Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
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J. Oral Maxillofac. Surg. · Sep 2003
Randomized Controlled Trial Clinical TrialDexamethasone suppresses peripheral prostanoid levels without analgesia in a clinical model of acute inflammation.
The therapeutic effects of glucocorticoids are generally attributed to suppression of multiple signaling pathways involved in the inflammatory response leading to decreased levels of inflammatory mediators at the site of injury. This study evaluated the in vivo relationship between levels of prostanoids at the site of tissue injury and analgesia after dexamethasone administration in a clinical model of tissue injury. ⋯ The lack of an analgesic effect for dexamethasone while reducing both PGE(2) and TxB(2) at the site of injury in comparison to ketorolac analgesia accompanied by greater reductions in levels of these prostanoids suggests that glucocorticoids at this dose do not suppress PGE(2) release sufficiently to attenuate peripheral sensitization of nociceptors after tissue injury.
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J. Oral Maxillofac. Surg. · Sep 2003
Randomized Controlled Trial Clinical TrialSingle doses of parecoxib sodium intravenously are as effective as ketorolac in reducing pain after oral surgery.
Our goal was to compare the analgesic efficacy and safety of single doses of intravenous parecoxib sodium, a prodrug of the novel cyclooxygenase (COX)-2-selective inhibitor valdecoxib, with intravenous ketorolac and placebo in postoperative oral surgery patients. ⋯ Parecoxib sodium, a novel parenteral prodrug of the COX-2-selective inhibitor valdecoxib, is as effective and longer acting at 50- and 100-mg intravenous doses than a standard dose of ketorolac 30 mg intravenously. Parecoxib sodium appears to be safe and well tolerated and, therefore, merits further evaluation in other models of postsurgical pain.
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We sought to assess the methods of treatment used and outcomes for a large sample of patients with comminuted fractures of the mandible. ⋯ The results of this study show that, when possible, the use of open reduction and stable internal fixation is associated with a low complication rate. However, not all comminuted fractures are amenable to this treatment, and in those, alternatives such as closed reduction with MMF or the application of external pin fixation may be necessary.
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J. Oral Maxillofac. Surg. · Jul 2003
The development of acute post-traumatic stress disorder after orofacial injury: a prospective study in a large urban hospital.
Psychologic distress is a common outcome among trauma survivors. This report examines both the development and predictors of acute post-traumatic stress disorder (PTSD) symptoms in a sample of US inner-city orofacial trauma survivors seeking treatment in a publicly funded hospital. ⋯ A substantial subsample of these traumatized medical patients had negative psychologic outcomes at 1 month. Results underscore the potential use of screening survivors of orofacial injury at urban trauma centers for PTSD and developing systems of care that facilitate referral to appropriate psychologic treatment.
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J. Oral Maxillofac. Surg. · Jul 2003
Case ReportsAdverse events with outpatient anesthesia in Massachusetts.
This retrospective study documented the frequency of various complications associated with outpatient anesthesia. ⋯ The results of this retrospective practitioner survey documented the specific incidence of untoward anesthetic events with outpatient anesthesia and found a mortality rate consistent with the 6 similar mortality studies since 1980. These 7 retrospective reviews found 34/28,399,193 outpatient deaths for an overall dental anesthesia mortality rate of 1/835,000.