A Case Report of Bilateral Phrenic Nerve Dysfunction After Unilateral Supraclavicular Brachial Plexus Block: Unveiling Preexisting Diaphragmatic Dysfunction.

A 48-year-old woman with a history of cardiac surgery developed severe dyspnea and anxiety following right-sided supraclavicular nerve block for hand surgery. In this case, right phrenic nerve blockade from a supraclavicular block unmasked a subclinical hemidiaphragmatic paresis from phrenic nerve injury on the left, the latter likely due to previous cardiac surgery. When performing brachial plexus block at or above the clavicle, particularly for prior cardiothoracic surgical patients, anesthesiologists can easily, quickly, and inexpensively use point-of-care ultrasound to assess whether any degree of phrenic nerve dysfunction exists on the contralateral side, as patients may be asymptomatic at baseline.

Psychiatric disorders, high-risk behaviors, and chronicity of episodes among predominantly African American homeless Chicago youth.

OBJECTIVE: This cross-sectional study investigated the relationships between psychiatric and substance-related disorders, high-risk behaviors, and the onset, duration, and frequency of homelessness among homeless youth in Chicago. METHODS: Sixty-six homeless youth were recruited from two shelters in Chicago. Demographic characteristics, psycho-pathology, substance use, and risk behaviors were assessed for each participant. RESULTS: Increased frequency and duration of homeless episodes were positively correlated with higher rates of psychiatric diagnoses. Increased number of psychiatric diagnoses was positively correlated with increased high-risk behaviors. Participants with diagnoses of Current Suicidality, Manic Episodes, Obsessive Compulsive Disorder, Substance Abuse, and Psychotic Disorder had a higher chronicity of homelessness than those without diagnoses. CONCLUSIONS: Significant differences were evident between the three time parameters, suggesting that stratification of data by different time variables may benefit homelessness research by identifying meaningful subgroups who may benefit from individualized interventions.