Biomedical subjects
Publications and source records attributed to M A Conover.
The novel bromotyrosine derivative verongamine [1] has been isolated from the marine sponge Verongula gigantea. The isolation of verongamine was facilitated by employing histamine-H3 bioassay-guided fractionation. Verongamine is a specific histamine-H3 antagonist at concentrations as low as 1 microgram/ml.
Computers are being integrated into all aspects of the dental office. This article uses a patient study to demonstrate the capabilities of new software systems to aid the orthodontist and surgeon in orthognathic treatment planning.
Thirty adult surgical patients admitted to the recovery room with an oral temperature less than or equal to 35.0 degrees C were randomized into two groups. Group 1 patients were covered with cotton blankets warmed to 37.0 degrees C, and group 2 patients were treated with a forced-air warming system. Mean oral temperature on admission to the recovery room was the same in both groups (34.3 degrees C). Oral temperature and the presence or absence of shivering were recorded at 15-min intervals. After application of the selected warming method, patients in group 2 were warmer at all time intervals. Mean temperatures in the forced-air heating group and in group 1 were, respectively, 34.8 degrees C and 34.3 degrees C (P less than 0.05) at 15 min; 35.0 degrees C and 34.2 degrees C (P less than 0.01) at 30 min; 35.2 degrees C and 34.5 degrees C (P less than 0.05) at 45 min; 35.8 degrees C and 34.7 degrees C (P less than 0.001) at 60 min; 36.0 degrees C and 35.0 degrees C (P less than 0.01) at 75 min; and 36.0 degrees C and 35.0 degrees C (P less than 0.01) at 90 min. The incidence of shivering was significantly greater in group 1 at 15 and 45 min. In addition, time spent in the recovery room was significantly greater in group 1 than in group 2, 156.0 min versus 99.7 min (P less than 0.003).
The association between preoperative smoking cessation and postoperative pulmonary morbidity was studied prospectively in 200 consecutive patients undergoing an elective coronary artery bypass surgical procedure. Detailed respiratory, cardiovascular, and smoking histories were elicited. Preoperative arterial blood gas analyses and bedside spirometry were performed. Urinary cotinine levels were measured to verify smoking histories. During spirometry, severe angina developed in seven patients, who were hence excluded from the study; one patient died of hemorrhage intraoperatively. An observer unaware of patients' preoperative histories assessed the remaining 192 patients throughout the intraoperative and postoperative periods for pulmonary complications. Postoperative pulmonary complications occurred in a third of the current smokers. Patients who had stopped smoking for 2 months or less had a pulmonary complication rate almost 4 times that of patients who had stopped for more than 2 months (57.1% versus 14.5%). Patients who had stopped smoking for more than 6 months had rates similar to those who had never smoked (11.1% and 11.9%, respectively). Preoperative pulmonary dysfunction, increased pack-years of smoking, prolonged surgical time, and the use of enflurane were independently associated with postoperative pulmonary morbidity (P less than 0.05). We concluded that smoking cessation should occur at least 2 months preoperatively to maximize the reduction of postoperative respiratory complications.
A shortened prophylactic regimen of antibiotics for maxillofacial and craniofacial surgery is evaluated. Eighty-five patients were divided into two groups on the basis of the type of incision used. Forty-nine patients undergoing intraoral procedures received penicillin perioperatively and were given one postoperative dose (regimen A). Thirty-six patients undergoing extraoral or combined intraoral and extraoral procedures received penicillin and oxacillin perioperatively, with nine receiving one postoperative dose and 27 receiving an average of seven postoperative doses (regimen B). One infection was observed in the regimen A group, and three were observed in the regimen B group. This infection rate compares favorably to that encountered in the authors' previously reported study on longer prophylactic courses of antibiotics.
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