There is a strong association with obesity. In children younger than 10 years, it is associated with metabolic endocrine disorders {hypothyroidism, panhypopituitarism, hypogonadism, renal osteodystrophy, growth hormone abnormalities). SCFE is considered chronic if it has been present more than 3 weeks and acute if it has been present for 3 weeks or less. It is called "stable" if the patient can bear weight and "unstable" if the patient cannot ambulate. Unstable SCFE is associated with more complications, including avascular necrosis of the femoral head (AVN). SCFE is diagnosed by x-ray of the pelvis and bilateral hips. The underlying cause is a widened epiphyseal growth plate, due to abnormal cartilage maturation and endochondral ossification. The treatment is surgical, requiring immediate internal fixation with a single screw. Delay in treatment {> 24 hours) leads to increased AVN, SCFE progression from stable to unstable, and high risk of future degenerative arthritis. Prophylactic contralateral fixation of the unaffected hip is not routinely done in the U.S., except in patients with endocrine abnormalities.

Stop suffering alone and get relief from vaginal atrophy symptoms

Hepatitis B is a serious disease caused by a virus that attacks the liver. The virus, which is called hepatitis B virus (HBV), can cause lifelong infection, cirrhosis (scarring) of the liver, liver cancer, liver failure, and death. Hepatitis B vaccine is available for all age groups to prevent HBV infection.

Lipomas are slow-growing soft tissue tumours that rarely reach a size larger than 2 cm. Lesions larger than 5 cm, so-called giant lipomas, can occur anywhere in the body but are seldom found in the upper extremities. The authors present their experiences with eight patients having giant lipomas of the upper extremity. In addition, a review of the literature, and a discussion of the appropriate evaluation and management are included.

a video showing fiberoptic laryngoscopy and bronchoscopy

A detailed description of the Hepato-pulmonary syndrome including its definition, pathophysiology, diagnosis and treatment. The pathophysiology includes nitric oxide in the pulmonary vasculature which results in intrapulmonary vasodilatation. This causes the classical and unique symptom of platypnea and orthodeoxia.

In dark or dim light, the pupil dilates to allow more light into the eye to improve vision. Normal pupil size tends to range between 2.0 and 5.0 millimeters, depending on the lighting. The younger you are, the larger your pupils tend to be.

A plastic surgeon in China has successfully grown an artificial ear on a man's arm in a pioneering medical procedure. The patient, surnamed Ji, lost his right ear in an accident and yearned to have it back. Doctor Guo Shuzhong from a hospital in Xi'an, China's Shaanxi Province, used Mr Ji's cartilage from his ribs to build the new ear; and he expects to transplanted the organ to the man's head in about four months. According to the Huanqiu report, Mr Ji sustained serious injuries in the right side of his face in a traffic accident about a year ago. His right ear was torn from his face. The man, whose age is not specified, has since received multiple surgical operations to restore his facial skin and his cheeks. However, he felt frustrated about losing his right ear for good. The patient told a report from China News: 'I lost one ear. I have always felt that I am not complete.' Having sought medical advice from multiple sources, Ji realised that it was impossible to restore his ear through conventional medical procedures as a substantial part of his right ear had gone missing. Upon hearing recommendations, Mr Ji went to see doctor Guo Shuzhong, who works at the First Affiliated Hospital of Xi'an Jiaotong University in the city of Xi'an. Doctor Guo, a renowned plastic surgeon, conducted China's first face transplant operation in 2006, according to China Daily.

The core features of migraine are headache, which is usually throbbing and often unilateral, and associated features of nausea, sensitivity to light, sound, and exacerbation with head movement. Migraine has long been regarded as a vascular disorder because of the throbbing nature of the pain.

Three to five years after gastric bypass surgery, some patients start to regain weight because the size of their stoma (the opening at the bottom of the stomach pouch) or their stomach pouch itself has increased. This can keep you from feeling full after small meals.

To resolve this problem, our surgeons use new surgical tools to create and suture folds into the pouch, reducing its volume and at the stoma to decrease its diameter. The surgeon performs the procedure entirely through the mouth -- inserting an endoscope under heavy sedation -- so there are no external incisions into the body.

Gunshot wounds have become increasing common in urban cities and many such cases can lead to undesirable outcomes. While gunshot wounds to the head are considered most lethal, gunshot wounds to the chest too may be dangerous. Gunshot wound to the chest is challenging owing to the presence of vital organs like lungs, heart and their surrounding structures including major blood vessels. Gunshot wound is caused by penetration of the bullet, which travels through a projectile path after being shot from a firearm. The bullet, on hitting the chest, punctures the tissue it first encounters with, the bones or the muscular chest wall. The extent and severity of the injury depends on the characteristics of the bullet and the firearm, the position and the distance of the victim, the projectile path and the nature of the tissue penetrated.

General Considerations Because a discussion of reproductive issues may be difficult for some women, it is important to obtain the history in a relaxed and private setting. The patient should be clothed, particularly if she is meeting the provider for the first time. Ordinarily, the patient should be interviewed alone. Exceptions may be made for children, adolescents, and mentally impaired women, or if the patient specifically requests the presence of a caretaker, friend, or family member. However, even in these circumstances, it is desirable for the patient to have some time to speak with the clinician privately. The manner of address should be formal using the title Mrs., Ms., Miss, or Dr. with the patient’s surname, unless the patient requests otherwise. In some settings, it may be appropriate for nursing staff to be involved with history taking. A nurse may be perceived as less threatening, and may be able to take the history in a less hurried manner.1 The provider can verify the history and focus on areas of concern. Alternatively, it may be helpful to ask the patient to complete a self-history form on paper or by computer prior to speaking with the provider. This allows the provider to devote time to addressing positive responses, and ensures that important questions are not missed. Hasley2 showed that responses to a computer-based questionnaire designed to update a patient’s gynecologic history were equivalent to those obtained during a personal interview. Several studies involving patients in non-gynecologic settings have shown that patients are more likely to provide sensitive information when responding to a computer-based questionnaire as opposed to a personal interview or even a paper questionnaire.3 In order to increase a patient’s level of comfort during the interview, questions should be asked in an open-ended and nonjudgmental way. Assumptions should not be made about aspects of the patient’s background such as sexual orientation. At the conclusion of the interview, patients should be asked whether there are concerns that they would like to discuss that were not addressed previously in the interview.

This animation describes what anti-TNF-alpha therapies are, how they work, and how patients with inflammatory bowel disease (IBD) can benefit.

There are two main purposes of an arterial line. Firstly when patients are very sick an arterial line is inserted to provide constant monitoring and recording of the patient's blood pressure. Secondly some patients require frequent blood tests and the arterial line provides easy access to a patient's blood.

M. D. Anderson Cancer Center provides a basic education on cancer.

DOING LESS BUT BRAINY DESCRIBES A NEW GENERATION OF IMMEDIATE ZIRCONIA IMPLANTS ANATOMICAL AND CUSTOM-MADE. YOUR DENTAL ROOT IS MILLED IN ZIRCONIA AND IN 20 SECONDS SEATED, NO DRILLING, NO AUGMENTATION, NO MEMBRANES, FLAPLESS, NO 3D PLANNING, NO CAD/CAM SPLINTS OR GUIDED SURGERY REQUIRED! EASY AND CONSEQUENTIAL SYSTEM. NO MORE INCONGRUOUS AND UGLY SILVER-COLORED TITANIUM IMPLANTS IN TIME CONSUMING, PAINFUL AND COSTLY PROCEDURES. IT`S HIGH TIME TO RESPECT THE ANATOMY NOT ALTER IT BY DRILLING AND AUGMENTATION. BIOIMPLANT

Frostbite is an injury caused by freezing of the skin and underlying tissues. First your skin becomes very cold and red, then numb, hard and pale. Frostbite is most common on the fingers, toes, nose, ears, cheeks and chin. Exposed skin in cold, windy weather is most vulnerable to frostbite. But frostbite can occur on skin covered by gloves or other clothing. Frostnip, the first stage of frostbite, doesn't cause permanent skin damage. You can treat very mild frostbite with first-aid measures, including rewarming your skin. All other frostbite requires medical attention because it can damage skin, tissues, muscle and bones. Possible complications of severe frostbite include infection and nerve damage.

Fremale to male gender reassignment surgery