scholarly journals Labor Analgesia in a Patient with Severe Dystrophic Calcinosis Cutis

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 3237-3239
Author(s):  
Ashley V Wong ◽  
Arnoley S Abcejo ◽  
Ashley R D Dahl ◽  
Emily E Sharpe
Keyword(s):  
Informed Consent ◽  
High Risk ◽  
Autoimmune Disease ◽  
Obstetric Anesthesia ◽  
Neuraxial Anesthesia ◽  
Labor Analgesia ◽  
Anesthesia Provider ◽  
Calcium Deposition ◽  
Calcinosis Cutis

Abstract Introduction Calcinosis cutis is a condition characterized by pathologic calcium deposition into superficial dermal skin layers. It is often associated with an autoimmune disease. However, it may also occur after minor localized trauma and infection. Description of Problem We report a case of lumbar epidural placement of labor analgesia in a parturient with severe dystrophic calcinosis cutis without apparent complications. Clinical Solution We recommend fastidious optimization of epidural placement conditions for all patients who may be at high risk for neuraxial anesthesia, including consideration of ultrasound use, use of an experienced anesthesia provider for neuraxial placement, and placement in early labor. Additionally, judicious discussion of risks, benefits, and alternatives when obtaining informed consent is critical, ideally with the patient identified for a comprehensive visit in a preoperative obstetric anesthesia clinic before delivery.

Establishing Obstetric Anesthesiology Practice Guidelines in the Republic of Armenia

2017 ◽  
Vol 127 (2) ◽  
pp. 220-226 ◽  
Author(s):  
Gordon Yuill ◽  
Ashot Amroyan ◽  
Simon Millar ◽  
Emil Vardapetyan ◽  
Ashraf S. Habib ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Practice Guidelines ◽  
Clinical Care ◽  
Obstetric Anesthesia ◽  
Neuraxial Anesthesia ◽  
Labor Analgesia ◽  
Capital City ◽  
Anesthesia Care ◽  
The Republic ◽  
The Impact

Abstract Background Disparity exists in anesthesia practices between high- and low-to-middle income countries, and awareness has been raised within the global health community to improve the standards of anesthesia care and patient safety. The establishment of international collaborations and appropriate practice guidelines may help address clinical care deficiencies. This report’s aim was to assess the impact of a multiyear collaboration on obstetric anesthesia practices in the Republic of Armenia. Methods An invited multinational team of physicians conducted six visits to Armenia between 2006 and 2015 to observe current practice and establish standards of obstetric anesthesia care. The Armenian Society of Anaesthesiologists and Intensive Care specialists collected data on the numbers of vaginal delivery, cesarean delivery, and neuraxial anesthesia use in maternity units during the period. Data were analyzed with the Fisher exact or chi-square test, as appropriate. Results Neuraxial anesthesia use for cesarean delivery increased significantly (P < 0.0001) in all 10 maternity hospitals within the capital city of Yerevan. For epidural labor analgesia, there was sustained or increased use in only two hospitals. For hospitals located outside the capital city, there was a similar increase in the use of neuraxial anesthesia for cesarean delivery that was greater in hospitals that were visited by an external team (P < 0.0001); however, use of epidural labor analgesia was not increased significantly. Over the course of the collaboration, guidelines for obstetric anesthesia were drafted and approved by the Armenian Ministry of Health. Conclusions Collaboration between Armenian anesthesiologists and dedicated visiting physicians to update and standardize obstetric anesthesia practices led to national practice guidelines and sustained improvements in clinical care in the Republic of Armenia.

scholarly journals Legal Aspects in Obstetric Anesthesia

2016 ◽  
Vol 10 (2) ◽  
pp. 3-9
Author(s):  
S Chattopadhyay ◽  
A Rudra ◽  
M Ray ◽  
S Sengupta ◽  
S Goswami
Keyword(s):  
High Risk ◽  
General Anesthesia ◽  
Obstetric Anesthesia ◽  
Legal Aspects ◽  
Routine Practice ◽  
Good Doctor ◽  
Surgical Safety ◽  
Valid Consent ◽  
Headache Pain ◽  
Time Of Admission

Obstetric anesthesia is a particularly high-risk sub-specialty of anesthesia and may lead to serious morbidities and even mortality. Good doctor-patient relation from the time of admission till discharge is the most important factor to avert future litigations. Any procedure done or planned should be clearly documented. Documentation should start with a valid consent in the patient’s own language, and have all three components of voluntariness, capacity and knowledge. A ‘Surgical Safety’ checklist is particularly helpful in documentation and decreasing errors. Safety of the mother (and her child) is paramount. Both regional as well as general anesthesia, either inadvertently or if not administered properly may be associated with morbidities like headache, pain and emotional distress. However, deaths do occur and general anesthesia is associated with care should be routine practice and inculcated by everyone involved in patient care.

Ethical Issues Surrounding High-Risk Kidney Recipients: Implications for the Living Donor

2007 ◽  
Vol 17 (3) ◽  
pp. 180-182 ◽  
Author(s):  
Jerome F. O'Hara ◽  
Katrina Bramstedt ◽  
Stewart Flechner ◽  
David Goldfarb
Keyword(s):  
Informed Consent ◽  
High Risk ◽  
Ethical Issues ◽  
Family Members ◽  
Transplant Recipients ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Kidney Recipients ◽  
Medical Issues ◽  
Donor Transplant

Evaulating patients for living kidney donor transplantation involving a recipient with significant medical issues can create an ethical debate about whether to proceed with surgery. Donors must be informed of the surgical risk to proceed with donating a kidney and their decision must be a voluntary one. A detailed informed consent should be obtained from high-risk living kidney donor transplant recipients as well as donors and family members after the high perioperative risk potential has been explained to them. In addition, family members need to be informed of and acknowledge that a living kidney donor transplant recipient with pretransplant extrarenal morbidity has a higher risk of a serious adverse outcome event such as graft failure or recipient death. We review 2 cases involving living kidney donor transplant recipients with significant comorbidity and discuss ethical considerations, donor risk, and the need for an extended informed consent.

scholarly journals Calcinosis cutis associated with systemic sclerosis: a rare case report

2020 ◽  
Vol 7 (8) ◽  
pp. 2803
Author(s):  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand Prasath Jayachandiran
Keyword(s):  
Systemic Sclerosis ◽  
The Body ◽  
Calcium Deposition ◽  
Pressure Sores ◽  
Connective Tissue Disorders ◽  
Calcinosis Cutis ◽  
Rare Case Report ◽  
The Face ◽  
Subcutaneous Tissues ◽  
Calcium Deposits

Calcinosis cutis is abnormal calcium deposition in the skin and subcutaneous tissues of the body. It is generally associated with autoimmune connective tissue disorders and in our case, it is systemic sclerosis. It most commonly occurs in the fingers presenting with pain and functional impairment. Here, we present a case of calcinosis cutis with systemic sclerosis in a teenage girl presented with bilateral gluteal pressure sores and multiple sites of calcium deposition like sacrum, upper limbs, knees and the face. We treated here with reconstructive surgery with Limberg flaps for the pressure ulcers with excision and primary closure of the other sites with calcium deposits. 

IDIOPATHIC CALCINOSIS CUTIS IN FINGERTIP TREATED WITH OCCLUSIVE DRESSING USING ALUMINUM FOIL: A CASE REPORT

Hand Surgery ◽  
2007 ◽  
Vol 12 (03) ◽  
pp. 149-154 ◽  
Author(s):  
Kazuki Sato ◽  
Toshiyasu Nakamura ◽  
Yoshiaki Toyama ◽  
Hiroyasu Ikegami ◽  
Kaori Kameyama ◽  
...  
Keyword(s):  
Case Report ◽  
Calcium Phosphate ◽  
Pain Relief ◽  
Aluminum Foil ◽  
Surgical Excision ◽  
Calcium Deposition ◽  
Calcinosis Cutis ◽  
Occlusive Dressing ◽  
Significant Pain

Calcium deposition in the skin, known as calcinosis cutis, is an uncommon disorder caused by an abnormal deposit of calcium phosphate in the skin. We report a case of idiopathic calcinosis cutis in fingertip treated with surgical excision followed by the occlusive dressing using aluminum foil, and obtained significant pain relief and round-shaped fingertip which looked normal.

Informed Consent in Obstetric Anesthesia Research Studies

1999 ◽  
Vol 90 (Supplement) ◽  
pp. 45A ◽  
Author(s):  
T. W. Breen ◽  
Tacie McNiel ◽  
Robin Brooks ◽  
Brian T. Price
Keyword(s):  
Informed Consent ◽  
Obstetric Anesthesia ◽  
Anesthesia Research ◽  
Research Studies

Clustering of autoimmune disease in families at high risk for multiple sclerosis? – Authors' reply

2007 ◽  
Vol 6 (3) ◽  
pp. 207
Author(s):  
Stephen L Hauser ◽  
Lisa F Barcellos ◽  
Margaret Pericak-Vance ◽  
Jonathan L Haines ◽  
Jorge R Oksenberg
Keyword(s):  
Multiple Sclerosis ◽  
High Risk ◽  
Autoimmune Disease

Informed Consent in Obstetric Anesthesia

2011 ◽  
Vol 112 (4) ◽  
pp. 912-915 ◽  
Author(s):  
Brian M. Broaddus ◽  
Shobana Chandrasekhar
Keyword(s):  
Informed Consent ◽  
Obstetric Anesthesia

Informed Consent in Obstetric Anesthesia

2011 ◽  
Vol 55 (6) ◽  
pp. 280-282
Author(s):  
Brian M. Broaddus ◽  
Shobana Chandrasekhar
Keyword(s):  
Informed Consent ◽  
Obstetric Anesthesia

scholarly journals Hematoma subdural como complicación de analgesia epidural de parto. A propósito de dos casos

2018 ◽  
Vol 10 (9) ◽  
pp. 2
Author(s):  
Rita Veloso de Sousa ◽  
Ana Belén Ortega López ◽  
José Francisco Guillén Perales
Keyword(s):  
Dural Puncture ◽  
Obstetric Anesthesia ◽  
Neuraxial Anesthesia ◽  
Intracranial Hemorrhages ◽  
Post Dural Puncture Headache ◽  
Frequent Complication ◽  
Healthy Women ◽  
Accidental Dural Puncture

Las hemorragias intracraneales son una complicación infrecuente pero potencialmente grave tras la punción dural asociada a anestesia neuroaxial. Las consecuencias pueden ser catastróficas, especialmente cuando hablamos de anestesia neuroaxial obstétrica en mujeres jóvenes y sanas. El diagnóstico puede ser difícil por la similitud de síntomas con la cefalea postpunción dural (CPPD), que es la complicación más frecuente tras una punción dural. Este trabajo tiene como objetivo, aumentar la conciencia de los profesionales ante la posibilidad de ocurrencia de este tipo de complicaciones ante una punción dural accidental.  ABSTRACT Intracranial hemorrhages are a rare but potentially serious complication following dural puncture associated with neuraxial anesthesia. The consequences can be catastrophic, especially when we talk about neuraxial obstetric anesthesia in young and healthy women. Dagnosis may be difficult due to the similarity of symptoms between these and post-dural puncture headache, which is the most frequent complication after a dural puncture. This work aims to increase the awareness of professionals for the possibility of occurrence of this type of complications when an accidental dural puncture has occured.

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