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Profound Bleeding after Dental Extractions during Dicumarol Therapy
N Engl J Med 1957; 256:351-353February 21, 1957DOI: 10.1056/NEJM195702212560806
This article has no abstract; the first 100 words appear below.
ANTICOAGULANT therapy, often maintained for months or years, is used widely in the management of actual or anticipated thromboembolic states. Drug-induced alteration of the clotting mechanism of the blood not only inhibits or retards beneficially intravascular coagulation but also creates simultaneously the hazard of hemorrhage. The hazard may be increased if the patient on such a regimen should undergo surgical intervention while prothrombic (or other coagulant) activity is reduced markedly. The potentially serious bleeding that occurred in 2 patients when dental extractions were performed during hypoprothrombinemia induced at therapeutic levels is the subject of this report.
Case Reports
Case 1. . . .
*From the Medical and Dental services, New York Veterans Administration Hospital.
**At this hospital measurements of plasma clotting (prothrombin) time are made by a modification of the Quick one-stage procedure.1 Bleeding and coagulation times are determined respectively by the Duke and Lee–White methods.
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NEW YORK CITY
†Public Health Service Postdoctoral Research Fellow of the National Heart Institute, Third Medical Division, Bellevue Hospital; formerly, resident in medicine, Veterans Administration Hospital.
‡Assistant clinical professor of periodontia and oral medicine, New York University College of Dentistry; chief, Dental Service, Veterans Administration Hospital.
§Formerly, resident in oral surgery, Veterans Administration Hospital.
¶Resident in medicine, Lenox Hill Hospital; formerly, resident in medicine, Veterans Administration Hospital.
∥Associate professor of clinical medicine, New York University College of Medicine; associate professor of medicine (in charge of Department of Medicine), New York University College of Dentistry; attending physician in medicine, Veterans Administration Hospital; associate visiting physician, Bellevue and University hospitals.
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