Articles: chronic.
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Case Reports
Fluctuating Pulse Oximetry Readings in an Adolescent With Hemoglobin Bibba: A Case Report.
Hemoglobinopathies caused by unstable hemoglobins represent a wide group of diseases that include hemoglobin Bibba. Hemoglobin instability may cause chronic hemolytic anemia and conformational changes in hemoglobin that affect affinity for oxygen and absorption of wavelengths of light used in pulse oximetry devices. We report the case of an adolescent with hemoglobin Bibba and α-thalassemia. SpO2 was unexpectedly low despite stable vital signs when his hemoglobin was closer to 10 g/dL and normal when his hemoglobin was lower, presumably when there was less unstable hemoglobin because of hemolysis.
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To replicate a study by Schutze and colleagues on a headache sample, rather than a heterogenous chronic pain sample, investigating whether level of mindfulness predicts key components in the Fear-Avoidance Model of chronic pain (pain intensity, negative affect, pain catastrophizing, pain-related fear, pain hypervigilance, and functional disability); to investigate the relationships between level of mindfulness and headache/migraine pain intensity, frequency, and duration. ⋯ Findings suggest that mindfulness may be integrated into the Fear-Avoidance Model of chronic pain for individuals with chronic headache/migraine. Directions for future research are discussed.
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Case Reports
Axillary Artery Dissection After Ultrasound-Guided Infraclavicular Brachial Plexus Block: A Case Report.
A 52-year-old man with end-stage renal disease underwent ultrasound-guided infraclavicular brachial plexus block for revision of an arteriovenous fistula. On postoperative day 2, the patient developed pain and loss of motor function in the surgical extremity. ⋯ Sensory deficits resolved over the next 3 days. Smoking, hypertension, diabetes mellitus, and chronic intake of a calcineurin inhibitor might have predisposed the patient to iatrogenic arterial dissection.
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Gaucher disease is a common inborn error of metabolism leading to widespread chronic inflammation and often thrombocytopenia. Here we discuss assessment of coagulation in a parturient with Gaucher disease treated with imiglucerase, who presented with thrombocytopenia and requested epidural analgesia for planned vaginal delivery. We used thromboelastography to determine the safety of placing an epidural catheter and to plan for potential peripartum bleeding. The patient had a normal coagulation profile by thromboelastography and had uncomplicated epidural analgesia for a successful spontaneous vaginal delivery.