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Biomedical subjects

J Montana

Publications and source records attributed to J Montana.

9 recordsLinked to original sources
PubMed1996

Vomiting and recovery after outpatient tonsillectomy and adenoidectomy in children. Comparison of four anesthetic techniques using nitrous oxide with halothane or propofol.

BACKGROUND: The authors' purpose in this study was to compare prospectively four different anesthetic induction and maintenance techniques using nitrous oxide with halothane and/or propofol for vomiting and recovery after outpatient tonsillectomy and adenoidectomy procedures in children. METHODS: Eighty unpremedicated children, aged 3-10 yr, were assigned randomly to four groups: group H/H, 0.5-2% halothane induction/halothane maintenance; group P/P, 3-5 mg.kg-1 propofol induction and 0.1-0.3 mg.kg-1.min-1 propofol maintenance; group H/P, 0.1-0.3 mg.kg-1.min-1 halothane induction/propofol maintenance; and group P/H, 3-5 mg.kg-1 propofol induction and 0.5-2% halothane maintenance. Nitrous oxide (67%) and oxygen (33%) were administered in all the groups. Other treatments and procedures were standardized intra- and postoperatively. Results of postoperative vomiting and recovery were analyzed in the first 6 h and beyond 6 h. RESULTS: Logistic regression showed that vomiting occurred 3.5 times as often when halothane was used for maintenance of anesthesia (groups H/H and P/H) compared with the use of propofol (groups P/P and H/P; Odds Ratio 3.5; 95% confidence interval 1.3 and 9.4, respectively; P = 0.012). A significant association between vomiting ( < 6 h: yes/no) and discharge times ( > 6 h: yes/no) (Odd's Ratio = 3.6; 95% confidence interval: 1.02, 12.4, respectively) (P = 0.046) was shown. However, no significant differences among the groups in the incidence of vomiting beyond 6 h, recurrent vomiting, or hospital discharge times were shown. CONCLUSIONS: After tonsillectomy and adenoidectomy procedures, despite reduced postoperative vomiting with use of propofol rather than halothane, along with nitrous oxide for anesthetic maintenance, the authors found no differences in "true" endpoints such as unplanned admissions or discharge times. Among the groups, the main factor that delayed hospital discharge beyond 6 h was vomiting within the first 6 h.

Adenoidectomy↗
PubMed1994

Lymphoma of the thyroid mimicking thyroiditis in a patient with the acquired immune deficiency syndrome.

A 35-year-old man with AIDS and a history of a remission from the lymphoma of the right tonsil (previously treated with chemotherapy and radiation) presented with a variety of clinical, laboratory and radiological findings strongly suggestive of subacute thyroiditis. Fine needle aspiration biopsy failed to establish the tissue diagnosis. Pathological examination of the thyroid tissue obtained during an open surgical biopsy revealed a lymphoma. Appropriate chemotherapy produced a rapid clinical and laboratory improvement manifested by the reduction of the goiter and restoration of a euthyroid state. Hypothyroidism subsequently developed, but therapy with thyroid hormone resulted in a rapid normalization of thyroid function tests. The patient expired because of AIDS-related complications.

Adult↗
PubMed1992

Clinical management of a patient following temporomandibular joint arthroscopy.

This case report describes a patient in whom arthroscopic surgery of the temporomandibular joint (TMJ) was used to break up adhesions between the TMJ disc and the articular eminence and therefore improve mobility of the joint. Postsurgical physical therapy procedures used were high voltage electrical stimulation, transcutaneous electrical nerve stimulation, moist heat, ultrasound, ice, mobilization, and therapeutic exercises. Postsurgical goals included normalization of range of motion, elimination of pain, elimination of inflammation, and mandibular function without restriction. Special emphasis is given to an unusually effective mobilization technique used to decrease tenderness in the TMJ. The conservative therapy described may be used for persons with similar symptoms and evaluation findings who do not require surgery. [Waide FL, Bade DM, Lovasko J, Montana J. Clinical management of a patient following temporomandibular joint arthroscopy.

Adolescent↗
PubMed1992

Acute closed lock in a patient with lupus erythematosus: case review.

Collagen failure has been shown to result in synovitis, joint adhesions, and internal joint derangement. This case report illustrates the similarities between patients with systemic lupus erythematosus and an internally deranged temporomandibular joint and patients with internal derangement with no lupus erythematosus. If abnormalities in intra-articular collagen tissue lead to adhesion formation and restrict normal mobility during translatory movements, joint mechanics would be compromised. Arthritic changes, vasculitis, and synovitis of systemic lupus erythematosus appear to be contributory factors in this pathophysiologic process. Diagnostic and therapeutic arthroscopic surgery was performed. Acute and chronic signs of synovitis were observed during surgery, and tissue samples were obtained for histologic interpretation.

Adult↗
PubMed1989

Spontaneous regression of choroidal melanoma over 8 years.

The authors observed clinical regression of an apparent primary choroidal melanoma in a 66-year old man over an eight-year interval. This regression was documented photographically and ultrasonographically. The authors discuss the possible mechanisms responsible for this clinical course.

Aged↗
PubMed1982

Cytologic cell collection, suspension and preservation for automated screening procedures.

Since disaggregation for monodispersion is optimal when the specimens are suspended in solutions of low alcohol content, we evaluated a modified Davis' solution as a collection and suspension medium. The preservation of specimens maintained at room temperature (21 C) in this solution, which contained only 10% ethanol instead of the usual 20%, was evaluated both qualitatively and quantitatively. Control slides were made on day 1, and experimental slides were made on days 3, 7, 14, 21 and 28. The slides were evaluated by a cytotechnologist and confirmed by a pathologist for the onset of degenerative changes and loss of diagnostic value. The slides were also quantitatively analyzed by a semiautomatic instrument, the Cyto-Tally, adding substantial numerical value to the inquiry. The fragility of leukocytes was evident by the 14th day. Squamous cell degeneration was seen in the interval between two and four weeks depending on the initial state of the specimen. However, the specimens were of diagnostic value for up to four weeks.

Cell Aggregation↗
PubMedDate not supplied

Isospora belli diarrheal infection in homosexual men.

Unsporulated Isospora belli oocysts were detected in the stool specimens of three homosexual men. The oocysts were ellipsoidal measuring 23-33 X 12-15 micron. It is acid fast with modified cold kinyoun stain (MCK) and reveals orange fluorescence with the Truant's stain. Sheather's sucrose flotation method is effective in concentrating Isospora oocyst as with other coccidial oocysts. One specimen showed many Charcot-Leyden crystals. All three patients responded to treatment. Isosporiosis is rare in this country and is endemic in the tropics and subtropics. Although one case acquired the infection after returning from an endemic area, the other two cases had no travel history. This raised the suspicion that this, like other parasitic infections (amebiasis, giardiasis, cryptosporidiosis) may be sexually transmitted. Such exotic parasitic infections in homosexual men during the outbreak of the acquired immunodeficiency syndrome adds another unusual infectious agent to the differential diagnosis of diarrheal disease in this high risk group of population.

Adult↗