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Sin M, Edwards D, Currie C, Corbett I. Prevalence of medical emergency events in primary dental care within the UK. Br Dent J 2023; 235:721-726. [PMID: 37945869 PMCID: PMC10635819 DOI: 10.1038/s41415-023-6444-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/01/2023] [Accepted: 06/19/2023] [Indexed: 11/12/2023]
Abstract
Introduction Dental professionals have an ethical and legal obligation to diagnose and manage medical emergencies which may occur in primary dental care.Aims and objectives To investigate the prevalence of medical emergencies in UK primary dental care and explore the medical emergency training needs of UK primary dental care professionals.Design and setting Cross-sectional survey, targeting dentists, dental hygienists and dental therapists across the UK working within primary dental care.Materials and methods An online survey was distributed via dental society mailing lists, social media groups and a dental conference. The questionnaire consisted of participants demographics and training in, prevalence of and confidence surrounding medical emergencies.Results Respondents (n = 400) were dentists (55.8%), dental hygienists/therapists (38.8%) and specialists (5.5%). Most participants received basic life support training (62%) in 2019, before COVID-19. The most common medical emergencies were syncope, non-specific collapse and hypoglycaemia, being encountered every 1.59, 1.64 and 8.26 years, respectively. The preferred method for medical emergency training was practical based, with more training in administering emergency drugs and equipment identified as a training need.Conclusion Dental professionals will encounter medical emergencies in primary dental care every 1-2 years and are therefore not uncommon.
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Affiliation(s)
- Melissa Sin
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, UK
| | - David Edwards
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, UK.
| | - Charlotte Currie
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, UK
| | - Ian Corbett
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, UK
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Awawdeh M, Alanzi AM, Alhasoun M, Babtain A, Alshahrani N, Alhamdan A, Almutairi N, Oteir A, Almhdawi K. A Cross-Sectional Study Investigating the Knowledge and Attitude of Health Professions Students in Saudi Arabia: Are They Ready for Cardiopulmonary Resuscitation? Cureus 2023; 15:e43048. [PMID: 37554372 PMCID: PMC10404914 DOI: 10.7759/cureus.43048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION Cardiopulmonary resuscitation (CPR) training is important for students of health professions to learn and be prepared to perform. Colleges have a responsibility to provide adequate training for their students to ensure that they are ready and confident to deal with life-threatening situations. However, studies have shown that some graduates and practitioners lack sufficient knowledge in performing CPR. The aim of this study is to assess the knowledge of health professions students in the Kingdom of Saudi Arabia (KSA) who have started clinical practice. Methodology: This cross-sectional study was conducted in February 2022 and included health professions students in all academic years, including interns and residents, across colleges of King Saud bin Abdulaziz University for Health Sciences, Riyadh, KSA. The study questionnaire consisted of three sections: attitudes, knowledge, and demographics. The attitudes section included 11 questions, while the knowledge section included 10. The demographic section included university level, Grade Point Average (GPA), CPR training status, willingness to learn CPR, witnessing CPR, and family history of cardiac disease. Statistical analysis was conducted using chi-squared tests, t-tests, two-sample proportion tests, ANOVA, and bivariate correlation analyses. RESULTS The mean age of the participants was 21.2 (±1.9) years. Participants had a mean knowledge score of 5.1 (±1.8) out of 10 potential points. Also, the participants had a total attitude score of 42.7 (±6.2) out of 55 potential points. CONCLUSION The study highlights the importance of CPR training for healthcare providers and the need for ongoing training to maintain knowledge and skills. The results suggest that attitudes towards providing CPR may be influenced by cultural beliefs and fear of liability or disease transmission. Higher participant GPA and positive attitudes towards chest compressions and CPR training were found to be associated with increased knowledge.
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Affiliation(s)
- Mohammed Awawdeh
- Preventive Dental Science, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdullah M Alanzi
- Dentistry, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Meshal Alhasoun
- Dentistry, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdulilah Babtain
- Dentistry, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Nasser Alshahrani
- Dentistry, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Ahmed Alhamdan
- Dentistry, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Naif Almutairi
- Dentistry, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Alaa Oteir
- Allied Medical Sciences, Jordan University of Science and Technology, Irbid, JOR
| | - Khader Almhdawi
- Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, JOR
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Kammerhofer G, Vegh D, Bányai D, Végh Á, Joob-Fancsaly A, Hermann P, Geczi Z, Hegedus T, Somogyi KS, Bencze B, Biczó Z, Juhász DH, Zaborszky P, Ujpál M, Vaszilkó MT, Németh Z. Association between Hyperglycemia and Medication-Related Osteonecrosis of the Jaw (MRONJ). J Clin Med 2023; 12:jcm12082976. [PMID: 37109314 PMCID: PMC10144577 DOI: 10.3390/jcm12082976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/12/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. The current study aimed to evaluate the associations between hyperglycemia and the development of medication-related osteonecrosis of the jaw. METHODS Our research group investigated data collected between 1 January 2019 and 31 December 2020. A total of 260 patients were selected from the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University. Fasting glucose data were used and included in the study. RESULTS Approximately 40% of the necrosis group and 21% of the control group presented with hyperglycemia. There was a significant association between hyperglycemia and MRONJ (p < 0.05, p = 0.003). Vascular anomaly and immune dysfunction caused by hyperglycemia can lead to necrosis after tooth extraction. Necrosis is more common in the mandible (75.0%) and in the case of parenteral antiresorptive treatment (intravenous Zoledronate and subcutaneous Denosumab). Hyperglycemia is a more relevant risk factor than bad oral habits (26.7%). CONCLUSIONS Ischemia is a complication of abnormal glucose levels, a possible risk factor for necrosis development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis after invasive dental or oral surgical interventions.
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Affiliation(s)
- Gabor Kammerhofer
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
| | - Daniel Vegh
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Dorottya Bányai
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Ádám Végh
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Oral Diagnostics, Semmelweis University, 1088 Budapest, Hungary
| | - Arpad Joob-Fancsaly
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
| | - Peter Hermann
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Zoltan Geczi
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Tamas Hegedus
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Kata Sara Somogyi
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Bulcsú Bencze
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, 1088 Budapest, Hungary
| | - Zita Biczó
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
| | - Donát Huba Juhász
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Faculty of Dentistry, Semmelweis University, 1088 Budapest, Hungary
| | - Péter Zaborszky
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
- Faculty of Dentistry, Semmelweis University, 1088 Budapest, Hungary
| | - Márta Ujpál
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
| | - Mihály Tamás Vaszilkó
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
| | - Zsolt Németh
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088 Budapest, Hungary
- Diabetes-Dental Working Group, Semmelweis University, 1088 Budapest, Hungary
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D’Orto B, Polizzi E, Nagni M, Tetè G, Capparè P. Full Arch Implant-Prosthetic Rehabilitation in Patients with Type I Diabetes Mellitus: Retrospective Clinical Study with 10 Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811735. [PMID: 36142007 PMCID: PMC9517153 DOI: 10.3390/ijerph191811735] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/05/2022] [Accepted: 09/11/2022] [Indexed: 05/08/2023]
Abstract
The aim of this retrospective clinical study was to evaluate and compare implant survival, marginal bone loss, and clinical and prosthetic complications in healthy patients and patients with type I diabetes undergoing full arch implant-prosthetic rehabilitation. A total of 47 patients needing total fixed rehabilitation of one or both arches were enrolled for this study. Based on the absence of any systemic diseases (Group A) or the presence of type I diabetes (Group B), the sample was divided into two groups. According to the grade of bone atrophy in the posterior region, patients received full arch rehabilitation (of one or both jaws) with 6 axial implants or, if the residual posterior bone height was insufficient, All-on-Four rehabilitation and a total 236 dental implants were placed. Follow-up visits were performed 1 week after surgery, at 3 and 6 months and then once a year for the next 10 years. No statistically significant differences between groups were recorded about implant survival rates, marginal bone loss, or clinical and prosthetic complications. However, concerning complications, post-surgical bleeding and wound infection were recorded in Group A more than in Group B. In cases of compensated diabetes compensation, implant placement could be considered a safe procedure.
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Affiliation(s)
- Bianca D’Orto
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Elisabetta Polizzi
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
- Center for Oral Hygiene and Prevention, Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Matteo Nagni
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Giulia Tetè
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Paolo Capparè
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
- Correspondence:
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Agani Z, Ahmedi J, Ademi Abdyli R, Prekazi Loxha M, Hamiti‐Krasniqi V, Rexhepi A, Stubljar D. The changes in levels of blood cortisol, glucose, and oxygen saturation in type 2 diabetic patients during tooth extraction. Clin Exp Dent Res 2022; 8:1449-1455. [PMID: 35909305 PMCID: PMC9760155 DOI: 10.1002/cre2.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/10/2022] [Accepted: 07/18/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The extraction of a tooth exacerbates the stress in diabetic patients leading to diabetic complications so the aim was to evaluate the changes in blood cortisol, glucose, and oxygen saturation in type 2 diabetic patients during tooth extraction to pay special attention during a routine surgical procedure. MATERIALS AND METHODS The research included 40 patients with type 2 diabetes with indications of tooth extraction. They were divided into two subgroups by 20 participants and split according to local anesthesia (lidocaine with additional adrenaline or lidocaine only). Cortisol, blood sugar, blood pressure, arterial pulse, and blood oxygen saturation were measured. Patients were also evaluated for their sensitivity to pain through the Visual Analog Scale (VAS). RESULTS Cortisol and glucose levels scientifically increased throughout the procedure. Meanwhile, systolic, and diastolic blood pressure and saturation showed no difference between the measurements during and after tooth extraction (p = .280; p = .090; p = .590, respectively). Most patients (60.0%) felt no pain during/after the procedure. None of the subjects was feeling more pain than 30 points by VAS. The comparison between groups receiving lidocaine showed no statistical differences when adding adrenaline to lidocaine. Evaluation of pain by VAS showed that more patients felt pain when they were receiving lidocaine without adrenaline. CONCLUSIONS Diabetic patients require a more cautious approach when undergoing teeth extractions despite it being a routine procedure.
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Affiliation(s)
- Zana Agani
- Department of Oral SurgeryUniversity of PrishtinaPrishtinaKosovo
| | - Jehona Ahmedi
- Department of Oral SurgeryUniversity of PrishtinaPrishtinaKosovo
| | | | | | | | - Aida Rexhepi
- UBT CollegeHigher Education InstitutionPrishtinaKosovo
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Gazal G, Aljohani H, Al-Samadani KH, Nassani MZ. Measuring the Level of Medical-Emergency-Related Knowledge among Senior Dental Students and Clinical Trainers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136889. [PMID: 34198982 PMCID: PMC8297173 DOI: 10.3390/ijerph18136889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/17/2021] [Accepted: 06/23/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aimed to measure the level of medical-emergency-related knowledge among senior dental students and clinical trainers in Saudi Arabia. METHODS This cross-sectional pilot survey was conducted at Taibah Dental College, Madina, Saudi Arabia between March 2017 and November 2018. Two hundred and seventy-five self-administered anonymous questionnaires on the management of common medical emergencies were distributed to all senior dental students and clinical trainers at Taibah Dental College. RESULTS There was a serious lack of knowledge regarding the management of medical emergency scenarios among the participants. Only 54% of participants knew the correct management for some frequent and life-threating conditions such as "crushed chest pain", and only 30-35% of participants knew the correct management of deeply sedated patients with benzodiazepine overdose and crisis of hypoadrenalism. Moderate-quality knowledge (50-74% of participants responded correctly) was noted for the following conditions: sudden onset of brain stroke, psychiatric patient, unconscious patient with hypoglycemia, patient with postural hypotension, and patient with hyperventilation. Based on the scale of knowledge, there were significant differences in the level of knowledge between clinical trainers, senior dental students, and junior dental students (p ≤ 0.01). Almost all students and 90% of trainers declared the need for further training. CONCLUSIONS The overall knowledge regarding the management of medical emergency crises in the dental chair was moderate. However, the scale of knowledge regarding the management of medical emergency crises has gradually increased with the number of years of experience. Most participants recognize the need for further training.
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Affiliation(s)
- Giath Gazal
- Department of Oral and Maxillofacial Surgery, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia;
- Correspondence:
| | - Hamzah Aljohani
- Department of Oral and Maxillofacial Surgery, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia;
| | - Khalid H Al-Samadani
- Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia;
| | - Mohammad Zakaria Nassani
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh 11512, Saudi Arabia;
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Abutayyem H, M L, Luke A, Khan YH, Muhammad M, George BT. Significance of Patient Safety and Safety Culture in Dental Schools: A Systematic Review. Open Dent J 2021. [DOI: 10.2174/1874210602115010241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives:
This article aims to systematically review and analyze the outcome of published literature on patient safety and safety culture related to dental schools. It also aims to observe implemented changes in dental school training and curriculum that have improved patient safety and safety culture within institutions.
Methods:
All studies concerning patient safety and safety culture from the period of January 2010 to May 2020 were included which were specific to dental educational institution settings. The assessment was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) checklist to ascertain that the included studies were specific to the objective of our systematic review.
Results:
The included studies were assessed for country-wise publication, type of study, and its outcome. Of the 10 studies that met the inclusion criteria, 5 articles were related to patient safety. 2 out of the 5 articles were from the United States of America (USA) 2 were from the United Kingdom (UK), followed by 1 from Mexico. For articles related to safety culture, 3 out of the 5 articles were from Saudi Arabia, and 2 were from the USA.
Conclusion:
The analysis of the selected review articles suggests that rigorous training should be implemented in inpatient record documentation, incident reporting, and infection control protocols. The authors suggested focused training on patient safety culture and the inclusion of safety culture awareness and training to the dental undergraduate curriculum.
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8
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Siemens MJ, Rice AN, Jensen TF, Muckler VCS. Implementation of contextualized, emergency management cognitive aids in a periodontics clinic. J Dent Anesth Pain Med 2021; 21:227-236. [PMID: 34136644 PMCID: PMC8187017 DOI: 10.17245/jdapm.2021.21.3.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Emergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to improve the staff knowledge and familiarity with critical performance elements for emergencies encountered in the setting of a periodontics clinic. METHODS Emergency cognitive aids tailored to the clinic's resources were created for anaphylaxis, airway obstruction, and sublingual hemorrhage. The project pre-post-test repeated measures design evaluated the effectiveness of cognitive aids using a combination of hands-on simulation, written knowledge assessments, and self-efficacy surveys. Training sessions and simulations were provided to the clinic's existing care teams made up of a periodontist and two dental assistants with an anesthetist who was present for simulations involving sedation. Due to the small sample size (N = 14) and non-normal distribution, all metrics were evaluated using non-parametric statistics. RESULTS Significant improvements were found in knowledge assessment (-2.310, P = 0.021) and self-efficacy (-2.486, P = 0.013) scores when retention after a training session before and after the introduction of cognitive aid was compared. The mean simulation scores and times improved steadily or reached maximum scores during the project progression. CONCLUSION Training sessions before and after cognitive aid introduction were effective in improving knowledge, self-efficacy, and simulation performance. Future projects should focus on validating the process for creating contextualized cognitive aids and evaluating the effectiveness of these cognitive aids in larger samples.
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Affiliation(s)
| | - Andi N Rice
- Periodontics of Greenville, Greenville, SC, USA
- Duke University School of Nursing Consulting Associate, Durham, NC, USA
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Solanki C, Geisinger ML, Luepke PG, Al-Bitar K, Palomo L, Lee W, Blanchard S, Shin D, Maupome G, Eckert GJ, John V. Assessing readiness to manage medical emergencies among dental students at four dental schools. J Dent Educ 2021; 85:1462-1470. [PMID: 33997984 DOI: 10.1002/jdd.12640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/09/2021] [Accepted: 04/03/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE Dentists treat a wide range of patients, including patients with compromised health conditions. While rendering treatment, various medical emergencies can and do occur. To help increase the knowledge required to manage such emergencies, dental students must be trained while in dental school. This study aims to assess the level of medical emergency preparedness and knowledge among dental students at four dental schools. MATERIAL AND METHODS The participating dental schools were IUSD, Case Western Reserve University School of Dentistry, Marquette University School of Dentistry, and the University of Alabama School of Dentistry. Groups were designed to include 20 dental students from Years 1 to 4. Students were asked to fill out a survey and were then tested on 10 clinical medical emergency scenarios. RESULTS A total of 331 dental students participated in the study. The scores based on 10 case scenarios presented with a range of 4.35-8.02. There was no statistically significant difference in the level of preparedness when dental schools were compared. However, Year 1 and Year 2 dental students had significantly lower total scores than those of Years 3 and 4. The students in Years 1 and 2 demonstrated less confidence in their current knowledge to manage medical emergencies. Satisfaction with the training received ranged from 38% to 84%. CONCLUSION The results from this study indicate that students' preparedness to manage medical emergencies at these four dental schools is statistically similar. Additional yearly training could enhance students' preparedness in the management of medical emergencies in the dental setting.
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Affiliation(s)
| | - Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Paul G Luepke
- Department of Periodontology, College of Dentistry, UTHSC, Memphis, Tennessee, USA
| | | | - Leena Palomo
- Department of Periodontology, Case Western School of Dental Medicine, Cleveland, Ohio, USA
| | - Wangsoo Lee
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Steven Blanchard
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Daniel Shin
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Gerardo Maupome
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA
| | - George J Eckert
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Vanchit John
- Department of Periodontology, Indiana University School of Dentistry, Indianapolis, Indiana, USA
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10
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Amiri Bavandpour M, Livas C, Jonkman REG. Management of medical emergencies in orthodontic practice. Prog Orthod 2020; 21:25. [PMID: 32776156 PMCID: PMC7415467 DOI: 10.1186/s40510-020-00327-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background The aims of this study were to survey the occurrence of acute medical situations in Dutch orthodontic practice and to examine the self-perceived competence of orthodontists in managing acute medical emergencies. Methods A self-designed questionnaire was distributed among all 149 Dutch orthodontists attending the spring meeting of the Dutch Society for Orthodontists. The questionnaire was divided into three parts, addressing background information of the orthodontist, precautions against and experiences in acute medical situations, and self-perceived competence of nine common medical emergencies. The statistical analysis was performed using the chi-square test and a multiple logistic regression analysis. Results The response rate was 74.5% (105 out of 149). The male to female ratio in this population was 55:50. Mean age of all participants was 46.9 years (SD 10.4 years) with on average 16.7 years of working experience (SD 10.6 years). The most common medical emergency reported by Dutch orthodontists was vasovagal collapse (n = 219), followed by acute allergic reaction (n = 163) and hyperventilation (n = 83). On average, 75% (n = 79) of the orthodontists felt competent to handle any acute medical situation with an average occurrence of 0.36 acute medical emergencies per orthodontist per year. Male participants were more likely to send patients towards the emergency department (p = 0.049). Moreover, a statistically significant negative correlation was observed between self-perceived competence handling hypoglycemia and years of clinical experience. The longer orthodontists were clinically active, the less competent they felt when encountered with a hypoglycemia (p = 0.031). Conclusions Medical emergencies may be rare but challenging occurrences in the orthodontic practice. It is strongly recommended for all orthodontists and supporting staff to be trained regularly in the management of medical emergencies and to possess up-to-date evidence-based knowledge. Familiarity with and availability of appropriate drugs and equipment are deemed essential to the management of acute medical emergencies that may arise in the orthodontic practice.
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Affiliation(s)
- M Amiri Bavandpour
- Department of Orthodontics, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
| | - C Livas
- Department of Orthodontics, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
| | - R E G Jonkman
- Department of Orthodontics, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands
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11
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Gazal G. Management of an emergency tooth extraction in diabetic patients on the dental chair. Saudi Dent J 2019; 32:1-6. [PMID: 31920272 PMCID: PMC6950840 DOI: 10.1016/j.sdentj.2019.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/04/2019] [Accepted: 07/27/2019] [Indexed: 02/08/2023] Open
Abstract
Background and objective Approximately 75% of diabetic patients in Saudi Arabia had poor glycaemic control. A high proportion of these patients will attend dental surgery clinics for treatment. Therefore, dentists should be well-prepared to control any complications they might arise on the dental chair during the dental procedures. Management of the associated risk factors is important to limit disease complications and improve the health of patients with diabetes.The objectives of this review were to determine the maximum acceptable level of blood glucose for tooth removal in diabetics, show a systematic technique for the management of patients with diabetes on the dental chair. By using PRISMA guidelines, analysis of the published articles and reports across the world is considered one of the most appropriate available methods to obtain strong evidence about the acceptable levels of blood glucose where teeth extraction can be done safely. Results A total of 1080 studies were retrieved using the search strategy. After screening 185 titles, abstracts and 85 full-text articles, 36 studies were included. The outcome of this systematic review revealed that fasting blood glucose level of 240 mg/dl is a critical point for any dental treatment because the warning signs of diabetes start coming out. Maximum acceptable levels of blood glucose for removal of teeth in diabetics are 180 mg/dl (before meal) and 234 mg/dl (2 h after a meal). High blood glucose levels reduce the secretion of nitric oxide (powerful vasodilator) in the body which leads to poor circulation and slow-healing socket. Uncontrolled diabetics are at high risk of infection because of the high ketone levels in the blood. Conclusion Fasting blood glucose level of 180 mg/dl is a cut-off point for any selective dental extraction. However, Random blood glucose level of 234 mg/dl (13 mmol/l) is a cut-off point for an emergency tooth extraction. Tightly controlled diabetic patients (blood glucose level below 70 mg/dl) are susceptible to hypoglycemia.
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Smereka J, Aluchna M, Aluchna A, Puchalski M, Wroblewski P, Checinski I, Leskiewicz M, Szarpak L. Medical emergencies in dental hygienists' practice. Medicine (Baltimore) 2019; 98:e16613. [PMID: 31348310 PMCID: PMC6709043 DOI: 10.1097/md.0000000000016613] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Dental hygienists in Poland work in various settings, including public health care institutions, private dental practices, dental clinics, kindergartens, and schools. They can often face medical emergencies, whose rate is increasing owing to comorbidities and aging of dental patients' populations. The aim of the study was to assess the prevalence of medical emergencies in dental hygienists' practice in Poland and the hygienists' preparedness and attitudes toward emergencies.A 10-question authors' own questionnaire was filled in by 613 dental hygienist. It referred to their cardiopulmonary resuscitation training, availability of emergency medical equipment in the workplace, the prevalence of medical emergencies including the need for an emergency medical service (EMS) call, and the management of cardiac arrest.Overall, 613 dental hygienists working in Poland participated in the study; 38.99% had taken part in basic life support (BLS) training within the previous 12 months and 35.89% within 2 to 5 years; 15.17% had experienced at least 1 emergency situation requiring an EMS call within the previous 12 months. Vasovagal syncope was the most common medical emergency (15.97%), followed by moderate anaphylactic reaction (13.87%), seizures (8.81%), hyperventilation crisis (7.50%), and hypoglycemia (7.34%).The most common medical emergency in dental hygienists' practice in Poland is syncope followed by mild anaphylactic reaction. Most of the dental hygienist had participated in a BLS course within the previous 5 years; however, 20% of them have never participated since graduation. Dental hygienists should participate in BLS courses every 2 years to keep the cardiopulmonary resuscitation skills and stay up-to-date with current guidelines. An important part of the study participants declare the lack of availability in their workplaces of life-saving equipment, including self-expanding bag resuscitator, oropharyngeal, and supraglottic airway device and oxygen source. Medical emergency equipment as recommended in the international guidelines should be available in every practice.
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Affiliation(s)
- Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University
| | - Marcin Aluchna
- Department of Conservative Dentistry, Medical University of Warsaw
| | | | - Marcin Puchalski
- Department of Emergency Medical Service, Wroclaw Medical University
| | - Pawel Wroblewski
- Department of Emergency Medical Service, Wroclaw Medical University
| | - Igor Checinski
- Department of Emergency Medical Service, Wroclaw Medical University
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Marti K, Sandhu G, Aljadeff L, Greene R, Lesch AB, Le JM, Pinsky HM, Rooney DM. Simulation-Based Medical Emergencies Education for Dental Students: A Three-Year Evaluation. J Dent Educ 2019; 83:973-980. [PMID: 30962311 DOI: 10.21815/jde.019.084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 12/20/2018] [Indexed: 11/20/2022]
Abstract
This aim of this study was to develop and evaluate a simulation program for dental students to supplement a lecture-based medical emergencies course. Students' self-reported knowledge, experience, confidence, and ability regarding medical emergencies were assessed as program outcomes. For three years (in 2014, 2015, and 2016), all second-year students (N=333) at one U.S. dental school were randomly assigned to groups of 15 and participated in 15 simulated clinical scenarios. All students completed a 21-item pre-post survey and rated their knowledge, experience, and confidence using simulated emergencies. Following the intervention, students' ability to complete critical actions was also peer-assessed using a ten-item checklist. Four open-ended questions were included on the post-intervention survey for acquisition of additional data. For all years, students' self-reported measurements significantly improved with high practical impact (p≤0.001, g=|0.62, 3.93|), with the exception of calling 911 (knowledge). Peer-rated performance indicated the students were deficient (<75% success) in the following: inhaler use, dose of local anesthetic, dose of epinephrine, and EpiPen use. Content analysis of students' comments pointed to areas that need improvement but found high satisfaction with the program. These findings indicate that this program improved students' knowledge, experience, and confidence using simulated medical emergencies.
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Affiliation(s)
- Kyriaki Marti
- Kyriaki Marti, DMD, MD, MHPE, PhD, CHSE, FEBOMFS, is Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Department of Periodontics and Oral Medicine, and Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry; Gurjit Sandhu, PhD, is Assistant Professor, Department of Surgery and Department of Learning Health Sciences, University of Michigan Medical School; Lior Aljadeff, DDS, MD, is Oral and Maxillofacial Surgery Resident, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center/Parkland Memorial Hospital; Rachel Greene, DDS, is Clinical Instructor, Department of Restorative Dentistry, University of Washington School of Dentistry; Amy B. Lesch, DDS, is Resident, Pediatric Dentistry and Dental Public Health Residency Program, Department of Pediatric Dentistry, University of Iowa College of Dentistry & Dental Clinics; John M. Le, DDS, is Oral and Maxillofacial Surgery Resident, University of Alabama at Birmingham; Harold M. Pinsky, DDS, is Adjunct Clinical Lecturer, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Deborah M. Rooney, PhD, is Assistant Professor, Department of Learning Health Sciences, University of Michigan Medical School.
| | - Gurjit Sandhu
- Kyriaki Marti, DMD, MD, MHPE, PhD, CHSE, FEBOMFS, is Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Department of Periodontics and Oral Medicine, and Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry; Gurjit Sandhu, PhD, is Assistant Professor, Department of Surgery and Department of Learning Health Sciences, University of Michigan Medical School; Lior Aljadeff, DDS, MD, is Oral and Maxillofacial Surgery Resident, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center/Parkland Memorial Hospital; Rachel Greene, DDS, is Clinical Instructor, Department of Restorative Dentistry, University of Washington School of Dentistry; Amy B. Lesch, DDS, is Resident, Pediatric Dentistry and Dental Public Health Residency Program, Department of Pediatric Dentistry, University of Iowa College of Dentistry & Dental Clinics; John M. Le, DDS, is Oral and Maxillofacial Surgery Resident, University of Alabama at Birmingham; Harold M. Pinsky, DDS, is Adjunct Clinical Lecturer, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Deborah M. Rooney, PhD, is Assistant Professor, Department of Learning Health Sciences, University of Michigan Medical School
| | - Lior Aljadeff
- Kyriaki Marti, DMD, MD, MHPE, PhD, CHSE, FEBOMFS, is Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Department of Periodontics and Oral Medicine, and Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry; Gurjit Sandhu, PhD, is Assistant Professor, Department of Surgery and Department of Learning Health Sciences, University of Michigan Medical School; Lior Aljadeff, DDS, MD, is Oral and Maxillofacial Surgery Resident, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center/Parkland Memorial Hospital; Rachel Greene, DDS, is Clinical Instructor, Department of Restorative Dentistry, University of Washington School of Dentistry; Amy B. Lesch, DDS, is Resident, Pediatric Dentistry and Dental Public Health Residency Program, Department of Pediatric Dentistry, University of Iowa College of Dentistry & Dental Clinics; John M. Le, DDS, is Oral and Maxillofacial Surgery Resident, University of Alabama at Birmingham; Harold M. Pinsky, DDS, is Adjunct Clinical Lecturer, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Deborah M. Rooney, PhD, is Assistant Professor, Department of Learning Health Sciences, University of Michigan Medical School
| | - Rachel Greene
- Kyriaki Marti, DMD, MD, MHPE, PhD, CHSE, FEBOMFS, is Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Department of Periodontics and Oral Medicine, and Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry; Gurjit Sandhu, PhD, is Assistant Professor, Department of Surgery and Department of Learning Health Sciences, University of Michigan Medical School; Lior Aljadeff, DDS, MD, is Oral and Maxillofacial Surgery Resident, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center/Parkland Memorial Hospital; Rachel Greene, DDS, is Clinical Instructor, Department of Restorative Dentistry, University of Washington School of Dentistry; Amy B. Lesch, DDS, is Resident, Pediatric Dentistry and Dental Public Health Residency Program, Department of Pediatric Dentistry, University of Iowa College of Dentistry & Dental Clinics; John M. Le, DDS, is Oral and Maxillofacial Surgery Resident, University of Alabama at Birmingham; Harold M. Pinsky, DDS, is Adjunct Clinical Lecturer, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Deborah M. Rooney, PhD, is Assistant Professor, Department of Learning Health Sciences, University of Michigan Medical School
| | - Amy B Lesch
- Kyriaki Marti, DMD, MD, MHPE, PhD, CHSE, FEBOMFS, is Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Department of Periodontics and Oral Medicine, and Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry; Gurjit Sandhu, PhD, is Assistant Professor, Department of Surgery and Department of Learning Health Sciences, University of Michigan Medical School; Lior Aljadeff, DDS, MD, is Oral and Maxillofacial Surgery Resident, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center/Parkland Memorial Hospital; Rachel Greene, DDS, is Clinical Instructor, Department of Restorative Dentistry, University of Washington School of Dentistry; Amy B. Lesch, DDS, is Resident, Pediatric Dentistry and Dental Public Health Residency Program, Department of Pediatric Dentistry, University of Iowa College of Dentistry & Dental Clinics; John M. Le, DDS, is Oral and Maxillofacial Surgery Resident, University of Alabama at Birmingham; Harold M. Pinsky, DDS, is Adjunct Clinical Lecturer, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Deborah M. Rooney, PhD, is Assistant Professor, Department of Learning Health Sciences, University of Michigan Medical School
| | - John M Le
- Kyriaki Marti, DMD, MD, MHPE, PhD, CHSE, FEBOMFS, is Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Department of Periodontics and Oral Medicine, and Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry; Gurjit Sandhu, PhD, is Assistant Professor, Department of Surgery and Department of Learning Health Sciences, University of Michigan Medical School; Lior Aljadeff, DDS, MD, is Oral and Maxillofacial Surgery Resident, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center/Parkland Memorial Hospital; Rachel Greene, DDS, is Clinical Instructor, Department of Restorative Dentistry, University of Washington School of Dentistry; Amy B. Lesch, DDS, is Resident, Pediatric Dentistry and Dental Public Health Residency Program, Department of Pediatric Dentistry, University of Iowa College of Dentistry & Dental Clinics; John M. Le, DDS, is Oral and Maxillofacial Surgery Resident, University of Alabama at Birmingham; Harold M. Pinsky, DDS, is Adjunct Clinical Lecturer, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Deborah M. Rooney, PhD, is Assistant Professor, Department of Learning Health Sciences, University of Michigan Medical School
| | - Harold M Pinsky
- Kyriaki Marti, DMD, MD, MHPE, PhD, CHSE, FEBOMFS, is Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Department of Periodontics and Oral Medicine, and Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry; Gurjit Sandhu, PhD, is Assistant Professor, Department of Surgery and Department of Learning Health Sciences, University of Michigan Medical School; Lior Aljadeff, DDS, MD, is Oral and Maxillofacial Surgery Resident, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center/Parkland Memorial Hospital; Rachel Greene, DDS, is Clinical Instructor, Department of Restorative Dentistry, University of Washington School of Dentistry; Amy B. Lesch, DDS, is Resident, Pediatric Dentistry and Dental Public Health Residency Program, Department of Pediatric Dentistry, University of Iowa College of Dentistry & Dental Clinics; John M. Le, DDS, is Oral and Maxillofacial Surgery Resident, University of Alabama at Birmingham; Harold M. Pinsky, DDS, is Adjunct Clinical Lecturer, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Deborah M. Rooney, PhD, is Assistant Professor, Department of Learning Health Sciences, University of Michigan Medical School
| | - Deborah M Rooney
- Kyriaki Marti, DMD, MD, MHPE, PhD, CHSE, FEBOMFS, is Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, Department of Periodontics and Oral Medicine, and Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry; Gurjit Sandhu, PhD, is Assistant Professor, Department of Surgery and Department of Learning Health Sciences, University of Michigan Medical School; Lior Aljadeff, DDS, MD, is Oral and Maxillofacial Surgery Resident, Division of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center/Parkland Memorial Hospital; Rachel Greene, DDS, is Clinical Instructor, Department of Restorative Dentistry, University of Washington School of Dentistry; Amy B. Lesch, DDS, is Resident, Pediatric Dentistry and Dental Public Health Residency Program, Department of Pediatric Dentistry, University of Iowa College of Dentistry & Dental Clinics; John M. Le, DDS, is Oral and Maxillofacial Surgery Resident, University of Alabama at Birmingham; Harold M. Pinsky, DDS, is Adjunct Clinical Lecturer, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Deborah M. Rooney, PhD, is Assistant Professor, Department of Learning Health Sciences, University of Michigan Medical School
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