RESUMO
Thirty-eight tracheostomies were performed on patients with respiratory failure secondary to SARS-CoV-2 infection over the month of April at North Shore University Hospital and Lenox Hill Hospital (members of Northwell Health System in Long Island and New York City). Follow-up by May 14 revealed that 21 (55.2%) had been weaned from ventilators and 7 (18.4%) underwent decannulation. Two patients (5.3%) expired in the weeks following tracheostomy. Between the 2 institutions, 10 attending surgeons performed all of the tracheostomies using appropriate personal protective equipment, and none demonstrated seroconversion within 1 to 2 weeks of this article.
Assuntos
COVID-19/complicações , Insuficiência Respiratória/cirurgia , Traqueostomia , Idoso , COVID-19/mortalidade , COVID-19/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New York/epidemiologia , Pandemias , Equipamento de Proteção Individual , Insuficiência Respiratória/etiologia , Estudos Retrospectivos , Resultado do Tratamento , Desmame do Respirador/estatística & dados numéricosRESUMO
Dermatillomania is a pathologic grooming disorder characterized by repetitive, ritualistic, impulsive skin picking without an underlying dermatologic condition. It can lead to skin damage and distress and can affect patient function. This disorder has not received much attention in the literature, with few studies reporting treatment efficacy. Patients with dermatillomania typically present to primary care physicians and frequently are referred to dermatologists; only rarely do patients receive additional psychiatric consultation that may improve treatment efficacy and decrease morbidity. We provide a case report of long-standing facial dermatillomania and our multimodal treatment approach.
Assuntos
Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Face , Cabelo , Higiene da Pele , Transtorno da Compulsão Alimentar/diagnóstico , Transtorno da Compulsão Alimentar/psicologia , Transtorno da Compulsão Alimentar/terapia , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/psicologia , Transtornos Dismórficos Corporais/terapia , Terapia Cognitivo-Comportamental , Depressão/diagnóstico , Depressão/psicologia , Depressão/terapia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/terapia , Cloridrato de Duloxetina , Exercício Físico , Feminino , Humanos , Pessoa de Meia-Idade , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Tiofenos/uso terapêuticoRESUMO
Vocal process avulsion is a rare condition in which laryngeal trauma causes a separation of the vocal process from the body of the arytenoid cartilage. Typically symptoms are dysphonia and shortness of breath during phonation. Strobovideolaryngoscopy, laryngeal electromyography, and laryngeal computed tomography are helpful in establishing this important and sometimes elusive diagnosis. Several treatment modalities have been reported with varying success. We report four new cases, review four cases reported previously by the senior author, and suggest approaches to diagnosis and optimal treatment of vocal process avulsion.
