Low-Threshold Buprenorphine via Community Partnerships and Telemedicine—Case Reports of Expanding Access to Addiction Treatment During COVID-19

AbstractIntrauterine myocardial infarction is a rare and frequently fatal diagnosis. It has been presented in the literature only as case reports and short series. We present a case report of a coronary occlusive intrauterine myocardial infarction and survival and present a systematic review of the literature. This is the first summative description of current data on intrauterine and perinatal myocardial infarction. We performed the systematic review based on the guidelines established by the PRISMA statement. Our population of intrauterine and perinatal myocardial infarction included published cases who presented as a live birth within the first 28 postnatal days, and had a diagnosis of myocardial infarction. We conducted descriptive statistics and regression analysis on short-term mortality as the primary outcome. After applying exclusion criteria we described 84 individual cases of myocardial infarction from 63 full-text articles including our own case. Presentation within the first 12 hours was associated with mortality (OR 3.90, p=0.004). Treatment modalities were varied and inconsistently recorded. The aetiologies and comorbidities are varied in our systematic review. We would have a low threshold to perform viral testing, consider anticoagulation early and coronary imaging if feasible. The use of extracorporeal membranous oxygenation may serve as a bridge to cardiac recovery.

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Implementation of a Medication for Addiction Treatment (MAT) and Linkage Program by Leveraging Community Partnerships and Medical Toxicology Expertise

Journal of Medical Toxicology ◽

10.1007/s13181-020-00813-4 ◽

2020 ◽

Author(s):

Gillian A. Beauchamp ◽

Lexis T. Laubach ◽

Samantha B. Esposito ◽

Ali Yazdanyar ◽

Paige Roth ◽

...

Keyword(s):

Addiction Treatment ◽

Medical Toxicology ◽

Community Partnerships ◽

Linkage Program

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Case Report: Intracranial Hypertension Secondary to Guillain-Barre Syndrome

Frontiers in Pediatrics ◽

10.3389/fped.2020.608695 ◽

2021 ◽

Vol 8 ◽

Author(s):

Christina Doxaki ◽

Eleftheria Papadopoulou ◽

Iliana Maniadaki ◽

Nikolaos G. Tsakalis ◽

Konstantinos Palikaras ◽

...

Keyword(s):

Intracranial Hypertension ◽

Case Reports ◽

Rare Complication ◽

Strong Association ◽

Guillain Barre Syndrome ◽

Predisposing Factor ◽

Current Case ◽

Guillain Barré Syndrome ◽

Low Threshold ◽

Guillain Barré

Guillain-Barre Syndrome (GBS), a common cause of acute flaccid paralysis, is characterized by a rapidly progressive, usually symmetric weakness of the extremities. Headache and intracranial hypertension (ICHT) are very rare complications of GBS. Herein we report our current case of an obese girl with typical signs of GBS associated with autonomic dysfunction, cranial nerve deficits and increased intracranial pressure (ICP). We also perform a systematic study presenting and discussing previous case reports of GBS associated with ICHT, papilledema or hydrocephalus, highlighting the differences of the current case compared to previous studies. Although intracranial hypertension is a rare complication of pediatric GBS, clinicians should promptly detect it. Obesity may be a predisposing factor, given the strong association between idiopathic intracranial hypertension (IIH) and weight gain. Neurological evaluation, fundus examination and low threshold for intracranial imaging should be an integral part of medical practice in case of obesity, headache or visual changes in GBS patients.

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Isolated Duodenal Rupture due to Go-Karting Accidents – Braking News

Annals of The Royal College of Surgeons of England ◽

10.1308/147870809x400930 ◽

2009 ◽

Vol 91 (4) ◽

pp. 340-343 ◽

Cited By ~ 7

Author(s):

Milan Thomas ◽

Narendra Nath Basu ◽

Manpreet Singh Gulati ◽

Tayo Oke ◽

Gabriel Constantinescu ◽

...

Keyword(s):

Case Reports ◽

Steering Wheel ◽

Duodenal Injury ◽

Quadrant Pain ◽

Operative Repair ◽

Computed Tomography Scanning ◽

Life Threatening ◽

Low Threshold ◽

Tomography Scanning ◽

Retroperitoneal Air

INTRODUCTION Isolated duodenal injury due to blunt abdominal trauma is extremely rare. We present a series of three such injuries due to go-karting accidents, which presented to our hospital over 5 months. CASE REPORTS Between October 2007 and February 2008, three cases of D3/D4 duodenal rupture presented to our hospital after go-karting accidents. Trauma occurred as a result of the steering wheel impacting on the abdomen. All patients presented similarly with symptoms of epigastric and right upper quadrant pain. In all cases, computed tomography scanning was highly suggestive of duodenal injury and, in particular, demonstrated presence of retroperitoneal air centred around the duodenum. Treatment required laparotomy and operative repair in all cases. CONCLUSIONS Duodenal injury presents insidiously due to its retroperitoneal position. A low threshold for investigating patients presenting with epigastric and right upper quadrant pain should be adopted along with active clinical vigilance to exclude serious and life-threatening trauma after go-karting accidents.

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Spontaneous Pneumomediastinum as a Complication of COVID-19 Infection: A Case Series.

Medical Case Reports Journal ◽

10.31531/2581-5563.1000120 ◽

2021 ◽

Vol 4 (1) ◽

pp. 1-4

Author(s):

Kyle Cilia ◽

Keyword(s):

Chest Trauma ◽

Case Reports ◽

Case Series ◽

Chest Imaging ◽

Connective Tissue Disorders ◽

Spontaneous Pneumomediastinum ◽

Free Air ◽

Low Threshold ◽

Male Patients

Spontaneous pneumomediastinum is the presence of free air around mediastinal structures and frequently associated with other forms of extra-alveolar air, such as pneumopericardium, and pneumothorax. It is an uncommon occurrence and typically presents with pleuritic chest discomfort, dyspnea, odynophagia, and neck pain. It is frequently seen following chest trauma or in patients with underlying lung or connective tissue disorders. COVID-19 infection has been linked to spontaneous pneumomediastinum. We present two case reports of pneumomediastinum in two male patients whilst being treated for COVID-19 pneumonia. In one case, the pneumomediastinum was completely spontaneous whilst in the second case it was likely secondary to high flow nasal oxygen therapy. In both cases, patients were treated conservatively, and follow-up chest imaging showed complete resolution. One should keep in mind the possibility of such complication and have a low threshold for chest imaging in patients failing to improve or have sudden deterioration.

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