The Journal of the American Osteopathic Association
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J Am Osteopath Assoc · Jul 2014
Case ReportsOsteopathic musculoskeletal examination and subarachnoid anesthetic administration in a patient with severe scoliosis.
Physicians primarily use palpation of anatomical landmarks to guide the placement of needles when administering neuraxial anesthetics. For patients with anatomical abnormalities such as scoliosis, it is also important for physicians to understand Fryette mechanics and spinal curvature anatomy, as well as preprocedural radiography and ultrasonography, to ensure accuracy in neuraxial anesthetic procedures. ⋯ Using palpation and imaging, his physicians were able to successfully administer a subarachnoid anesthetic injection on the first attempt. The authors discuss considerations for improving success rates of neuraxial anesthetic administration in these patients.
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J Am Osteopath Assoc · Jul 2014
ReviewManagement of ionizing radiation injuries and illnesses, Part 3: Radiobiology and health effects of ionizing radiation.
Ionizing radiation exposure can induce profound changes in intracellular components, potentially leading to diverse health effects in exposed individuals. Any cellular component can be damaged by radiation, but some components affect cellular viability more profoundly than others. ⋯ In other cases, activation of the genetic machinery can lead to a genetic cascade potentially leading to mutations or cell death by apoptosis. In the third of 5 articles on the management of injuries and illnesses caused by ionizing radiation, the authors provide a clinically relevant overview of the pathophysiologic process associated with potential exposure to ionizing radiation.