Dental patients often give a medical history that suggests the possibility of a coagulopathy from drugs, with a corresponding risk for prolonged bleeding during and following an invasive procedure. Identification of patients who may be prone to oral bleeding requires specific medical history information and the proper use of laboratory tests. Some NSAIDs are reported to cause prolonged oral bleeding, but scientific evidence is lacking. Likewise, the risk of oral bleeding from anticoagulants such as warfarin is often over stated, and unnecessary adjustment of NSAID or warfarin dosage puts patients at risk for significant morbidity and mortality. Some commonly employed laboratory tests such as the prothrombin time provide helpful information when used in the appropriate setting, but others, such as the bleeding time test, provide little or no predictive value in the determination of patients at risk for oral bleeding. Dental management of patients with potential coagulopathies from medications requires an understanding of basic principles of coagulation. The vast majority of these patients can be managed in the community setting without risk and without alteration of anticoagulant drug regimes.
The addition of wheat fiber in the diet of post-surgical orthopedic patients as a means of preventing constipation was studied using a quasi-experimental design. It was hypothesized that a 20 gm supplement of All Bran and natural bran would promote spontaneous bowel movements, reduce the incidence of constipation, and thus decrease the need for elimination interventions. The results show that the study group had more spontaneous bowel movements and required fewer elimination interventions than did the control group.
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