Health
Franki Janlio
Abstract
Repetition and type of oral hygiene should be done based on oral cavity examination instead of routine. A soft, small toothbrush with a neutral pH moistened with water is more effective than scrubs or sticky foams. Hydrogen peroxide diluted in a 20% solution in a ratio of 1 to 4 diluted with water or ...
Read More
Repetition and type of oral hygiene should be done based on oral cavity examination instead of routine. A soft, small toothbrush with a neutral pH moistened with water is more effective than scrubs or sticky foams. Hydrogen peroxide diluted in a 20% solution in a ratio of 1 to 4 diluted with water or sodium bicarbonate (one-half teaspoon per 500 cc) of water can be used to remove debris and dissolve thick mucus. If there are signs of infection such as stomatitis or generitis, antimicrobial mouthwashes or toothpaste such as (Chalrhexidine gluconate 1%) can be used, but the best way to prevent infection is to clean plaque. To prevent dry lips, they should be lubricated with Vaseline or kg gel. Neutral mouthwash solution that does not cause dry mouth, as it may be very easy to use by the patient, but has not been shown to have an effect on maintaining mucosal cohesion. Limited use of glycerin and lemon water-absorbing mouthwash 2-3 times a day may help stimulate saliva secretion. Artificial saliva spray can be used if the mouth is very dry and the patient's fluid intake is limited or they have difficulty swallowing. Dentures should be removed at night, cleaned and soaked in water. Being hydrated will help relieve dry mouth.
Medicine
Marjan Dehdilan; Khosrow Hashemzadeh
Abstract
Introduction: Postoperative onset atrial fibrillation (POAF) is a common complication of coronary artery bypass surgery (CABG). However, the long-term risk of thromboembolism in patients who develop POAF after CABG surgery is unknown. Also, there is no information about stroke prevention in this setting. ...
Read More
Introduction: Postoperative onset atrial fibrillation (POAF) is a common complication of coronary artery bypass surgery (CABG). However, the long-term risk of thromboembolism in patients who develop POAF after CABG surgery is unknown. Also, there is no information about stroke prevention in this setting. To investigate the long-term risk of stroke and thromboembolism in patients with new-onset POAF after initial CABG alone compared with patients with non-functional non-valvular atrial fibrillation (NVAF)Material and Methods: This study used data from the Clinical Cardiac Surgery Database and the Danish National Registry to identify patients undergoing a primary CABG procedure and de novo CABG between January 1, 2000 and June 30, 2015. The age, sex, CHA2DS2-VASc score and year of diagnosis of these patients were compared with dysfunctional NVAF between 1 and 4. Data analysis was performed between 2012-15. Proportion of patients starting oral anticoagulation within 30 days and thromboembolic rate.Results: 115 patients who developed POAF after CABG surgery and 115 patients who developed NVAF were compared. In the total population of 10,540 patients, the median (interquartile range) age was 69 years.2 (63.7-74.7) years; 8675 patients (82.3%) were male. 175 POAF patients (8.4% and 3549 patients with NVAF (42.9%). The risk of thromboembolism was lower in the POAF group than in the NVAF group (18.3 vs. 29.7 events per 1000 person-years; adjusted hazard ratio [HR], 0.55; 95% confidence interval, 0.32-0.95; P = .03) and NVAF (adjusted HR, 0.59; 95% CI, 0.68; P < .001) compared with patients not receiving anticoagulant therapy.Conclusion: Patients undergoing CABG surgery had a longer risk of thromboembolic new POAF than those undergoing NVAF. These data do not support the view that de novo POAF should be considered the same as primary NVAF in terms of long-term thromboembolic risk.
Medicine
Khosrow Hashemzadeh; Marjan Dehdilan
Abstract
Introduction: Our primary aim was to examine postoperative complications in cardiac surgery patients and their relationship to the use of cardiopulmonary resuscitation (CPB). A secondary aim was to evaluate the association of postoperative complications with outcome measures. Material and Methods: Single-institution ...
Read More
Introduction: Our primary aim was to examine postoperative complications in cardiac surgery patients and their relationship to the use of cardiopulmonary resuscitation (CPB). A secondary aim was to evaluate the association of postoperative complications with outcome measures. Material and Methods: Single-institution observational study of consecutive cardiac surgery patients over 1 year. Five cardiac cases and 15 extracardiac cases were studied. CPB use, CPB parameters, demographics and Risk Adjusted Classification of Congenital Cardiac Surgery (RACHS-1) levels were evaluated as complication risk factors. Outcomes examined included duration of mechanical ventilation, length of stay in pediatric hospital, length of stay, and mortality. Results: Logistic regression analysis, after adjusting for age, sex, prior sternotomy, and RACHS-1 level, provided insufficient evidence for an association between CPB support and the incidence of cardiovascular or extracardiac problems. For patients receiving CPB, longer duration of CPB, higher RACHS-1 levels, and lower CPB temperature were associated with more cardiovascular events (P < .01). Longer CPB duration and higher RACHS-1 levels were associated with more cardiovascular complications (P = .006). Postoperative complications were associated with longer ventilator time, longer pediatric heart failure hospital stay, longer hospital stay, and death (P < .01). Conclusion: Postoperative complications occurred in 43% of pediatric cardiac procedures with and without CPB. Complications include longer use of ventilators, pediatric heart failure and hospital stay, and increased mortality.
