A Case Report of Bilateral Phrenic Nerve Dysfunction After Unilateral Supraclavicular Brachial Plexus Block: Unveiling Preexisting Diaphragmatic Dysfunction.

A 48-year-old woman with a history of cardiac surgery developed severe dyspnea and anxiety following right-sided supraclavicular nerve block for hand surgery. In this case, right phrenic nerve blockade from a supraclavicular block unmasked a subclinical hemidiaphragmatic paresis from phrenic nerve injury on the left, the latter likely due to previous cardiac surgery. When performing brachial plexus block at or above the clavicle, particularly for prior cardiothoracic surgical patients, anesthesiologists can easily, quickly, and inexpensively use point-of-care ultrasound to assess whether any degree of phrenic nerve dysfunction exists on the contralateral side, as patients may be asymptomatic at baseline.

Psychiatric disorders, high-risk behaviors, and chronicity of episodes among predominantly African American homeless Chicago youth.

Objective: This cross-sectional study investigated the relationships between psychiatric and substance-related disorders, high-risk behaviors, and the onset, duration, and frequency of homelessness among homeless youth in Chicago.

Methods: Sixty-six homeless youth were recruited from two shelters in Chicago. Demographic characteristics, psycho-pathology, substance use, and risk behaviors were assessed for each participant.