A&A practice
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Case Reports
Perioperative Management of an Adult Patient With Myoclonic Epilepsy With Ragged Red Fibers Syndrome: A Case Report.
Myoclonic epilepsy with ragged red fibers (MERRF) syndrome is a rare mitochondrial disease potentially associated with increased sensitivity to anesthesia and metabolic decompensation. We present the perioperative management in a 59-year-old man with MERRF scheduled for lipomatosis cure under general anesthesia (GA). ⋯ Propofol and sevoflurane may be used in asymptomatic MERRF adult patients. Such patients present high risk of residual neuromuscular blockade that should be monitored and reversed.
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The Internet is a source of professional self-education for medical students and residents. Unfortunately, much of the content discovered through search engines is of insufficient quality for professional education. ⋯ As of March 2020, 64 anesthesiology residency programs in the United States subscribed to the AT (41% of total). Since the onset of the pandemic in March, AT has added 25 programs (28% increase) and gained 1156 users (26% increase).
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Case Reports
Use of Airway Ultrasound in Infants With Unexpected Subglottic Stenosis During Anesthesia Induction: A Case Report.
Point-of-care ultrasound has been integrated into airway management because it allows for rapid and noninvasive assessments. We present 2 cases of unexpected subglottic stenosis in infants during induction of anesthesia. ⋯ The severity of subglottic stenosis in the first case was grade III, requiring emergent tracheostomy. In conclusion, airway ultrasound helps to assess possibility of intubation and plan further airway management in children with unexpected difficult airway.
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Case Reports
First Report of Spinal Anesthesia for Cesarean Delivery in a Parturient With Jeune Syndrome: A Case Report.
Jeune syndrome, also known as asphyxiating thoracic dystrophy, is a rare form of autosomal recessive skeletal dysplasia. Respiratory distress due to thoracic and lung dysplasia is the primary complication associated with this disorder in neonates. Women with Jeune syndrome seldom conceive and give birth, as only a few survive until adulthood. Herein, we report the world's first case of a cesarean delivery under spinal anesthesia in a pregnant woman with Jeune syndrome with a history of chest wall reconstruction and spinal fusion surgeries.
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Despite efforts by medical and social activists, transgender parturients encounter barriers to adequate and gender-inclusive health care, resources, and support. We present a case of a 38-year-old transgender man presenting for induction of labor at term. Our case highlights the importance of multidisciplinary planning, appropriate gender-related language, and interventions that may ameliorate gender dysphoria during childbirth. Because some transgender men may desire childbirth, we recommend that health care providers become familiar with and respectful of the unique considerations for this patient population in the peripartum setting.