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Biomedical subjects

M W Ochs

Publications and source records attributed to M W Ochs.

25 records · Page 2Linked to original sources
PubMed1991

Facial erysipelas: report of a case and review of the literature.

The diagnosis of erysipelas is usually made clinically. Features that help distinguish erysipelas are acute onset, erythema, warmth, edema, pain, fever, and isolated regional involvement with clearly demarcated margins. High ASO titers and response to penicillin therapy are reassuring. Simple uncomplicated erysipelas or cellulitis in adults can usually be treated on an outpatient basis. Extensive facial involvement with fever and a toxic appearance warrants hospitalization. Facial cellulitis or erysipelas in children, unless quite limited, requires hospitalization because of the high risk of Hemophilus influenzae infection and sepsis. Hospitalized patients should show visible signs of resolution and be afebrile for at least 24 hours prior to discharge. They should be maintained on oral antibiotic therapy at home for an additional 7 to 10 days.

Adult↗
PubMed1990

The effectiveness of flumazenil in reversing the sedation and amnesia produced by intravenous midazolam.

In this double-blind study 31 outpatients undergoing third molar extraction were randomly assigned to one of two groups. All patients were sedated with intravenous midazolam (IV) by titration method. The flumazenil group (n = 20) received an average of 0.8 +/- 0.17 mg of flumazenil IV. The placebo patients (n = 11) each received 10 mL of normal saline. By both observer and patient alertness ratings, patients receiving flumazenil appeared significantly more alert than placebo patients at 5, 15, 30, and 60 minutes following reversal. After reversal the flumazenil group had significantly higher scores than the placebo group at all intervals through 60 minutes. All the patients receiving flumazenil were able to walk without assistance at 5 minutes, compared with only one patient in the placebo group, and more patients in the flumazenil group recognized the picture card shown to them at 5, 15, 30, and 60 minutes postreversal. Flumazenil is effective in terminating the amnestic properties of midazolam, but this appears to occur to a lesser extent than the reversal of its sedative properties.

Amnesia↗
PubMed1990

Heparinization after Le Fort I osteotomy in a patient with chronic atrial fibrillation.

The middle-aged patient with a dentofacial deformity complicated by partial edentulism and underlying medical problems presents a challenge to the orthodontic-surgical team. The clinical management of a 51-year-old man with maxillary deficiency and chronic atrial fibrillation is presented. Preoperative evaluation and planning, and a scheme and rationale for perioperative anticoagulation, are crucial. The etiology and risks of chronic atrial fibrillation are reviewed along with anticoagulation therapy.

Atrial Fibrillation↗
PubMed1986

A comparison of amnesia in outpatients sedated with midazolam or diazepam alone or in combination with fentanyl during oral surgery.

Midazolam is a new, water-soluble benzodiazepine that has been reported to produce a greater degree of amnesia than does diazepam. This study compares the amnesia produced in patients sedated with midazolam or diazepam or in combination with fentanyl during oral surgery. Twenty-four hours after surgery, each patient answered a questionnaire designed to assess his or her recall of events during and after surgery. Patients who received midazolam alone recalled significantly less than did patients in either diazepam group. The addition of fentanyl to midazolam did not produce any significant difference in recall.

Anesthesia, Dental↗
PubMed1986

Arterial blood gas levels after midazolam or diazepam administered with or without fentanyl as an intravenous sedative for outpatient surgical procedures.

The purpose of this study was to compare arterial blood gas measurements made during the baseline, initial sedation, maintenance, and recovery periods in patients sedated with midazolam and saline (MS), midazolam and fentanyl (MF), diazepam and saline (DS), and diazepam and fentanyl (DF). During induction both the MF and the DF groups had significantly lower average PO2, pH, and O2 saturations and significantly higher PCO2 values than either the MS or the DS group. While the differences were not as great, the same was also true during the maintenance phase of the procedure. During recovery, patients receiving MF had lower average PO2, pH, and O2 saturation and higher PCO2 values than the MS or the DF group. Patients receiving MF had significantly lower average PO2, pH, and O2 saturation levels and significantly higher average PCO2 levels during all three postsurgical periods than at baseline. Patients receiving DF had significantly lower average PO2, pH, and O2 saturation levels and significantly higher Pco2 levels during both induction and maintenance than at baseline.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

Recovery following sedation with midazolam or diazepam alone or in combination with fentanyl for outpatient surgery.

Midazolam is a new water-soluble benzodiazepine with a much shorter pharmacologic half-life than diazepam. Despite this shorter pharmacologic half-life, several reports indicate that patients do not recover more rapidly after sedation with midazolam than with diazepam. The purpose of this study was to compare recovery of patients sedated with either midazolam or diazepam alone or in combination with fentanyl using the digit symbol substitution test (DSST) and Trieger test. Patients were randomly divided into treatment groups and recovery tests were administered to the patients prior to sedation and at 60, 120, and 180 minutes after achieving a standardized sedative endpoint. Patients who received midazolam alone had significantly fewer numbers of correct reponses on the DSST than patients who received midazolam plus fentanyl or diazepam with or without fentanyl. When midazolam was combined with fentanyl there was no significant difference between results obtained on the DSST when compared with either diazepam group. Comparisons between all groups using dots missed or millimeter deviation on the Trieger test showed no statistical difference between any groups. These data indicate that midazolam as a single IV agent has a slightly prolonged recovery phase compared to diazepam. The addition of fentanyl to the sedation regimen allows reduction in the midazolam dose resulting in a recovery time comparable to that of diazepam.

Anesthesia Recovery Period↗