Donald Sadowsky

Central hemangioma of the mandible

Abstract A case report of a central hemangioma in an 11-year-old boy is presented along with cogent literature review. Issues discussed include the histogenesis, clinical presentation, diagnosis, and variations in mode of treatment. The case in question involved collateralization of contralateral vessels and two operative procedures. The outcome appears to have been complete remission of the lesion.

Mucormycosis: Discussion and report of a case involving the maxillary sinus

Abstract Mucormycosis is a human fungal infection which occurs in two main forms: superficial and visceral. The visceral variety has been associated with a poor prognosis and usually presents with either pulmonary, gastrointestinal, or head and neck involvement. Mucormycosis is frequently found in patients with uncontrolled or poorly controlled diabetes. This article reports a case of this potentially lethal disease in which satisfactory treatment and cure entailed both definitive surgical intervention and a therapeutic regimen of amphotericin B.

Myotonic dystrophy: Surgical and anesthetic considerations during orthognathic surgery

The surgical and anesthetic considerations of orthognathic surgery for a patient with myotonic dystrophy are discussed. A case report is presented demonstrating how a surgical treatment plan can be modified to avoid the potential postoperative problems associated with this disease.

Predictors of dentists' level of knowledge regarding the recommended prophylactic regimen for patients with rheumatic heart disease

Maintaining knowledge of clinical practices, conforming to the latest scientific information, is a major challenge for health professionals. The study aims were to measure clinicians knowledge and to determine what social factors could best explain and predict those dental clinicians who are most knowledgeable about current expert recommendations for the use of appropriate antibiotic regimens for patients at risk for bacterial endocarditis. Telephone interviews were conducted with 322 New York State dentists, assigned to the study by a computer-generated randomization procedure from lists of oral surgeons, urban general practitioners and rural general practitioners. Data demonstrated extraordinary differences in level of knowledge between oral surgeons and general practitioners, while the level of knowledge between urban and rural general practice groups was quite similar. General Linear Model (GLM)-based analyses indicated that practice size, rationalization of practice, and practice setting and affiliations contributed to the explanation of knowledge level among general practitioners, when adjusted for age. R2s for each of those variables and age, ranged from a low of 0.132 to a high of 0.334. Age made a significant contribution to the explanation of knowledge level in all of the models presented, while the explanatory power of the practice structure variables varied according to respondents locale (urban vs rural) and age (younger vs older). In order to assess the impact of these structural variables, they were dichotomized (high-low) and entered into a GLM program which accounted for age and locale. Differences in excess of 20 points (on a 0-100 knowledge scale) were sometimes noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Monocular blindness secondary to a non-displaced molar fracture

We report a case of monocular blindness subsequent to a non-displaced malar fracture. Injury to the optic nerve, secondary to orbital apex syndrome, was implicated as the cause of blindness. Although most non-displaced malar fractures require no surgical intervention and resolve quite uneventfully, they can be associated with significant morbidity. Patients diagnosed as having non-displaced malar fractures should be followed on admission by careful observation and ophthalmologic consultation.

Professional life cycle changes and their effect on knowledge level of dental practitioners.

Utilizing a national data set (U.S.A.), the effect of age and age-related professional characteristics on dentists knowledge with regard to prevention of infective endocarditis was examined. The following research questions were addressed: (1) Do age-related characteristics produce different effects on knowledge level at various stages of professional careers?; (2) What are the key changes in these age-related characteristics and what processes are suggested by these changes? Multiple regression analysis assessed the influence of potential predictors of variation in knowledge level with regard to prevention of infective endocarditis for the entire sample. Using these findings as a guide, variation in the effect of significant predictor variables was then analyzed for three time segments of approximately equal duration: early professional life less than 40, mid-professional life 40-54, and older professional life 55 or greater than. Age had a profoundly negative effect on knowledge level, i.e. the level progressively declines as clinicians grow older. The impact of the age-related characteristics on knowledge level of infective endocarditis prevention also varied according to the stage of the professional life cycle. Indices measuring the size or extent of theoretical understanding, in-office networks, institutional affiliations, and consulting networks were significant predictors of endocarditis prevention knowledge for younger clinicians. For those 40-54, only practice organization (office business and staff size and diversity) was a significant predictor, while for older clinicians theoretical understanding was the only significant predictor. Differences in the mean levels of these predictor (independent) variables across age groups were also examined via ANOVA.(ABSTRACT TRUNCATED AT 250 WORDS)

Predicting knowledge acquisition in two clinician groups: Rethinking the standard paradigm

The focus of this study was an innovative antibiotic preventive regimen recommended by experts and regularly updated. Data about knowledge of this regimen and potential predictors of knowledge levels were obtained from representative samples of New York State urban and rural general dental practitioners. Using multivariate analyses, four research objectives were achieved: measurement of clinicians level, of knowledge in both groups; identification of personal and professional work and communication factors influencing clinicians knowledge level; assessment of the effect of each of these factors on knowledge; and differentiation between sets of predictors for each group. Explanatory factors in this study appeared to be specific, situational, and/or ecologic. The role of distinct configurations of communication networks in the knowledge acquisition process is noted.