Pneumocephalus and Facial Droop on an Airplane: A Case Report

Introduction: Pneumocephalus (PNC) is most commonly associated with trauma or intracranial surgery, less commonly secondary to an infectious source, and is rarely caused by barotrauma. Case report: A 32-year-old woman presented to the emergency department with complaint of resolved left-sided facial droop and a lingering paresthesia of her left upper extremity after a cross-country flight. Computed tomography demonstrated several foci of air in the subdural space consistent with PNC. Conclusion: For PNC to occur there must be a persistent negative intracranial pressure gradient, with or without an extracranial pressure change. In this case the pressure change occurred due to cabin pressure

Low-Cost, Low Fidelity Meat Model to Teach Ultrasound Guided Nerve Blocks

Audience: The target audience of this workshop is emergency medicine residents; however, it is appropriate for all level of learners from medical students to faculty. Introduction: Pain control is a major focus in the emergency department. Regional anesthesia is a rapidly growing alternative to opioid analgesia or procedural sedation. Nerve blocks are useful in many procedures and are relevant to some of our most common chief complaints. Ultrasound guided regional anesthesia has been shown to be highly successful with minimal complications, and has been shown to reduce the need for supplemental anesthesia such as sedation and narcotics.1 Ultrasound guidance both decreases complications and increases success rate of nerve blocks.2 We provide a simple format for learning relatively safe and technically easy ultrasound guided nerve block techniques. Meat models provide realistic and superior tactilesensation, sono-anatomy, and injection resistance compared to homemade or commercial gel models. Meat and tendons for models are inexpensive and universally available. Objectives: Upon completion of this workshop, learners will be able to: 1) Describe the risks and benefits of ultrasound guided nerve blocks. 2) Choose the appropriate nerve to block based on the area that needs anesthesia. 3) Display proficiency in performing an ultrasound guided nerve block on meat models. 4) Verbalize confidence in successfully performing ultrasound guided regional anesthesia. By successfullymeeting these objectives, we aim to improve learner confidence and clinical ability in performing ultrasound guided nerve blocks. Methods: This module consists of a short introductory lecture followed by small group practicums. Learners will rotate through this workshop in groups of four. Each rotation will require about 30 minutes. The instructor will demonstrate appropriate technique for ultrasound guided nerve block using the prepared meat model. Learners will then practice the in-plane ultrasound guided nerve block techniqu

Pneumocephalus and Facial Droop on an Airplane: A Case Report

Introduction: Pneumocephalus (PNC) is most commonly associated with trauma or intracranial surgery, less commonly secondary to an infectious source, and is rarely caused by barotrauma.Case report: A 32-year-old woman presented to the emergency department with complaint of resolved left-sided facial droop and a lingering paresthesia of her left upper extremity after a cross-country flight. Computed tomography demonstrated several foci of air in the subdural space consistent with PNC.Conclusion: For PNC to occur there must be a persistent negative intracranial pressure gradient, with or without an extracranial pressure change. In this case the pressure change occurred due to cabin pressure

Facebook, stress, and incidence of upper respiratory infection in undergraduate college students

Having a large social network is generally beneficial to health. However, it is unclear how Internet-based social networks might influence health. Chronic stress can have negative health consequences, and some data suggest that Facebook could be a new source of psychological stress. Thus, we examined undergraduate college student perceptions of Facebook use and incidence of upper respiratory infections (URIs). We hypothesized that subjects with more diverse networks (i.e., more friends on Facebook) would have fewer URIs than their less diverse counterparts; that subjects reporting Facebook-induced stress would be more susceptible to URIs; and that subjects with more diverse networks who report Facebook-induced stress would be less susceptible to URIs than subjects with less diverse social networks who reported Facebook-induced stress. In this prospective study, healthy college students completed online questionnaires that assessed use and perceptions of Facebook and technology, and then were interviewed weekly for 10 weeks to track incidence of URI. URI episodes were defined by a symptom-based criterion. The social network size was significantly related to the rate of URI, such that, the larger the social network, the greater the incidence rate of URI. Most (85.7 percent) respondents experienced some degree of Facebook-induced stress. The effects of Facebook-induced stress on incidence of URI varied across the social network size, such that, the impact of stress on the URI incidence rate increased with the size of the social network. These results are largely in contrast to our hypotheses, but clearly suggest an association between Facebook use, psychological stress, and health. © Copyright 2012, Mary Ann Liebert, Inc. 2012

Operations management teaching on European MBA programmes

A comprehensive review of the literature established that several investigations have been made of operations management teaching in the USA, whereas almost nothing has been published on European teaching. Therefore, an exploratory investigation was made of operations management teaching on the MBA courses of ten leading European business schools. The results show that course content is similar across schools, but there are large variations on three dimensions: the time allocated by schools to the subject; the balance between operations strategy and tools and techniques in teaching; and the level of emphasis given to service operations. The results also indicate the emerging importance of integrating operations management with other subjects in the MBA curriculum and the key challenge facing faculty - the need to raise the perceived importance of operations management. The comparison of courses will be of interest to all operations management faculty who teach core courses and particularly those who are looking for ideas on how to re-design courses