Open Access DOI:10.23937/2377-4630/1410095

Epidural Anesthesia for a Caesarean Delivery in a Parturient with an Intrathecal Baclofen Pump and Sickle Cell Disease: A Case Report

Bastian J, Bauer A, Kern C and Robertson-Baeriswyl M

Article Type: Case Report | First Published: August 23, 2019

A 32-year-old primigravida woman received an epidural anesthetic at 38 weeks of gestation for an elective caesarean delivery. She had for the past 10 years an intrathecal baclofen infusion pump to relieve spastic tetraparesis secondary to perinatal cerebral anoxia. She otherwise also suffered from sickle cell disease complicated by several vaso-occlusive crisis during pregnancy and a recent history of thromboembolic disease. A recent CT scan showed the intrathecal catheter entering the L3-L4 int...

 Open Access DOI:10.23937/2377-4630/1410094

Persistent Lactic Acidosis - Think beyond Sepsis

Emily Pallister and Thogulava Kannan

Article Type: Case Report | First Published: August 21, 2019

A 79-year-old patient with type 2 diabetes mellitus was admitted to the Intensive Care Unit for management of Acute Kidney Injury refractory to fluid resuscitation. She had felt unwell for three days with poor oral intake. Admission bloods showed severe lactic acidosis and Acute Kidney Injury (AKI). The patient was initially managed with fluid resuscitation in A&E, but there was no improvement in her acid/base balance or AKI. The Intensive Care team were asked to review the patient and she was s...

 Open Access DOI:10.23937/2377-4630/1410093

Posterior Quadratus Lumborum Block versus Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy

Hazem El Sayed Moawad Weheba, MD, Tamer Abdelsalam, MSc, Sameh Ghareeb, MD and Mohamed Younis Makharita, MD

Article Type: Research Article | First Published: August 08, 2019

Effective perioperative analgesia with laparoscopic cholecystectomy enhances early recovery, ambulation, and discharge. Subcostal TAP block has been shown to reduce perioperative opioid use and provide effective perioperative analgesia. Currently, the QLB is performed as one of the perioperative pain management procedures for patients undergoing abdominal surgery. In the current study, we hypothesized that posterior QLB would be equal to or better than the subcostal TAP block with regard to pain...

 Open Access DOI:10.23937/2377-4630/1410092

A Prospective Observational Study of Air Burden in Intravenous Tubing: Factors that Increase Patient Exposure

Christopher F Tirotta, Richard G Lagueruela, Danielle Madril, Marysory Irizarry, John McBride, Davinder Ramsingh and Jonathan Ho

Article Type: Clinical Study Summary | First Published: August 08, 2019

An observational prospective trial was conducted in operating room settings across multiple study sites. A total of 120 surgical patients undergoing a variety of interventional and surgical procedures were included, representing multiple patient populations, case types and anesthesia setups. The ClearLine IV, a device that detects and removes air from IV tubing, was inserted into the IV circuit. Clinicians followed standard protocols. Blood warmers were used at the practitioner's discretion. IV ...

 Open Access DOI:10.23937/2469-5742/1510060

Case Report on Adult Wilms Tumor and Review of the Literature

Alvaro Sanchez Gonzalez, MD, Joseba Salguero Segura, MD, Victoria Gomez Dos Santos, PhD, Julia Carrasco Valiente, PhD, Ana Martinez Lopez, MD, Javier Burgos Revilla, PhD and Maria J Requena Tapia, PhD

Article Type: Case Report | First Published: September 07, 2019

On December 2014, elective left radical nephrectomy with loco-regional lymphadenectomy and right lobe partial hepatectomy was performed. Despite a good initial evolution, an urgent open hepaticojejunostomy was performed on the 4th postoperative day, as the patient started with elevation of cholestasis enzymes, as well as coluria and acolia, and CT scan described intrahepatic bile duct dilatation and pneumoperitoneum. Afterward, the patient evolved favorably, being discharged on January 2015....

 Open Access DOI:10.23937/2643-4512/1710027

School Education Program in Asthma and Allergic Diseases: PIPA and VIDA in Uruguaiana, Brazil

Marilyn Urrutia-Pereira and Dirceu Sole

Article Type: Review Article | First Published: September 14, 2019

Children and adolescents spend a lot of time in school where it is possible that critical allergic episodes occur. Also, there is some lack of knowledge of staff and teachers about how to assist a child in an emergency situation, especially if he or she is having an allergic reaction to something. Due to the need to improve care, knowledge, monitoring, and education regarding asthma, the Children's Asthma Prevention Program (Programa Infantil de Prevenção de Asma, PIPA) was implemented along w...

 Open Access DOI:10.23937/2643-4512/1710026

Distracted Driving Prevention Requires More than Just Legislation: Preliminary Results of a Cross-Sectional Survey

Santa Ponce, Will Pho, Cathy Farr and Ruby Skinner

Article Type: Original Article | First Published: September 04, 2019

This work, along with the vast amount of attention surrounding distracted driving led our research team to explore the behavioral and psychological characteristics of people that predispose them to risky behaviors and driving with distractions such as texting or mobile phone use. Our primary objective in this preliminary work is to characterize patterns of distracted behavior among adult drivers and to potentially identify high-risk subsets of our population to target prevention efforts. Based o...

 Open Access DOI:10.23937/2643-4016/1710012

Management Protocol of Infected Non-Union of Diaphyseal Forearm Fractures by Using External Fixation Over Intramedullary Nailing

Mohamed Ahmed AL Kersh, MD, Ahmed Said Ali, MD, Mahmoud A Mahran, MD, (MRCS UK) and Mostafa Ashoub, MD

Article Type: Research Article | First Published: August 31, 2019

The study cohort included fourteen male and seven female patients who presented to our hospital setting with an infected nonunion of the diaphysis of the radius or ulna. Every patient had a minimum of 2-year follow-up. The average patient age was 35.3 years (range 21-45). Thirteen patients had initially fractured both the radius and ulna. six patients had an isolated radius fractures, and two patients had fracture ulna alone. All patients underwent a protocol that combines aggressive surgical de...

 Open Access DOI:10.23937/2469-5823/1510131

Determinants of Health Care Utilization among the Elderly Population in Jimma Town, Oromia Region, Southwest Ethiopia

Yonas Biratu Terfa, Gugsa Nemera Germossa, Fikadu Balcha Hailu, Garuma Tolu Feyisa, Fikru Tafese Jeleta and Shimelis Olollo Sinkie

Article Type: Research Article | First Published: September 09, 2019

A community-based cross-sectional study on 422 residents was conducted in Jimma town, from November 1-8, 2012. Respondents were identified using multistage sampling methods. Data was collected using face to face interviewer. The data was entered into Epi Data version 3.1 and exported to Statistical Package for Social Sciences version 20. Logistic regression analysis was carried out and all variables with p-value less than 0.25 in the bivariate analysis were candidates for multivariable logistic ...

 Open Access DOI:10.23937/2469-5823/1510130

Quality of Life and Clinical-Epidemiologic Profile of Clinical Infirmary Patients

Amanda Travaglia Vitoy, Esther de Paiva Mota, Katarinne Lima Moraes, Jacqueline Andreia Bernardes Leao-Cordeiro, Rogerio Jose de Almeida, Cesar Augusto Sam Tiago Vilanova-Costa and Antonio Marcio Teodoro Cordeiro Silva

Article Type: Original Article | First Published: August 26, 2019

Traditionally, the evaluation of involvement in patient medical care was grounded in mortality and morbidity rates. Therefore, medical judgement followed clinical, laboratorial and statistic parameters. However, the clear need for a monitoring and evaluation method centered on the patient gave birth to new methods and tools with the aim of measuring individual quality of life subjectively. The population pattern of high prevalence of chronic degenerative diseases was confirmed. Elderly, retired ...