Acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery: a case report

<p>Abstract</p> <p>Introduction</p> <p>Spinal anesthesia is a widely used general purpose anesthesia. However, serious complications, such as intracranial subdural hemorrhage, can rarely occur.</p> <p>Case presentation</p> <p>We report the case of a 73-year-old Japanese woman who had acute onset of intracranial subdural hemorrhage five days after spinal anesthesia for knee arthroscopic surgery.</p> <p>Conclusion</p> <p>This case highlights the need to pay attention to acute intracranial subdural hemorrhage as a complication after spinal anesthesia. If the headache persists even in a supine position or nausea occurs abruptly, computed tomography or magnetic resonance imaging of the brain should be conducted. An intracranial subdural hematoma may have a serious outcome and is an important differential diagnosis for headache after spinal anesthesia.</p

Sensation Seeking - Auf der Suche nach dem Kick. Eine empirische Untersuchung des Stimulationsbedürfnisses Opiatabhängiger mit und ohne Substitutionsbehandlung

Mit der Etablierung von niedrigschwelligen Angeboten in der Suchtkrankenhilfe in den 1990er Jahren konnten erstmalig Drogenabhängige ohne vordringliche Abstinenzmotivation erreicht werden. Intention dieser Basisversorgung war die Verminderung von Morbidität und unmittelbarer Mortalität durch Opiatkonsum/-abhängigkeit. Trotz der verschiedenen Angebote der Suchtkrankenhilfe, die sich in den letzten Jahren entwickelt haben, bleibt festzustellen, dass es weiterhin eine Gruppe von Opiatabhängigen gibt, die hiervon nicht oder nur in geringem Maße profitieren. In diesem Zusammenhang stellt sich die Frage welche intrapersonalen Faktoren zum „Nichterreichen“ der Behandlungsangebote durch die Klientel beitragen. Im Folgenden sollen Persönlichkeitsmerkmale dieser Gruppe mittels Arnett Inventory of Sensation Seeking (AISS) sowie dem BFI-K (Big Five- Kurzversion) genauer betrachtet werden. Die vorliegende Dissertation untersucht Persönlichkeitsmerkmale im Hinblick auf das individuelle Konsumverhalten und versucht hieraus Erkenntnisse bezüglich der in der Suchtkrankenhilfe bestehenden Behandlungsmöglichkeiten herauszuarnbeiten

Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants

Hydroxychloroquine (HCQ) has been largely used and investigated as therapy for COVID-19 across&nbsp;various settings at a total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use&nbsp;of low-dose HCQ (total 2400 mg over 5 days) was recommended for hospitalised patients with COVID-19. We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19&nbsp;hospital surveillance data. Patients treated either with HCQ monotherapy and supportive care (HCQ group)&nbsp;were compared with patients treated with supportive care only (no-HCQ group) using a competing risks&nbsp;proportional hazards regression with discharge alive as competing risk, adjusted for demographic and&nbsp;clinical features with robust standard errors. Of 8075 patients with complete discharge data on 24 May&nbsp;2020 and diagnosed before 1 May 2020, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the&nbsp;multivariable analysis, mortality was lower in the HCQ group compared with the no-HCQ group [adjusted hazard&nbsp;ratio (aHR) = 0.684, 95% confidence interval (CI) 0.617–0.758]. Compared with the no-HCQ group,&nbsp;mortality in the HCQ group was reduced both in patients diagnosed ≤5 days ( n = 3975) and &gt; 5 days ( n =&nbsp;3487) after symptom onset [aHR = 0.701 (95% CI 0.617–0.796) and aHR = 0.647 (95% CI 0.525–0.797),&nbsp;respectively]. Compared with supportive care only, low-dose HCQ monotherapy was independently&nbsp;associated with lower mortality in hospitalised patients with COVID-19 diagnosed and treated early or later&nbsp;after symptom&nbsp;onset.</p