[5 years' experience with conscious sedation with midazolam (Dormicum Roche) in stomatology]. / Nase petileté zkusenosti se sedací pri vedomí midazolamem (Dormicum Roche) ve stomatologii.

The authors used Midazolam in dental treatment of 225 patients of both sexes (ASA I-IV). 25 patients suffering from heart diseases (ASA III-IV) were ECG monitored during the treatment. Midazolam with the biological half-life of 0.5-1.5 hours was successfully used for premedication of dental out-patients. The used doses had no significant influence on hemodynamic and respiratory values. Specific antagonist Flumazenil reduced the period of psychological recovery of the patients and thus made it possible for the patients to be dismissed within 30 minutes after the dental treatment if accompanied.

[Eikenella corrodens as part of the polymicrobial flora in infectious endocarditis]. / Eikenella corrodens jako soucást polymikrobiální flóry pri infekcní endokarditide.

The authors describe a case of polymicrobial endocarditis in a 24-year-old patient with immunodeficiency and a damaged heart (mitral valve affection, septal defect). Among the mixed flora, comprising Streptococcus intermedius and two types of the genus Bacteroides, in the haemoculture also a microaerophil potentially pathogenic type Eikenella corrodens was cultivated. The authors describe the properties of Eikenella corrodens, its occurrence in man and its ability to produce an infectious process in primarily damaged organs (in particular the endocardium) in weakened subjects and drug addicts. The authors mention the diagnostic criteria for assessment of Eikenella corrodens and how to cultivate it from infectious material.

Eikenella corrodens infection of the oral cavity as a cause of bacterial endocarditis.

The authors describe the case of a 24-year-old woman with valve disease. After a bout of respiratory tract infection, she was diagnosed to have bacterial endocarditis associated with mitral valve disease. The causative agents isolated included Eikenella corrodens, Streptococcus intermedius, Bacteroides oralis and Bacteroides bivius. At the same time, the patient was found to have developed IgA immunodeficiency. A complication accompanying the cardiac disease was spontaneous pneumothorax. Since antibiotic therapy had failed, the mitral valve was replaced by a prosthetic one. After the procedure, the patient had her teeth examined. The examination revealed complete destruction of tooth 36, thick layers of calculus and chronic gingivitis. E. corrodens was isolated also after microbiological examination of the patient's oral cavity. The reason for reporting on what we regard as an interesting case is that bacterial endocarditis with E. corrodens implicated as the causative agent is relatively rare; to date, polymicrobial endocarditis due to E. corrodens and other microorganisms has been described in intravenous drug addicts only.