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.

ow does a perforation of the eardrum occur? There are many ways an eardrum perforation can occur. An infection behind the eardrum in the middle ear may cause a rupture of the eardrum. Trauma to the ear may result from an object entering the ear canal and puncturing the eardrum. A traumatic blow to the ear with a cupped hand can rupture the eardrum. Hot welding slag can burn a hole through the eardrum. After a ventilation tube has been extruded or is removed, the opening usually closes; in some cases a permanent opening of the eardrum may occur. Chronic ear problems such as deep retraction pockets and cholesteatoma​​ can weaken and erode the eardrum, resulting in a defect or perforation.

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.

Watch that video of Removing Gauze From a Spider's Bite

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.

A visual prosthesis, often referred to as a bionic eye, is an experimental visual device intended to restore functional vision in those suffering from partial or total blindness. In 1983 Joao Lobo Antunes, a Portuguese doctor, implanted a bionic eye in a person born blind.

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.

Fremale to male gender reassignment surgery

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

Dilated cardiomyopathy (DCM) is a condition in which the heart's ability to pump blood is decreased because the heart's main pumping chamber, the left ventricle, is enlarged and weakened.

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

Stem-cell therapy is the use of stem cells to treat or prevent a disease or condition. Bone marrow transplant is the most widely used stem-cell therapy, but some therapies derived from umbilical cord blood are also in use...

Testosterone treatment in adolescent boys with constitutional delay

Truncus arteriosus is a rare type of heart disease that in which a single blood vessel (truncus arteriosus) comes out of the right and left ventricles, instead of the normal 2 vessels (pulmonary artery and aorta). It is present at birth (congenital heart disease)

Histology of Female Urethra

Dr. Ed Tingstad, Orthopedic Surgeon with Pullman Regional Hospital’s Orthopedic Center of Excellence and Inland Orthopaedic Surgery & Sports Medicine Clinic performs a total knee replacement using orthopedic robotics – VELYS. The VELYS Robotic-Assisted Solution technology makes for a more exact fitting knee replacement and uses intra-operative data to inform the surgeon during surgery. In this full-length total knee replacement video, Dr. Tingstad narrates a procedure from start to finish.
Learn more: pullmanregional.org/orthopedics

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.

From across the room, using controls and pedals—pediatric surgeons at Golisano Children’s Hospital are now able to operate on patients without even touching them. “It allows performances of deep surgeries in the pelvis or abdomen through tiny, little incisions as opposed to a traditional, large incision to get access to the areas where urologists often operate,” explained Dr. Rahman Abd-El-Barr, a pediatric urologist with Golisano Children’s Hospital of Southwest Florida.

The DaVinci robot is a robotic platform that allows surgeons to do minimally invasive surgery, leaving patients with smaller incisions and a quicker recovery. “This is important because it allows us to minimize recovery time, pain, bleeding with surgery, and especially with kids, it helps them to get back on their feet right away,” he said.

So when high school athlete, Reagan Rebeor found out she needed to have kidney surgery, she decided to have it robotically. “Thankfully, I did that because if not, I would have had a long scar down my stomach instead of small holes, small incisions. I had pain for three days, three or four days. Then after that, I was fine,” she said.

While it’s not an option for all pediatric surgeries, doctors say it can be very beneficial for teenage and adult patients needing reconstructive surgery. An option that allows patients a quicker and easier recovery.


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