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High-velocity traumatic amputations of the proximal upper extremity are devastating to the patient and represent an extreme surgical challenge to the treatment team. The hand surgeon must simultaneously battle devascularization with timely microvascular anastomosis, gross contamination with meticulous debridement, and amputation with stable fixation. In restoring a functional extremity, many of these goals are in contention with each other.
View Article and Find Full Text PDFImpact of Anti-Fatigue Floor Mat on Surgical Staff Comfort Levels in Head and Neck Surgery Cases.
Laryngoscope Investig Otolaryngol
February 2025
Objective: Musculoskeletal symptoms are common among surgical staff and can have long-term implications on health and wellbeing. The purpose of this study is to evaluate the impact of anti-fatigue floor mat on the comfort level of surgical teams during head and neck surgeries lasting ≥ 3 h.
Methods: Over 4 months, we prospectively randomized 34 major (≥ 3 h) head and neck procedures to the use or not of an anti-fatigue floor mat.
EPO-Mimetic Peptide Pegmolesatide Therapy for Pure Red Cell Aplasia in a Patient with Non-dialysis-dependent Type 1 Diabetic Nephropathy: A Case Report.
Kidney Med
February 2025
Department of Nephrology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Pure red cell aplasia (PRCA) is a rare complication of erythropoietin (EPO) therapy, characterized by a severe deficiency in red blood cell production. There is no guideline on the treatment for PRCA because there have been too few cases to perform prospective cohort studies. The main treatments for PRCA include immediate cessation of EPO, restrictive transfusion, and immunosuppressive therapies.
View Article and Find Full Text PDFThe Cost of Gaps in Care: A Case of Lidocaine Toxicity and Postpartum Seizures.
Cureus
December 2024
Internal Medicine, Wyckoff Heights Medical Center, New York, USA.
This report describes the case of a 20-year-old Spanish-speaking female at 39 weeks gestation who experienced a generalized seizure immediately after lidocaine administration for a labial fold episiotomy repair following a complicated vaginal delivery. With limited prenatal care, language barriers, and socioeconomic challenges, the patient required intubation and intensive care unit (ICU) transfer for management. Extensive workup ruled out common causes, and the likely diagnosis was an atypical presentation of preeclampsia.
View Article and Find Full Text PDFMinimal methimazole exposure-induced fatal pancytopenia.
BMJ Case Rep
January 2025
Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
This case highlights that refractory pancytopenia leading to death can occur with methimazole treatment even at a very low cumulative dose and after a very short duration of exposure. In addition, the standard treatments to correct the pancytopenia may not be effective and a bone marrow transplant may be required. Current American Thyroid Association guidelines do not recommend routine monitoring of the complete blood count in patients receiving thionamides because of the rapidity of the onset of agranulocytosis and the lack of positive evidence that such monitoring would be useful.
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