A 55-year-old COVID-19-positive man managed with self-regulation of high-flow oxygen by high-velocity nasal insufflation therapy.

Management of critically ill coronavirus disease 2019 (COVID-19) patients remains both risky and technically challenging. A 55-year-old male COVID-19-positive patient with obstructive sleep apnoea (OSA), diabetes, and obesity presented with cough and shortness of breath, escalating to requiring high-flow oxygen therapy by high-velocity nasal insufflation. The patient's flow rate and oxygen fraction remained labile throughout much of the hospitalization. This lability required frequent clinician interactions and use of personal protective equipment. The patient was alert and oriented and was instructed on the operation of the high-flow system, specifically the adjustment of both flow rate and oxygen percentage. The patient was instructed to modify oxygen to maintain an SpO2 (peripheral capillary oxygen saturation) target range, and flow rate to address dyspnoea as well as reduction of flow as tolerated when other staff entered the room. The patient was successfully self-regulated for 10 days and was discharged on 2 L/min nasal cannula on day 14 of his illness.

Malignant ameloblastoma metastatic to the lungs 29 years after primary resection: a case report.

We describe a case of a 55-year-old man presenting with a metastatic malignant ameloblastoma 29 years after the primary tumor was resected. This represents the longest period between initial diagnosis and first subsequent metastasis recorded as a case report. This case illustrates distinctions between the terms metastatic and malignant; it also highlights the difficulties derived from the accumulation of data by new diagnostic modalities (electron beam CT and positron emission tomography) and their integration into assessment algorithms.