ABSTRACT
Immunoglobulin G4 (IgG4) related disease (IgG4-RD) is currently considered an immune-mediated condition and is recognized as a disorder group with common pathological, hematological, and clinical characteristics. This disease may involve diverse organs of the head and neck, and include mainly the lacrimal gland, orbit, thyroid gland, pituitary gland, and the meninges.Here, we report a case of IgG4-RD in a 65-year-old female showing head- and neck-limited but synchronously and mainly manifesting as otalgia and facial neuritis.
ABSTRACT
OBJECTIVE: Outbreaks of transmissible respiratory infection are suspected to have significant effects on the health of pediatric and geriatric patients. The objective was to assess the impact of the Middle East respiratory syndrome (MERS) outbreak on the use of emergency resources. METHODS: An ecologic analysis of emergency department (ED) records between September and December 2015, was performed. Data was obtained from the National Emergency Department Information System database for Korea. All demographic and diagnostic data from patients presenting with febrile symptoms as a main complaint were collected. The data were compared to the equivalent period in the three years preceding the MERS outbreak in Korea. RESULTS: Following the MERS outbreak, there was an increase in overall ED visits by febrile patients and the proportion of visits by febrile patients, relative to total ED attendances. This effect was more prominent in the children under five years. The duration of the chief complaint before ED arrival and the length of ED stay were significantly increased among younger pediatric patients. Decreased body temperature on arrival was observed in younger pediatric patients. CONCLUSION: MERS outbreak appears to have had a significant effects on ED use by febrile patients. The use of emergency care services by pediatric patients makes them more vulnerable to an outbreak of a transmissable disease. An effective strategy to control emergency center visits by non-urgent febrile patients and provide proper medical services is urgently needed.
Subject(s)
Child , Humans , Body Temperature , Coronavirus Infections , Disease Outbreaks , Emergencies , Emergency Medical Services , Emergency Service, Hospital , Fever , Information Systems , Korea , Middle East Respiratory Syndrome Coronavirus , Middle East , OverallABSTRACT
PURPOSE: Emergency department (ED) overcrowding is recognized as a major concern not only because it is associated with patient dissatisfaction, but also because it impinges on quality of care. The goal of this study is to evaluate the mid-term effects of hospital bed capacity expansion on overcrowding in the emergency department for two years. METHODS: This was a pre-post study conducted using administrative data from the ED. On May 1st, 2011, the hospital licensed beds were expanded from 1150 to 1300. Data from one year of the pre-expansion period (May 1st, 2010 to April 30th, 2011) and two years of post-expansion were divided into two periods; early period and late period were included for this analysis. In these periods, we calculated the National Emergency Department Overcrowding Scale (NEDOCS) and occupancy rate at the same time of every day. The main outcomes included length of stay (LOS) in the ED and NEDOCS. RESULTS: A total of 177,766 patients were included. The mean number of daily ED patients was increased; 156.3+/-32.5 in the pre-expansion period, 162.5+/-32.5 and 167.9+/-32.4 in the early and late post-expansion periods, respectively (p<0.001). In multivariate linear regression analysis, hospital bed expansion, the number of admission hold patients, age, number of admission patients and operating rate of hospital beds showed association with mean ED LOS (coefficient=-82.9, 2.7, 6.4, 11.4 and 5.4 respectively, R2=0.628, p<0.001). CONCLUSION: Expansion of hospital beds could be helpful in resolving ED overcrowding for at least two years.
Subject(s)
Humans , Bed Occupancy , Crowding , Emergency Service, Hospital , Hospital Bed Capacity , Length of Stay , Linear Models , Tertiary Care CentersABSTRACT
Focal osteoporotic bone marrow defect (FOBMD) is a radiolucent area corresponding to the presence of hematopoietic tissue rarely found in the jaws. FOBMD is most commonly located in the mandibular edentulous posterior area of a middle-aged female. From November 2011 to November 2012, we experienced three cases involving removal of implants that had accidentally fallen into the FOBMD area. All patients happened to be female, with a mean age of 54 years (range: 51-60 years). One case involved hypoesthesia of the lower lip and chin, while two cases healed without any complication. Displacement of an implant into the FOBMD area is an unusual event, which occurs rarely during placement of a dental fixture. The purpose of this study was to report on three cases of FOBMD and to provide a review of related literature.
Subject(s)
Female , Humans , Bone Marrow , Chin , Dental Implants , Displacement, Psychological , Hypesthesia , Jaw , LipABSTRACT
Transcervical resection of endometrium is under-utilized in the treatment of dysfunctional uterine bleeding, uterine myoma and menorrhagia. The procedure is similar to transurethral resection of prostate in men with a possibility of substantial absorption of irrigation fluid. Absorption of a large volume of fluid can cause excessive intravascular volume, hyponatremia, cerebral edema and death. Severe hyponatremia leading to extrapontine myelinolysis is an extremely rare complication of this procedure. So, We report a case of developed extrapontine myelinolysis after hysteroscopic myomectomy which, however, showed complete recovery.
Subject(s)
Female , Humans , Male , Absorption , Brain Edema , Endometrium , Hyponatremia , Leiomyoma , Menorrhagia , Metrorrhagia , Myelinolysis, Central Pontine , Transurethral Resection of ProstateABSTRACT
We must be assured that sympathetic ganglion block interrupts a vicious cycle of nerve impulses. Therefore, it prevents vasospasm and improves local circulation. The sympathetic ganglion block is effective in acute stage of herpes zoster and reduces the incidence of post-herpetic neuralgia. Herpes zoster is more often involved in an immunosuppressive imbalance. Three cases of herpes zoster were treated by repeated sympathetic ganglion block with 1% proved. Duration from onset of pain was 1 week, 1 month and 2 months, respectively. The block decreased the degree of pain markedly and dried up the vesicle in the early stage. Two of these three cases had suffering from diabetes melitus.
Subject(s)
Action Potentials , Ganglia, Sympathetic , Herpes Zoster , Incidence , NeuralgiaABSTRACT
Lidocaine is considered a safe and effective local anesthetic in anesthesiology and is the standard to which new amide anesthetics are compared. As it an amide derivative, and the frequency with which lidocaine elicits an allergic response is much less than that of anesthetics derived from paraaminobenroic acid esters. Case reports od sensitivity to lidoeaine have been reported, but they are rare. This 29 year old male patient had on episode of asthmatic breathing after supraclavicular brachial plexus block using 30 ml of 1% lidocaine with epinephrine(1:200,000). We report a case of asthmatic breathing due to lidocaine and a review of the literature for allergy local anesthetics.