Brachial plexopathy as a result of anatomical prone position in COVID-19 patients-Systematic review.

In patients with COVID-19 different methods improving therapy have been used, including one of the anatomical position-prone position, to support ventilation. The aim of this review was to summarize the cases of brachial plexopathy as a consequence of the prone position in COVID-19 patients, and thus bring closer the issue of the brachial plexus in the face of clinical aspects of its function, palsy, and consequences. The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed, inclusion criteria were created according to Patients, Interventions, Comparisons, Outcomes (PICO). PubMed and Scopus were searched until April 1, 2023 by entering the key term with Boolean terms. The risk of bias was assessed using JBI's critical appraisal tools. Fifteen papers with 30 patients were included in the review. This study showed that brachial plexopathy after the prone position occurs more often among males, who are at least 50 years old with comorbidities like hypertension, overweight, and diabetes mellitus. The most common symptoms were weakness, pain, and motion deficits. Duration of the prone position session and the number of episodes were different as well as the modification of positioning. Brachial plexopathy is a significant problem during prone position, especially when hospitalization is prolonged, patients are males, have comorbidities, and changes in body weight. Attention should be drawn to understand the anatomy of the brachial plexus, correct positioning, avoiding factors worsening the prognosis, and proper nutrition of the patients.

The azygos lobe, an incidental finding in computer tomography.

The azygos lobe is an anatomical variant of the upper lobe, which occurs most often in the right lung. Atypical course of the azygos vein is formed during embryogenesis, while the precursor of this vein migrates through the lung and creates the azygos fissure. Despite its rare occurrence, this variation is well described. This article presents a case of 62-year-old male with the azygos lobe, which was found accidentally in the computer tomography. The knowledge about the azygos vein is significant for surgeons, because it might reduce iatrogenic damage and help them avoid unexpected bleeding during thoracic surgery. The azygos vein might be confused with pathological conditions. It might also be associated with lung cancers, pneumothorax and congenital abnormalities. Despite the fact that the azygos lobe is well known variant, dissemination of knowledge about it is still inadequate.