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Jan 10, 2019Open    AccessArticle

A Clinical Triad of Digital Clubbing, “Arthritis” and Ossifying Periostitis in a Man: Case Report

Chun-Ruh Ng, Yet-Lin Loh
A 49 years old gentleman presented with intermittent bilateral knee swelling for the past 37 years and was eventually diagnosed as primary hypertrophic osteoarthropathy after secondary forms were excluded. This case illustrated that the disease can present during childhood with an insidious onset and progressively becoming more severe and that is when medical attention is sought. Furthermore, the patient did not voluntarily report

Aug 12, 2016Open    AccessArticle

Anesthetic Management of Nasopharyngeal Angiofibroma Resection with Carotid Invasion in a Pediatric Patient

Julia Reich Camasmie, Michele Cristianini, Rafael Moura, Claudia Biasi, Carlos Darcy Bersot
The nasopharyngeal angiofibroma is an aggressive, vascular tumor that may represent a challenge for the anesthesiologist by the risk of profuse bleeding. We report the case of a 13 years old, 52 kg, ASA1, who was scheduled for the resection of an angiofibroma invading facial sinuses and internal carotid artery, and submitted to external carotid and internal maxillary arteries embolization one day before surgery. Mallampati 2, prev

Aug 26, 2015Open    AccessArticle

Guillain Barre and Anesthesia— Intraoperative Disaster?

Omonele O. Nwokolo, Semhar J. Ghebremichael, Sara Guzman-Reyes
This is the case of a 76 y/o AA man with a past medical history of Hypertension and Guillain Barre Syndrome (GBS), who presented for a median sternotomy and excision of a thymic mass after workup for multiple episodes of syncope revealed the thymic mass. Intraoperatively, the patient had 2 episodes of cardiac arrest with asystole. He was adequately resuscitated and extubated. He was later determined by Neurology to have severe autonomic dysfunction and not a candidate for any elective surgery.

Jun 29, 2015Open    AccessArticle

Persistent Epidural Fluid at the Cervical Spine Level, Lessons from Radiology

Madhumani N. Rupasingh, Naveen Vanga, Aseem R. Hemmad, Sonya A. Johnson
Following an accidental dural puncture during the placement of epidural anesthesia, leakage of cerebrospinal fluid occurs. This leads to tugging on intracranial pain-sensitive structures and causes a headache that is postural in nature. According to radiology literature, the presence of retro spinal fluid collections has been associated with the diagnosis of spontaneous intracranial hypotension. The characteristic C1-C2 radiographic sign, called the C1-C2 false localizing sign, can be found on m...

Jun 26, 2014Open    AccessArticle

A Short Report of the First Use of Catheter-over-Needle System (Contiplex®C) for Continuous Peripheral Nerve Block Placement in Children in the UK

Shu Ying Lee, Peter C. Murphy
Continuous peripheral nerve blocks (CPNB) are gaining popularity in paediatric practice owing to its superiority over neuraxial blocks in terms of side effects. The advent of ultrasound and development of new materials have made CPNBs feasible even in children, facilitating early ambulation, effective and prolonged post-operative analgesia. The usual perineural catheter sets we have used are “ca- theter through needle” types. The inability to fix and locate the catheter position after threading ...