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Postmenopausal bleeding (PMB) is defined for practical purposes as vaginal bleeding occurring after twelve months of amenorrhoea, in a woman of the age where the menopause can be expected.[1] Hence it does not apply to a young woman, who has had amenorrhoea from anorexia nervosa, or a pregnancy followed by lactation. However, it can apply to younger women following premature ovarian failure or premature menopause. Unscheduled bleeding in women of menopausal age taking hormone replacement therapy (HRT) should be managed in the same way from a practical perspective.[2] 'Unscheduled bleeding' is defined as non-cyclical bleeding still continuing six months after commencing HRT or after six months of amenorrhoea.
Your baby's sex is set at conception. At around 7 weeks, your baby's internal sex organs – such as ovaries and testes – begin to form in the abdomen. Male and female sex organs and genitalia look the same at this stage because they're derived from the same structures. At around 9 weeks, boys and girls begin to develop differently. In girls, a tiny bud emerges between the tissue of the legs. This bud will become the clitoris. The membrane that forms a groove below the bud separates to become the labia minora and the vaginal opening. By 22 weeks, the ovaries are completely formed and move from the abdomen to the pelvis. They already contain a lifetime supply of 6 million eggs. In boys, the bud develops into the penis and starts to elongate at around 12 weeks. The outer membrane grows into the scrotal sac that will later house the testicles. By 22 weeks, the testes have formed in the abdomen. They already contain immature sperm. Soon they'll begin their descent to the scrotum, but it's a long journey. They'll reach their destination late in pregnancy, or for some boys, after birth. If you're eager to find out whether you're having a girl or a boy, you'll have to wait until you're at least 17 weeks pregnant. That's when the genitals have developed enough to be seen on an ultrasound.
Children are special patients, and their medical needs are unique, including their surgical needs. At UNC Hospitals, an expert and experienced team of physicians treat children in a kid-friendly and family-centered environment. UNC Pediatric Surgeon Dr. Timothy Weiner explains
Patellar tendon rupture is a rupture of the tendon that connects the patella to the tibia. The superior portion of the patellar tendon attaches on the posterior portion of the patella, and the posterior portion of the patella tendon attaches to the tibial tubercle on the front of the tibia.
This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.
In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.
***Thanks to the patient for sharing his history and exam with YouTube world***
This form of liver cancer is called primary liver cancer. Noncancerous, or benign, liver tumors are common. They do not spread to other areas of the body, and they usually do not pose a serious health risk. In most cases, benign liver tumors are not detected because they cause no symptoms.
MRCPCH Clinical Revision - more videos at http://mrcpch.paediatrics.co.uk
Revise for your MRCPCH Clinical exam, with videos and high quality content created by the London Paediatrics Trainees Committee.
Video Credits: Dr Caroline Fertleman, Dr Hermione Race, Dr Camilla Sen, Dr Chloe Macaulay, Dr Emma McLaren, Chris Knapp
Possible complications could include: Difficulty healing. Infection. Stump pain (severe pain in the remaining tissue) Phantom limb pain (a painful sensation that the foot or toe is still there) Continued spread of gangrene, requiring amputation of more areas of your foot, toes or leg. Bleeding. Nerve damage.
Start in RLQ (so you don’t miss a giant spleen). Get your fingers set then ask patient to take a deep breath. Don’t dip your fingers or do anything but wait. When patient expires, take up new position. Note lowest point of spleen below costal margin, texture of splenic contour, and tenderness If spleen is not felt, repeat with pt lying on right side. Gravity may bring spleen within reach. “LET THE SPLEEN PALPATE YOUR FINGERS AND NOT THE OTHER WAY AROUND. THERE IS NO GOLD, SO DON’T DIG!”
Olympus has extended the value of its award-winning combined surgical energy device, THUNDERBEAT, to open surgical procedures. Watch Dr. Francois Blaudeau master use of THUNDERBEAT Open Extended Jaw (OEJ) in a total abdominal hysterectomy.
http://medical.olympusamerica.com/products/thunderbeat?utm_source=youtube&utm_campaign=Total%20Abdominal%20Hysterectomy%20Surgery%20-%20THUNDERBEAT&utm_medium=description&utm_term=energy&utm_content=surgical
Childbirth (also called labour, birth, partus or parturition) is the culmination of a human pregnancy or gestation period with birth of one or more newborn infants from a woman’s uterus. The process of normal human childbirth is categorized in three stages of labour: the shortening and dilation of the cervix, descent and birth of the infant, and birth of the placenta. In some cases, childbirth is achieved through caesarean section, the removal of the neonate through a surgical incision in the abdomen, rather than through vaginal birth
This is a diabetic foot ulcer. The patient reportedly went on vacation and noticed this ulcer upon their return. Debridement (removal of damaged tissue) to the level of healthy bleeding tissue is medically necessary as damaged tissue acts an impediment to wound healing. Due to their diabetic neuropathy, they did not feel any pain or indication that a wound was forming. This ulcer appeared to have penetrated to the level of subcutaneous tissue or even fascia, but turned out to be much deeper than that. These are serious wounds and are the beginnings of what lead to foot and leg amputations if they are not treated promptly by your healthcare provider, AKA Podiatrist.