Articles: chronic.
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Case Reports
Neglected Bilateral Facet Dislocation of the Cervical Spine with Intact Neurology: Reduction Technique.
Bilateral cervical facet dislocation is a serious injury that in majority cause neurologic deficit requiring prompt medical attention. Rarely, they retain normal neurology due to spontaneous decompression even though patients can have objective myelopathic or root compression signs. ⋯ Here, we report a case of a 26-year-old female who had neglected bilateral facet dislocation with neck stiffness that was operated with posteroanterior approach with near-complete reduction and intact neurology. We describe the technique employed and discuss the literature.
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Reduced glomerular filtration rate and presence of albuminuria are both associated with increased risk of several poor outcomes. People with chronic kidney disease also commonly suffer from lower quality of life than their age-matched peers. The experiences reported by patients with chronic kidney disease include being shocked by the diagnosis, being uncertain about the cause and worrying about progression and future treatment. ⋯ Helping people to live well with a long-term condition like chronic kidney disease should include efforts to reduce the risk of adverse events occurring in the future, and consider what can be done to enhance quality of life now. Clinicians can help by being aware of the patient perspective, communicating clearly and recommending interventions that reduce future risk as well as recognising and treating symptoms. Assessing overall treatment burden is an important component of management and non-pharmacological interventions that may improve mobility, strength and pain should be considered.
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Current pricing of commercial mechanical ventilators in low-/middle-income countries (LMICs) markedly restricts their availability, and consequently a considerable number of patients with acute/chronic respiratory failure cannot be adequately treated. Our aim was to design and test an affordable and easy-to-build noninvasive bilevel pressure ventilator to allow a reduction in the serious shortage of ventilators in LMICs. ⋯ The low-cost, easy-to-build noninvasive ventilator performs similarly to a high-quality commercial device, with its open-source hardware description, which will allow for free replication and use in LMICs, facilitating application of this life-saving therapy to patients who otherwise could not be treated.