In carpal tunnel syndrome (CTS), the median nerve is compressed at the level of the carpal tunnel in the wrist. This entrapment manifests as unpleasant symptoms, such as burning, tingling, or numbness in the palm that extends to the fingers. As the disease progresses, afflicted individuals also report decreased grip strength accompanied by hand weakness and restricted movement. The first half of this review elaborates on CTS pathology by providing readers with a comprehensive understanding of the etiology, relevant anatomy, and disease mechanism.CTS is considered the most common entrapment neuropathy, affecting around 3-6% of the adult population. Further, CTS prevalence has seen a dramatic increase in the last few decades paralleling the growth of everyday technology usage. Despite how common it is to have CTS, it can be quite challenging for physicians to make a definite diagnosis due to differentials that present with overlapping symptoms. Even more difficult can be deciding on a course of treatment that is the most effective and considerate of patient needs. Thus arises the need for clear clinical direction, and hence we end with a discussion around such guidelines that serve as a starting point toward effective diagnoses and patient treatment.

The emergence and rapid spread of the coronavirus disease 2019 (COVID-19) pandemic have revealed the limitations in current healthcare systems to handle patient records securely and transparently, and novel protocols are required to address these shortcomings. An attractive option is the use of Ethereum smart contracts to secure the storage of medical records and concomitant data logs. Ethereum is an open-source platform that can be used to construct smart contracts, which are collections of code that allow transactions under certain parameters and are self-executable. MethodsThe present study developed a proof-of-concept smart contract that stores COVID-19 patient data such as the patient identifier (ID), variant, chest CT grade, and significant comorbidities. A sample, fictitious patient data for the purpose of testing was configured to a private network. A smart contract was created in the Ethereum state and tested by measuring the time to insert and query patient data. ResultsTesting with a private, Proof of Authority (PoA) network required only 191 milliseconds and 890 MB of memory per insertion to insert 50 records while inserting 350 records required 674 milliseconds and similar memory per insertion, as memory per insertion was nearly constant with the increasing number of records inserted. Retrieving required 912 MB for a query involving all three fields and no wildcards in a 350-record database. Only 883 MB was needed to procure a similar observation from a 50-record database. ConclusionThis study exemplifies the use of smart contracts for efficient retrieval/insertion of COVID-19 patient data and provides a case use of secure and efficient data logging for sensitive COVID-19 data.

This is a multicenter retrospective study of 24 Adult trauma centers examining risks of VTE and ICHE with initiation of early (<24 hours) VTE prophylaxis.