Progressive paraplegia after upper thoracic epidural block-related pneumorachis: A case report.

INTRODUCTION AND IMPORTANCE: While the typical symptom associated with pneumorachis after an epidural block is radiculopathy in one or several corresponding segments, there has been a rare case report of significant complications such as cardiac arrest leading to death, or paraplegia. CASE PRESENTATION: We present a case of an eighty-nine-year-old male patient who developed progressive paraplegia following an upper thoracic epidural block-associated pneumorachis. The procedure was performed at a different hospital using the loss of resistance (LOR) technique. Interestingly, the onset of paraplegia was delayed, occurring six hours after the procedure. Furthermore, there was a discrepancy between the clinical symptoms and the identified lesion in imaging studies. Despite the performance of an emergency laminectomy to remove the epidural gas, the paralysis continued to progress proximally. CLINICAL DISCUSSION: Healthcare professionals should observe patients for an appropriate duration after the procedure to detect and manage any delayed symptoms. And it is crucial to recognize the potential for lesion extension beyond the symptomatic segment and perform thorough imaging examinations. CONCLUSION: These findings emphasize the importance of exercising caution during the procedure, even when using a minimal amount of air with the LOR technique in the thoracic spine.

Effect of a Real-Time Audio Ventilation Feedback Device on the Survival Rate and Outcomes of Patients with Out-of-Hospital Cardiac Arrest: A Prospective Randomized Controlled Study.

The purpose of this study was to evaluate the effect of real-time audio ventilation feedback on the survival of patients with an out-of-hospital cardiac arrest (OHCA) during advanced cardiac life support (ACLS) performed by paramedics. This research was a prospective randomized controlled study performed in Busan, South Korea, from July 2022 to December 2022. This study included 121 patients, ages 19 and up, who were transferred to the study site, excluding 91 patients who did not receive CPR under a doctor's direction as well as those who had a '(DNR)' order among 212 adult CA patients. OHCA patients' clinical prognosis was compared by being randomly assigned to either a general manual defibrillator (NVF) group (N = 58) or a manual defibrillator with an audio ventilation feedback (AVF) group (N = 63). To verify the primary outcome, the cerebral performance category (CPC), return of spontaneous consciousness (ROSC), 30h survival, and survival discharge were compared. Multivariate logistic regression was conducted to analyze the association between the audio-feedback manual defibrillator (AVF) and the ROSC of OHCA patients. This study analyzed 121 patients among 212 OHCA patients. The ROSC (AVF group: 32 {26.4%} vs. NVF group: 21 {17.3%}), 24 h survival (AVF group: 24 {19.8%} vs. NVF group: 11 {9.0%}), and survival discharge (AVF group: 12 {9.9%} vs. NVF group: 6 {4.9%}) were higher in the AVF group than the NVF group. However, upon analyzing CPC scores in the surviving patients between the two groups, there was no significant difference (AVF group: 4.1 ± 1.23 vs. NVF group:4.7 ± 1.23, p = 1.232). Multivariate logistic regression analysis showed that the use of AVF was associated with a higher ROSC (odds ratio {OR}, 0.46; 95% confidence interval {CI}, 0.23-0.73; p < 0.01) and higher survival at 30 h (OR, 0.63; 95% CI, 0.41-0.98; p = 0.01).

Relationships among Premenstrual Syndrome, Perfection and Anxiety among the College Student.

PURPOSE: The purpose of this study was to compare the premenstrual syndrome (PMS) and the relationships among PMS, perfection, and anxiety in nursing college students and general college students. METHODS: The questionnaire survey was carried out with a convenience sample of 215 college students. The MDQ (Menstrual Distress Questionnaire), APS-R (Almost Perfect Scale-Revised), STAI (State and Trait Anxiety Inventory) were used. The data were collected from June to October, 2011. Data analysis included frequency, chi2-test, t-test, and Pearson correlation. RESULTS: There were significant differences in PMS and perfection but there not in anxiety between nursing college students and general college students. There were significant correlations among PMS, perfection and anxiety in nursing college students, and there were significant correlations among PMS and anxiety in general college students but not significant correlations among PMS and perfection. CONCLUSION: The findings suggest that to provide effective interventions for PMS in college students, it is necessary to design nursing interventions that consider perfection and anxiety.