These Are the Top Pediatric Care Providers in Westchester

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adult primary care essex :: Article Creator UVM Medical Center Eyes $8.6 Million Primary Care Project UVM Medical Center. File photo by Mike Dougherty/VTDigger [U]niversity of Vermont Medical Center is planning an $8.6 million expansion of its primary care services in Chittenden County, new state documents show. Amid a statewide shortage of adult primary care services, hospital administrators have proposed a new facility in Essex that could handle up to 10,500 additional patient visits annually. It would be twice the size of the hospital's current Essex practice and would add seven new staff. The practice also would include an in-house psychiatrist and a drug and alcohol counselor as part of a statewide and nationwide effort to integrate such services with medical care. "It's kind of one-stop shopping," said Dr. Jennifer Gilwee, division chief of general internal medicine and geriatrics. "It just makes it easier to access...
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Dental Procedures - Epilepsy Foundation

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Before a dental procedure, levels of antiepileptic drugs (AEDs) should be measured and adjusted based on the individual patient's history. The dental team should be informed about the patient's seizure type and first aid.

Seizure-precipitating factors, such as sleep deprivation or alcohol intake, should be avoided before the procedure.

Methohexital was compared to local anesthetic in conservative dental procedures. Although a seizure occurred in only 1 out of 200 patients, the main disadvantage of its use over local anesthetic is side effects, including tongue movements, coughing, hiccoughs, and prolonged lethargy after the procedure.105

Seizures that occur during or after a dental procedure can occur with N2O104 and methohexital.51 In these studies, seizures most often occurred in patients with undiagnosed epilepsy or those who missed a dose of their antiepileptic medications on the day of the dental procedure.

Other studies demonstrate that N2O and propofol in subanesthetic doses for conscious sedation are safe for mentally handicapped epilepsy patients who undergo dental procedures.45 N2O and propofol are almost always safe in epilepsy patients who are adequately treated with AEDs.

Adapted from: Najjar S, Devinsky O, Rosenberg AD, et al. Procedures in epilepsy patients. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;499–513. With permission from Elsevier (www.elsevier.com).

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