Microcalcifications in the breast can be the first sign of cancer. They are, as the name says, very small and clustered. A precise biopsy without pain under stereotactic guidance is the standard procedure. What makes this Spirotome different from the vacuum assisted biopsies is that only a few biopsies are needed and that the approach of the needle towards the microcalcifications is direct and frontal. There is no damage to the surrounding tissues making this procedure rather painfree and with minimal bleeding.

An animation for Acumed demonstrating their new line of screws for fixing fractures. This one is focused on a Scaphoid fracture in the hand.

Resection of sigmoid colostomy prolapse

Sexually Transmitted Diseases (STDs) affect millions of people each year. The most common STDs are gonorrhea, chlamydia and trichomoniasis. While even thinking about STDs and whether you may have one is scary, knowing the facts can make a big difference in your long-term health. Here is what you need to know:

People who are sexually active with multiple partners and are not using barrier protection are at most risk. Teenagers are a large part of this group, because they dont always practice safe sex and they are more likely to have multiple partners. It is recommended that women who are sexually active with multiple partners get screened yearly or immediately after they have engaged in unprotected sex. If you discover that you have an STD, both you and your partner would most likely be treated with antibiotics.

Gonorrhea
Approximately 350,000 cases of gonorrhea were reported to the CDC in 2006, but because not everyone is getting tested for STDs, experts believe the actual numbers are twice that.

The symptoms for gonorrhea are burning with urination, abnormal discharge or pelvic pain. Pelvic pain indicates a very severe infection. Untreated gonorrhea can lead to a serious infection as the disease may spread to a womans fallopian tubes and cause infertility.

Chlamydia
There were 1,000,000 cases of chlamydia reported to the CDC in 2006; experts think the actual rate of infection is as high as 2,000,000 cases.

Chlamydia is often called the silent disease because many people with chlamydia have no symptoms. Chlamydia can affect the urethra, the vagina, the cervix and the fallopian tubes. Symptoms include burring with urination, abnormal discharge and pelvic pain. If you are experiencing any of these systems you should see your doctor to determine if you have chlamydia. Women with chlamydia who arent treated are likely to develop pelvic inflammatory disease. Pelvic inflammatory disease occurs when the infection spreads and causes scarring to the uterus and fallopian tubes. Untreated chlamydia can result in infertility.

Trichomoniasis
Trichomoniasis is the most common STD. About 7 million women and men have trichomoniasis. Women who have trichomoniasis will often experience a frothy yellow or green discharge coming from their vagina. But some people wont have any symptoms.

Understanding STDs, what causes them, and how to treat them will help you stay in control of your health.

This video demonstrates a step-by-step technique for using the TFN-Advanced™ Proximal Femoral Nailing System (TFNA).

USMLE Step 2 CS - LOC This is just preview video. To get full access please visit our website : www.usmletutoring.com

This device can freeze breast cancer.

Avideo showing suturing of the uterus and abdominal wall after c-section

Is your vertigo or dizziness BPPV or autoimmune?

We herein describe endoscopic treatment of symptomatic pancreatic pseudocyst with significant necrosis and a fistula. Fifty eight year old man had presented to us with a large pseudocyst following an episode of acute pancreatitis. He was complaining of significant abdominal pain for two months. A... CT scan abdominal had revealed a large retro-gastric pseudocyst with necrosis and portal venous thrombosis. An upper GI endoscopy had revealed small linear fundal varcies. Endoscopic as well as surgical treatment for the cyst was discussed with the patient. Patient wished not to undergo surgical treatment and therefore endoscopic treatment was selected after a proper consent. EUS was performed to see for the interposed vessel prior to the pseudocyst puncture. Needle knife puncture was made and a guide wire was passed in the pseudocyst cavity. After confirming the wire placement in the cyst, the tract was dilated up to 20 mms using a CRE balloon. Fluid from the cyst was emptied out in the stomach. An ERCP scope was passed in to the cyst cavity, which revealed a significant necrotic material (much more than what the CT scan had revealed). All the free lying necrotic material was taken out with the help of a snare and a dormia basket. A lot of necrotic was stuck to the cyst wall, which was removed with the help of water jet, mechanical scooping and cutting through using a needle knife papillotome. Three 10 fr. Pigtail stents were placed at the end of the procedure. Further necrosectomy was carried out on alternate days for three more sessions. Dilation was required prior to each session three pigtail trans-gastric stents were placed at the end of each session. Single stent was kept in situ during each procedure to guide the path (the position of the stoma changed dramatically once the cyst was empty). During the last lesion (session four), a pancreatogram was taken. It revealed a mildly dilated CBD in the head, normally duct in the proximal body with a leak from the distal body, and contrast was seen going in to the pseudocyst cavity. The duct could not be opacified distally. A 7 fr. 15 cms stent was placed trans-papillary. When the cyst cavity was reentered through trans-gastric route, the trans-papillary pancreatic stent was clearly visible with soft necrotic material around it. In fact, the stent guided further necrosis removal. It also helped in diverting the pancreatic juice to the duodenum rather than in the pseudocyst cavity. Patient was discharged after this session and was followed up regularly. A CT scan was obtained after three months, which revealed a complete resolution of the necrosis and pseudocyst. There was a possibility of a persistent fistula after the removal of trans-papillary stent and a recurrence of the pseudocyst. Fistula closure with cyanoacrylate glue is well described in the literature. The procedure can have obvious complications secondary to accidental blockage of the main pancreatic duct. So, we thought it prudent to use a safer alternative to treat the condition. We removed the longer pancreatic stent and replaced it with a shorter pancreatic stent occupying only the head region. The patient was followed up after a month; sonography of the abdomen did not reveal any recurrence of the pseudocyst. All the stents were removed at this examination.

Carpal Tunnel Syndrome Information

About Us Contact Disclaimer Get Published! Follow Us Epomedicine Medical Students Clinical Discussion Cases Emergencies Blog Medical Mnemonics Clinical Skills Search Subjects Clinical examination Gastrointestinal system Internal medicine Updated on January 31, 2017 Percussion of Spleen Traube’s semilunar space Borders: Superiorly: Left 6th rib superiorly Laterally: Left midaxillary line or Left anterior axillary line Inferiorly: Left costal margin Method: Patient’s position: supine with left arm slightly abducted. Percuss: from medial to lateral Interpretation: Resonance (Normal) and Dullness (Splenomegaly) Also: Pleural effusion or mass in stomach may cause dullness in Traube’s space.

What is a Whipple procedure?
Also called a pancreaticoduodenectomy, the Whipple procedure is performed to address chronic pancreatitis and cancer of the pancreas, ampulla of Vater, duodenum, and the distal bile duct. The Whipple procedure involves removing the cancerous parts of the pancreas, duodenum, common bile duct, and if required, part of the stomach.

Sacrococcygeal teratoma (SCT) is an unusual tumor that, in the newborn, is located at the base of the tailbone (coccyx). This birth defect is more common in female than in male babies. Although the tumors can grow very large, they are usually not malignant (that is, cancerous).

Truncal Vagotomy and Pyloroplasty

Suprapubic Catheterization / Cystostomy

Pediatric Neurological Examination Introduction

Watch that video of People should have gone to the dentist a lot sooner

Hysteroscopy adhesiolysis for treating Ashermann syndrome

Heart failure can be ongoing (chronic), or your condition may start suddenly (acute). Heart failure signs and symptoms may include: Shortness of breath (dyspnea) when you exert yourself or when you lie down Fatigue and weakness Swelling (edema) in your legs, ankles and feet Rapid or irregular heartbeat Reduced ability to exercise Persistent cough or wheezing with white or pink blood-tinged phlegm Increased need to urinate at night Swelling of your abdomen (ascites) Sudden weight gain from fluid retention Lack of appetite and nausea Difficulty concentrating or decreased alertness Sudden, severe shortness of breath and coughing up pink, foamy mucus Chest pain if your heart failure is caused by a heart attack