In the video, Dr Hilary Jones talks about the important role the gut has in the immune system and the valuable role second generation prebiotics such as Bimuno IMMUNAID can play.

The winter season is upon us and with it comes the dreaded flu season. Some people are more susceptible than others and so, it’s important to be aware that not only does the gut play a central role in your immune system but there are positive measures we can take to support it. In this video, Dr Hilary Jones talks about the important role the gut has in the immune system and the valuable role second generation prebiotics can play.

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How revolutionizing advancements helps patients with metastatic melanoma kick start the body’s immune system to increase survival.

Minimally Invasive Surgery (MIS) Hip Joint Replacement is an advancement in hip replacement that offers important advantages over standard surgical procedures. Stryker has partnered with surgeons worldwide to develop MIS procedures and surgical instruments that are designed to help your surgeons do their very best to help you recover your lifestyle. These techniques bring together a wide variety of hip implants, new minimally invasive surgical techniques, and new instrumentation. The direct anterior approach is one of the minimally invasive techniques used in hip replacement surgery. Continuing orthopaedic experience suggests that this procedure may offer several advantages over the more traditional surgical approaches to hip replacement.1 Traditional hip replacement techniques involve operating from the side (lateral) or the back (posterior) of the hip, which requires a significant disturbance of the joint and connecting tissues and an incision approximately 8-12 inches long. In comparison, the direct anterior approach requires an incision that is only 3-4 inches in length and located at the front of the hip.1 In this position, the surgeon does not need to detach any of the muscles or tendons.

Twin Childbirth Video

bilateral tubal ligation as modified Pomeroy technique during a C-Section

PARAPHARYNGEAL SPACE TUMORS: SURGICAL APPROACH

CIAP patienten hebben vaak pijn met al de karaketristieken van neuropathische pijn. Amitriptyline en pregabaline per os geven vaak bijwerkingen, vooral in de oudere patienten. Ons behandelprotocol gaf het volgende resultaat bij een refractaire patient met CIAP: palmitoylethanolamide (3 maal 400 mg capsules), samen met 10% topicale magistrale amitriptyline creme

An amputation is the removal of an extremity or appendage from the body. Amputations in the upper extremity can occur as a result of trauma, or they can be performed in the treatment of congenital or acquired conditions. Although successful replantation represents a technical triumph to the surgeon, the patient's best interests should direct the treatment of amputations. The goals involved in the treatment of amputations of the upper extremity include the following : Preservation of functional length Durable coverage Preservation of useful sensibility Prevention of symptomatic neuromas Prevention of adjacent joint contractures Early return to work Early prosthetic fitting These goals apply differently to different levels of amputation. Treatment of amputations can be challenging and rewarding. It is imperative that the surgeon treat the patient with the ultimate goal of optimizing function and rehabilitation and not become absorbed in the enthusiasm of the technical challenge of the replantation, which could result in poorer outcome and greater financial cost due to lost wages, hospitalization, and therapy.

Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures

External cephalic version, or version, is a procedure used to turn a fetus from a breech position or side-lying (transverse) position into a head-down (vertex) position before labor begins. When successful, version makes it possible for you to try a vaginal birth.

What is Venipuncture? While venipuncture can refer to a variety of procedures, including the insertion of IV tubes into a vein for the direct application of medicine to the blood stream, in phlebotomy venipuncture refers primarily to using a needle to create a blood evacuation point. As a phlebotomist, you must be prepared to perform venipuncture procedures on adults, children, and even infants while maintaining a supportive demeanor and procedural accuracy. Using a variety of blood extraction tools, you must be prepared to respond to numerous complications in order to minimize the risk to the patient while still drawing a clean sample. In its entirety, venipuncture includes every step in a blood draw procedure—from patient identification to puncturing the vein to labeling the sample. Patient information, needle placement, and emotional environment all play a part in the collection of a blood sample, and it's the fine details that can mean the difference between a definite result and a false positive. After placing the tourniquet and finding the vein, it's time for the phlebotomist to make the complex choice on what procedure will best suit the specific situation. Keeping this in mind, it should be noted that the following information is not an instructional guide on how to perform these phlebotomy procedures. Rather, the information below is intended to serve as an educational resource to inform you of the equipment and procedures you will use. Venipuncture Technqiues Venipuncture with an Evacuated or Vacuum Tube: This is the standard procedure for venipuncture testing. Using a needle and sheath system, this procedure allows multiple sample tubes to be filled through a single puncture. This procedure is ideal for reducing trauma to patients. After drawing the blood, the phlebotomist must make sure the test stopper is correctly coded and doesn't contact exposed blood between samples. Venipuncture with a Butterfly Needle : This is a specialized procedure that utilizes a flexible, butterfly needle adaptor. A butterfly needle has two plastic wings (one on either side of the needle) and is connected to a flexible tube, which is then attached to a reservoir for the blood. Due to the small gauge of the needle and the flexibility of the tube, this procedure is used most often in pediatric care, where the patients tend to have smaller veins and are more likely to move around during the procedure. After being inserted into a vein at a shallow angle, the butterfly needle is held in place by the wings, which allow the phlebotomist to grasp the needle very close to the skin. Phlebotomists should be careful to watch for blood clots in the flexible tubing. Venipuncture with a Syringe: This technique is typically only used when there is a supply shortage, or when a technician thinks it is the appropriate method. It uses the classic needle, tube, and plunger system, operating in a similar manner to the vacuum tube but requiring multiple punctures for multiple samples. Additionally, after the blood is drawn it must be transferred to the appropriate vacuum tube for testing purposes. If you choose to use this method, remember to check for a sterile seal, and use a safety device when transferring the sample. Fingerstick (or Fingerprick): This procedure uses a medical lance to make a small incision in the upper capillaries of a patient's finger in order to collect a tiny blood sample. It is typically used to test glucose and insulin levels. When performing a Fingerstick, the phlebotomist should remember to lance the third or fourth finger on the non-dominant arm. Never lance the tip or the center of the finger pad; instead, lance perpendicular to the fingerprint lines. Heelstick (or Heelprick): Similar to the Fingerstick procedure, this process is used on infants under six months of age. A medical lance is used to create a small incision on the side of an infant's heel in order to collect small amounts of blood for screening. As with a Fingerstick, the incision should be made perpendicular to the heel lines, and it should be made far enough to the left or right side of the heel to avoid patient agitation. Before performing a Heelstick, the infant's heel should be warmed to about 42 degrees Celsius in order to stimulate capillary blood and gas flow. Therapeutic Phlebotomy: This involves the actual letting of blood in order to relieve chemical and pressure imbalances within the blood stream. Making use of a butterfly needle, this therapy provides a slow removal of up to one pint of blood. Though the blood removed is not used for blood transfusions, the procedure and concerns are the same as with routine blood donation. As with any phlebotomy procedure, one should pay close attention to the patient in order to prevent a blood overdraw. Bleeding Time: A simple diagnostic test that is used to determine abnormalities in blood clotting and platelet production. A shallow laceration is made, followed by sterile swabbing of the wound every 30 seconds until the bleeding stops. Average bleed times range between one and nine minutes. As a phlebotomist, you should familiarize yourself with the application and cross-application of these procedures in order to recognize when a procedure is necessary, and what the risks are for each.

What is an Aneurysm? A cerebral or intracranial aneurysm is an abnormal focal dilation of an artery in the brain that results from a weakening of the inner muscular layer (the intima) of a blood vessel wall. The vessel develops a "blister-like" dilation that can become thin and rupture without warning. The resultant bleeding into the space around the brain is called a subarachnoid hemorrhage (SAH). This kind of hemorrhage can lead to a stroke, coma, and/or death. Aneurysms are usually found at the base of the brain just inside the skull, in an area called the subarachnoid space. In fact, 90 percent of SAHs are attributed to ruptured cerebral aneurysms and the two terms are often used synonymously.

The brachial plexus is the network of nerves that sends signals from your spine to your shoulder, arm and hand. A brachial plexus injury occurs when these nerves are stretched, compressed, or in the most serious cases, ripped apart or torn away from the spinal cord. Minor brachial plexus injuries, known as stingers or burners, are common in contact sports, such as football. Babies sometimes sustain brachial plexus injuries during birth. Other conditions, such as inflammation or tumors, may affect the brachial plexus. The most severe brachial plexus injuries usually result from auto or motorcycle accidents. Severe brachial plexus injuries can leave your arm paralyzed, with a loss of function and sensation. Surgical procedures such as nerve grafts, nerve transfers or muscle transfers can help restore function.

Most of the time, treatment for hemorrhoids involves steps that you can take on your own, such as lifestyle modifications. But sometimes medications or surgical procedures are necessary. Medications If your hemorrhoids produce only mild discomfort, your doctor may suggest over-the-counter creams, ointments, suppositories or pads. These products contain ingredients, such as witch hazel or hydrocortisone, that can relieve pain and itching, at least temporarily. Don't use an over-the-counter cream or other product for more than a week unless directed by your doctor. These products can cause side effects, such as skin rash, inflammation and skin thinning. Minimally invasive procedures If a blood clot has formed within an external hemorrhoid, your doctor can remove the clot with a simple incision, which may provide prompt relief. For persistent bleeding or painful hemorrhoids, your doctor may recommend another minimally invasive procedure. These treatments can be done in your doctor's office or other outpatient setting. Rubber band ligation. Your doctor places one or two tiny rubber bands around the base of an internal hemorrhoid to cut off its circulation. The hemorrhoid withers and falls off within a week. This procedure — called rubber band ligation — is effective for many people. Hemorrhoid banding can be uncomfortable and may cause bleeding, which might begin two to four days after the procedure but is rarely severe. Injection (sclerotherapy). In this procedure, your doctor injects a chemical solution into the hemorrhoid tissue to shrink it. While the injection causes little or no pain, it may be less effective than rubber band ligation. Coagulation (infrared, laser or bipolar). Coagulation techniques use laser or infrared light or heat. They cause small, bleeding, internal hemorrhoids to harden and shrivel. While coagulation has few side effects, it's associated with a higher rate of hemorrhoids coming back (recurrence) than is the rubber band treatment. Surgical procedures If other procedures haven't been successful or you have large hemorrhoids, your doctor may recommend a surgical procedure. Surgery can be performed on an outpatient basis or you may need to stay in the hospital overnight. Hemorrhoid removal. During a hemorrhoidectomy, your surgeon removes excessive tissue that causes bleeding. Various techniques may be used. The surgery may be done with a local anesthetic combined with sedation, a spinal anesthetic or a general anesthetic. Hemorrhoidectomy is the most effective and complete way to treat severe or recurring hemorrhoids. Complications may include temporary difficulty emptying your bladder and urinary tract infections associated with this problem. Most people experience some pain after the procedure. Medications can relieve your pain. Soaking in a warm bath also may help. Hemorrhoid stapling. This procedure, called stapled hemorrhoidectomy or stapled hemorrhoidopexy, blocks blood flow to hemorrhoidal tissue. Stapling generally involves less pain than hemorrhoidectomy and allows an earlier return to regular activities. Compared with hemorrhoidectomy, however, stapling has been associated with a greater risk of recurrence and rectal prolapse, in which part of the rectum protrudes from the anus. Talk with your doctor about what might be the best option for you.

How to Insert a Tampon

Breast cancer usually starts off in the inner lining of milk ducts or the lobules that supply them with milk. A malignant tumor can spread to other parts of the body. A breast cancer that started off in the lobules is known as lobular carcinoma, while one that developed from the ducts is called ductal carcinoma. The vast majority of breast cancer cases occur in females. This article focuses on breast cancer in women. We also have an article about male breast cancer. Breast cancer is the most common invasive cancer in females worldwide. It accounts for 16% of all female cancers and 22.9% of invasive cancers in women. 18.2% of all cancer deaths worldwide, including both males and females, are from breast cancer. Breast cancer rates are much higher in developed nations compared to developing ones. There are several reasons for this, with possibly life-expectancy being one of the key factors - breast cancer is more common in elderly women; women in the richest countries live much longer than those in the poorest nations. The different lifestyles and eating habits of females in rich and poor countries are also contributory factors, experts believe. According to the National Cancer Institute, 232,340 female breast cancers and 2,240 male breast cancers are reported in the USA each year, as well as about 39,620 deaths caused by the disease.

Nipple Sensation After Breast Augmentation

Primary infection with herpes simplex viruses (HSVs) is clinically more severe than recurrent outbreaks. However, most primary HSV-1 and HSV-2 infections are subclinical and may never be clinically diagnosed. Orolabial herpes Herpes labialis (eg, cold sores, fever blisters) is most commonly associated with HSV-1 infection. Oral lesions caused by HSV-2 have been identified, usually secondary to orogenital contact. Primary HSV-1 infection often occurs in childhood and is usually asymptomatic. Primary infection Symptoms of primary herpes labialis may include a prodrome of fever, followed by a sore throat and mouth and submandibular or cervical lymphadenopathy. In children, gingivostomatitis and odynophagia are also observed. Painful vesicles develop on the lips, the gingiva, the palate, or the tongue and are often associated with erythema and edema. The lesions ulcerate and heal within 2-3 weeks. Recurrences The disease remains dormant for a variable amount of time. HSV-1 reactivation in the trigeminal sensory ganglia leads to recurrences in the face and the oral, labial, and ocular mucosae. Pain, burning, itching, or paresthesia usually precedes recurrent vesicular lesions that eventually ulcerate or form a crust. The lesions most commonly occur in the vermillion border, and symptoms of untreated recurrences last approximately 1 week. Recurrent erythema multiforme lesions have been associated with orolabial HSV-1 recurrences. A recent study reported that HSV-1 viral shedding had a median duration of 48-60 hours from the onset of herpes labialis symptoms. They did not detect any virus beyond 96 hours of symptom onset.[7] Genital herpes HSV-2 is identified as the most common cause of herpes genitalis. However, HSV-1 has been increasingly identified as the causative agent in as many as 30% of cases of primary genital herpes infections likely secondary to orogenital contact. Recurrent genital herpes infections are almost exclusively caused by HSV-2. Primary infection Primary herpes genitalis occurs within 2 days to 2 weeks after exposure to the virus and has the most severe clinical manifestations. Symptoms of the primary episode typically last 2-3 weeks. In men, painful, erythematous, vesicular lesions that ulcerate most commonly occur on the penis, but they can also occur on the anus and the perineum. In women, primary herpes genitalis presents as vesicular/ulcerated lesions on the cervix and as painful vesicles on the external genitalia bilaterally. They can also occur on the vagina, the perineum, the buttocks, and, at times, the legs in a sacral nerve distribution. Associated symptoms include fever, malaise, edema, inguinal lymphadenopathy, dysuria, and vaginal or penile discharge. Females may also have lumbosacral radiculopathy, and as many as 25% of women with primary HSV-2 infections may have associated aseptic meningitis. Recurrences After primary infection, the virus may be latent for months to years until a recurrence is triggered. Reactivation of HSV-2 in the lumbosacral ganglia leads to recurrences below the waist. Recurrent clinical outbreaks are milder and often preceded by a prodrome of pain, itching, tingling, burning, or paresthesia. Individuals who are exposed to HSV and have asymptomatic primary infections may experience an initial clinical episode of genital herpes months to years after becoming infected. Such an episode is not as severe as a true primary outbreak. More than one half of individuals who are HSV-2 seropositive do not experience clinically apparent outbreaks. However, these individuals still have episodes of viral shedding and can transmit the virus to their sexual partners. Other HSV infections Localized or disseminated eczema herpeticum is also known as Kaposi varicelliform eruption. Caused by HSV-1, eczema herpeticum is a variant of HSV infection that commonly develops in patients with atopic dermatitis, burns, or other inflammatory skin conditions. Children are most commonly affected. Herpes whitlow, vesicular outbreaks on the hands and the digits, was most commonly due to infection with HSV-1. It usually occurred in children who sucked their thumbs and, prior to the widespread use of gloves, in dental and medical health care workers. The occurrence of herpes whitlow due to HSV-2 is increasingly recognized, probably due to digital-genital contact. Herpes gladiatorum is caused by HSV-1 and is seen as papular or vesicular eruptions on the face, arms, or torsos of athletes in sports involving close physical contact (classically wrestling). Disseminated HSV infection can occur in females who are pregnant and in individuals who are immunocompromised. These patients may present with atypical signs and symptoms of HSV, and the condition may be difficult to diagnose. Herpetic sycosis, a follicular infection with HSV, may present as a vesiculopustular eruption on the beard area. This infection often results from autoinoculation after shaving through a recurrent herpetic outbreak. Classically caused by HSV-1, there have been rare reports of relapsing beard folliculitis caused by type 2 HSV.[8] Neonatal HSV HSV-2 infection in pregnancy can have devastating effects on the fetus. Neonatal HSV usually manifests within the first 2 weeks of life and clinically ranges from localized skin, mucosal, or eye infections to encephalitis, pneumonitis, disseminated infection, and demise. Most women who deliver infants with neonatal HSV had no prior history, signs, or symptoms of HSV infection. Risk of transmission is highest in pregnant women who are seronegative for both HSV-1 and HSV-2 and acquire a new HSV infection in the third trimester of pregnancy. Factors that increase the risk of transmission from mother to baby include the type of genital infection at the time of delivery (higher risk with active primary infection), active lesions, prolonged rupture of membranes, vaginal delivery, and an absence of transplacental antibodies. The mortality rate for neonates is extremely high (>80%) if untreated.

Your Little Finger Reveals What Kind of a Person You Are

Inflammation of the uvula is known as uvulitis. Your uvula will appear red, puffy, and larger than normal. Other symptoms of uvulitis may include: itching burning a sore throat spots on your throat snoring difficulty swallowing trouble breathing If you have a swollen uvula along with a fever or abdominal pain, consult with your doctor right away. In rare cases, the uvula can swell enough to block your airway. Swelling of the throat is a life-threatening event. If this happens, seek immediate medical attention. What causes a swollen uvula? Causes Inflammation is your body’s response when it’s under attack. Triggers for inflammation include: environmental and lifestyle factors an infection trauma genetics Environmental and Lifestyle Factors The most common food allergies are peanuts tree nuts milk eggs wheat soy fish, including shellfish You could be having an allergic reaction to something you touched, swallowed, or breathed in. Some common allergens include: food irritants , such as dust, animal dander, or pollen medication exposure to chemicals or other toxic substances, including tobacco Infection You can get viral infections or bacterial infections. Examples of viral infections include: the common cold the flu mononucleosis chickenpox measles croup The most common bacterial infection is strep throat, which occurs due to Streptococcus pyogenes, which is a type of group A Streptococcus. If you have infected tonsils, or tonsillitis, severe inflammation can cause them to push against and irritate your uvula. Trauma Trauma to the uvula can happen if you need an intubation, such as during surgery. Your uvula can also be injured during a tonsillectomy. This is a procedure to remove your tonsils, which are located on both sides of your uvula. Your throat and uvula can also become irritated if you have acid reflux disease or if you vomit frequently. Genetics A condition called hereditary angioedema (HAE) can cause swelling of the uvula and throat, as well as swelling of the face, hands, and feet. Other symptoms include nausea, vomiting, and abdominal pain. It’s an uncommon genetic mutation that occurs in 1 in 10,000 to 1 in 50,000 people. It’s rare, but there are case reports of individuals who have an elongated uvula, which can also interfere with breathing. What are the risk factors for a swollen uvula? Risk Factors Anyone can get uvulitis, but adults get it less often than children do. You’re at increased risk if you: have allergies use tobacco products are exposed to chemicals and other irritants in the environment have a weakened immune system, making you more susceptible to infections How is a swollen uvula diagnosed? Diagnosis If you have fever or swelling of your throat, see your doctor. Be prepared to give a complete medical history. Tell your doctor: about all the over-the-counter and prescription medications you take if you’re a smoker or you chew tobacco if you’ve recently tried new foods if you’ve been exposed to chemicals or unusual substances about your other symptoms, such as abdominal pain, fever, or dehydration Your doctor may be able to make a diagnosis through a physical exam. It’s likely you’ll also need a throat swab to evaluate for strep or to obtain secretions for culture to determine if you have another bacterial or fungal infection. This test is known as the rapid strep test. You may also need a nasal swab to test for influenza. Blood testing can help identify or rule out some other infectious agents. If those tests are inconclusive, you may need to see an allergist. Blood and skin tests can help identify foods or other substances that cause a reaction. Learn more: Allergy testing » If necessary, imaging tests can provide a more detailed view of your throat and the surrounding area. What’s the treatment for a swollen uvula? Treatment When you have something like the common cold, swelling usually clears up on its own without treatment. Otherwise, treatment will depend on how severe your symptoms are, as well as what’s causing the inflammation. Infection Viral infections tend to clear up without treatment. The only upper respiratory infection for which an antiviral medication is available is influenza. Antibiotics can treat bacterial infections. Even after symptoms clear up, take all the medication as prescribed. If your condition may be contagious, stay home until your doctor tells you that you’re no longer at risk of spreading it to others. Allergy If you test positive for an allergy, try to avoid the allergen in the future. Doctors usually treat allergies with antihistamines or steroids. Anaphylaxis is a severe allergic reaction. Doctors use epinephrine to treat this reaction. Hereditary angioedema Your doctor may treat HAE with any of the following: anabolic steroids, or androgens antifibrinolytics C1 inhibitors, such as C1 esterase inhibitor (Berinert) or C1 esterase inhibitor (recombinant) (Ruconest) a plasma kallikrein inhibitor, such as ecallantide (Kalbitor) bradykinin receptor antagonist, such as icatibant injection (Firazyr) Tell your doctor if you have new or worsening symptoms, and follow up as necessary. Tips for relief home treatment If you have a swollen uvula or sore throat, it’s your body’s way of telling you that something is wrong. A few home remedies can help keep you strong and soothe your irritated throat. Make sure you’re getting enough fluids. If your throat hurts when you drink, try drinking small amounts throughout the day. Your urine should be light in color. If it’s dark yellow or brown, you’re not drinking enough and may be dehydrated. Additional tips include the following: Cool your throat by sucking on ice chips. Frozen juice bars or ice cream may also do the trick. Gargle with warm salt water to ease your dry, scratchy throat. Aim for a full night’s sleep, and nap during the day if you can. What’s the outlook? Outlook A swollen uvula isn’t a common occurrence. Most of the time it clears up without treatment. If you have an infection, prompt treatment should take care of the problem within a week or two. If you have allergies that lead to swelling of the uvula or throat, do your best to avoid that allergen. You should also be prepared to deal with an attack if you come into contact with the substance again. If you’ve ever had anaphylaxis, ask your doctor if you should carry injectable epinephrine (EpiPen) in case of emergency. People with HAE must learn to recognize triggers and early warning signs of an attack. Talk to your doctor about how to manage HAE. 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