Emergencies in dental surgery during the COVID-19 pandemic

Introduction: Patients' negligence and difficult access to healthcare have an impact on the worsening of emergency conditions, which require immediate treatment due to the possibility of exacerbation in a short period of time. Untreated intra- and extraoral abscesses can have serious consequences on the patient's health and in many cases are life-threatening conditions increasing risk of respiratory obstruction, thrombophlebitis, meningitis, mediastinitis and septicemia. Background: The aim of this study is to investigate the impact of the pandemic and the resulting impediments to accessing medical care on the incidence and type of emergencies in the Oral Surgery Department. Material and methods: This was a retrospective study of 85375 patients aged 2 months to 90 years old with diagnosed intra- and extraoral abscesses before COVID-19 pandemic (2018,2019), and during pandemic (2020, 2021) in the Department of Oral Surgery of the Medical University in Lublin. The obtained results were statistically analyzed with the use of a computer program. Conclusions: The fewest patients were admitted in 2020, and the most in 2021, where we can already see the effects of the pandemic. Emergencies occurred most frequently in people aged 21-30, then 31-40. In 365 cases, tooth extraction was performed, and only in 28 cases, root canal treatment was attempted. Conclusions. Oral health service provision has been significantly affected by COVID-19. Patients came to their appointments too late, which in most cases resulted in the necessity of tooth extraction without attempting root canal treatment.

Focus on laryngeal disease in the cat

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Screening tool to improve patient referral to acute surgical care from accident and emergency

IntroductionThis study aimed, first, to audit the appropriateness of surgical referrals to an acute surgical unit for urgent assessment and, second, to devise a screening tool for use in the emergency department to categorise patients into those who need an urgent surgical review and those who can be seen in an ambulatory setting within the next few days.MethodsThe first phase of the study was an audit of surgical referrals between 1 and 18 February 2020 to check the appropriateness of the surgical referral. In the second phase, a tool was designed to screen patients who did not require urgent surgical review and could be seen in the ambulatory clinic. A prospective questionnaire study was conducted from 1 February to 24 March 2020 with patients who were admitted to an acute surgical ward. Based on responses to the screening tool, patients were given the outcome of whether they can be discharged and seen in an ambulatory clinic. The accuracy of the screening tool outcome was assessed and compared with actual patient discharge outcomes by the surgical team evaluating patients' electronic medical records.ResultsIn the first audit of referrals to the acute surgical ward, 206 patients were referred to the acute surgical unit and seen by the senior surgeon. Of these, 142 (68.9%) were discharged on the same day with or without follow-up in the ambulatory surgical clinic. In the prospective questionnaire phase of the study, 98 patients completed the questionnaire. The most common presentation was abdominal pain (n=60) followed by urological symptoms (n=11), symptoms of hernia complication (n=10), abscess (n=7), testicular pain (n=2) and trauma (n=2). Of the patients discharged on the same day, 50% were given ambulatory care appointments and 50% were discharged with no further follow-up. The sensitivity and specificity of the screening tool were 100% and 60.7%, respectively;the overall accuracy was 88.4%.ConclusionA large proportion of patients who are referred to the acute surgical unit can be deferred and seen in the ambulatory clinic. The screening tool used for acute surgical referral had reasonable sensitivity and high specificity to screen patients who can be seen in ambulatory clinics. At the same time, it identified patients who were unwell and required urgent surgical admission.

COVID-19-related orbital abscesses: a case report

Orbital cellulitis is a condition with a high risk of morbidity, including visual loss. It commonly originates from the paranasal sinuses. We present a case of multifocal intraorbital abscesses secondary to viral sinusitis in an adolescent with SARS-CoV-2 infection. This patient presented with classic symptoms of orbital cellulitis, but did not display classical symptoms of COVID-19. The patient initially underwent endoscopic drainage, followed by a combined approach which yielded no pus. He recovered without complication. This is the second report of its type showing a causative link between SARS-CoV-2 and orbital cellulitis.

Extensive rhino-orbital-cerebral mucormycosis in kidney transplant recipient associated with COVID-19 infection: a case report

Rhino-orbital-cerebral mucormycosis is an invasive disease caused by fungi. Diabetes mellitus and solid organ transplantation are known risk factors, while it is increasingly recognized in patients with COVID-19 although the exact causal relationship is unknown. Early diagnosis and treatment with liposomal amphotericin B with surgical debridement carries a better outcome in these patients. We present a case of extensive rhino-orbital-cerebral mucormycosis involving the paranasal sinuses, left orbit, cavernous sinus, middle cranial fossa with abscess formation in the left middle cerebellar peduncle in a 46-year-old kidney transplant recipient with concomitant COVID-19 infection.

Fungal brain abscesses caused by Acremonium species.

Unusual fungal agents that exist environmentally as saprophytes can often lead to opportunistic infections, hyalohyphomycosis is a group of fungal infections caused by fungi characterized by hyaline septate hyphae and can infect both immunocompetent as well as immunocompromised patients, and Acremonium has drawn the attention of clinicians and microbiologists, as a potential pathogen in patients with and without underlying risk factors. It has also been increasingly implicated in systemic fungal diseases. Herein, we describe a case presentation of an immunocompromised patient with fungal brain abscesses due to Acremonium species.

A case of amebic colitis and liver abscesses that occurred after treatment of coronavirus disease 2019 with dexamethasone.

Entamoeba histolytica infections, which can be asymptomatic, are endemic to developing countries; traveling to such countries is a risk factor for contracting these infections. A 65-year-old Japanese man was hospitalized for coronavirus disease 2019 (COVID-19)-associated respiratory distress, and was treated with remdesivir, dexamethasone, and oxygen supplementation. Although his respiratory condition improved and the oxygen support was discontinued, he developed a fever, severe abdominal pain, and diarrhea on day 13 of hospitalization. Fifteen years ago, he was hospitalized for diarrhea of an unknown origin in Suzhou, China, and had a history of passing loose stools for 1 year. Contrast-enhanced abdominal and pelvic computed tomography revealed liver abscesses in both lobes and intestinal edema from the ascending colon to the descending colon. The abscesses were suspected to be amebic based on the characteristics of the drained abscess fluid. The patient was treated with cefotaxime and metronidazole, and his temperature declined and abdominal pain improved. A culture analysis of abscess fluid yielded negative findings; however, polymerase chain reaction analyses of abscess and stool samples were positive for Entamoeba histolytica. We speculated that the patient was infected with Entamoeba histolytica while in China, and that the corticosteroid usage for COVID-19 had exacerbated the infection. Clinicians should be aware that corticosteroid treatments can lead to recurrent invasive amebiasis in asymptomatic amebic carriers.

Myeloid Sarcoma Mimicking Dental Abscess in a Patient with Chronic Myeloid Leukemia: Diagnostic and Therapeutic Dilemma

Chronic myeloid leukemia (CML) is a hematologic malignancy that has significant improvement in its prognosis after the introduction of tyrosine kinase inhibitors. Transformation to accelerated phase or blast phase can happen. Myeloid sarcoma or chloroma is an uncommon extramedullary disease. It is very unusual for patients with CML to develop myeloid sarcoma. We report a young man with CML in the chronic phase who developed myeloid sarcoma. There were many difficulties in the diagnosis of myeloid sarcoma due to the simulation of other more common conditions like infections and other malignancies. In addition, there are treatment challenges because of lack of standardized treatment. The case shed light on this rare complication, the challenging diagnosis, and its implication in patients with CML.

A retrospective review of paediatric neurosurgical suppurative intracranial infections

836 Figure 1 Origin by age[Figure omitted. See PDF] 836 Table 1Patient Culture and AbxConclusionSuppurative intracranial infections are rare but serious neurological diseases. This cohort demonstrated a decrease in the incidence of Paediatric Suppurative Brain Infection in 2020-2021 of 78% (p<0.003). This correlated with the first year of the SARS-CoV-2 pandemic.This audit supports a high clinical suspicion for brain abscess in children with a recent infection, particularly sinusitis. Ceftriaxone and Metronidazole are an adequate first line empiric treatment, with adjustment according to sensitivities.The emerging patterns in this audit are supported by similar, larger studies;this data presents valuable information for the management of paediatric intracranial infections and informs further studies.ReferencesPaediatric focal intracranial suppurative infection: a UK single-centre retrospective cohort study, Van der Velden et al.Clinical and Microbiologic Features Guiding Treatment Recommendations for Brain Abscesses in Children, Felsenstein et al.

What is Your Radiologic Diagnosis?: Journal of Pediatric Infection

Septic sacroiliitis is septic arthritis of the sacroiliac joints and is extremely rare. Since its clinical picture is not specific, imaging is integral to diagnosis. The patient, who had dyspnea and chest pain at the time of admission, had a body temperature of 39.2°C, showed bilateral subpleural multifocal ground-glass opacities in the thoracic CT performed in an external center, and findings consistent with perimyocarditis in cardiac magnetic resonance imaging (MRI) performed in our hospital. Cases of Pseudomonas aeroginosa have been documented in immunocompromised individuals or intravenous drug users, while cases of E. coli-associated septic sacroiliitis have been reported In patients with urinary tract Infections (5). Unilaterally Increased Involvement Is observed In septic sacroiliitis. Since the clinical picture Is not specific, especially In children at an early age, this can help determine the location of the pain (7).

Quarterly report of investigations of suspected exotic diseases: July to September 2021

Exotic pest and disease investigations are managed and reported by the Ministry for Primary Industries' (MPI's) Diagnostic and Surveillance Directorate. This article presents a summary of investigations of suspect exotic and emerging pests and diseases in New Zealand during the period from July to September 2021.

HEALING THE HEALERS IN A POST-PANDEMIC WORLD

In Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference, physician-scientists Stephen Trzeciak and Anthony Mazzarelli, who admittedly were "not in the market for an awakening when they embarked on the journey into the data of compassion, suggest that compassion and human connection not only can have health benefits for patients, but also they can help reverse the cost of healthcare and be an antidote for burnout among healthcare providers.1 With compassion and empathy comes the differentiation between healing and curing. Lissa Rankin, MD, the author of The Anatomy of a Calling, states that "doctors feel unappreciated, devalued, and disenfranchised by forces outside of their control, including managed care, insurance companies, the pharmaceutical industry, and political lobbies.3 Furthermore, modern physicians have been conditioned by a culture of perfectionism, mastery, knowledge, and competency above all else, and as a result, patient expectations of them run wild. With technological advancements, changes in the healthcare landscape, and the societal shift in patient expectations, doctors must, as Eric Topol, MD, suggests in The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Healthcare, "adjust to being a guiding force and partner to the patient, offering judgment, experience, compassion, and outstanding communicative skills4 - all behaviors that were not well-addressed in medical school education and training. The medical student, the hero in this epic, battles unforeseen forces to a climax of certain victory, the medical diploma, and returns from the adventure with the power to share the knowledge gained to the benefit of all. [...]the doctor becomes the knower and healer of all human maladies.

The First Case of the Subretinal Abscess After Sars-CoV2 Infection

Ever since the new coronavirus has become the cause of the COVID-19 pandemic, it has manifested with unknown and new presentations. In this report, we are presenting a 46-year-old female infected with COVID-19 (confirmed by RT-PCR nasal swab test) and a known case of Diabetes mellites type 2 who had a history of ICU admission due to COVID-19 with uncontrolled diabetes mellites. In the second admission after recovery, she had blurred vision. Fundus examination revealed multiple yellow-white well-demarcated nonpigmented masses. Diagnosis of the multiple subretinal abscesses was confirmed. KOH-Calcofluor staining of vitreous fluid was negative for fungal infections of the eye. No polymorphonuclear leukocytes (PMN), epithelial cells nor any organisms were detected. The patient was treated with an injection of the intravitreal Amphotericin B 10 µg/0.1cc. To our knowledge, the presented case is the first case of the subretinal abscess after covid-19 infection.

Omentoplasty technique in a patient with COVID-19 infection complicated with pulmonary abscess and bronchopleural fistula

One of the described complications in patients with SARS-CoV-2 is the occurrence of a lung abscess in the presence of ventilator-associated pneumonia. In cases of lung abscess indicated for surgical treatment, we face a number of challenges, the main of which is the treatment of the residual cavity and bronchial fistula. Omentoplasty is a method for treatment of various intrathoracic complications but its use in the filling of cavity defects and bronchial fistula is not much represented. We present the case of a 33-year-old patient with a severe form of COVID-19 infection who developed a massive lung abscess complicated by bronchopleural fistula and empyema during.

Diary of a Family Physician

See PDF] 9:00 a.m. A hair stylist presents for the third time in one month with a recurrent abscess between the fourth and fifth toes of her left foot. An ultrasound-guided biopsy of one of the inguinal nodes was positive for adenocarcinoma, so I refer him to oncology. 11:00 a.m. My medical assistant announces that he has just received a call from the dean of the medical school where he had interviewed and was told he had been accepted. Examination of her palms reveals a diffuse erythematous papular rash consistent with hand-foot-and-mouth disease.

2021 Subject Index

18F FDG PET/CT 292 25(OH)D 267 Accessory foramen 165 ACE 82 Acute coronary syndrome 147 Acute pancreatitis 153 Amphetamine type stimulant 35 Anaplastic astrocytoma 75 Angiotensin converting enzyme 82 Angiotensin-2 82 Animal model 1 Ankle-brachial pressure index 218 Anterior nasal spine 165 Anti-vaccination movement 96 Appendicitis 181 Arterial stiffness 218 Asthma 104 Autoimmune disease 267 Basophil activation test 297 Bioethics 260 Biologics 136 Bisulfide treatment 274 Bladder cancer 175 Blast effect 156 Bloodstream infection 42 Brain bank 1 Bronchoscopic lung volume reduction 193 Buccal shelf area 13 Calcitriol 267 Carcinoma in situ 175 Cardiometabolic risk 205 Caregiver 186 Caregiver burden 186 Carotid cavernous fistula 159 CCF superior ophthalmic vein 159 CD203c 297 CD4 count 20 CD63 297 Chest wall 123 Child 72 Children 87 Chorioretinal abscess 229 Chronic hepatitis B 200 Chronic hepatitis C 200 Chronic obstructive pulmonary disease 59 Classification 68 Collectivism 260 Complicated appendicitis 181 Composites 30 Computer game addiction 87 Condylar hypoplasia 225 Cone beam computed tomography 225 COPD awareness level of smokers 59 COPD awareness survey 59 Coracoacromial arch 254 Coracoacromial ligament 254 Coronavirus 305 Coronavirus disease-2019 136 Cortical bone thickness 13 COVID-19 82, 136, 246, 305 Cytokine 104 Dacryocystorhinostomy 170 Dens in dente 68 Dental esthetics 238 Dental papilla 68 Dental student 305 Dentistry 305 Depression 141 Diabetes mellitus 212, 229 Diabetic ketoacidosis 212 Discoloration 30 Disinfection 280 Doctor-patient relationship 162 Ear canal 25 Education 8 Emphysema 193 Endobronchial valve 193 Endophthalmitis 78 Epiphora 170 Epithelial mesenchymal transition 232 ERAS 287 Fatigue 141 Flow diverter stent 159 Gene 1 General anesthesia 287 Glioma 274 Gunshot injury 156 GWAS 1 Health care worker 162 Hematologic malignancy 42 Hemifacial microsomia 225 Hidradenitis suppurativa 136 HIV 20 HMGB1 246 Hypogonadism 205 IL-1β 200 IL-33 104 IL-6 200 Immune infiltration 246 Immunization 96 Immunosuppressive 136 Incisor 68 Individual autonomy 260 Infarction 78 Infections 25 Infraorbital foramen 165 Intensive care unit 212 Ischemia-reperfusion injury 129 Isolated hypertension 218 Klebsiella 78 Knowledge 280 Lactate 212 Laser therapy 170 Le Fort type-1 osteotomy 165 Learning 8 Lecture 8 Liver abscess 229 Liver surgery 129 Lung cancer 292 Lung volume reduction coil 193 Macula 78 Malaysia 274 Malignant phyllodes tumor 313 Malnutrition 72, 147 Mandibular advancement device 52 Metastasis 232, 292 Metastatic tumor 123 Methadone maintenance therapy 35 Methylation 274 Miniscrew implant 13 Molecular biology 1 Mortality 110 Multicentric glioma 75 Multiple sclerosis 141 Myeloproliferative disorders 117 Nasolacrimal duct obstruction 170 Neutrophil to lymphocyte ratio 181 NLR 205 Nongerminoma 72 O6-methylguanine-DNAmethyltransferase 274 Obesity 87 Obstructive sleep apnea 52 Opioid 35 Oral lichen planus 267 Otitis externa 25 Paediatrics 260 Pain 141 Pandemic 136, 305 Pericardial effusion 20 Pilocytic astrocytoma 75 PLR 205 Polycythemia vera 117 Positron-emission tomography 292 Practices 280 Primary myelofibrosis 117 Primary tumor 123 Prostatectomy 287 Psychiatric diseases 1 Pulse oximeter device 52 Pulse wave velocity 218 Questionnaire 280 Radiocontrast media 297 Rafsanjan 110 Reconstruction 123 Rectum injury 156 Recurrence 313 Remote ischemic preconditioning 129 Resection 123 Respiratory function tests 193 Risk factors 25,11 SARS-CoV-2 82, 246 Shoulder impingement syndrome 254 Sleep disorders 141 Smartphone sleep applications 52 Smoking cessation polyclinic 59 Snoring 52 Solid tumor 42 Spinal anesthesia 287 Sterilization 280 Steroids 153 Stroke 110 Students 8 Subacromial space 254 Supraspinatus fascia 254 Surgery 313 Survival 175 SYNTAX score 147 Systemic lupus erythematosus 153 Teaching 8 Teeth bleaching 238 Testosterone 205 Therapy 246 TNF-α 200 Tooth abnormalities 68 Tooth discolorations 238 Toothpaste 30 Traumatic brain injury 186 Tuberculosis 20 Tumor recurrence 175 Tumor staging 292 Urothelial cancer 175 accination 96, 260 Antivaccination 260 Vaccine refusal 96 Validation 280 Vimentin 232 Violence 162 Vitamin D 25, 267 White blood cell count 181 Whitening 30 Workplace violence 162 Young woman 313 Zygomatico-maxillary suture 165

ATYPICAL INFLAMMATORY PHENOMENA IN COVID-19: PLEURAL EFFUSION, LUNG ABSCESS AND PERICARDIAL EFFUSION

Pleural and pericardial effusions are uncommon in COVID-19 patients who are not severely ill. To our knowledge, this is the first case reporting co-occurrence of pleural and pericardial effusions and lung abscess as complications of COVID-19 infection. [Extracted from the article] Copyright of Critical Care Medicine is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)