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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.
Eric knew he needed help when an old knee injury began worsening over the course of time and was significantly affecting his quality of life. That’s when he turned to his hometown orthopedic experts at Mayo Clinic Health System in Mankato, who recommended a total knee replacement. After overcoming some initial fears, Eric decided it was time to have the operation — a fuller and more active life with his family depended on it.
Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV). For some people, hepatitis B infection becomes chronic, meaning it lasts more than six months. Having chronic hepatitis B increases your risk of developing liver failure, liver cancer or cirrhosis — a condition that causes permanent scarring of the liver. Most people infected with hepatitis B as adults recover fully, even if their signs and symptoms are severe. Infants and children are more likely to develop a chronic hepatitis B infection. A vaccine can prevent hepatitis B, but there's no cure if you have it. If you're infected, taking certain precautions can help prevent spreading HBV to others.
Closed Reduction of Distal Radius Fractures - Discussion: (distal radius fracture menu) - closed reduction & immobilization in plaster cast remains accepted method of treatment for majority of stable distal radius frx; - unstable fractures will often lose reduction in the cast and will slip back to the pre-reduction position; - patients should be examined for carpal tunnel symptoms before and after reduction; - carpal tunnel symptoms that do not resolve following reduction will require carpal tunnel release; - cautions: - The efficacy of closed reduction in displaced distal radius fractures. - Technique: - anesthesia: (see: anesthesia menu) - hematoma block w/ lidocaine; - w/ hematoma block surgeon should look for "flash back" of blood from hematoma, prior to injection; - references: - Regional anesthesia preferable for Colles' fracture. Controlled comparison with local anesthesia. - Neurological complications of dynamic reduction of Colles' fractures without anesthesia compared with traditional manipulation after local infiltration anesthesia. - methods of reduction: - Jones method: involves increasing deformity, applying traction, and immobilizing hand & wrist in reduced position; - placing hand & wrist in too much flexion (Cotton-Loder position) leads to median nerve compression & stiff fingers; - Bohler advocated longitudinal traction followed by extension and realignment; - consider hyper-extending the distal fragment, and then translating it distally (while in extended position) until it can be "hooked over" proximal fragment; - subsequently, the distal fragment can be flexed (or hinged) over the proximal shaft fragment; - closed reduction of distal radius fractures is facilitated by having an assistant provide counter traction (above the elbow) while the surgeon controls the distal fragment w/ both hands (both thumbs over the dorsal surface of the distal fragment); - flouroscopy: - it allows a quick, gentle, and complete reduction; - prepare are by prewrapping the arm w/ sheet cotton and have the plaster or fibroglass ready; - if flouroscopy is not available, then do not pre-wrap the extremity w/ cotton; - it will be necessary to palpate the landmarks (outer shaped of radius, radial styloid, and Lister's tubercle, in order to judge success of reduction; - casting: - generally, the surgeon will use a pre-measured double sugar sugar tong splint, which is 6-8 layers in thickness; - more than 8 layers of plaster can cause full thickness burns: - reference: Setting temperatures of synthetic casts. - position of immobilization - follow up: - radiographs: - repeat radiographs are required weekly for 2-3 weeks to ensure that there is maintenance of the reduction; - a fracture reduction that slips should be considered to be unstable and probably require fixation with (pins, or ex fix ect.) - there is some evidence that remanipulation following fracture displacement in cast is not effective for these fractures; - ultimately, whether or not a patient is satisfied with the results of non operative treatment depends heavily on th
Thoracentesis is a procedure to remove fluid or air from around the lungs. A needle is put through the chest wall into the pleural space. The pleural space is the thin gap between the pleura. The pleura are a double layer of membranes that surrounds the lungs.
The epididymis is a long coiled tube that lies above and behind each testicle. The epididymis collects and transports sperm from the testis to the vas deferens (tubes that transport sperm to the urethra). An epididymal cyst is a cyst-like mass in the epididymis that contains clear fluid. Typically, epididymal cysts and spermatoceles do not cause symptoms. When discovered, the epididymal cyst is usually about the size of a pea and feels separate from the top of the testis. Spermatoceles typically arise from the head of the epididymis, and are felt on the top portion of the testicle. Epididymal cysts and spermatoceles are often incidental findings on testicular self-examination or routine physical examination. It is important that any mass noted in the scrotum be examined by a urologist in order to obtain an accurate diagnosis, especially a mass on the testicle itself. Our team in the Division of Urology will typically be able to confirm the diagnosis on physical exam. However, a scrotal ultrasound may also be used in order to rule out other conditions.
Highlights of a fetal laser surgery for twin-to-twin transfusion syndrome (TTTS) will be shown from Tampa General Hospital
TTTS affects 10 to 15 percent of identical-twin pregnancies and is the result of abnormal blood exchange between identical twins through a common placenta. The larger of the twins, or recipient, is surrounded by too much amniotic fluid and in danger of heart failure as its body tries to pump the overwhelming volume of blood intended for both. The smaller, or donor twin, is encased in a shrinking amniotic sac deprived of blood. Without treatment, both will likely die.
Rubén Quintero, M.D., Medical Director of Maternal Fetal Medicine/Fetal Surgery at Tampa General Hospital and Professor and Director of the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of South Florida College of Medicine will narrate the procedure and answer e-mail questions live as taped highlights of the procedure are shown.
The MAKOplasty® procedure is an FDA-cleared treatment option for patients who suffer from osteoarthritis damage in the medial (inner) portion of the knee. ... Only the diseased portion of your knee is removed, leaving the healthy bone and tissue surrounding it untouched.
This particular video is intended as a demonstration of a physical exam that may be useful in evaluating a patient with shoulder pain.
It is not intended as a complete instructional video and should not be considered a source of complete physical examination instruction. It is also intended not as a perfect example of a physical exam that would be performed for a patient in clinical practice, but is designed to optimize function and efficiency for a OSCE testing setting.
Instead, it should be treated as a supplement to independent learning using primary Osteopathic Physical Examination instructional resources. Clinical skills are best learned and developed with support from faculty in the context of a complete Osteopathic Medical School Curriculum.
Osteopathic Clinical Skills is a channel dedicated to discussing and exploring Osteopathic Clinical Skills concepts for medical students, residents, and clinicians and presenting them in an easy to understand manner.
Attributions:
Many thanks to the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC - TCOM) for permitting use of the Medical Education Training (MET) facilities and equipment during the production of this video.
Additional thanks to the UNTHSC-TCOM learner and faculty volunteers who participated in this production and provided permission for the use of their image in this video.
A fractured rib is usually a result of a fall or accident. Prolonged coughing and sports with repetitive movement, such as golf, also can cause a rib fracture. Symptoms include pain when taking a deep breath, pressing on the injured area, or bending or twisting the body. In most cases, fractured ribs usually heal on their own in one or two months. Pain relievers can make it easier to breathe deeply.