26
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Lustig JP, Zagury A, Reisin LH, Neder A. Thrombolytic therapy for acute myocardial infarction after oral surgery. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1993; 75:547-8. [PMID: 8488017 DOI: 10.1016/0030-4220(93)90220-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Two cases of mild-to-moderate bleeding after thrombolytic streptokinase therapy are presented, and the treatment modalities are discussed. To the best of our knowledge, these are the first two cases reported in the medical and dental literature.
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27
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Camacho-Vázquez C, Silva Melchor L, Ortigosa J, Fernández-Lozano I, de Artaza M. Dysphagia as a complication of oral anticoagulation therapy. Chest 1993; 103:322. [PMID: 8417922 DOI: 10.1378/chest.103.1.322a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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28
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Sapone A, Basaglia R, Biagi GL. [Drug-induced changes in the teeth and mouth. II]. LA CLINICA TERAPEUTICA 1992; 140:575-83. [PMID: 1638857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
As in the previous paper the unwanted effects of drugs or chemicals in the orofacial region are described. The authors take into consideration alterations such as gingival hyperplasia and hypertrophy, discoloration of the oral mucosa and teeth, oral ulceration and stomatitis, cervical lymphadenopathy, drug induced blood dyscrasias, bleeding caused by aspirin and other drugs, and cleft lip and cleft palate.
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29
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Hosokawa S, Oyamaguchi A, Yoshida O. Clinical evaluation of nafamstat mesilate (FUT 175). A new anticoagulant for plasmapheresis. ASAIO J 1992; 38:59-60. [PMID: 1554918 DOI: 10.1097/00002480-199201000-00014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Nafamstat mesilate (FUT), a new anticoagulant with a short half-life of biologic activity, was used in six patients who had a history of bleeding (two from the eye, two nasally, and two orally) during plasmapheresis (PP) due to overdosage of heparin. FUT (1.2 mg/kg/hr) was injected into the arterial blood line during PP. Prothrombin time (PT), activated partial thromboplastin time (APTT), bleeding time (BT), and complete blood count (CBC) were measured before and after PP. Values of PT (17 +/- 1.4 sec) after treatment were nearly 1.5 times the levels of PT (12.5 +/- 0.8 sec) before treatment. Levels of APTT after PP (70.4 +/- 4.1 sec) were nearly double the values of APTT before PP (36.8 +/- 2.6 sec). There were no significant differences between red blood cell (RBC), hemoglobin (Hgb), or platelet counts before and after PP. No patient developed thrombosis, hemorrhage, or other side effect during PP. In conclusion, the optimal dosage of FUT was 1.2 mg/kg body weight/hr during PP. FUT is recommended as a useful anticoagulant during PP treatment of patients with an increased risk of bleeding.
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30
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Poskitt L. Angina bullosa haemorrhagica: associated steroid inhaler use. THE NEW ZEALAND MEDICAL JOURNAL 1991; 104:522. [PMID: 1758667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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31
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Abstract
Reported is the case of a patient with vertebrobasilar artery ischemia who received tissue plasminogen activator with resulting hemorrhage into the tongue and nearly exsanguinating hemorrhage from a branch of the lingual artery. Suggestions for immediate management of the hemorrhage as well as prevention are presented. As the use of thrombolytic agents increases and the list of their indications expands, unusual life-threatening hemorrhagic problems other than gastrointestinal or intracranial bleeding will be seen, and management decisions may be life saving.
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32
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Barak S, Shaked Y, Bar ZG, Samra Y. Drug-induced post-surgical haemorrhage resulting from trimethoprim-sulphamethoxazole. A case report. Int J Oral Maxillofac Surg 1989; 18:206-7. [PMID: 2507668 DOI: 10.1016/s0901-5027(89)80053-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A case of life-endangering post-operative haemorrhage due to thrombocytopenia resulting from administration of trimethoprim-sulphamethoxazole is described. Withdrawal of the drug led to complete recovery. This side effect should be kept in mind, especially in patients scheduled for surgical intervention. As thrombocytopenia may develop insidiously and gradually, it is highly recommended to perform full blood tests immediately prior to surgery and repeat them in the post-operative period.
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33
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Cohen AF, Warman SP. Upper airway obstruction secondary to warfarin-induced sublingual hematoma. ARCHIVES OF OTOLARYNGOLOGY--HEAD & NECK SURGERY 1989; 115:718-20. [PMID: 2655669 DOI: 10.1001/archotol.1989.01860300072020] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Sublingual hematoma is a rare but potentially fatal complication of oral warfarin sodium. Less than ten cases are reported in the English-language literature with only two of these appearing in the otolaryngologic literature. Spontaneous bleeding into the sublingual and submaxillary spaces creates a "pseudo-Ludwig's" phenomenon with elevation of the tongue and floor of mouth and subsequent airway compromise. Two new cases, along with a review of the literature are presented. Management is directed at prompt control of the airway and reversal of the coagulopathy. Sore throat is a uniform, early complaint that should be taken seriously in any patient receiving oral anticoagulation therapy.
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34
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High AS, Main DM. 'Angina bullosa haemorrhagica: a complication of long-term steroid inhaler use'. Br Dent J 1988; 165:357. [PMID: 3265065 DOI: 10.1038/sj.bdj.4806645] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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35
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Porter K, Porter SR, Scully C. 'Angina bullosa haemorrhagica: a complication of long-term steroid inhaler use'. Br Dent J 1988; 165:279. [PMID: 3264178 DOI: 10.1038/sj.bdj.4806603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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36
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Naylor GD, Terezhalmy GT. Oral complications of cancer chemotherapy: prevention and management. SPECIAL CARE IN DENTISTRY 1988; 8:150-6. [PMID: 2978774 DOI: 10.1111/j.1754-4505.1988.tb00722.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Cancer chemotherapy is used to destroy rapidly proliferating cells. However, normal cells with high mitotic indexes are also affected by chemotherapy, particularly those in the oral and gastrointestinal mucosa and the hemopoietic system. Ultimately, this may lead to certain oral complications of cancer chemotherapy such as mucositis, infection, hemorrhage, xerostomia, and neurologic and nutritional disorders. The prevention and management of these oral complications that may result from the chemotherapeutic management of cancer are discussed here.
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37
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Wahlin YB, Matsson L. Oral mucosal lesions in patients with acute leukemia and related disorders during cytotoxic therapy. SCANDINAVIAN JOURNAL OF DENTAL RESEARCH 1988; 96:128-36. [PMID: 3258443 DOI: 10.1111/j.1600-0722.1988.tb01419.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study reports the presence of oral mucosal lesions in 26 patients with acute leukemia during the initial weeks of treatment (induction period). For comparison, three groups of patients without malignant disorders (acute disorders, long-term hospitalization, antibiotic treatment) were included. All patients were treated at the University Hospital of Umeå, Sweden. During the period of hospitalization hemorrhages were seen in 14 of the 26 patients with leukemia. No specific location was found. A correlation between presence of hemorrhages and low platelet counts was noted. Eighteen of the patients revealed ulcerations during the period. Ulcerations were predominantly found on the buccal mucosa, the lips, and the tongue. A tendency to an increase in the number and severity of ulcers was noted during the period of induction therapy. A correlation between presence of ulcers and low granulocyte counts was found. Candidiasis-like changes were seen in eight of the patients with leukemia. Compared with the patients with leukemia the patients in the reference groups showed a low prevalence of oral mucosal lesions.
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38
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Dreizen S, McCredie KB, Bodey GP, Keating MJ. Quantitative analysis of the oral complications of antileukemia chemotherapy. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1986; 62:650-3. [PMID: 3491969 DOI: 10.1016/0030-4220(86)90258-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Almost half of 1500 patients (46.9%) treated for acute leukemia developed chemotherapy-related oral infections, oral mucositis, and/or oral hemorrhages at some time during their hospitalization. The frequencies of 34.2% for infections, 16.3% for mucositis, and 13.6% for hemorrhages were each within 1.3% to 3.1% of those previously reported from this institution for smaller groups of patients. The stomatologic disruptions reflected the cytotoxic, myelosuppressive, and immunosuppressive properties of the antileukemia drugs. Because there are as yet no alternatives to the use of potent stomatotoxic drugs for the treatment of acute leukemia, it is essential that their side effects be kept to a minimum by early recognition and appropriate treatment.
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Duong TC, Burtch GD, Shatney CH. Upper-airway obstruction as a complication of oral anticoagulation therapy. Crit Care Med 1986; 14:830-1. [PMID: 3488874 DOI: 10.1097/00003246-198609000-00016] [Citation(s) in RCA: 30] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We treated a patient for warfarin-induced sublingual hematoma causing upper-airway obstruction. This complication of oral anticoagulation therapy is rare; only three other cases have been reported in the English literature. All reported patients developed acute respiratory embarrassment necessitating emergency airway establishment. Sublingual hematomas usually resolve spontaneously, and surgical drainage is rarely necessary.
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40
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Gardin M, Simondi R, Teramo MG, Gallamini A. [Thrombocytopathy due to aspirin. A case report]. MINERVA STOMATOLOGICA 1986; 35:839-44. [PMID: 3491283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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41
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Ogiuchi H, Ando T, Tanaka M, Kuwasawa T, Sangu Y, Abe H, Kawanishi I. Clinical reports on dental extraction from patients undergoing oral anticoagulant therapy. THE BULLETIN OF TOKYO DENTAL COLLEGE 1985; 26:205-12. [PMID: 3880496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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43
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Steidler NE. Aspirin and post-surgical haemorrhage. AUSTRALIAN ORTHODONTIC JOURNAL 1985; 9:245. [PMID: 3879802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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44
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Wright JM. Oral manifestations of drug reactions. Dent Clin North Am 1984; 28:529-43. [PMID: 6235135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The clinical manifestations of oral reactions to the more commonly prescribed drugs have been presented. These reactions include the following conditions: stomatitis, ulceration and necrosis, opportunistic infections, hemorrhage, gingival hyperplasia, pigmentation, altered salivary function, and altered taste sensation. A patient who complains of any of these signs and symptoms should be thoroughly questioned regarding medication. If an offending drug can be identified, its alteration or elimination, in consultation with the prescribing clinician, will often result in resolution of the clinical problem.
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45
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Dreizen S, McCredie KB, Keating MJ. Chemotherapy-associated oral hemorrhages in adults with acute leukemia. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1984; 57:494-8. [PMID: 6610154 DOI: 10.1016/0030-4220(84)90306-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The frequency, nature, and management of chemotherapy-associated oral hemorrhages were studied in 1,093 adult inpatients undergoing treatment for acute leukemia or the blastic phase of chronic leukemia. Of this number, 163 (14.9%) manifested gross bleeding from the mouth during the course of treatment. The most common oral bleeding sites were the lips, tongue, and gingiva. Thrombocytopenia was the underlying cause in 88% of the cases, disseminated intravascular coagulation in 6%, and combinations of thrombocytopenia and hypofibrinogenemia and of thrombocytopenia and vitamin K deficiency in 5.5% and 0.6%, respectively. The vast majority of the patients with mouth bleeding had platelet counts below 40,000/mm3. Approximately 50% had indirect evidence of a coagulation factor deficiency in the blood. The oral hemorrhages were best managed by transfusions of HLA-compatible fresh platelets and fresh frozen plasma, together with topically applied clot-promoting agents, until hemostatic control was restored.
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46
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Bhatt AP. Case of the month. Persistent gingival bleeding. JOURNAL OF THE INDIAN DENTAL ASSOCIATION 1983; 55:inside front cover. [PMID: 6607291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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47
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Toth BB, Frame RT. Dental oncology: the management of disease and treatment-related oral/dental complications associated with chemotherapy. Curr Probl Cancer 1983; 7:7-35. [PMID: 6602033 DOI: 10.1016/s0147-0272(83)80011-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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48
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Abstract
During a clinical trial for evaluating the antiplaque effect of two flavoured chlorhexidine rinses, the observation was made that bleeding after gentle massage of the gingival margin occurred more often after chemical than after mechanical oral hygiene measures. In order to ascertain the validity of this unexpected observation, the same dental students participated in a repetition of the trial 18 months later. The results of the two trials indicate that gingival bleeding after gentle massage of the margin with the side of a periodontal probe actually occurs more frequently after rinsing twice daily with a 0.2% aqueous chlorhexidine solution for 1 week than after meticulous mechanical oral hygiene measures during an equally long time period. The average frequency of bleeding, in per cent of all examined gingival units, ranged from 1.3% after mechanical cleaning of the teeth to 5.4% after rinsing with chlorhexidine for 1 week. Neither the frequency of bleeding nor the difference between mechanical and chemical plaque control were considered to be of clinical significance. Further microbiological and histological studies are being conducted in an attempt to clarify the reason for the observed bleeding tendency.
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49
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Matvias FM. Oral complications in the immuno- and myelosuppressed patient. JOURNAL OF THE MISSOURI DENTAL ASSOCIATION 1981; 61:16, 18-20. [PMID: 6973636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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50
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Lee M, Berger HW, Granada MG. Acute upper airway obstruction. Sodium warfarin-induced hemorrhage into the base of the tongue and epiglottis. Chest 1980; 77:454-5. [PMID: 6965638 DOI: 10.1378/chest.77.3.454] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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