Outpatient management of asthma in adults: A snapshot of the 2020 GINA report.

The Global Strategy for Asthma Management and Prevention publishes an annual report on asthma management and prevention. The report reflects the most recent evidence on asthma and its treatment and provides recommendations for clinical practice. This article reviews the guidelines with a focus on what's new and clinically important for practitioners treating this patient population.

Evaluating the Role of a Neurosurgery Consultation in Management of Pediatric Isolated Linear Skull Fractures.

BACKGROUND: The purpose of this study was to determine if a pediatric neurosurgical consultation for isolated linear skull fractures (ILSF) in pediatric patients with Glasgow Coma Scale (GCS) scores of ≥14 changed their management. METHODS: A 10-year retrospective chart review at a Level 1 Pediatric Trauma Center was performed. Exclusion criteria were age > 18 years, open, depressed, or skull base fractures, pneumocephalus, poly-trauma, any hemorrhage (intraparenchymal, epidural, subdural, subarachnoid), cervical spine fractures, penetrating head trauma, and initial GCS scores ≤13. Primary outcomes were neurosurgery recommendations to change acuity of care, obtain additional imaging studies, and perform invasive procedures. Secondary outcomes were patient demographics, injury type, transfer status, admitting service, length of hospital stay, consult location, and clinical course. RESULTS: There were 127 cases of ILSF meeting study criteria with an average age of 2.36 years. Unilateral parietal bone fracture was the most common injury (46.5%). Falls were the most common mechanism (81.1%). All patients received pediatric neurosurgical consultations within 24 h of hospital arrival. There were no neurosurgical recommendations to obtain additional imaging studies, change acuity of care, or perform invasive procedures. CONCLUSIONS: Routine neurosurgical consultation in children with ILSF and GCS 14-15 does not appear to alter clinical management.

Synovial sarcoma of the brachial plexus: case report.

BACKGROUND AND IMPORTANCE: Synovial sarcoma (SS) is a malignant soft-tissue tumor that rarely involves brachial plexus. The authors report a case of brachial plexus SS and review the relevant literature. CLINICAL PRESENTATION: A 53-year-old woman presented with gradually enlarging right subclavicular mass over 5 years associated with sharp aching pain radiating down toward the radial 3 fingers. On examination, she had a corresponding firm mass in the supraclavicular region with a positive Tinel sign. There was no objective neurological deficit. She underwent partial excision of this mass without any further adjuvant radiation or chemotherapy. Pathology was consistent with SS. CONCLUSION: Lack of any recurrence in this case 6 years after incomplete excision with no adjuvant therapy suggests slow clinical course in some of these sarcomas.