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Magnetic resonance imaging (MRI) can be an important tool in the diagnosis of multiple sclerosis (MS). MRI can also be used to monitor the progression of the disease in people living with MS. How does it work? MRI uses very strong magnets, radio signals, and computer software to take 3-dimensional pictures of the inside of the body. Will I need contrast material? Maybe. Contrast material is a substance that temporarily changes the way imaging tools interact with the body. They are often used to visualize certain types of MS disease activity on the MRI. If your doctor thinks your scan requires this contrast material, you may get an injection before you get in the MRI machine. How long will it take? The time may vary based on the type of MRI. Be sure to discuss with your doctor in advance so he or she can provide you with exact timing. But don’t worry, you won’t have to stay still the whole time. The technician will let you know when they’re starting a new image.
A cricothyrotomy (also called crike, thyrocricotomy, cricothyroidotomy, inferior laryngotomy, intercricothyrotomy, coniotomy or emergency airway puncture) is an incision made through the skin and cricothyroid membrane to establish a patent airway during certain life-threatening situations, such as airway obstruction by ...
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.
Renal artery stenosis is a narrowing of arteries that carry blood to one or both of the kidneys. Most often seen in older people with atherosclerosis (hardening of the arteries), renal artery stenosis can worsen over time and often leads to hypertension (high blood pressure) and kidney damage.
Iatrogenic injury to the ureter is a potentially devastating complication of modern surgery. The ureters are most often injured in gynecologic, colorectal, and vascular pelvic surgery. There is also potential for considerable ureteral injury during endoscopic procedures for ureteric pathology such as tumor or lithiasis. While maneuvers such as perioperative stenting have been touted as a means to avoid ureteral injury, these techniques have not been adopted universally, and the available literature does not make a case for their routine use. Distal ureteral injuries are best managed with ureteroneocystostomy with or without a vesico-psoas hitch. Mid-ureteral and proximal ureteral injuries can potentially be managed with ureteroureterostomy. If the distal segment is unsuitable for anastomosis then a number of techniques are available for repair including a Boari tubularized bladder flap, transureteroureterostomy, or renal autotransplantation. In rare cases renal autotransplantation or ureteral substitution with gastrointestinal segments may be warranted to re-establish urinary tract continuity. Laparoscopic and minimally invasive techniques have been employed to remedy iatrogenic ureteral injuries.
The bone marrow aspiration is usually done first. The doctor makes a small incision, then inserts a hollow needle through the bone and into the bone marrow. Using a syringe attached to the needle, the doctor withdraws a sample of the liquid portion of the bone marrow. You may feel a brief sharp pain or stinging.
Fungal infections in bone marrow transplant patients. PURPOSE OF REVIEW: Invasive fungal infections have become the leading infectious cause of death in recipients of hematopoietic cell transplantation. Several factors have led to a renaissance in the study of invasive fungal infections.
When taking oral corticosteroids longer term, you may experience: Clouding of the lens in one or both eyes (cataracts) High blood sugar, which can trigger or worsen diabetes. Increased risk of infections. Thinning bones (osteoporosis) and fractures. Suppressed adrenal gland hormone production
A colonoscope is the special tool used to perform a colonoscopy. It is a thin, flexible, tubular ‘telescope’ with a light and video camera that your doctor carefully guides through your colon in order to see and determine the health of your colon. Watch this animation to learn about the features of the colonoscope, how the colonoscopy procedure is performed and how polyps are removed, and the follow-up care you and your doctor should talk about after your procedure.
In patients age ;::25, HPV DNA testing is the preferred next step in management if the initial cytology shows ASC-US. In this method, samples are collected for both cytology and reflex HPV DNA. If cytology results are positive, HPV DNA testing is performed. If cytology results are negative, the sample for HPV DNA is discarded. HPV DNA testing along with Pap smear at 3 years is recommended if initial cytology shows ASC-US but HPV DNA testing is negative
all pregnant women be screened for Chlamydia at the first prenatal visit. Women under age 25 and those at increased risk for chlamydia! Infection should have repeat testing in the third trimester. Chlamydia endometritis during pregnancy can lead to chorioamnionitis and premature delivery of the fetus. Untreated infection during pregnancy can also lead to conjunctivitis (ophthalmia neonatorum) and pneumonia in the newborn baby