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Supporting Your Practice

How do I treat a patient with hemophilia?

This Medical Condition Consult is presented by the JCDA Oasis Team. It is also available through the Oasis Help system Our sincere thanks go to the MDs who developed and reviewed this medical consult.  Hemophilia is a hereditary bleeding disorder caused by low factor VIII coagulant activity (hemophilia A) or low levels of factor IX coagulant activity (hemophilia B). Both forms have an X-linked recessive pattern of inheritance. Men are usually affected. Women are carriers. Hemophilia Severity Classification Mild: No spontaneous bleeding; delayed onset of bleeding after trauma, surgery, or dental extractions (6%–49% of the normal clotting factor). Moderate: Bleeding with minor ...

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Culture clash? Pediatric dental practice in the age of helicopter parenting

May 3rd, 2013 marks the 100th anniversary of the department of dentistry at the Hospital for Sick Children (SickKids). A full-day educational symposium with notable speakers is planned, including Dr. Ed Barrett, staff pediatric dentist at the hospital.     Dr. John O’Keefe sat down with Dr. Barrett and spoke about dentistry in the age of helicopter parenting. The interview  tackled questions, such as: How is the helicopter parenting concept defined? What are the implications of a culture clash for general practitioners? Is the helicopter parent a guilty parent, when there is dental disease?   Main points The most important relationship you have ...

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How do I manage a patient suffering from a spontaneous gingival hemorrhage?

This Urgent care Scenario (USC) is presented by the JCDA Oasis Team in collaboration with Dr. Hagen Klieb. The USC is also available through the Oasis Help system A patient presents with copious gingival bleeding: Bleeding is prolonged and cannot be stopped with pressure Several such episodes have occurred recently without provocation   Suggested Resources Nematullah A, Alabousi A, Blanas N, Douketis JD, Sutherland SE. Dental surgery for patients on anticoagulant therapy with warfarin: a systematic review and meta-analysis. J Can Dent Assoc. 2009;75(1):41. Gupta A, Epstein JB, Cabay RJ. Bleeding disorders of importance in dental care and related patient management. J Can Dent Assoc. 2007;73(1):77-83.    Do you need further information ...

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How do I manage a necrotic tooth with unstoppable drainage?

This Urgent Care Scenario (USC) is presented by the JCDA Oasis Team in collaboration with Dr. Brian Jafine. The USC is also available through the Oasis Help system   Suggested Resources Imura N, Zuolo ML. Factors associated with endodontic flare-ups: a prospective study. Int Endod J. 1995;28(5):261-5. Morse DR, Koren LZ, Esposito JV, Goldberg JM, Belott RM, Sinai IH, et al. Asymptomatic teeth with necrotic pulps and associated periapical radiolucencies: relationship of flare-ups to endodontic instrumentation, antibiotic usage and stress in three separate practices at three different time periods. Int J Psychosom. 1986;33(1):5-87. Walton R, Fouad A. Endodontic interappointment flare-ups: a prospective study of incidence and related factors. ...

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Is your patient on barbiturates?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Barbiturates Barbiturates Product Summary Information   Barbiturates are nonselective central nervous system (CNS) depressants, capable of producing all degrees of depression from mild sedation and hypnosis to general anesthesia, deep coma and death. The extent of CNS depression varies with the route of administration, dose and pharmacokinetic characteristics of the particular barbiturate. Patient-specific factors such as age, physical or emotional state and the concomitant use of other drugs will also affect response. Indications Barbiturates have been used parenterally in the management of status epilepticus or acute seizure episodes ...

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How do I manage acute pain?

This post is adapted from the Canadian Pharmacists Association (CPhA) Therapeutic Choices on Neurologic Disorders: Acute Pain Pain is one of the commonest symptoms. It needs to be recognized, assessed for cause and treated appropriately as soon as possible.  The absence of treatment can lead to physiological and psychological adverse effects.  Treatment should be tailored to the level of pain; an analgesic that is effective in one patient may not necessarily be helpful in another with the same type of pain.  The absence of a diagnosis should not delay measures to relieve pain.   Therapeutic Choices. © Canadian Pharmacists Association   Do ...

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How do I manage the patient with aphthous ulcers?

This Urgent Care Scenario (USC) is presented by the JCDA Oasis Team in collaboration with Dr. David Clark. The USC is also available through the Oasis Help system Dr. David Clark is clinical director of dental services at Ontario Shores Centre for Mental Health Sciences and associate in clinical dentistry with the department of oral medicine, faculty of dentistry, University of Toronto Aphthous Ulcers (a.k.a aphthous stomatitis, canker sores) Presentation Population Typical onset in childhood or early adulthood Women affected more often than men Signs Minor aphthous ulcerations (Fig. 1) Approx. % of cases: 80% Shape and dimensions: round to ovoid ulcers no ...

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Is your patient is on ACE Inhibitors?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: ACE Inhibitors ACE Inhibitors Product Summary Information Drug Administration Dosage Form Strength Benazepril Oral Tablet 5 mg, 10 mg, 20 mg Captopril Oral  Tablet 6.25 mg, 12.5 mg, 25 mg, 50 mg, 100 mg Cilazapril Oral  Tablet 1 mg, 2.5 mg, 5 mg Enalapril Maleate Oral  Tablet 2.5 mg, 5 mg, 10 mg, 20 mg Enalaprilat IV Solution 1.25 mg/mL Fosinopril Oral Tablet 10 mg, 20 mg Lisinopril Oral Tablet 5 mg, 10 mg, 20 mg Perindopril Oral Tablet 2 mg, 4 mg, 8 mg Quinapril Oral Tablet ...

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