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Drs. Moore and Miklos are very excited to be one of the first centers in the US to offer the next step in minimally invasive treatment for Stress Urinary Incontinence, the single incision Mini-sling. The procedure utilizes the same concepts of the tension-free tape mid-urethral slings, however only one incision is needed and the procedure can be completed in as little as 5-10 minutes under local anesthesia.
The procedure was initially released in September of 2006 by Gynecare with a procedure called the TVT-Secure and Dr Miklos and Moore were some of the first surgeons to evaluate and study the procedure. They liked the concept of a single incision sling, however were not enthused by the engineering and design of the Secure sling. In early 2007, with development input from Dr Moore and Miklos, American Medical Systems made several improvements to the procedure and in April, Dr Moore was the first surgeon in the United States to place the Mini-Arc mini-sling. Dr Moore’s and Miklos’s center in Atlanta, because of their reputation of being world leader’s in treatment for Stress Urinary Incontinence, was chosen as the lead center in the USA to evaluate and study the Mini-Arc procedure. Dr Moore was chosen as principal investigator, leading 5 centers in the USA and the world, to study and present the initial results in the USA, which have been excellent and very exciting!
Alexandra J. Golby, MD, Director, Image-guided Neurosurgery at Brigham and Women’s Hospital, discusses technological advancements to improve the precision of surgery to remove brain tumors.
It’s estimated that each year nearly 80,000 people are diagnosed with primary brain tumors and 100,000 with metastatic brain tumors. Nearly everybody is at risk for developing a brain tumor. Brain tumors can affect people from childhood to the last years of their lives. Men are slightly more affected than women and the causes of most brain tumors are not known.
There are a number of unique challenges in treating brain tumors. One challenge is that primary tumors can have indistinct margins that are difficult to see. Another challenge is that the tissue around a brain tumor is uniquely important and may impact things like language, visual and motor function.
The AMIGO Suite, opened in 2011 at Brigham and Women’s Hospital, is the Advanced Multimodality Image Guided Operating Suite. It's an NIH-funded national center which was developed with the goal of translating technological advances into improvements in surgical and interventional care for patients. In the AMIGO Suite, there is an intraoperative MRI scanner which can be brought in and out of the operating room during surgery to help surgeons visualize a patient’s tumor better.
Image-guided surgery uses the information obtained from advanced imaging and translates that into the planning and execution of surgery by acquiring high resolution and specialty structural images of the brain and also functional images of the brain. These images can be registered to one another and then to the patient's head during surgery. This allows surgeons to pinpoint the location of the tumor as well as the areas that we would like to preserve, areas that serve critical brain functions are located.
One of the big challenges, even with image-guided surgery, is that as we perform the surgery, the configuration of the brain is changing, and we call that brain shift. And it's due to changes in the brain itself and also as we remove tissue, things are constantly shifting and moving. When we're talking about doing brain tumor surgery, a few millimeters of movement can be a big difference. How to measure and track brain shift is an important area of research and a number of technologies are being studied to understand how to measure brain shift during surgery.
The development of various intraoperative imaging technologies allows surgeons to provide the most accurate surgical treatment for each individual patient.
Learn more about precision brain surgery at Brigham and Women’s Hospital:
https://www.brighamandwomens.o....rg/neurosurgery/brai
The bones, ligaments and tendons that make up your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule thickens and tightens around the shoulder joint, restricting its movement. Doctors aren't sure why this happens to some people, although it's more likely to occur in people who have diabetes or those who recently had to immobilize their shoulder for a long period, such as after surgery or an arm fracture.
poor posture (postural kyphosis) – slouching, leaning back in chairs and carrying heavy bags can stretch supporting muscles and ligaments, which can increase spinal curvature. abnormally shaped vertebrae (Scheuermann's kyphosis) – if the vertebrae don't develop properly, they can end up being out of position.
Suspect that a patient has a subphrenic abscess if he deteriorates, or recovers and then deteriorates, between the 14th and the 21st day after a laparotomy, with a low, slowly increasing, swinging fever, sweating, and a tachycardia. This, and a leucocytosis, show that he has ''pus somewhere', which is making him anorexic, wasted, and ultimately cachectic. If he has no sign of a wound infection, a rectal examination is negative, and his abdomen is soft and relaxed, the pus is probably under his diaphragm. The pus might be between his diaphragm and his liver, in (1) his right or (2) his left subphrenic space, or under his liver in (3) his right or (4) his left subhepatic space in his lesser sac. He may have pus in more than one of these spaces. Explore him on the suspicion that he might have a subphrenic abscess. Exploration is not a major operation; the difficulty is knowing where to explore, so refer him if you can. If you cannot refer him, explore him yourself. If you fail to find pus, you have done him no harm; missing a subphrenic abscess is far worse. If it is anterior, you can drain it by going under his costal margin anteriorly. If it is posterior, you can go through the bed of his 12th rib posteriorly.
Morning erections have colloquially been termed as “morning wood” while scientifically it is called nocturnal penile tumescence. It is a normal and healthy physiological reaction and response that most men experience in their lives. Morning erections are really the ending of a series of erections that happen to men during the night. Healthy men can, on average, have anywhere between three to five erections in a full night of sleep, each of which lasts from 25-35 minutes.
The cause of pectus excavatum is not known however it can run in families, with up to 25 percent of affected patients reporting chest wall abnormalities in other family members. Pectus excavatum occurs in approximately 1 out of 400–1000 children and is three to five times more common in males than females.
Pulmonary capillary wedge pressure (PCWP) provides an indirect estimate of left atrial pressure (LAP). Although left ventricular pressure can be directly measured by placing a catheter within the left ventricle, it is not feasible to advance this catheter back into the left atrium. LAP can be measured by placing a special catheter into the right atrium then punching through the interatrial septum; however, for obvious reasons, this is not usually performed because of damage to the septum and potential harm to the patient.