A Case of Adult Clival Osteomyelitis.

Clival osteomyelitis is a potentially life-threatening skull base infection. It is rare and generally challenging to diagnose and treat. Clival osteomyelitis is typically seen in the pediatric population and is very rare in the adult population. It occurs as a complication of recurring paranasal infections and malignant otitis externa. The exact pathophysiology of osteomyelitis of the clivus is relatively uncertain. Here, we describe a case of a 36-year-old man with medical history significant for hypertension and poorly controlled type 1 diabetes mellitus who experienced recurrent paranasal sinus infection for 2 years. He received multiple antibiotic treatments and underwent adenoidectomy without substantial improvement of symptoms. Ultimately, a diagnosis of the clival osteomyelitis through the help of a computed tomography (CT) scan of the paranasal sinus and neck was made. This diagnosis allowed for adequate intervention and treatment of our patient with subsequent resolution of his presenting symptoms. This case highlights the importance of high suspicion for clival osteomyelitis in patients with recurring sinus infections.

Pharmacist-Pharmacy Technician Intraprofessional Collaboration and Workplace Integration: Implications for Educators.

Globally, concerns have been expressed regarding the impact of regulation of pharmacy technicians. After more than a decade of experience with technician regulation in Ontario, Canada, uptake of the full scope of practice for technicians has been sporadic at best. The objective of this study was to examine barriers and facilitators to intraprofessional collaboration between pharmacists and pharmacy technicians for the purpose of identifying possible curricular or educational interventions to enhance workplace integration. A qualitative, interview-based study of 24 pharmacists, technicians, educators, pharmacy managers, and owners was undertaken using a semi-structured interview guide. Key findings of this research include: i) Confirmation of suboptimal utilization of regulated technicians in practice; ii) identification of crucial knowledge and skills gaps for both pharmacists and technicians; and iii) proposals for undergraduate education and training, and continuing professional development learning opportunities to address these gaps. In order to achieve the promise and potential of regulation of pharmacy technicians, system-wide change management-beginning with education-will be required and will benefit from multiple stakeholder engagement and involvement.