Excessive bleeding after dental procedures are one of the most frequent complications occurring in patients with hereditary bleeding disorders. In this retrospective study we collected data from 10 years of experience in the oral care of patients with congenital haemorrhagic disorders in three Italian Hemophilia Centers. Between 1993 and 2003, 247 patients with inherited bleeding disorders underwent 534 dental procedures including 133 periodontal treatments, 41 conservative dentistry procedures, 72 endodontic treatments and 288 oral surgery procedures. We recorded 10 bleeding complications (1.9%), most of which occurred in patients with severe/moderate haemophilia A undergoing multiple dental extractions. Thus, our protocol of management of patients with hereditary bleeding tendency undergoing oral treatment or surgery has been shown to be effective in preventing haemorrhagic complications.

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Purpose The current TNM classification is still unsatisfactory for collecting all the prognostic information from the clinical presentation of early gastric cancer: "T" is limited to two levels, the classes of "N" are still wide and "M" is generally absent. Patients and Methods This study involved 99 patients who underwent radical gastric resection for early gastric cancer. Clinical and histological parameters were prognostically analyzed for both observed and relative survival. Univariate and multivariate analyses were applied to the proportional hazards model. Results Number of metastatic lymph nodes and measure of the largest diameter of the tumor were the only independent prognosticators of observed and relative survival. Their similar relative hazards allowed an additive use of them in the N class. Two cut-off values of this composite clinical parameter are proposed for a good discrimination of the relative survival. Discussion The number of metastatic lymph nodes is the cornerstone of the current TNM system and was confirmed as adequate. The possibility of adding tumor size to the number of the involved lymph nodes improves and amplifies the prognostic ability, which is presently limited by the rarity of lymph node involvement and the small number of the lymph nodes usually involved.

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