Curēus
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Case Reports
Sphenopalatine Ganglion Block: Treatment of Migraine and Trigeminal Neuralgia Associated With Multiple Sclerosis.
Head and facial pain are a burden to many people both directly and indirectly. This is manifested not only as a personal burden but also as a financial one in the form of sick leaves from work and loss of workplace productivity. ⋯ We present a case of a young female suffering from headache and orofacial pain secondary to multiple sclerosis (MS) and trigeminal neuralgia (TN) refractory to traditional medical management, who underwent SPGB with immediate relief of her symptoms. Due to its effectiveness, the role of the SPGB in the treatment of various other conditions causing headache and orofacial pain, such as MS or even TN, continues to expand providing relief and restoring functionality.
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There has been a substantial burden of healthcare worker infection during the current coronavirus (COVID-19) pandemic, likely due to a lack of adequate preparedness, suboptimal institutional infection control measures, atypical patient presentation, poor compliance with personal protective equipment (PPE) and exposure to high-risk aerosol generating procedures, such as endotracheal intubation. There is significant concern that developing countries will face heightened levels of staff exposure during the COVID-19 pandemic. ⋯ However, in practice these boxes were found to hamper endotracheal intubation and other procedures due to the limited space and manoeuvrability they allow. To further reduce particle dispersion and to improve on the practicality and ergonomic design of the prototype "aerosol box", the Intubox was developed by staff at the Charlotte Maxeke Johannesburg Academic Hospital after instituting several changes to the prototype design.
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Morel-Lavallée lesions are closed degloving soft tissue injuries that should be considered in post-traumatic patients with persistent pain or swelling. Physicians must keep a high index of suspicion for this commonly missed entity, as early diagnosis is critical to preventing complications. We describe a case of a 46-year-old male who presented to the emergency department following a motorcycle accident. ⋯ He later returned with worsening right thigh pain and swelling. Further imaging showed a large fluid collection between the muscle and subcutaneous tissues consistent with a Morel-Lavallée lesion. This case report discusses the common presentation, diagnostic modalities, and treatments to help improve the identification and management of Morel-Lavallée lesions.
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During the initial wave of the coronavirus disease 2019 (COVID-19) pandemic, many hospitals struggled to forecast bed capacity and the number of mechanical ventilators they needed to have available. Numerous epidemiological models forecast regional or national peak bed and ventilator needs, but these are not suitable for predictions at the hospital level. We developed an analytical model to assist hospitals in determining their census and ventilator requirements for COVID-19 patients during future periods of the pandemic, by using their data. ⋯ A major benefit to individual hospitals from such modeling has been to provide reassurance to state and local governments that the hospitals have sufficient resources available to meet anticipated needs for new COVID-19 patients without having to set aside substantially greater numbers of beds or ventilators for such care. Such ongoing activity is important for the economic recovery of hospitals that have been hard-hit economically by the shutdown in elective surgery and other patient care activities. The modeling software is freely available at https://FDshort.com/COVID19, and its parameters can easily be modified by end-users.
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Case Reports
A Case Report of Disseminated Blastomycosis With Thyroid Involvement in a Pregnant Patient.
Blastomyces dermatitidis is the causal agent of blastomycosis, an invasive and often serious fungal infection. Blastomycosis typically presents as a pulmonary infection, but common extrapulmonary manifestations of blastomycosis include the skin, bones, and reticuloendothelial systems. Disseminated blastomycosis occurs more prominently in immunocompromised individuals, such as organ transplant recipients, HIV patients, and pregnant women. We report here a rare case of disseminated blastomycosis to the thyroid in a pregnant patient. This case emphasizes the unique challenges of diagnosing and treating disseminated fungal infections in pregnancy.