The importance of being fully informed about serious heart conditions like atrial fibrillation

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Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.

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here may be no symptoms of stomach cancer early on. Later, symptoms include feeling bloated after eating, feeling full after eating small amounts of food, nausea, heartburn, or indigestion.

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The major elements of the cardiac exam include observation, palpation and, most importantly, auscultation (percussion is omitted). As with all other areas of the physical exam, establishing adequate exposure and a quiet environment are critical. Initially, the patient should rest supine with the upper body elevated 30 to 45 degrees. Most exam tables have an adjustable top. If not, use 2 or 3 pillows. Remember that although assessment of pulse and blood pressure are discussed in the vital signs section they are actually important elements of the cardiac exam.

What is Esophageal Dilation?
Esophageal dilation is a procedure that allows your doctor to dilate, or stretch, a narrowed area of your esophagus [swallowing tube]. Doctors can use various techniques for this procedure. Your doctor might perform the procedure as part of a sedated endoscopy. Alternatively, your doctor might apply a local anesthetic spray to the back of your throat and then pass a weighted dilator through your mouth and into your esophagus.
Why is it Done?
The most common cause of narrowing of the esophagus, or stricture, is scarring of the esophagus from reflux of acid occurring in patients with heartburn. Patients with a narrowed portion of the esophagus often have trouble swallowing; food feels like it is "stuck" in the chest region, causing discomfort or pain. Less common causes of esophageal narrowing are webs or rings (which are thin layers of excess tissue), cancer of the esophagus, scarring after radiation treatment or a disorder of the way the esophagus moves [motility disorder].
How Should I Prepare for the Procedure?
An empty stomach allows for the best and safest examination, so you should have nothing to drink, including water, for at least six hours before the examination. Your doctor will tell you when to start fasting.
Tell your doctor in advance about any medications you take, particularly aspirin products or anticoagulants (blood thinners). Most medications can be continued as usual, but you might need to adjust your usual dose before the examination. Your doctor will give you specific guidance. Tell your doctor if you have any allergies to medications as well as medical conditions such as heart or lung disease. Also, tell your doctor if you require antibiotics prior to dental procedures, because you might need antibiotics prior to esophageal dilation as well.
What Can I Expect during Esophageal Dilation?
Your doctor might perform esophageal dilation with sedation along with an upper endoscopy. Your doctor may spray your throat with a local anesthetic spray, and then give you sedatives to help you relax. Your doctor then will pass the endoscope through your mouth and into the esophagus, stomach and duodenum. The endoscope does not interfere with your breathing. At this point your doctor will determine whether to use a dilating balloon or plastic dilators over a guiding wire to stretch your esophagus. You might experience mild pressure in the back of your throat or in your chest during the procedure. Alternatively, your doctor might start by spraying your throat with a local anesthetic. Your doctor will then pass a tapered dilating instrument through your mouth and guide it into the esophagus.
What Can I Expect after Esophageal Dilation?
After the dilation is done, you will probably be observed for a short period of time and then allowed to return to your normal activities. You may resume drinking when the anesthetic no longer causes numbness to your throat, unless your doctor instructs you otherwise. Most patients experience no symptoms after this procedure and can resume eating the next day, but you might experience a mild sore throat for the remainder of the day.
If you received sedatives, you probably will be monitored in a recovery area until you are ready to leave. You will not be allowed to drive after the procedure even though you might not feel tired. You should arrange for someone to accompany you home, because the sedatives might affect your judgment and reflexes for the rest of the day.
What are the Potential Complications of Esophageal Dilation?
Although complications can occur even when the procedure is performed correctly, they are rare when performed by doctors who are specially trained. A perforation, or hole, of the esophagus lining occurs in a small percentage of cases and may require surgery. A tear of the esophagus lining may occur and bleeding may result. Complications from heart or lung diseases are potential risks

Menopause is defined as occurring 12 months after your last menstrual period and marks the end of menstrual cycles. Menopause can happen in your 40s or 50s, but the average age is 51 in the United States. Menopause is a natural biological process. Although it also ends fertility, you can stay healthy, vital and sexual. Some women feel relieved because they no longer need to worry about pregnancy. Even so, the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or — for some women — trigger anxiety or feelings of sadness and loss. Don't hesitate to seek treatment for symptoms that bother you. Many effective treatments are available, from lifestyle adjustments to hormone therapy.

Microsurgical varicocelectomy is performed for patients with a varicocele and impaired semen parameters, testicular atrophy or pain due to the varicocele.

How to Use a Menstrual Cup Fold and hold. Always start by washing your hands. ... Insert and ensure. As with tampons, gently insert the folded cup into your vagina, tilting it back to the base of your spine. ... Use it up to twelve hours. ... Remove and empty. ... Re-insert.

DMC Eye specialist restores a woman's vision by removing cataracts and installing an artificial lens. ~ Detroit Medical Center

Experience with endoscopic retrograde cholangiopancreatography (ERCP) in children has been limited due to multiple factors, including the relatively low incidence of diseases requiring ERCP in this age group, the impression that the procedure is technically difficult in children, and because the indications and safety of ERCP in children have not been well defined. As a result, patients are generally referred to a tertiary care facility or to adult endoscopists who perform a high volume of procedures.

Papillary fibroelastoma is the third most common primary tumor of the heart and is most likely to involve the cardiac valves. Like myxomas, they arise from the endocardium in most patients and since these tumors are often incidental findings at echocardiography or autopsy, the true incidence is difficult to estimate. Most patients are older than 60 years, which also contrasts with myxomas. Papillary fibroelastomas can embolize, leading to severe neurological complications and therefore, surgical removal is advised, although there is controversy regarding small incidental lesions and the need for surgery.

Learn the SIRS Criteria and how to calculate it. Greater than or equal to 2 or more of the following: Temperature Fever of greater than 38°C (100.4°F) or Less than 36°C (96.8°F) Heart Rate Greater than 90 beats per minute Respiratory Rate Greater than 20 breaths per minute or PaCO2 of less than 32mm Hg White Blood Cell Count Greater than 12,000cells/mm³ or Less than 4,000cells/mm³ or Greater than 10% Bands

A video from Physical Exam Series of Loyola University Health System, Chicago showing the medical examination of the abdomen

Rhinoplasty enhances facial harmony and the proportions of your nose. It can also correct impaired breathing caused by structural defects in the nose. Rhinoplasty surgery can change: Nose size in relation to facial balance Nose width at the bridge or in the size and position of the nostrils Nose profile with visible humps or depressions on the bridge Nasal tip that is enlarged or bulbous, drooping, upturned or hooked Nostrils that are large, wide, or upturned Nasal asymmetry If you desire a more symmetrical nose, keep in mind that everyone’s face is asymmetric to some degree. Results may not be completely symmetric, although the goal is to create facial balance and correct proportion.

19 years old young man with inguinoscrotal right hernia.Decision-making for repair with minimal prosthetic residual material, and no stitches use for best comfort

Pediatric orthopedic surgeons at Columbia are using a new device with magnetic technology that avoids the need for multiple spine-lengthening surgeries to correct early-onset scoliosis, a severe curvature of the spine in young children. In April 2014, Michael Vitale, MD, the Ana Lucia Professor of Pediatric Orthopedic Surgery at CUMC and 1995 graduate of P&S, performed the first procedure in the New York area, using the device to treat a 5-year-old boy. When braces and casts cannot control scoliosis in young children, surgeons turn to growing rods, which help correct the curve while allowing the spine to grow. When spinal maturity is near, the rods are removed and a spinal fusion can be performed. But during years of treatment with growing rods, patients must undergo surgery every six months to lengthen the rods to keep up with the patients’ growth. A patient may undergo eight to 10 procedures, which are costly and result in lost time for parents at work and children at school. The new device—MAGEC (MAGnetic Expansion Control) rods—contains a mechanism inside the growing rods that allows surgeons to lengthen the rods with a handheld external magnet, without surgery.