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J R Hupp

Publications and source records attributed to J R Hupp.

15 recordsLinked to original sources

Advances in cardiovascular pharmacological therapy.

Progress in the pharmacological management of cardiovascular disease has been accompanied by the appearance of drugs with never before seen capabilities to alter human physiological processes. The widespread use of these potent agents poses a challenge to the oral and maxillofacial surgeon attempting to safely manage patients in the ambulatory setting. This article reviews the field of contemporary cardiovascular pharmacotherapy from the aspect of how it affects the practice of oral and maxillofacial surgery.

Anti-Arrhythmia Agents

Steel coils.

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Adult

Myocardial infarction: current management strategies.

Coronary artery disease is a common malady in industrialized societies. The end stage of this progressive disorder frequently results in myocardial infarction (MI), now known to be due to acute thrombosis of a narrowed coronary artery. In the past, supportive care was all that could be offered to patients suffering MI. But the new therapeutic modalities of thrombolysis and transluminal coronary angioplasty now offer a means of limiting the damage caused by coronary stenosis and thrombosis in many cases. This article reviews conventional, recently introduced, and possible future treatment strategies to manage coronary obstruction. Current concepts of handling the patient suffering a suspected acute coronary thrombosis in the office setting are presented as well.

Angioplasty, Balloon

Use of porous hydroxylapatite blocks for augmentation of atrophic mandibles.

A clinical study of the use of porous blocks of hydroxylapatite (Interpore 200) for augmentation of atrophic residual mandibular ridges was performed. Fifteen patients each had three preoperatively customized blocks placed. They were then examined clinically and radiographically for at least 2 years. Six patients had skin-graft vestibuloplasties performed over the blocks 3 months after implantation; dentures were made for 11 of the patients. No clinical or radiographic evidence of migration or resorption of the blocks was found; however, all 15 patients suffered complications. Eleven developed ulcerations over the blocks with persistent exposure, six had suture line dehiscence leading to exposure, two infections occurred, and two patients developed chronic pain in the area of block insertion. The skin graft took only partially in all patients undergoing subsequent vestibuloplasties. To date, 37 of the original 45 blocks have required complete removal. Histologic examination of removed blocks has revealed partial filling of the pores with lamellar bone. The use of blocks of porous hydroxylapatite to reconstruct atrophic residual mandibular ridges was found to have an unacceptably high rate of failure and the ability to sustain an overlying split-thickness skin graft was unpredictable.

Aged

Intensity and duration of amnesia from intravenous midazolam given for sedation.

A clinical study was performed investigating the ability of intravenous midazolam to cause amnesia for visual, auditory and painful stimuli presented during surgical removal of third molars. Various stimuli were presented prior to and after administration of a sufficient quantity of midazolam to produce profound sedation. Recall was then tested immediately after, one day, and one week following the surgery. The study found that midazolam produces at least 20 minutes of profound amnesia for all stimuli in 93 +/- 6% of individuals. However, little correlation was found between the dose of midazolam and the duration of amnesia. Anesthesia literally means the loss of sensation. In the clinical dental situation, the principle sensation lost, when using either regional or general anesthesia, is pain perception. Although prevention of pain sensation is the primary reason patients request local anesthesia prior to invasive dental care, for many patients, control of pain only partially prepares them to receive dental care. These patients request the adjunctive use of sedation or general anesthesia, not for further pain control, but rather requiring periodontal or oral/maxillofacial surgery in which such factors as the sight and taste of blood, the noise of bone-cutting equipment, or the pressure placed on the jaws is not eliminated by local anesthetics. Although effective anxiolytic oral, inhalational, or parenteral agents have been available for several decades, patients still usually retain their memory of events occurring during their dental care, particularly anxiety-provoking events. This memory of the uncomfortable portions of dental care stimulates additional anxiety so that patients may procrastinate when dental care is necessary.(ABSTRACT TRUNCATED AT 250 WORDS)

Amnesia

Superselective angiography with digital subtraction and embolization of a maxillary hemangioma in a patient with Eisenmenger's syndrome.

Central maxillofacial hemangiomas can represent diagnostic and therapeutic problems. The concurrent existence of Eisenmenger's complex in the presented case added an anesthetic challenge. The development of superselective arterial catheterization and digital subtraction angiography has been instrumental in improving the ability of clinicians to diagnose and effectively manage vascular lesions, especially in the maxillofacial region. Embolization remains an excellent adjunctive therapy for vascular processes.

Adult