Proceedings (Baylor University. Medical Center)
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Proc (Bayl Univ Med Cent) · Jul 2020
Case ReportsSubsternal goiter excision in a Jehovah's Witness.
Jehovah's Witnesses present a unique challenge in oral and head and neck surgery. We report a case of a substernal goiter excised on a Jehovah's Witness without the use of blood transfusion, in accordance with the patient's beliefs. Additionally, we review the literature on the care of this patient population, focusing on preoperative optimization, perioperative management, and postoperative care.
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Drug reaction with eosinophilia and systemic symptoms, otherwise known as DRESS syndrome, is a rare, potentially life-threatening drug-induced hypersensitivity reaction that primarily involves a widespread skin rash, fever, hematological abnormalities, lymphadenopathy, and organ injury. Anti-epileptics, sulfonamides, and allopurinol are the most common triggers, but other offending medications have been reported in the literature. ⋯ The patient's clinical picture was initially consistent with recurring red-man syndrome that eventually became persistent after failing treatment with infusion rate reduction and diphenhydramine. This case highlights the need for a detailed review of medications taken within 2 months of the onset of the rash, as well as the importance of being cognizant of medications that incite multiple drug reactions.
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Proc (Bayl Univ Med Cent) · Jul 2019
Case ReportsAir embolism following peripheral intravenous access.
Air embolism is a rare, often misdiagnosed, potentially fatal condition. It is most frequently associated with invasive vascular procedures and mechanical ventilation. ⋯ We present a case of symptomatic venous air embolism likely arising from peripheral intravenous access gained during an interventional pain procedure. This case highlights the need to consider air embolism in the differential diagnoses of patients presenting with neurological symptoms following vascular interventions.
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Proc (Bayl Univ Med Cent) · Jul 2019
Case ReportsSurgical anesthesia for revision total hip arthroplasty with quadratus lumborum and fascia iliaca block.
We present a case in which surgical anesthesia was provided for revision of earlier total hip arthroplasty with quadratus lumborum and fascia iliaca blocks. We believe that this case is the first to be reported using this technique for this procedure. Our patient was a high-risk candidate for general and neuraxial anesthesia because of significant cardiac dysfunction and therapeutic anticoagulation.
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Proc (Bayl Univ Med Cent) · Apr 2019
Case ReportsPatent foramen ovale and ascending aortic aneurysm causing the platypnea-orthodeoxia syndrome.
Patent foramen ovale (PFO) is present in about 25% of the population. Platypnea-orthodeoxia syndrome (POS), which is dyspnea and hypoxemia in the upright position that is relieved when supine, is a rare manifestation of PFO. ⋯ Symptoms were resolved after undergoing percutaneous PFO closure. This case highlights the mechanism by which an ascending aortic aneurysm can alter hemodynamics through an existing PFO, leading to symptoms of a previously clinically insignificant PFO, and emphasizes how early recognition of POS allows for appropriate intervention.