Patients and Methods: A retrospective chart review of infected mandible fractures managed by a single oral and maxillofacial surgeon at a level I trauma center during a 7-year period was accomplished by independent examiners. All patients were treated selleck products with incision and drainage, culture and sensitivity testing, extraction of nonsalvageable teeth, placement of maxillomandibular fixation when possible, fracture reduction with bone debridement and decortication, rigid internal fixation of the mandible

by an extraoral approach, and antibiotic therapy. The medical and social history was contributory in most patients. The analysis was stratified by the differentiation of the fractures into 2 groups: those with soft tissue infections in the fracture region versus those with hard tissue-infected fractures (biopsy-proven osteomyelitis).

Results: A total of 44 patients were included in this study, with an average follow-up of 18.2 months from the date of surgery (range 3 to 48). The treatment protocol was successful in all 18 patients (100%.) with soft tissue infected mandibular GDC 0068 fractures and 24 (92%) of 26 patients with hard tissue-infected fractures.

Conclusions: A protocol consisting of concomitant incision

and drainage, mandibular debridement, fracture reduction, and stabilization with rigid internal fixation can be effectively used for single-stage management of infected mandible fractures. (C) 2009 American Association of Oral and Maxillofacial Surgeons J Oral

Maxillofac Surg 67:1046-1051, 2009″
“To present a rare case of a multiparous woman undergoing elective cesarean section with apparent symptoms of acute coronary syndrome and who was later diagnosed with Takotsubo cardiomyopathy (TCM; “”broken heart syndrome”"). To review similar case reports already reported in literature.

Literature search on the occurrence of TCM in pregnancy using MEDLINE and Cochrane databases.

TCM might occur in women with no known pre-existing cardiomyopathy and uncomplicated pregnancies undergoing cesarean section, especially in combination IWR-1-endo with the administration of catecholamines/vasoconstrictive substances and possibly also oxytocin and prostaglandins.

Since TCM is related to emotional and physical stress, the surroundings during cesarean section should be kept quiet and smooth. Adrenergic stimulants (adrenaline, phenylephrine, ergonovine, ephedrine) and anticholinergics (atropine) should be used with caution and adequate volume substitution prior to the onset of spinal analgesia for the prevention of hypotension should be provided. If signs of an acute coronary syndrome during cesarean section do occur, echocardiography is obligatory for diagnosis of TCM.