Nose Plastic Surgery: Open Rhinoplasty

The fascinating way doctors insert a stent when there is plaque buildup in an artery.

Unruptured Aneurysms: When and How to Treat

Vaginal prolapse (also called vaginal vault prolapse) is quite common after a hysterectomy (surgery to remove the uterus), but not everyone who has a hysterectomy experiences POP. Without the uterine attachments to hold it up, the top of the vagina can drop into the vaginal canal.

The heart and circulatory system (also called the cardiovascular system) make up the network that delivers blood to the body's tissues. With each heartbeat, blood is sent throughout our bodies, carrying oxygen and nutrients to all of our cells.

This hormone, insulin, causes the liver to convert more glucose into glycogen (this process is called glycogenesis), and to force about 2/3 of body cells (primarily muscle and fat tissue cells) to take up glucose from the blood through the GLUT4 transporter, thus decreasing blood sugar.

Kiki Challenge

Finger metacarpophalangeal (MCP) joint collateral ligament sprains should not be overtreated. First-degree sprains may require a brief period of protection, usually consisting of buddy taping for 2-3 weeks. Second-degree sprains are immobilized in mid flexion for 3 weeks. Finger MCP joint hyperextension injuries may be treated by gently flexing the proximal phalanx and immobilizing the MCP joint in 30° of flexion for 2-3 weeks. A dorsal extension-block splint protects the healing volar plate while allowing active flexion of the finger. Early protected motion minimizes postinjury stiffness. Thumb MCP joint hyperextension injuries ("locked MCP joint") are immobilized in 20° MCP joint flexion for 3 weeks.

Pediatric febrile seizures, which represent the most common childhood seizure disorder, exist only in association with an elevated temperature. Evidence suggests, however, that they have little connection with cognitive function, so the prognosis for normal neurologic function is excellent in children with febrile seizures. [1] Epidemiologic studies have led to the division of febrile seizures into 3 groups, as follows: Simple febrile seizures Complex febrile seizures Symptomatic febrile seizures Essential update: Starting MMR/MMRV vaccination earlier may reduce seizure risk In a case-series analysis of a cohort of 323,247 US children born from 2004 to 2008, Hambidge et al found that delaying the first dose of measles-mumps-rubella (MMR) or measles-mumps-rubella-varicella (MMRV) vaccine beyond the age of 15 months may more than double the risk of postvaccination seizures in the second year of life. [2, 3] In infants, there was no association between vaccination timing and postvaccination seizures. [3] In the second year of life, however, the incident rate ratio (IRR) for seizures within 7-10 days was 2.65 (95% confidence interval [CI], 1.99-3.55) after first MMR doses at 12-15 months of age, compared with 6.53 (95% CI, 3.15-13.53) after first MMR doses at 16-23 months. For the MMRV vaccine, the IRR for seizures was 4.95 (95% CI, 3.68-6.66) after first doses at 12-15 months, compared with 9.80 (95% CI, 4.35-22.06) for first doses at 16-23 months.

Open reduction and internal fixation (ORIF) is surgery used to stabilize and heal a broken bone. You might need this procedure to treat your broken thighbone (femur). The femur is the large bone in the upper part of your leg. Different kinds of trauma can damage this bone, causing it to fracture into 2 or more pieces. This might happen to the part of the femur near your knee, near the middle of the femur, or in the part of the femur that forms part of your hip joint. In certain types of femur fractures, your femur has broken, but its pieces still line up correctly. In other types of fractures (displaced fractures), the trauma moves the bone fragments out of alignment. If you fracture your femur, you usually need ORIF to bring your bones back into place and help them heal. During an open reduction, orthopedic surgeons reposition your bone pieces during surgery, so that they are back in their proper alignment. This contrasts with a closed reduction, in which a healthcare provider physically moves your bones back into place without surgically exposing your bone.

Most intact aortic aneurysms do not produce symptoms. As they enlarge, symptoms such as abdominal pain and back pain may develop. Compression of nerve roots may cause leg pain or numbness. Untreated, aneurysms tend to become progressively larger, although the rate of enlargement is unpredictable for any individual. Rarely, clotted blood which lines most aortic aneurysms can break off and result in an embolus. They may be found on physical examination. Medical imaging is necessary to confirm the diagnosis. Symptoms may include: anxiety or feeling of stress; nausea and vomiting; clammy skin; rapid heart rate. In patients presenting with aneurysm of the arch of the aorta, a common symptom is a hoarse voice as the left recurrent laryngeal nerve (a branch of the vagus nerve) is stretched. This is due to the recurrent laryngeal nerve winding around the arch of the aorta. If an aneurysm occurs in this location, the arch of the aorta will swell, hence stretching the left recurrent laryngeal nerve. The patient therefore has a hoarse voice as the recurrent laryngeal nerve allows function and sensation in the voicebox. Abdominal aortic aneurysms, hereafter referred to as AAAs, are the most common type of aortic aneurysm. One reason for this is that elastin, the principal load-bearing protein present in the wall of the aorta, is reduced in the abdominal aorta as compared to the thoracic aorta (nearer the heart). Another is that the abdominal aorta does not possess vasa vasorum, hindering repair. Most are true aneurysms that involve all three layers (tunica intima, tunica media and tunica adventitia), and are generally asymptomatic before rupture. The most common sign for the aortic aneuysm is the Erythema nodosum also known as leg lesions typically found near the ankle area. The prevalence of AAAs increases with age, with an average age of 65–70 at the time of diagnosis. AAAs have been attributed to atherosclerosis, though other factors are involved in their formation. An AAA may remain asymptomatic indefinitely. There is a large risk of rupture once the size has reached 5 cm, though some AAAs may swell to over 15 cm in diameter before rupturing. Before rupture, an AAA may present as a large, pulsatile mass above the umbilicus. A bruit may be heard from the turbulent flow in a severe atherosclerotic aneurysm or if thrombosis occurs. Unfortunately, however, rupture is usually the first hint of AAA. Once an aneurysm has ruptured, it presents with a classic pain-hypotension-mass triad. The pain is classically reported in the abdomen, back or flank. It is usually acute, severe and constant, and may radiate through the abdomen to the back. The diagnosis of an abdominal aortic aneurysm can be confirmed at the bedside by the use of ultrasound. Rupture could be indicated by the presence of free fluid in potential abdominal spaces, such as Morison's pouch, the splenorenal space (between the spleen and left kidney), subdiaphragmatic spaces (underneath the diaphragm) and peri-vesical spaces. A contrast-enhanced abdominal CT scan is needed for confirmation. Only 10–25% of patients survive rupture due to large pre- and post-operative mortality. Annual mortality from ruptured abdominal aneurysms in the United States alone is about 15,000. Another important complication of AAA is formation of a thrombus in the aneurysm.

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

Skin cancer is the most common type of cancer. There are three major types of skin cancer — Basal Cell Carcinoma, Squamous Cell Carcinoma and melanoma. Out of these, Melanoma is the deadliest form of skin cancer. Melanoma appears on the skin as a new spot or growth or a change in an already existing mole. It is often fast growing and can spread to other parts of your body, including your bones, liver, and lungs to form a new cancer.

How a Tattoo is Removed

Systemic Lupus Erythematosus (SLE)information

Infant CPR Learn more at http://www.ProTrainings.com

In the Dialysis Unit you have an opportunity to provide Dialysis care for a variety of patients, including those with End-Stage Chronic Kidney disease and acutely ill patients requiring dialysis and plasmapheresis.
The Chronic Dialysis Nurse focuses on patients receiving Hemodialysis, Peritoneal Dialysis, or Home Hemodialysis. Our patients range in age from newborns to young adults. The Hemodialysis patient receives their dialysis treatment in the clinic 3-5 times a week. The Peritoneal Dialysis and Home Hemodialysis treatments are provided in the patient’s home once the parent/caregiver is trained to operate the machine. They are followed monthly in clinic. The patient receiving Chronic Dialysis is supported by a multidisciplinary team that consists of a physician, nurses, social worker, nutritionist, pharmacist, child-life therapist, teacher, and counselor. The group works together to meet the medical and emotional needs of the patient and caregiver. Care is specialized to meet the needs of each individual patient.
The Acute Dialysis Nurse focuses on acute dialysis related therapies such as: Continuous Renal Replacement Therapy (CRRT); therapeutic plasmapheresis; or acute peritoneal dialysis. The acute dialysis team works with the multi-disciplinary inpatient nephrology team to provide acute dialysis services to the critically ill ICU patients. The work environment is highly technical and fast-paced.
The Dialysis Unit operates on 12hr shifts 7a – 7p; 7 days a week. Night call is required and shared by the nurses. We provide a detailed orientation plan to the nurse to become proficient in providing hemodialysis, peritoneal dialysis, continuous renal replacement therapy and plasmapheresis. Previous experience in dialysis or pediatrics is not required.

The lymphatic system is a network of specialized vessels (lymph vessels) throughout the body whose purpose is to collect excess lymph fluid with proteins, lipids, and waste products from the tissues. This fluid is then carried to the lymph nodes, which filter waste products and contain infection-fighting cells called lymphocytes. The excess fluid in the lymph vessels is eventually returned to the bloodstream. When the lymph vessels are blocked or unable to carry lymph fluid away from the tissues, localized swelling (lymphedema) is the result.

Posterior Urethral Strictures Associated with Urinary Incontinence after Prostatectomy Management

Foley Catheter Insertion Men and Women