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Liver transplantation is surgery to remove a diseased or injured liver and replace it with a healthy whole liver or a segment of a liver from another person, called a donor. People with either acute or chronic liver failure may need a liver transplant to survive.
Finding a donor heart can be difficult. The heart must be donated by someone who is brain-dead but is still on life support. The donor heart must be matched as closely as possible to your tissue type to reduce the chance that your body will reject it. You are put into a deep sleep with general anesthesia, and a cut is made through the breastbone. Your blood flows through a heart-lung bypass machine while the surgeon works on your heart. This machine does the work of your heart and lungs while they are stopped, and supplies your body with blood and oxygen. Your diseased heart is removed and the donor heart is stitched in place. The heart-lung machine is then disconnected. Blood flows through the transplanted heart, which takes over supplying your body with blood and oxygen. Tubes are inserted to drain air, fluid, and blood out of the chest for several days, and to allow the lungs to fully re-expand.
Chronic pancreatitis is a long-standing inflammation of the pancreas that alters the organ's normal structure and functions. It can present as episodes of acute inflammation in a previously injured pancreas, or as chronic damage with persistent pain or malabsorption.
Red eyes usually are caused by allergy, eye fatigue, over-wearing contact lenses or common eye infections such as pink eye (conjunctivitis). However, redness of the eye sometimes can signal a more serious eye condition or disease, such as uveitis or glaucoma.
Before Dr. Benjamin Carson became the first person to successfully separate twins conjoined at the head, before he had a TV movie made about his life, before he became known for his "gifted hands" and before he became head of pediatric neurosurgery at Johns Hopkins, Ben Carson was headed down the wrong path in life.
The examination room should be quiet, warm and well lit. After you have finished interviewing the patient, provide them with a gown (a.k.a. "Johnny") and leave the room (or draw a separating curtain) while they change. Instruct them to remove all of their clothing (except for briefs) and put on the gown so that the opening is in the rear. Occasionally, patient's will end up using them as ponchos, capes or in other creative ways. While this may make for a more attractive ensemble it will also, unfortunately, interfere with your ability to perform an examination! Prior to measuring vital signs, the patient should have had the opportunity to sit for approximately five minutes so that the values are not affected by the exertion required to walk to the exam room. All measurements are made while the patient is seated. Observation: Before diving in, take a minute or so to look at the patient in their entirety, making your observations, if possible, from an out-of-the way perch. Does the patient seem anxious, in pain, upset? What about their dress and hygiene? Remember, the exam begins as soon as you lay eyes on the patient. Temperature: This is generally obtained using an oral thermometer that provides a digital reading when the sensor is placed under the patient's tongue. As most exam rooms do not have thermometers, it is not necessary to repeat this measurement unless, of course, the recorded value seems discordant with the patient's clinical condition (e.g. they feel hot but reportedly have no fever or vice versa). Depending on the bias of a particular institution, temperature is measured in either Celcius or Farenheit, with a fever defined as greater than 38-38.5 C or 101-101.5 F. Rectal temperatures, which most closely reflect internal or core values, are approximately 1 degree F higher than those obtained orally. Respiratory Rate: Respirations are recorded as breaths per minute. They should be counted for at least 30 seconds as the total number of breaths in a 15 second period is rather small and any miscounting can result in rather large errors when multiplied by 4. Try to do this as surreptitiously as possible so that the patient does not consciously alter their rate of breathing. This can be done by observing the rise and fall of the patient's hospital gown while you appear to be taking their pulse. Normal is between 12 and 20. In general, this measurement offers no relevant information for the routine examination. However, particularly in the setting of cardio-pulmonary illness, it can be a very reliable marker of disease activity. Pulse: This can be measured at any place where there is a large artery (e.g. carotid, femoral, or simply by listening over the heart), though for the sake of convenience it is generally done by palpating the radial impulse. You may find it helpful to feel both radial arteries simultaneously, doubling the sensory input and helping to insure the accuracy of your measurements. Place the tips of your index and middle fingers just proximal to the patients wrist on the thumb side, orienting them so that they are both over the length of the vessel.
To record the sequence, Stephan Gordts and Ivo Brosens of the Leuven Institute for Fertility & Embryology in Belgium performed transvaginal laparoscopy, which involves making a small cut in the vaginal wall and observing the ovary with an endoscope.
"This allows us direct access to and observation of the tubo-ovarian structures without manipulation using forceps," says Gordts.
For the photos of ovulation, which only accidentally captured the critical moment, Jacques Donnez at the Catholic University of Louvain (UCL) in Brussels, Belgium, used gas to distend the organs for photography. However, Gordts and Brosens planned the procedure to coincide with ovulation and used saline solution to "float" the structures.
Perfect timing
Observation was timed for the day of the peak of the patient's luteal hormone cycle. Ovulation was predicted to occur on the evening of the day of the LH peak, and the endoscope introduced at 6 pm.
A small amount of saline was used to float the opening of the fallopian tube, its fimbriae (the "fingers" that sweep the egg into the tube) and the ovary itself. This gives a more natural appearance than gas, says Gordts.
In the video, the fimbriae can be seen sweeping in time with the patient's heartbeat. A mucus plug can be seen protruding from the ovary – this contains the egg.
"The ovum is not captured 'naked'," says Gordts. "There is no eruption like a volcano."
Gordts says that in clinical practice it is not easy to organise the observation of ovulation. "We were probably lucky to be successful at our first attempt," he says.
Menstruation is a woman's monthly bleeding. When you menstruate, your body sheds the lining of the uterus (womb). Menstrual blood flows from the uterus through the small opening in the cervix and passes out of the body through the vagina. Most menstrual periods last from 3 to 5 days.
In this episode, Dr. Mo explores the transformative power of kidney transplantation. He delves into the benefits and key considerations, outlines the essential steps involved in the transplant process, and discusses the potential costs associated with this life-saving procedure.
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The Kidney Zone Podcast with Dr. Mo
Welcome to the Kidney Zone, where we will dive deep into the fascinating world of our body's remarkable filters. Get ready to unlock the secrets of the kidneys and transplantation as we travel through their pathways, uncovering vital tips, insightful knowledge, and practical advice to keep our kidneys healthy. Whether you're a patient with kidney disease, a medical professional, or simply curious about the kidneys, this is the place for you.
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Dr. Mo Ibrahim is an assistant professor of kidney transplantation at the University of Maryland, Baltimore. He completed his clinical transplant nephrology fellowship at Washington University in 2022. Originally from Cairo, he pursued a physician/scientist career, conducting research at Duke University from 2012 to 2019. He has authored 70+ journal articles, given a TEDx talk, and holds 5 patents. Currently finishing his PhD at Erasmus University, he drives international collaborations to advance medical technology and improve medical monitoring.
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DISCLAIMER
The content of this episode is intended for informational purposes only and is not to be considered medical advice. The information presented here is not meant to diagnose, treat, cure, or prevent any disease or medical condition.
Always consult with a qualified healthcare professional or your doctor before making any healthcare decisions or starting any treatment regimen. Individual medical situations can vary, and only a licensed healthcare provider can offer personalized advice tailored to your specific needs.
The creators of this episode are not responsible for any actions taken based on the information provided herein. Any reliance on the content of this episode is at your own risk. If you have any medical concerns or questions, please seek guidance from a medical professional promptly.
Remember that medical knowledge and practices can evolve over time, and new information may become available after the creation of this episode. Therefore, it is essential to stay up-to-date with the latest medical research and consult with your healthcare provider to ensure the best possible care for your health.
Symptoms of liver failure include vomiting, diarrhea and fatigue as well as the symptoms from stage 3. While the progression from cirrhosis to failure can take years, the damage is irreversible and leads to eventual death. The key to treating liver disease is to diagnose the condition as early as possible.