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Management of severe post-bariatric hypoglycaemia with octreotide delivered via a Tandem t:slim insulin pump.
BMJ Case Rep
January 2025
Diabetes, Greenlane Hospital, Auckland, Auckland, New Zealand.
A woman in her 40s presented with severe post-bariatric hypoglycaemia that persisted despite nutritional therapy and pharmacological therapy with acarbose and subcutaneous octreotide with meals. The nutritional limitations were difficult to sustain, and she developed adverse effects to the pharmacological therapy, and hence, doses could not be increased. She was subsequently treated with subcutaneous octreotide via an insulin pump, with a continuous basal rate and additional bolus doses with meals.
View Article and Find Full Text PDFVancomycin-induced acute generalised exanthematous pustulosis.
BMJ Case Rep
January 2025
Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA.
Antibiotics have been well documented to result in several dermatological adverse reactions. Many of these adverse reactions are rashes that are difficult to distinguish. We present a case of a female patient in her 30s with acute generalised exanthematous pustulosis following vancomycin treatment for left breast cellulitis.
View Article and Find Full Text PDFRural and remote health care: the case for spatial justice.
Rural Remote Health
January 2025
School of Health Sciences, Western Sydney University, Campbelltown, NSW 2560, Australia.
Almost universally, people living in rural and remote places die younger, poorer, and sicker than urban-dwelling citizens of the same country. Despite clear need, health services are commonly less available, and more costly and challenging to access, for rural and remote people. Rural geography is commonly cited as a reason for these disparities, that is, rural people are said to live in places too distant, too underpopulated, and too difficult to access.
View Article and Find Full Text PDFCombined intrathecal baclofen pump revision to the cervical level and lumbosacral ventral-dorsal rhizotomy for severe medically refractory hypertonia: illustrative cases.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Background: Medically refractory hypertonia (MRH) within the pediatric population causes severe disability and is difficult to treat. Neurosurgery for mixed MRH includes intrathecal baclofen (ITB) and lumbosacral ventral-dorsal rhizotomy (VDR). Surgical efficacy limitations can be mitigated by combining the two into a multimodal strategy.
View Article and Find Full Text PDFTranscirculation repair of a direct carotid-cavernous fistula in a patient who presented with hydrocephalus: illustrative case.
J Neurosurg Case Lessons
January 2025
The Trauma and Neuroscience Institutes, St. John's Hospital and Medical Center, Tulsa, Oklahoma.
Background: Direct carotid-cavernous fistulas (CCFs) are relatively rare but dangerous complications of penetrating traumatic brain injury or maxillofacial trauma. A variety of clinical signs have been described, including ophthalmological and neurological ones. In some cases, severely altered cerebral blood flow can present as massive life-threatening bleeding through the nose, subarachnoid hemorrhage, and/or intraparenchymal hemorrhage.
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