Spartan medical research journal最新文献

筛选
英文 中文
Multi-Specialty Care for Second-Degree Pressure Cooker Explosion Burn Injuries. 高压锅爆炸二度烧伤的多专科护理。
Spartan medical research journal Pub Date : 2020-10-30
Casey Schukow, Billy R Nordyke
{"title":"Multi-Specialty Care for Second-Degree Pressure Cooker Explosion Burn Injuries.","authors":"Casey Schukow, Billy R Nordyke","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Context: </strong>Although pressure cookers are very common kitchen utensils used in the United States, only a few cases of serious injuries secondary to pressure cooker explosions have been reported in the medical literature. When second-degree (i.e., \"partial-thickness\") burns result from pressure cooker explosions, wounds involving near to or greater than 10% of total body surface area typically require multidisciplinary treatment, with burn center referral for proper wound care, potential fluid resuscitation, and eventual scar management.</p><p><strong>Example case: </strong>The example patient described in this report was an African American female in her early 30s who presented during the summer of 2020 after suffering varying levels of second-degree burns to her bilateral upper torso and left wrist (i.e., approximately 10%, total body surface area). The authors first saw the patient during a primary care office visit a week after her initial injury when she first went to a local urgent care clinic. Upon her arrival to the second author's family medicine clinic, a multi-specialty wound recovery plan was initiated since her first urgent care visit treatment had been minimal without prophylactic antibiotic therapy or placement of a burn center referral.</p><p><strong>Conclusions: </strong>Partial and full-thickness burn injuries generally warrant immediate clinical (i.e., body surface area burn assessment, fluid resuscitation, empiric antibiotics) as well as ongoing (burn center referral, debridement procedures, active scar management, provision of psychological support) treatment needs. This paper discusses the critical opportunities posed for more extensive burn patients' physicians to first categorize the extent of burn wounds and initiate subsequent specialty care in other settings.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"5 2","pages":"17738"},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25431776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does Peritraumatic Ketamine Reduce Symptoms of Post-Traumatic Stress Disorder? 创伤后氯胺酮能减轻创伤后应激障碍的症状吗?
Spartan medical research journal Pub Date : 2020-10-30 DOI: 10.51894/001c.17647
Jack Brodeur, Ryley Mancine, A. Ley, J. Magen
{"title":"Does Peritraumatic Ketamine Reduce Symptoms of Post-Traumatic Stress Disorder?","authors":"Jack Brodeur, Ryley Mancine, A. Ley, J. Magen","doi":"10.51894/001c.17647","DOIUrl":"https://doi.org/10.51894/001c.17647","url":null,"abstract":"INTRODUCTION Acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) are chronic diseases which can affect patients following a severe trauma. As these patients typically first present to the emergency department, it is critical for emergency physicians to remain updated on the use of ketamine or other anesthetic agents which may impede development or reduce symptoms which may impair normal functioning. The purpose of this clinical review was is to review the literature regarding how the use of peritraumatic ketamine could decrease the incidence of ASD and PTSD. In 2019, the authors completed a MEDLINE search was performed yielding 25 articles which were initially evaluated by the first and second authors. Four articles which met inclusion criteria are discussed in this manuscript. SUMMARY of EVIDENCE Although two earlier research groups have found that peritraumatic ketamine administration contributed to increased symptoms of PTSD (e g., reexperiencing, dissociation, avoidance, and hyperarousal), two later studies have indicated that ketamine had no effect on PTSD development. Additionally, one 2012 study group has suggested propofol use may alleviate PTSD symptoms at six months post-trauma. Another 2017 study team found that the number of surgical procedures was directly correlated with increased PTSD development. CONCLUSIONS Based on the literature to date, peritraumatic ketamine does not appear to influence the prevention nor development of ASD and subsequent PTSD. More research is needed to clarify the psychopharmacologic effects of ketamine when used in the management of reactions to acute trauma experiences. Based on the results of the two later works, future research is indicated considering whether propofol may contribute to PTSD development.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42717715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Wilkie’s Weight Loss Wonder: A Case Series 威尔基的减肥奇迹:一个案例系列
Spartan medical research journal Pub Date : 2020-10-30 DOI: 10.51894/001c.13485
Akhlema Haidar, A. Davies, Afzal Hussain, Samuel Gregerson, Dheeraj Thammineni, J. Markus
{"title":"Wilkie’s Weight Loss Wonder: A Case Series","authors":"Akhlema Haidar, A. Davies, Afzal Hussain, Samuel Gregerson, Dheeraj Thammineni, J. Markus","doi":"10.51894/001c.13485","DOIUrl":"https://doi.org/10.51894/001c.13485","url":null,"abstract":"INTRODUCTION Wilkie’s Syndrome, also known as Superior Mesenteric Artery Syndrome (SMAS), is a rare cause of bowel obstruction that can contribute to vague abdominal symptoms on clinical presentation. This syndrome occurs when the aortomesenteric angle decreases, compressing the third portion of the duodenum between the aorta and the superior mesenteric artery. An acute decrease in the mesenteric fat pad cushion between these two blood vessels is the primary etiology, although other causes (e.g., anatomical, postoperative, functional, and pubescent etiologies) have also been described. CASE PRESENTATION In the present cases, 2 females with a common history of recent weight loss presented to our institution with similar symptoms of abdominal pain, nausea and vomiting. Each patient was subsequently diagnosed with SMAS following imaging studies. Both patients experienced successful resolution of symptoms with conservative nutritional management. DISCUSSION Common presenting complaints of SMAS include nausea, vomiting, early satiety and postprandial pain. These symptoms overlap with other gastrointestinal disorders (i.e., mesenteric ischemia, intestinal volvulus, peptic ulcer disease) making diagnosis difficult. SMAS can be identified through imaging modalities including barium studies and computer tomography. First line therapies typically include conservative nutritional support and promotion of weight gain. If conservative therapies fail, various surgical procedures can be pursued. Delayed diagnosis can lead to further pathological sequelae, including duodenal compromise, ischemia and necrosis. As the syndrome progresses, success of conservative nutritional support is less likely, and surgical correction becomes increasingly necessary. CONCLUSION Therefore, a clinical goal for SMAS should include as swift a recognition and diagnosis as possible.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44620953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Radiological Findings of COVID-19 Patients in Italy 意大利COVID-19患者的放射学表现
Spartan medical research journal Pub Date : 2020-10-30 DOI: 10.51894/001c.14505
Zachary Brennan, Samantha Guerra, S. Seman
{"title":"Radiological Findings of COVID-19 Patients in Italy","authors":"Zachary Brennan, Samantha Guerra, S. Seman","doi":"10.51894/001c.14505","DOIUrl":"https://doi.org/10.51894/001c.14505","url":null,"abstract":"CONTEXT The emergence of COVID-19/SARS-CoV2 (COVID-19) was an outbreak that began in December 2019 and rose to pandemic levels in 2020. One of the largest problems with COVID-19 is the typical delay in testing and diagnosis that can lead to additional transmission of the disease. Under consultation with a board-certified radiologist, the study team evaluated the common radiological findings of COVID-19 on computed tomography (CT) and compared the efficacy of chest radiographs (i.e., x-rays) to CT in diagnosing COVID-19. METHODS In 2020, the authors completed a retrospective review of radiologic imaging data (i.e., the original imaging report notes) from Italy performed on 47 patients who had tested positive for COVID-19 in Italy during the national outbreak from February to March 2020. Radiologic images were obtained from Società Italiana di Radiologia Medica e Interventistica radiological database of COVID-19 patients. Each case was analyzed for whether they had positive findings on either chest radiograph or CT or both among patients who had positive COVID-19 test results. RESULTS The authors found significant radiological finding similarities among the 47 COVID-19 positive case studies from Italy during the February to March 2020 time period. Ground glass opacities and crazy paving were the most significant findings, resembling the findings in China and other Coronavirus strains. The authors’ statistical analyses indicated that CT scans were more reliable by 30.7% than chest radiographs in identifying signs of COVID-19. In cases where either an initial negative swab for COVID-19 or providers lacked patient social histories, chest radiographs were used to show clinical findings consistent with COVID-19. CONCLUSIONS Based on these results, chest radiographs appear to be a consistent method to assist in the diagnosis of most COVID-19 cases. The authors discuss several scenarios in community-based and non-hospital US settings for COVID-19 diagnostic processes.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43997913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Ray Resection for Recurrent Invasive Squamous Cell Carcinoma: A Case Report 复发性侵袭性鳞状细胞癌的射线切除术1例报告
Spartan medical research journal Pub Date : 2020-10-30 DOI: 10.51894/001c.14612
Josiah Valk, B. Valk, Matthew Caid, Alexander J Colen, R. Singer
{"title":"Ray Resection for Recurrent Invasive Squamous Cell Carcinoma: A Case Report","authors":"Josiah Valk, B. Valk, Matthew Caid, Alexander J Colen, R. Singer","doi":"10.51894/001c.14612","DOIUrl":"https://doi.org/10.51894/001c.14612","url":null,"abstract":"Squamous cell carcinoma is the most common tumor of the hand. This malignancy requires unique treatment considerations; the surgeon and patient must balance retention of maximal functional capacity of the hand and minimization of the risk of recurrence and metastasis. Digital-sparing and digital-sacrificing therapies should be considered. Chance for cure, recurrence and metastasis risk, cosmetic concerns, and functional concerns should be addressed on a case-by-case basis. We report a case of a fifty-three-year-old man with cutaneous squamous cell carcinoma of his non-dominant hand. Ulceration and rapid growth of a long-standing lesion of the dorsal hand prompted evaluation and treatment. Over the course of a year, three separate surgeries including digital amputations and metacarpal resections were required to manage this recurrent and invasive malignancy. Seven years post-operatively, our patient retained a full, painless range of motion arc of the left thumb and ability to grip utilizing a functional brace. Treatment of squamous cell carcinoma of the hand is not always straightforward. High rates of local recurrence require negative margins and diligent postoperative surveillance. Digital sparing therapy should be considered to minimize functional impairment and maximize cosmesis. However, aggressive treatment and amputation must be considered for advanced disease and if pursued, should focus on maximization of functional capacity as one of the treatment goals.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47489048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Discovering Pathologies in the Anatomy Lab: The Case of Brachial Plexopathy Mimicking Neurological Thoracic Outlet Syndrome. 在解剖学实验室发现病理学:模拟神经胸廓出口综合征的臂丛病病例。
Spartan medical research journal Pub Date : 2020-10-30
Ryley Mancine, Paul Kowalski, William McMillan, Nicole Geske, Loro Kujjo
{"title":"Discovering Pathologies in the Anatomy Lab: The Case of Brachial Plexopathy Mimicking Neurological Thoracic Outlet Syndrome.","authors":"Ryley Mancine, Paul Kowalski, William McMillan, Nicole Geske, Loro Kujjo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Context: </strong>Well-established human anatomy labs with access to expert faculty are exceedingly valuable tools to medical student education. In this manuscript, we detail an infero-lateral subclavicular lipoma which was discovered as a result of the utilization of both those labs and expert faculty. This lipoma may have caused brachial plexopathy or may serve as an unusual cause of neurologic thoracic outlet syndrome (NTOS) due to the location of the mass.</p><p><strong>Educational case presentation: </strong>During prosection of a donor in the human anatomy lab, a mass was discovered by a medical student. This medical student utilized the human anatomy lab faculty members and resources to identify the mass as a lipoma. The lipoma compressed the lateral cord of the brachial plexus and the suprascapular nerve, but no diagnosis of NTOS or brachial plexopathy was made during the life of the donor, nor was any surgical intervention indicated. Removal of the lipoma immediately relieved stress upon the nerves. Histochemical analysis confirmed the diagnosis of a lipoma and demonstrated almost only mature adipocytes.</p><p><strong>Conclusion: </strong>The authors concluded that the lipoma of this patient was not identifiable with computerized tomography imaging modalities, despite ultrasound demonstrating a hyperechoic outline of the mass in the cadaver of the patient. It is very likely that this lipoma had not been diagnosed previously due to the atypical location of the tumor. Equally, typical surgical methods associated with brachial plexopathy or NTOS treatment would be difficult or more complicated, due to the lateral and inferior location of the lipoma. Physicians treating thoracic outlet syndrome-type symptoms without resolution should consider potential non-malignant obstruction located outside the thoracic outlet, toward the extremity. Deep palpatory methods and physical therapy should be considered until diagnosis is certain, as ultrasound would be difficult and typical transaxillary surgical methods would be nonhelpful. Medical students and early-career residents and physicians should be aware of the resources provided to them via campus human anatomy laboratories which they may utilize to further their understanding and knowledge of specific pathologies.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"5 2","pages":"14179"},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of a COVID-influenced Curriculum to Address Food Insecurity in a Detroit Family Medicine Residency Clinic. 评估受 COVID 影响的课程,以解决底特律家庭医学住院医生诊所的粮食不安全问题。
Spartan medical research journal Pub Date : 2020-10-30
Amrien Ghouse, William Gunther, Matthew Sebastian
{"title":"Evaluation of a COVID-influenced Curriculum to Address Food Insecurity in a Detroit Family Medicine Residency Clinic.","authors":"Amrien Ghouse, William Gunther, Matthew Sebastian","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Context: </strong>To date, numerous projects have demonstrated that an ongoing limited access to nutritionally dense food (i.e., \"food insecurity\") plays a key role in the overall health and wellbeing of lower income at-risk populations.</p><p><strong>Methods: </strong>For this 2019-2020 pilot project, the resident physician authors first created and administered a simple five-item questionnaire screening process to systematically identify food insecure patients in their metropolitan Detroit residency clinic. A sample of patients who had been identified as food insecure and pre-diabetic were then provided improved access to healthy foods, supplemented by a six-week program of nutritional education classes using a nationally recognized \"Cooking Matters'' six-week long curriculum with a licensed chef and nutrition educator.</p><p><strong>Results: </strong>After institutional review board approval, the authors enrolled a sample of 10 adults. The authors successfully measured both pre- and post-program Hemoglobin A1c (HbA1C) levels for all participants who completed the required course and subsequent clinic follow up visits. Using a series of initial non-parametric Wilcoxon Signed Rank matched pair tests, post-program follow-up at three months revealed statistically significant reductions in documented HbA1c levels from baseline for six enrolled patients (W=1, Z = - 2.226, p = 0.026) and six-month follow up (i.e., more than four months after completion of the program) (W = 1, Z = - 2.060, p = 0.039). In post-program surveys, each respondent indicated that they found the class content to be generally beneficial to increase their nutritional knowledge.</p><p><strong>Conclusions: </strong>In the authors' setting, this food insecurity program has subsequently led to a more formal screening process to evaluate and identify food insecure patients. The authors discuss the scheduling difficulties they experienced from the COVID-19 pandemic for their sample patients. However, these pilot results suggest that prolonged benefits may require ongoing \"virtual\" teaching sessions with pre-diabetic patients to address the complex factors influencing food insecurity levels identified in similar inner-city settings.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"5 2","pages":"17649"},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25431775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lingual Osseous Choristoma: A Systematic Review of Lesion Presentation, Histology, and Morphology 舌骨脉络膜瘤:病变表现、组织学和形态学的系统综述
Spartan medical research journal Pub Date : 2020-10-30 DOI: 10.51894/001c.17543
Zaid J. Shareef, S. Shareef, C. Kerndt, Arielle Aughenbaugh, Anthony Di Ponio
{"title":"Lingual Osseous Choristoma: A Systematic Review of Lesion Presentation, Histology, and Morphology","authors":"Zaid J. Shareef, S. Shareef, C. Kerndt, Arielle Aughenbaugh, Anthony Di Ponio","doi":"10.51894/001c.17543","DOIUrl":"https://doi.org/10.51894/001c.17543","url":null,"abstract":"INTRODUCTION Osseous choristomas of the tongue are rare, benign tumor-like lesions composed of abnormally placed bone and cartilage tissue. The few publications to date concerning this condition have been primarily limited to case reports. This systematic review aimed to clarify the clinical presentations of osseous choristomas and how to delineate them from other oral pathologies. METHODS The authors utilized PubMed, Embase, and Cochrane Library reference databases from 1971 to mid-2020. Search terms were “osseous choristoma,” “oral cavity,” and “lingual.” Preferred Reporting Systems for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to aggregate relevant data from each study. The authors specifically collected data regarding patient demographics, clinical findings, symptoms, treatments, and subsequent outcomes relating to lingual osseous choristomas. RESULTS A total of 35 (14.6% of total identified) publications that met inclusion criteria were identified concerning a total of 69 lingual osseous choristoma cases. Results were compiled focusing on sex and age, presenting symptoms, histology, appearance of the lesion base being most commonly pedunculated (e.g., stalk or stem-like), the lesion’s location on the tongue, and subsequent treatments. Osseous choristomas had a higher rate of occurrence in females, 48 (70%) and those under the age of 40. Symptomatic presentations occurred in 38 (55%) patients, with the most common presenting symptoms being gagging/globus (i.e., lump or foreign body) sensation (n = 47, 68%) and dysphagia (n = 20, 29%). Identified masses were pedunculated in 33 (80%) of cases and eight (20%) were identified as sessile (i.e., immobile). A total of 41 (59%) lesions were more commonly located in the posterior one third of the tongue compared to 28 (41%) in the anterior two thirds of the tongue. Of those 49 (71%) cases requiring surgical mass excisions, recurrence was reported in 0% of cases. CONCLUSIONS Although osseous choristomas are benign processes that rarely arise from the tongue, providers should carefully inspect patients with a gagging/globus sensation and pedunculated mass toward the back of the tongue. Surgical resection remains the best treatment to prevent recurrence.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49251214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Discovering Pathologies in the Anatomy Lab: The Case of Brachial Plexopathy Mimicking Neurological Thoracic Outlet Syndrome 解剖实验室病理发现:模拟神经性胸廓出口综合征的臂丛病病例
Spartan medical research journal Pub Date : 2020-10-30 DOI: 10.51894/001c.14179
Ryley Mancine, P. Kowalski, W. McMillan, N. Geske, L. Kujjo
{"title":"Discovering Pathologies in the Anatomy Lab: The Case of Brachial Plexopathy Mimicking Neurological Thoracic Outlet Syndrome","authors":"Ryley Mancine, P. Kowalski, W. McMillan, N. Geske, L. Kujjo","doi":"10.51894/001c.14179","DOIUrl":"https://doi.org/10.51894/001c.14179","url":null,"abstract":"CONTEXT Well-established human anatomy labs with access to expert faculty are exceedingly valuable tools to medical student education. In this manuscript, we detail an infero-lateral subclavicular lipoma which was discovered as a result of the utilization of both those labs and expert faculty. This lipoma may have caused brachial plexopathy or may serve as an unusual cause of neurologic thoracic outlet syndrome (NTOS) due to the location of the mass. EDUCATIONAL CASE PRESENTATION During prosection of a donor in the human anatomy lab, a mass was discovered by a medical student. This medical student utilized the human anatomy lab faculty members and resources to identify the mass as a lipoma. The lipoma compressed the lateral cord of the brachial plexus and the suprascapular nerve, but no diagnosis of NTOS or brachial plexopathy was made during the life of the donor, nor was any surgical intervention indicated. Removal of the lipoma immediately relieved stress upon the nerves. Histochemical analysis confirmed the diagnosis of a lipoma and demonstrated almost only mature adipocytes. CONCLUSION The authors concluded that the lipoma of this patient was not identifiable with computerized tomography imaging modalities, despite ultrasound demonstrating a hyperechoic outline of the mass in the cadaver of the patient. It is very likely that this lipoma had not been diagnosed previously due to the atypical location of the tumor. Equally, typical surgical methods associated with brachial plexopathy or NTOS treatment would be difficult or more complicated, due to the lateral and inferior location of the lipoma. Physicians treating thoracic outlet syndrome-type symptoms without resolution should consider potential non-malignant obstruction located outside the thoracic outlet, toward the extremity. Deep palpatory methods and physical therapy should be considered until diagnosis is certain, as ultrasound would be difficult and typical transaxillary surgical methods would be nonhelpful. Medical students and early-career residents and physicians should be aware of the resources provided to them via campus human anatomy laboratories which they may utilize to further their understanding and knowledge of specific pathologies.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70847899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does Peritraumatic Ketamine Reduce Symptoms of Post-Traumatic Stress Disorder? 创伤性氯胺酮能减轻创伤后应激障碍的症状吗?
Spartan medical research journal Pub Date : 2020-10-30
Jack Brodeur, Ryley Mancine, Alyse Ley, Jed Magen
{"title":"Does Peritraumatic Ketamine Reduce Symptoms of Post-Traumatic Stress Disorder?","authors":"Jack Brodeur, Ryley Mancine, Alyse Ley, Jed Magen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) are chronic diseases which can affect patients following a severe trauma. As these patients typically first present to the emergency department, it is critical for emergency physicians to remain updated on the use of ketamine or other anesthetic agents which may impede development or reduce symptoms which may impair normal functioning. The purpose of this clinical review was is to review the literature regarding how the use of peritraumatic ketamine could decrease the incidence of ASD and PTSD. In 2019, the authors completed a MEDLINE search was performed yielding 25 articles which were initially evaluated by the first and second authors. Four articles which met inclusion criteria are discussed in this manuscript.</p><p><strong>Summary of evidence: </strong>Although two earlier research groups have found that peritraumatic ketamine administration contributed to increased symptoms of PTSD (e g., reexperiencing, dissociation, avoidance, and hyperarousal), two later studies have indicated that ketamine had no effect on PTSD development. Additionally, one 2012 study group has suggested propofol use may alleviate PTSD symptoms at six months post-trauma. Another 2017 study team found that the number of surgical procedures was directly correlated with increased PTSD development.</p><p><strong>Conclusions: </strong>Based on the literature to date, peritraumatic ketamine does not appear to influence the prevention nor development of ASD and subsequent PTSD. More research is needed to clarify the psychopharmacologic effects of ketamine when used in the management of reactions to acute trauma experiences. Based on the results of the two later works, future research is indicated considering whether propofol may contribute to PTSD development.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"5 2","pages":"17647"},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25431774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信