scholarly journals SARS-CoV-2 Nasopharyngeal Swab as a Foreign Body: A Case Report

2021 ◽  
pp. 014556132199683
Author(s):  
Madelyn N. Stevens ◽  
George T. Lin ◽  
Sarah M. Tittman ◽  
Kevin M. Motz
Keyword(s):  
Foreign Body ◽  
Health Care Providers ◽  
Gastroesophageal Junction ◽  
Management Strategies ◽  
Gastrointestinal Symptoms ◽  
Upper Airway ◽  
Nasopharyngeal Swab ◽  
Care Providers ◽  
Retained Foreign Body ◽  
Body Retention

The SARS-CoV-2 pandemic response utilizes nasopharyngeal swabbing as a prolific testing method for presence of viral RNA. The depth of the swab to the nasopharynx coupled with breakpoints along the shaft leads to a risk for foreign body retention. Here, we present a case of a nasopharyngeal swab that became a retained foreign body during routine swabbing to test for the SARS-CoV-2 virus. Bedside flexible fiberoptic endoscopy was performed and did not reveal a foreign body in the nasopharynx or larynx. Subsequent computed tomography (CT) scan demonstrated the radiopaque retained foreign body at the distal gastroesophageal junction. The patient remained asymptomatic and did not have any upper airway or gastrointestinal symptoms. This unique case demonstrates a potential risk associated with SARS-CoV-2 nasopharyngeal swab testing and highlights management strategies that serve the patient while adequately protecting health care providers. A standardized approach to evaluation optimally includes bedside flexible endoscopy with appropriate personal protective equipment, prompt airway evaluation if aspiration is suspected, and noncontrasted CT imaging if the known foreign body is not identified via other modalities.

Risk factors for glaucoma: what do they really mean?

2011 ◽  
Vol 17 (3) ◽  
pp. 233 ◽  
Author(s):  
Anthea Worley ◽  
Karen Grimmer-Somers
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Risk Factor ◽  
Health Care Providers ◽  
Management Strategies ◽  
Care Providers ◽  
Reference Guide ◽  
Future Assessment ◽  
Primary Health Care Providers ◽  
Patient’S History

Glaucoma is an insidious eye disease, potentially putting 4% of older Australians at risk of blindness, unless detected sufficiently early for initiation of effective treatment. This paper reports on the strengths of evidence and glaucoma risk factors that can be identified by primary health care providers from a patient’s history. A comprehensive search of peer-reviewed databases identified relevant secondary evidence published between 2002 and 2007. Risk factors that could be determined from a patient’s history were identified. A novel glaucoma risk factor reference guide was constructed according to evidence strength and level of concern regarding risk of developing glaucoma. The evidence is strong and consistent regarding the risk of developing glaucoma, and elevated intraocular pressure, advancing age, non-Caucasian ethnicity and family history of glaucoma. There is moderate evidence of association with glaucoma, and migraine, eye injury, myopia and long-term use of corticosteroids. There is conflicting evidence for living in a rural location, high blood pressure, diabetes and smoking. Early detection of people at risk of developing glaucoma can be initiated using our risk factor guide coupled with a comprehensive patient history. Timely future assessment and subsequent management strategies for at-risk individuals can then be effectively and efficiently actioned.

scholarly journals Fractured aluminum nasopharyngeal swab during drive-through testing for COVID-19: radiographic detection of a retained foreign body

2020 ◽  
Vol 49 (11) ◽  
pp. 1873-1877 ◽  
Author(s):  
Antoine Azar ◽  
Daniel E. Wessell ◽  
Jeffrey R. Janus ◽  
Leslie V. Simon
Keyword(s):  
Foreign Body ◽  
Nasopharyngeal Swab ◽  
Retained Foreign Body

scholarly journals Canadian Expert Panel Recommendations on the Management of CNS Symptoms Related to Efavirenz

2001 ◽  
Vol 12 (suppl c) ◽  
pp. 20C-30C ◽  
Author(s):  
M John Gill ◽  
Anita Rachlis ◽  
Sharon Walmsley ◽  
Mark Halman ◽  
The Efavirenz Consensus Working Group
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Health Care Providers ◽  
Highly Active Antiretroviral Therapy ◽  
Primary Care Physicians ◽  
Sleep Disturbances ◽  
Present Report ◽  
Management Strategies ◽  
Routine Practice ◽  
Care Providers

Efavirenz is a potent antiretroviral agent used in combination with other antiretroviral agents as part of highly active antiretroviral therapy. Efavirenz is generally well tolerated because the majority of its adverse effects are self-limiting, with central nervous symptoms and rash being the most frequent. In routine practice, the discontinuation rate of efavirenz due to adverse effects appears higher than that described in clinical trials. To minimize early treatment interruption and maximize the benefit of long term viral suppression that can be achieved with efavirenz therapy, health care providers and patients have identified that there is a need for information, education about and practical tools for the management of efavirenz-related side effects. To this end, a panel of experts in the care of HIV patients consisting of primary care physicians, infectious disease specialists, psychiatrists and pharmacists was convened. Through the evaluation of current literature and discussion among the group, the panel arrived at consensus recommendations. The present report outlines general management recommendations that apply to adverse effects related to efavirenz initiation, as well as specific management strategies for central nervous system symptoms such as agitation, sleep disturbances, dreams, dizziness, impaired concentration and depression. It is hoped that these practical recommendations will aid clinicians in minimizing and improving patient tolerance of side effects, thereby achieving improved adherence and patient outcomes.

scholarly journals Multiple Idiopathic Cervical Root Resorption: A Challenge for a Transdisciplinary Medical-Dental Team

2021 ◽  
Vol 2 ◽  
Author(s):  
Emily Y. Chu ◽  
Janina Golob Deeb ◽  
Brian L. Foster ◽  
Evlambia Hajishengallis ◽  
Martha J. Somerman ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Viral Infections ◽  
Root Resorption ◽  
Integrated Management ◽  
Management Strategies ◽  
Care Providers ◽  
Drug Induced ◽  
External Root Resorption ◽  
Cervical Root

The goal of this perspective article is to use multiple idiopathic cervical root resorption (MICRR) as a model to demonstrate the need for transdisciplinary collaborations, from basic science to treatment planning, to improve the quality of health care for all. This is not a review of the literature on the current state of MICRR. Tooth root resorption is a normal physiological process required for resorption and exfoliation of primary teeth; however, root resorption of adult teeth is largely pathological. MICRR is an aggressive form of external root resorption, which occurs near the cemento-enamel junction (CEJ). The cause of MICRR remains elusive, however, it is mediated primarily by osteoclasts/odontoclasts. Accumulating case studies and experiments in animal models have provided insights into defining the etiologies and pathophysiological mechanisms for MICRR, which include: systemic conditions and syndromes, inherited genetic variants affecting osteoclast/odontoclast activity, altered periodontal structures, drug-induced root resorption and rebound effects after cessation of anti-resorptive treatment, chemotherapy, exposure to pets or viral infections, and other factors such as inflammatory conditions or trauma. To determine the causative factors for MICRR, as well as other oral-dental conditions, at minimum, a comprehensive health history should be collected for all patients by dental care providers, discussed with other health care providers and appropriate collaborations established. The examples highlighted in this perspective emphasize the need for transdisciplinary research collaborations coupled with integrated management strategies between medicine and dentistry in order to identify cause(s) early and improve clinical outcomes.

scholarly journals Nipah: An Interesting stance

2020 ◽  
Vol 10 (1) ◽  
pp. 5-7
Author(s):  
Ruchi D. Raval ◽  
Mansi Mehta
Keyword(s):  
Health Care Providers ◽  
Date Palm ◽  
Management Strategies ◽  
Nipah Virus ◽  
Electronic Media ◽  
Northeast India ◽  
Care Providers ◽  
Main Mode ◽  
Palm Juice ◽  
Mode Of Transmission

Nipah instead was one of the most fatal outbreaks of diseases in the mankind which was initially assumed as Japanese encephalitis. A multidisciplinary exploration was done at several levels of microbiology, histopathology and genetics which led to the discovery of a new paramyxovirus named Nipah virus (NiV). The disease was primarily identified in Malaysia in 1998 and named after a village, Sungai Nipah. The main mode of transmission in the Malaysian outbreaks was thought to be the consumption of bat’s dropping, urine and fruit partially eaten by pigs. In Bangladesh and northeast India, the virus was directly transmitted from bats to human through consumption of raw date palm juice. To limit the epidemic, coordinated efforts by health care providers have become mandatory. This article gives a note about the NiV, its infection and on-going researches on its management strategies. Data were collected using electronic media consisting of articles, books and websites.

scholarly journals Consultations With Health Care Providers and Use of Self-management Strategies for Prevention and Treatment of COVID-19 Related Symptoms. A Population Based Cross-sectional Study in Norway, Sweden and the Netherlands

2021 ◽  
Author(s):  
Agnete Kristoffersen ◽  
Esther van der Werf ◽  
Trine Stub ◽  
Frauke Musial ◽  
Barbara Wider ◽  
...  
Keyword(s):  
Health Care ◽  
The Netherlands ◽  
Dietary Supplements ◽  
Health Care Providers ◽  
Management Strategies ◽  
Self Management ◽  
Use Of Self ◽  
Care Providers ◽  
Self Help ◽  
Prevention And Treatment

Abstract BackgroundThe present study was initiated to determine consultations with health care providers and use of self-management strategies such as herbal remedies, dietary supplements and self-help techniques for prevention and treatment of COVID-19 related symptoms in countries with a full lockdown (Norway), a partial (’intelligent’) lockdown (the Netherlands) and no lockdown (Sweden) during the first three months of the COVID-19 pandemic, and if such use correlates with worries of being infected by COVID-19 disease. MethodsData were collected in collaboration with the global marketing company Ipsos A/S in April-June 2020 during the first wave of the COVID-19 pandemic. An adapted version of the I-CAM-Q was used and the categories “for prevention of COVID-19” and “to treat COVID-19-related symptoms” added to the original “reasons for use” options. Data were collected among a representative sample in Norway, Sweden and the Netherlands using data assisted telephone interviews (Norway, n=990 and Sweden, n=500), and an online survey (the Netherlands, n=1004). Total response rate was 30%. ResultsOnly a very small number of people in any of the three countries consulted a health care provider with the intention to treat or prevent COVID-19 (1.2% and 1.0% respectively) with medical doctors mostly visited (1.0% and 0.9%). Similarly, the use of self-management strategies to prevent or treat COVID-19 was low (3.4% and 0.2% respectively); most commonly used were vitamins and minerals (2.8%) for prevention of COVID-19, primarily vitamin C (1.7%), vitamin D (0.9%), and multivitamins (0.5%). Consultations with health care providers and use of self-management strategies for prevention of COVID-19 were positively associated with worries of being infected with COVID-19. No such associations were found for worries about loved ones or the perception that COVID-19 is more dangerous than ordinary influenza. ConclusionsThe COVID-19 pandemic does not seem to have evoked a large-scale difference in behaviour related to consultations with health care providers or the use of self-management strategies such as dietary supplements and self-help techniques in any of the three countries, despite different containment and mitigation measures.

scholarly journals Cannabis Vaping–Induced Acute Pulmonary Toxicity: Case Series and Review of Literature

2020 ◽  
Vol 8 ◽  
pp. 232470962094726
Author(s):  
Sreedhar Adapa ◽  
Vijay Gayam ◽  
Venu Madhav Konala ◽  
Srinadh Annangi ◽  
Mina P. Raju ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Health Care Providers ◽  
Management Strategies ◽  
Clinical Manifestations ◽  
Case Series ◽  
Clinical Findings ◽  
Care Providers ◽  
Medicinal Use ◽  
Common Laboratory

The use of cannabis for recreational as well as medicinal use is on the rise recently with more states legalizing it. We conducted a review analysis of the literature published on acute respiratory failure from vaping cannabis oil. We have also summarized the clinical details (age, length of stay, mode of ventilation, common clinical findings, and steroid use) along with common laboratory abnormalities. This article aims to educate health care providers on the clinical manifestations and management strategies for vaping-induced acute respiratory failure. We also discussed the different available formulations of cannabis oil and key ingredients responsible for the vaping-associated lung injury.

scholarly journals iCanCope with Pain™: User-Centred Design of a Web- and Mobile-Based Self-Management Program for Youth with Chronic Pain Based on Identified Health Care Needs

2014 ◽  
Vol 19 (5) ◽  
pp. 257-265 ◽  
Author(s):  
Jennifer N Stinson ◽  
Chitra Lalloo ◽  
Lauren Harris ◽  
Lisa Isaac ◽  
Fiona Campbell ◽  
...  
Keyword(s):  
Social Support ◽  
Health Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Health Care Providers ◽  
Barriers To Care ◽  
Management Strategies ◽  
Management Program ◽  
Self Management ◽  
Care Providers

BACKGROUND: While there are emerging web-based self-management programs for children and adolescents with chronic pain, there is currently not an integrated web- and smartphone-based app that specifically addresses the needs of adolescents with chronic pain.OBJECTIVES: To conduct a needs assessment to inform the development of an online chronic pain self-management program for adolescents, called iCanCope with Pain™.METHODS: A purposive sample of adolescents (n=23; 14 to 18 years of age) was recruited from two pediatric chronic pain clinics in Ontario. Interdisciplinary health care providers were also recruited from these sites. Three focus groups were conducted with adolescents (n=16) and one with pediatric health care providers (n=7). Individual adolescent interviews were also conducted (n=7).RESULTS: Qualitative analysis uncovered four major themes: pain impact; barriers to care; pain management strategies; and transition to adult care. Pain impacted social, emotional, physical and role functioning, as well as future goals. Barriers to care were revealed at the health care system, patient and societal levels. Pain management strategies included support systems, and pharmacological, physical and psychological approaches. Transition subthemes were: disconnect between pediatric and adult systems; skills development; parental role; and fear/anxiety. Based on these identified needs, the iCanCope with Pain™ architecture will include the core theory-based functionalities of: symptom self-monitoring; personalized goal setting; pain coping skills training; peer-based social support; and chronic pain education.CONCLUSIONS: The proposed iCanCope with Pain™ program aims to address the self-management needs of adolescents with chronic pain by improving access to disease information, strategies to manage symptoms and social support.

“We’re a Little Biased”: Medicine and the Management of Bias through the Case of Contraception

2021 ◽  
pp. 002214652110032
Author(s):  
Jamie L. Manzer ◽  
Ann V. Bell
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Contraceptive Use ◽  
Management Strategies ◽  
The United States ◽  
Care Providers ◽  
Patient Counseling ◽  
Patient Centered ◽  
American Health Care System ◽  
Centered Care

There is a wealth of literature demonstrating the presence of bias throughout the American health care system. Despite acknowledging such presence, however, little is known about how bias functions within medical encounters, particularly how providers grapple with bias in their patient counseling and decision-making. We explore such processes through the case of contraceptive counseling, a highly raced, classed, and gendered context. In-depth interviews with 51 health care providers reveal that providers use four primary strategies to navigate and minimize bias in their care—using scientific rationale, employing “safe” biases, standardizing counseling, and implementing patient-centered care. Paradoxically, using these strategies can exacerbate rather than resolve bias. Understanding these bias management strategies reveals provider-held biases, how they manifest within appointments, and the potential consequences for patients’ health autonomy. Such knowledge informs interventions that promote contraceptive use among women in the United States, addresses bias in health care broadly, and thus ultimately helps combat health disparities.

scholarly journals Distinguishing active pediatric COVID-19 pneumonia from MIS-C

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Daniel D. Reiff ◽  
Melissa L. Mannion ◽  
Nichole Samuy ◽  
Paul Scalici ◽  
Randy Q. Cron
Keyword(s):  
Health Care Providers ◽  
Laboratory Data ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Response To Treatment ◽  
Treatment Modalities ◽  
Care Providers ◽  
Male Predominance ◽  
Clinical Notes ◽  
Exposure History

Abstract Importance Active pediatric COVID-19 pneumonia and MIS-C are two disease processes requiring rapid diagnosis and different treatment protocols. Objective To distinguish active pediatric COVID-19 pneumonia and MIS-C using presenting signs and symptoms, patient characteristics, and laboratory values. Design Patients diagnosed and hospitalized with active COVID-19 pneumonia or MIS-C at Children’s of Alabama Hospital in Birmingham, AL from April 1 through September 1, 2020 were identified retrospectively. Active COVID-19 and MIS-C cases were defined using diagnostic codes and verified for accuracy using current US Centers for Disease Control case definitions. All clinical notes were reviewed for documentation of COVID-19 pneumonia or MIS-C, and clinical notes and electronic medical records were reviewed for patient demographics, presenting signs and symptoms, prior exposure to or testing for the SARS-CoV-2 virus, laboratory data, imaging, treatment modalities and response to treatment. Findings 111 patients were identified, with 74 classified as mild COVID-19, 8 patients as moderate COVID-19, 8 patients as severe COVID-19, 10 as mild MIS-C and 11 as severe MIS-C. All groups had a male predominance, with Black and Hispanic patients overrepresented as compared to the demographics of Alabama. Most MIS-C patients were healthy at baseline, with most COVID-19 patients having at least one underlying illness. Fever, rash, conjunctivitis, and gastrointestinal symptoms were predominant in the MIS-C population whereas COVID-19 patients presented with predominantly respiratory symptoms. The two groups were similar in duration of symptomatic prodrome and exposure history to the SARS-CoV-2 virus, but MIS-C patients had a longer duration between presentation and exposure history. COVID-19 patients were more likely to have a positive SAR-CoV-2 PCR and to require respiratory support on admission. MIS-C patients had lower sodium levels, higher levels of C-reactive protein, erythrocyte sedimentation rate, d-dimer and procalcitonin. COVID-19 patients had higher lactate dehydrogenase levels on admission. MIS-C patients had coronary artery changes on echocardiography more often than COVID-19 patients. Conclusions and relevance This study is one of the first to directly compare COVID-19 and MIS-C in the pediatric population. The significant differences found between symptoms at presentation, demographics, and laboratory findings will aide health-care providers in distinguishing the two disease entities.

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