos relacionados con el paciente de riesgo quirúrgico en el plan de estudios D de la carrera de Estomatología. Métodos: Se realizó un análisis de los programas de las asignaturas del plan de estudios vigente. Se revisaron y analizaron documentos como: perfil profesional, modos de actuación, programa de la disciplina integradora y programas de las asignaturas. Se valoraron los contenidos relacionados con el paciente de riesgo quirúrgico, el semestre en que se imparte la asignatura, los objetivos, los temas, el sistema de conocimientos y de habilidades, la denominación del paciente de riesgo quirúrgico y las horas dedicadas en cada programa a este tópico. Se realizaron entrevistas a los profesores, en las que se consideraron los aspectos anteriores. Resultados: Las asignaturas que incorporaron la atención a los pacientes de riesgo quirúrgico correspondieron a la disciplina integradora: Operatoria Clínica, Atención integral a la familia II y Cirugía bucal. El análisis documental realizado y las entrevistas ejecutadas mostraron la existencia de diversos criterios en relación con el paciente que constituye riesgo quirúrgico en las asignaturas abordadas. Conclusiones: Los programas de las asignaturas relacionadas con riesgo quirúrgico presentaron insuficiencias desde el punto de vista didáctico y en ellas no se estudian todos los pacientes de riesgo quirúrgico(AU)

Introduction: Comprehensive dental care is implemented through prioritized groups. Among these are patients with chronic diseases, which constitute a risk during surgical dental treatments. For various reasons, caring for these patients becomes difficult, while many deficiencies can appear during the teaching process. Objective: To assess the contents related to the surgical-risk patient in the D Plan of Studies of the dental medicine major. Methods: An analysis was carried out of the syllabi of the subjects from the current study plan. Documents such as the professional profile, modes of action, the syllabus of the integrative discipline and the syllabi of the programs were reviewed and analyzed. A group of contents were assessed: those related to the surgical-risk patient, the semester in which the subject is taught, the objectives, the topics, the knowledge and skills systems, the name of the surgical-risk patient and the hours allotted to this topic in each syllabus. Interviews were conducted with the professors, in which the above aspects were considered. Results: The subjects that included care for surgical-risk patients belonged to the integrative discipline: Clinical Surgery, Comprehensive Family Care II and Oral Surgery. The document analysis carried out and the interviews conducted showed the existence of various criteria regarding the patient who is at surgical risk in the subjects addressed. Conclusions: The syllabi of the subjects related to surgical risk presented didactic inadequacies, while their study does not include all surgical-risk patients(AU)

Curso optativo de riesgo quirúrgico para estudiantes de pregrado de la carrera de estomatología / Elective course on surgical risk for undergraduate dental medicine students

Introducción: Los pacientes de riesgo quirúrgico presentan enfermedades asociadas que deben considerarse durante el tratamiento estomatológico. Investigaciones realizadas revelan la existencia de deficiencias durante la atención estomatológica a este tipo de paciente y que el tema debe ser reforzado durante el pregrado. Objetivos: Exponer las generalidades del curso optativo de atención estomatológica integral al paciente de riesgo quirúrgico y los criterios emitidos por sus participantes. Métodos: Se realizó una investigación descriptiva de corte pedagógico para exponer las características más importantes del curso. Se tuvieron en cuenta las siguientes variables: temas, objetivos, sistema de conocimientos y de habilidades. Se aplicó la técnica de Positivo, Negativo, Interesante a todos los participantes del curso. Resultados: El curso implementado contó con cinco temas: el primero dedicado a las generalidades y las características particulares en la confección de historia clínica; el segundo y tercero, a las enfermedades de riesgo quirúrgico y los tratamientos estomatológicos; el cuarto, al uso de medicamentos para la enfermedad sistémica y las posibles interacciones; y el quinto, a experiencias clínicas. Los estudiantes aportaron criterios positivos, negativos e interesantes. Conclusiones: El curso diseñado ofrece conocimientos y habilidades al estudiante que no se proporcionan en las asignaturas de pregrado, lo cual permite una mejor atención estomatológica integral a los pacientes de riesgo quirúrgico. Los estudiantes participantes del curso optativo aportaron criterios favorables sobre su estructura, pertinencia y valor científico(AU)

Introduction: Surgical risk patients have associated diseases that must be considered during dental treatment. Some research carried out have revealed the existence of deficiencies during dental care for this type of patients, a reason why the issue must be strengthened during undergraduate studies. Objective: To present the generalities of an elective course of comprehensive dental care for patients at surgical risk and the criteria issued by its participants. Methods: A descriptive research with a pedagogical nature was carried out to expose the most important characteristics of the course. The following variables were taken into account: topics, objectives, knowledge system and skills system. The positive-negative-interesting technique was applied to all the course participants. Results: The implemented course had five topics: the first was dedicated to generalities and particular characteristics in the preparation of a clinical record; the second and third courses, to surgical risk diseases and dental treatments; the fourth course, to the use of drugs for systemic diseases and possible interactions; and the fifth, to clinical experiences. The students provided positive, negative and interesting criteria. Conclusions: The designed course offers knowledge and skills to the student that are not provided in undergraduate subjects, which allows better comprehensive dental care to patients at surgical risk. The students participating in the elective course provided favorable criteria about the course's structure, relevance and scientific value(AU)

Rubinstein-Taybi syndrome: principal oral and dental disorders and literature update

Introduction: Oral and dental (OD) disorders in children with Rubinstein-Taybi syndrome (RTS) are frequent but not well-known by dentists and pediatricians due to the syndrome being extremely rare. Objective: To describe the OD findings observed in a 5-year-old girl with RTS and to update the literature. Clinical case: The patient presented the following OD manifestations: prominent lower lip, narrow mouth opening, narrow and arched palate, history of angular cheilitis, micrognathia, poor lingual motility, plaque and tartar, bleeding from gingival areas due to poor dental prophylaxis, and malocclusion in the form of an anterior open bite. These OD manifestations are seen in more than 40-60% of patients with RTS. Conclusions: Professionals who treat children with RTS should become aware of the advisability of referring them to the pediatric dentist from 1 year of age and performing check-ups every 6 months. Dental management is often difficult so collaboration with anesthesiologists is recommended in order to carry out a safe and effective treatment (AU)

A Short Review on the Model of Government Support Programs for Special Patients in Iran, United Kingdom, United States of America, Italy, and Sweden.

Over the past few decades, caring for special patients has taken center stage in healthcare systems. Moreover, what necessitates conducting a comparative study into the conditions of special patients and designing a suitable model are as follows: high admission rates of these patients in hospitals, continual recurrence of the illness, sky-high costs of treatment and medicine, lack of coordination between the services offered by hospitals and community needs, and severe pressure of special patients on their families. Therefore, the present study aimed to compare the models of government support programs for special patients in Iran, the United Kingdom, the USA, Italy and Sweden through a descriptive-documentary method. The findings revealed that the Ministry of Health and Welfare and the private sector were the major providers of health services to special patients in most of the countries under study. It was also demonstrated that the services offered to special patients are jointly mainly funded by governments, associations, and non-governmental organizations and partially by insurance premiums and so forth. The results also indicated that the bulk of healthcare provision was shouldered by non-governmental sectors and the contribution of charitable people. Finally, it can be concluded that both health-related policies and the health of special patients can be closely honed and monitored through the formation of committees on the health of special patients at the Supreme Council of Health, the establishment of an office for special patients at the Vice-chancellery for Health at the Ministry of Health, Treatment and Medical Education, provision of decentralized services, and financing through taxation and contribution of charitable people and international organizations.

Percepción y conocimientos de los estudiantes sobre la atención estomatológica al paciente con riesgo quirúrgico / Students' perception of and knowledge about the dental care of patients at surgical risk

Introducción: El estomatólogo debe estar preparado para la atención a pacientes con enfermedades crónicas, las cuales constituyen un riesgo para los tratamientos estomatológicos, sobre todo los quirúrgicos. Objetivo: Describir la percepción de la preparación recibida y el nivel de conocimientos de estudiantes de los planes C y D sobre la atención estomatológica a los pacientes con riesgo quirúrgico. Métodos: Se realizó un estudio descriptivo mediante encuestas de percepción sobre la preparación recibida y el examen de conocimientos a estudiantes de cuarto año, 81 del Plan C (2010-2011) y 85 del Plan D (2017-2018). Resultados: La percepción con respecto a la preparación recibida fue regular en el 63 por ciento de los estudiantes del Plan C y en el 52 por ciento de los del Plan D. El 32,9 por ciento de los estudiantes del Plan D la consideraron entre buena y excelente, mientras que solo el 25,9 por ciento del Plan C la valoró en estas categorías. El nivel de conocimientos resultó bajo, con el 72,8 por ciento de los alumnos del Plan C y el 71,7 por ciento de los del Plan D. El 11,7 por ciento del Plan D y el 8,6 por ciento en el C obtuvieron la categoría de alto. Conclusiones: Predominó la categoría de regular en la percepción sobre la preparación recibida en ambos grupos, aunque casi la mitad de los estudiantes del plan D la calificaron entre excelente y buena. En relación con el nivel de conocimientos, la categoría de bajo primó en los estudiantes de ambos planes, pero los estudiantes del Plan D lograron mejores resultados(AU)

Introduction: Dentists should be prepared to treat patients with chronic diseases representing a risk to dental procedures, particularly surgical ones. Objective: Describe the perception of the training received and the knowledge acquired by students attending Curricula C and D as concerns the dental care of patients at surgical risk. Methods: A descriptive study was conducted based on perception surveys about the training received and the knowledge acquired by fourth year students: 81 attending Curriculum C (2010-2011) and 85 attending Curriculum D (2017-2018). Results: Perception of the training received was fair in 63 percent of the Curriculum C students and 52 percent of the Curriculum D students. 32.9 percent of the Curriculum D students ranked it as between good and excellent, while only 25.9 percent of the Curriculum C students awarded such scores. The level of knowledge was seen as low by 72.8 percent of the Curriculum C students and 71.7 percent of the Curriculum D students. It was ranked high by 11.7 percent of the students in Curriculum D and 8.6 percent of the students in Curriculum C. Conclusions: A predominance was found of the category of fair in the perception of the training received by both groups, though almost half of the Curriculum D students ranked it as between excellent and good. As to level of knowledge, the category of low prevailed among students from both curricula, but those from Curriculum D awarded better scores(AU)

[Strategies of using the new antiepileptic drugs for epilepsy in adults]. / Az új antiepileptikumok alkalmazásának szempontjai felnottkori epilepsziákban.

The new antiepileptic drugs have not changed the basic pharmacological treatment principles of epilepsy, but they have given greater choice in focal and in generalized epilepsies as well. The new drugs are not necessarily more effective than traditional drugs, but they have favourable pharmacokinetic characteristics, fewer interactions and better adverse effect profile in the acute and chronic phase of the treatment. They generally show a lower teratogenicity risk than the standard antiepileptics, although carbamazepine, one of the standard drugs can be used and zonisamide, a new one must be avoid in pregnancy. Due to characteristics mentioned above they are not only effective as add-on therapy, but in monotherapy as well. On the basis of the international and national recommendation lamotrigine and levetiracetam belong to the first line antiepileptics. The favourable tolerability of the new antiepileptics may improve the patient's compliance and adherence to the given treatment. The low teratogenicity makes them especially suitable for the treatment of women of childbearing age. The new antiepileptic drugs can succesfully used for the treatment of special patients' groups as for the post stroke, poszttraumatic epilepsies, for the epilepsies accompanied with brain tumours as well as for epilepsies in the elderly. The new drugs are advantageous for the treatment of such patients who have psychiatric symptoms or signs of cognitive decline and high risk of these symptoms respectively.

Research progress on antiviral therapy in severe hepatic impairment patients and special population with HCV infection / 中华临床感染病杂志

The research and development of direct-acting antiviral agents (DAAs) for hepatitis C achieved significant results in the last decade .DAAs is highly effective in treatment of hepatitic C patients with convenience and safety , and the sustained virological response of DAAs is over 90％, which will greatly contribute to achieving the WHO's goal of eliminating hepatitis C by 2030.The European Association for the Study of the Liver (EASL), American Association for the Study of Liver Diseases (AASLD) and WHO all updated guidelines for diagnosis and treatment of hepatitis C in 2018, which will play a positive role for the management of hepatitis C globally .This article reviews the related guidelines and literature on prevention and treatment of hepatitis C , and summarizes the advantages of antiviral therapy for severe hepatic impairment patients and special population with HCV infection .

Intraoperative nursing coordination during removing upper gastrointestinal foreign bodies in special patients by endoscopy / 现代临床护理

Objective To summarize the nursing experience during removing the upper gastrointestinal foreign bodies in special patients by painless endoscopy. Method Retrospective analysis was done to investigate the clinical records on endoscopy for removing the upper gastrointestinal foreign bodies in 69 special patients. Result The foreign bodies in 67 patients were removed by endoscopy successfully, without severe complications such as bleeding and perforation; one patient was removed with duodenum lateral telescope; one patient turned for sugery . Conclusion Sufficient preoperative preparation and skilled surgical nursing cooperation are promising for the successful removal of upper gastrointestinal foreign bodies in special patients.

Achieving the best bowel preparation for colonoscopy.

Bowel preparation is a core issue in colonoscopy, as it is closely related to the quality of the procedure. Patients often find that bowel preparation is the most unpleasant part of the examination. It is widely accepted that the quality of cleansing must be excellent to facilitate detecting neoplastic lesions. In spite of its importance and potential implications, until recently, bowel preparation has not been the subject of much study. The most commonly used agents are high-volume polyethylene glycol (PEG) electrolyte solution and sodium phosphate. There has been some confusion, even in published meta-analyses, regarding which of the two agents provides better cleansing. It is clear now that both PEG and sodium phosphate are effective when administered with proper timing. Consequently, the timing of administration is recognized as one of the central factors to the quality of cleansing. The bowel preparation agent should be administered, at least in part, a few hours in advance of the colonoscopy. Several low volume agents are available, and either new or modified schedules with PEG that usually improve tolerance. Certain adjuvants can also be used to reduce the volume of PEG, or to improve the efficacy of other agents. Other factors apart from the choice of agent can improve the quality of bowel cleansing. For instance, the effect of diet before colonoscopy has not been completely clarified, but an exclusively liquid diet is probably not required, and a low-fiber diet may be preferable because it improves patient satisfaction and the quality of the procedure. Some patients, such as diabetics and persons with heart or kidney disease, require modified procedures and certain precautions. Bowel preparation for pediatric patients is also reviewed here. In such cases, PEG remains the most commonly used agent. As detecting neoplasia is not the main objective with these patients, less intensive preparation may suffice. Special considerations must be made for patients with inflammatory bowel disease, including safety and diagnostic issues, so that the most adequate agent is chosen. Identifying neoplasia is one of the main objectives of colonoscopy with these patients, and the target lesions are often almost invisible with white light endoscopy. Therefore excellent quality preparation is required to find these lesions and to apply advanced methods such as chromoendoscopy. Bowel preparation for patients with lower gastrointestinal bleeding represents a challenge, and the strategies available are also reviewed here.

Dental findings in children with West syndrome.

INTRODUCTION: West syndrome (WS) is a rare age-related syndrome of epilepsy. The oral manifestations of WS are still unknown. OBJECTIVE: To assess the oral health status and oral findings of a sample of WS children being treated at a specialized referral center. MATERIAL AND METHODS: The dental record forms of 528 children were searched at this center. Eight of the children had been diagnosed with WS. RESULTS: The ages of those with WS ranged from 6 months to 13 years, and 62% of them were male. All of them were taking antiepileptic medication. Twenty-five percent of them had tongue interposition between the dental arches and a deep palate. The mean DMFT was .25 and dmft was 1.12. CONCLUSION: Patients with WS seem to have low caries experience, can have a deep palate, and may have their tongue positioned between the arches or on the incisive papilla.

Prader-Willi Syndrome: clinical case report

Introduction: Prader-Willi syndrome (PWS) is a neurobehavioral genetic disease whose cause is failure on chromosome 15. It is considered the primary genetic cause of obesity, since it is characterized by hyperphagia. Although the scientific literature will produce articles on Prader-Willi syndrome, few reported oral conditions of these patients. Objective: This study aimed to describe the oral health status of a patient diagnosed with PWS. Case report: A boy aged 10 years-old, leucoderma, attended the Discipline of Dentistry for Special Care Patients, Pontifical Catholic University of Paraná (PUCPR), with all the inherent PWS characteristics such as hyperphagia and obesity. Clinical, radiographic and laboratory tests were performed to verify the oral health conditions which showed the presence of biofilm accumulation, gingivitis and a high DMFT index. It was necessary to adequate oral environment through extractions, restorations, and prophylactic therapy. Conclusion: Considering the information obtained, it was concluded that the motivation to maintain oral health should be constant for this patient and involve family, since hyperphagia, which is a determinant for obesity, decisively contributes to the evolution of oral diseases.

Atención odontológica a pacientes especiales: una realidad creciente / Special dental care patients: a growing reality

En la actualidad más del 10% de la población mundial presenta algún tipo de discapacidad y tres cuartas partes de ella no reciben ningún tipo de atención odontológica a pesar de la mayor prevalencia que tienen de padecer enfermedades bucodentales. Debido a que la higiene bucal es deficiente por las alteraciones físicas y psíquicas que impiden realizar un cepillado eficiente, a las dietas que suelen ser blandas y pegajosas, a la alta ingesta de fármacos y a las pocas visitas de control odontológico, la incidencia de caries, enfermedad periodontal y maloclusiones es mayor que en el resto de la población. Existen diversas alterativas para la atención de los pacientes especiales que van desde la aplicación de técnicas de modificación de conducta, pasando por la restricción física hasta el uso de terapéuticas farmacológicas. En conclusión, es importante cambiar los paradigmas de la Odontología actual y tener una capacitación adecuada que permita mejorar la salud bucal de estos pacientes.

Actually around 10% of the world's population live with a disability and ¾ of them did not received odontological attention instead of the high prevalence of oral and dental pathologies that they have. Oral hygiene is deficient, diets are highly cariogenic, the use of medicaments is frequent and the odontological control did not happen as frequently as it must be. For all reasons the incidence of cavities, periodontal diseases and malocclusions is more common that in the rest of population. There are many options to treat patients with special needs like psychological techniques, physical restriction and pharmacological alternatives. In conclusion, is very important to change paradigms in actual dentistry to increase oral health in these patients.

Prevalence of periodontal disease in special needs patients at APAE-PF/RS and the effect of local prevention programs

Aim: The objective of this study was to assess the prevalence and severity of periodontal disease and the efficiency of oral health programs in patients with special needs under treatment at APAE/ PF-RS (Association of Parents and Friends of Special Needs Individuals - Passo Fundo/RS). Methods: The periodontal condition of 109 patients was evaluated through clinical examination by two undergraduate students calibrated for the Periodontal Screening and Recording (PSR) index. The data collected were analyzed by SPSS 15.0 for Windows focusing on qualitative research. A descriptive analysis of data (percentile, frequency, mean and standard deviation) was performed, as well as statistical analysis by the chi-square at 5% significance level, and Pearson’s t-test to verify the correlation of the variables age, gender, handicap level and PSR index. Results: Age was a significant factor for PSR1, PSR2, PSR4 and PSR5, where younger patients showed better periodontal health than older ones; however, gender and handicap level did not show significant differences when correlated with the PSR. The patients presented prevalence of periodontal health in the majority of sextants, followed by gingivitis. Few patients showed more severe degrees of periodontal disease. Conclusions: This study demonstrated that the patients had acceptable oral hygiene, and low prevalence of gingivitis and periodontitis, suggesting that the program of prevention and dental care adopted at the facility was efficient and may represent a model for periodontal health care for patients in other institutions and towns.

Tratamento odontológico em pacientes com comprometimento cardiovascular / Dental treatment in patients with cardiovascular disease

Introdução: A correta avaliação de pacientes com comprometimento cardiovascular baseia-se numa minuciosa anamnese e no conhecimento prévio das principais desordens coronarianas e suas seqüelas. Objetivo: Este artigo revisou conceitos e características de diversas doenças coronarianas, como cardiopatia isquêmica, angina do peito, insuficiência cardíaca congestiva, arritmia e bradicardia. Revisão da literatura e conclusão: Complicações como o infarto do miocárdio e a endocardite bacteriana foram descritas com enfoque nos procedimentos clínicos odontológicos. O manejo dessas informações é importante na determinação do risco cardíaco dos pacientes, a fim de classificá-lo como elevado, moderado ou mínimo. O profissional de odontologia deve planejar as consultas clínicas de acordo com o risco individual preestabelecido. Consultas de curta duração e a limitação dos níveis de estresse e ansiedade, com uso de medicamentos antiansiolíticos e sedação complementar, podem ser importantes para um trans e pósoperatório sem complicações. Os procedimentos emergenciais, nos casos em que as alterações coronarianas ocorrem durante o procedimento clínico, foram também discutidos.

Introduction: The correct evaluation of patients with cardiovascular disease is based on a careful anamnesis and on the previous knowledge of the main coronary diseases and its sequels. Objective: This article revised the concepts and characteristics of diverse heart illnesses as the ischemic cardiopathy, chest angina, congestive cardiac insufficiency, arrhythmia and bradycardia. Literature review and conclusion: Complications like myocardium infarct and bacterial endocarditis were described focusing the dental clinical procedures. The handling of this information is important during the determination of the cardiac risk of each patient, classifying as high, moderate, or minimum risk. Dental professionals must plan the clinical appointments according to preestablished patient´s risk. Short duration appointments and the limitation of the stress and anxiety levels with the use of anti-anxiolytic medicines and complementary sedation can be important for a transoperative and postoperative without complications. The urgent procedures that occurred during the clinical trial in patients with coronary disease were also discussed.