RESUMO
Given the growing trend towards medical indications for continuous use of anticoagulants, the number of patients on these medications continues to rise. The management of patients on oral anticoagulants requiring oral surgical procedures has aroused much controversy. Changes in an anticoagulation regimen are associated with an increased risk of thromboembolism. However, it seems logical and advantageous for the patients' health if surgery could be performed without any change to the anticoagulation therapy. In dentistry, high-power lasers have been poorly explored in this field. The hemostatic properties of high-power lasers could be helpful during oral soft tissue surgeries in anticoagulated patients. The aim of this study was to compare bleeding time in anticoagulated rats after lingual frenectomy performed with a scalpel or diode laser with bleeding time in healthy animals. Twenty-four male Wistar rats were assigned to four groups (n = 6): (CS) Control-Scalpel Surgery; (AS) Anticoagulated-Scalpel Surgery; (CL) Control-Laser (diode laser 810 nm/1.5 W) Surgery; and (AL) Anticoagulated-Laser Surgery (diode laser 810 nm/1.5 W). Warfarin administration was used to induce anticoagulation. Blood was blotted every 30 seconds with filter paper until bleeding stopped to verify bleeding time. Two blinded researchers performed the surgeries and collected the bleeding time data. Diode laser surgery led to complete hemostasis in rats during and after lingual frenectomy. Zero bleeding was assessed during surgeries and after diode laser surgeries in anticoagulated rats. Laser-induced hemostasis offered an alternative solution to the controversial issue of intraoperative and postoperative bleeding control in patients on anticoagulation therapy.
Assuntos
Coagulação Sanguínea/efeitos da radiação , Fotocoagulação a Laser/métodos , Lasers Semicondutores/uso terapêutico , Freio Lingual/cirurgia , Hemorragia Pós-Operatória/prevenção & controle , Animais , Anticoagulantes/uso terapêutico , Tempo de Sangramento , Método Duplo-Cego , Masculino , Ratos Wistar , Reprodutibilidade dos Testes , Fatores de Risco , Tromboembolia , Resultado do Tratamento , Varfarina/uso terapêuticoRESUMO
Abstract Given the growing trend towards medical indications for continuous use of anticoagulants, the number of patients on these medications continues to rise. The management of patients on oral anticoagulants requiring oral surgical procedures has aroused much controversy. Changes in an anticoagulation regimen are associated with an increased risk of thromboembolism. However, it seems logical and advantageous for the patients' health if surgery could be performed without any change to the anticoagulation therapy. In dentistry, high-power lasers have been poorly explored in this field. The hemostatic properties of high-power lasers could be helpful during oral soft tissue surgeries in anticoagulated patients. The aim of this study was to compare bleeding time in anticoagulated rats after lingual frenectomy performed with a scalpel or diode laser with bleeding time in healthy animals. Twenty-four male Wistar rats were assigned to four groups (n = 6): (CS) Control-Scalpel Surgery; (AS) Anticoagulated-Scalpel Surgery; (CL) Control-Laser (diode laser 810 nm/1.5 W) Surgery; and (AL) Anticoagulated-Laser Surgery (diode laser 810 nm/1.5 W). Warfarin administration was used to induce anticoagulation. Blood was blotted every 30 seconds with filter paper until bleeding stopped to verify bleeding time. Two blinded researchers performed the surgeries and collected the bleeding time data. Diode laser surgery led to complete hemostasis in rats during and after lingual frenectomy. Zero bleeding was assessed during surgeries and after diode laser surgeries in anticoagulated rats. Laser-induced hemostasis offered an alternative solution to the controversial issue of intraoperative and postoperative bleeding control in patients on anticoagulation therapy.
Assuntos
Animais , Masculino , Coagulação Sanguínea/efeitos da radiação , Fotocoagulação a Laser/métodos , Hemorragia Pós-Operatória/prevenção & controle , Lasers Semicondutores/uso terapêutico , Freio Lingual/cirurgia , Tromboembolia , Varfarina/uso terapêutico , Tempo de Sangramento , Método Duplo-Cego , Reprodutibilidade dos Testes , Fatores de Risco , Resultado do Tratamento , Ratos Wistar , Anticoagulantes/uso terapêuticoRESUMO
PURPOSE: To determine the mechanism of proton radiation- induced coagulopathy. MATERIAL AND METHODS: Ferrets were exposed to either solar particle event (SPE)-like proton radiation at a predetermined dose rate of 0.5 Gray (Gy) per hour (h) for a total dose of 0 or 1 Gy. Blood was collected pre- and post-irradiation for a complete blood cell count or a soluble fibrin concentration analysis, to determine whether coagulation activation had occurred. Tissue was stained with an anti-fibrinogen antibody to confirm the presence of fibrin in blood vessels. RESULTS: SPE-like proton radiation exposure resulted in coagulation cascade activation, as determined by increased soluble fibrin concentration in blood from 0.7-2.4 at 3 h, and 9.9 soluble fibrin units (p < 0.05) at 24 h post-irradiation and fibrin clots in blood vessels of livers, lungs and kidneys from irradiated ferrets. In combination with this increase in fibrin clots, ferrets had increased prothrombin time and partial thromboplastin time values post-irradiation, which are representative of the extrinsic/intrinsic coagulation pathways. Platelet counts remained at pre-irradiation values over the course of 7 days, indicating that the observed effects were not platelet-related, but instead likely to be due to radiation-induced effects on secondary hemostasis. White blood cell (WBC) counts were reduced in a statistically significant manner from 24 h through the course of the seven-day experiment. CONCLUSIONS: SPE-like proton radiation results in significant decreases in all WBC counts as well as activates secondary hemostasis; together, these data suggest severe risks to astronaut health from exposure to SPE radiation.
Assuntos
Coagulação Sanguínea/efeitos da radiação , Furões , Prótons/efeitos adversos , Animais , Contagem de Células Sanguíneas , Coagulação Sanguínea/efeitos dos fármacos , Fator IX/farmacologia , Fibrina/química , Fibrina/metabolismo , Atividade Solar , Solubilidade , Vitamina K 1/farmacologiaRESUMO
Duzentos e vinte e oito pacientes portadores de hemorroidas internas de segundo grau foram, aleatoriamente, distribuidos em tres grupos denominados, respectivamente de A,B, e C. Cada grupo foi submetido a ligadura elastica, os do grupo B a crioterapia e os grupo C ao infravermelho. Os resultados obtidos foram analisados e comparados com a finalidade de avaliaçao terapeutica. Todos os metodos foram considerados eficazes no tratamento das hemorroidas internas de segundo grau, salientando-se que a ligadura elastica foi o metodo menos doloroso de utilizaçao e que a crioterapia foi o metodo que menor indice de dor ofereceu no pos-tratamento, sendo o mais demorado para ser aplicado, e que o infravermelho foi o de melhor resultado quanto a desapariçao do sangramento, sendo o que apresentou complicaçoes de maior gravidade.