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Achalasia is a neurogenic esophageal motility disorder characterized by impaired esophageal peristalsis and a lack of lower esophageal sphincter relaxation during swallowing. Symptoms are slowly progressive dysphagia, usually to both liquids and solids, and regurgitation of undigested food. Evaluation typically includes manometry, barium swallow, and endoscopy. Treatments include dilation, chemical denervation, surgical myotomy, and peroral endoscopic myotomy.
Asthma was originally described as an inflammatory disease that predominantly involves the central airways. Pathological and physiological evidence reported during the past few years suggests that the inflammatory process extends beyond the central airways to the peripheral airways and the lung parenchyma. The small airways are capable of producing T-helper-2 cytokines, as well as chemokines, and they have recently been recognized as a predominant site of airflow obstruction in asthmatic persons. The inflammation at this distal site has been described as more severe than large airway inflammation. These findings are of great clinical significance, and highlight the need to consider the peripheral airways as a target in any therapeutic strategy for treatment of asthma.
Robotic-assisted endoscopic thyroid surgery using the daVinci® Surgical System can safely and effectively offer those needing thyroid surgery relief without neck incisions. Dr. Ron Kuppersmith and Dr. Andrew deJong are now performing this procedure at the College Station Medical Center in Texas.
Like any syndrome, fetal alcohol syndrome (FAS) is a group of signs and symptoms that appear together and indicate a certain condition. In the case of FAS, the signs and symptoms are birth defects that result from a woman's use of alcohol during her pregnancy.
Tension pneumothorax describes the progressive accumulation of air in the pleural cavity (normally a potential space) through a defect in the visceral pleura. This leads to positive pressure being maintained and increasing throughout the respiratory cycle causing vessels within the mediastinum to be compressed with catastrophic consequences if left untreated. Clinical signs include hypoxia, hypotension, tachycardia, reduced breath sounds and hyper resonance ipsilaterally, with tracheal deviation (away from the affected side) and distended neck veins being late clinical signs.
MRCPCH Clinical Revision - more videos at http://mrcpch.paediatrics.co.uk
Revise for your MRCPCH Clinical exam, with videos and high quality content created by the London Paediatrics Trainees Committee.
Video Credits: Dr Caroline Fertleman, Dr Hermione Race, Dr Camilla Sen, Dr Chloe Macaulay, Dr Emma McLaren, Chris Knapp
A circulatory anastomosis is a connection (an anastomosis) between two blood vessels, such as between arteries (arterio-arterial anastomosis), between veins (veno-venous anastomosis) or between an artery and a vein (arterio-venous anastomosis). An end artery (or terminal artery) is an artery that is the only supply of oxygenated blood to a portion of tissue. Examples of an end artery include the splenic artery that supplies the spleen and the renal artery that supplies the kidneys.
Aortoiliac occlusive disease (AIOD) occurs commonly in patients with PAD. Significant lesions in the aortoiliac arterial segment are exposed easily by palpation of the femoral pulses. Any diminution of the palpable femoral pulse indicates that a more proximal obstruction exists. Obstructive lesions may be present in the infrarenal aorta, common iliac, internal iliac (hypogastric), external iliac, or combinations of any or all of these vessels. Occasionally, degenerated nonstenotic atheromatous disease exists in these vessels and may manifest by atheroembolism to the foot, the "blue toe" or "trash foot" syndrome. Generally, patients with aortoiliac PAD have a poorer general prognosis than those with more distal PAD.
Open heart (coronary artery bypass, or CABG) surgery is performed in order to reroute, or "bypass," blood around blocked arteries, thereby improving the supply of oxygen-rich blood to the heart. Surgeons usually use an artery from the chest wall to construct the "detour" around the blocked part of the artery. Veins from the legs are also used.
Function and Anatomy: The hip is a ball and socket type joint, formed by the articulation of the head of the femur with the pelvis. Normal range of motion includes: abduction 45 degrees, adduction 20-30 degrees, flexion 135 degrees, extension 30 degrees, internal and external rotation. Hip pathology can cause symptoms anywhere around the joint, though frequently pain is anterior and radiates to the groin region. Additionally, pathology outside of the hip can be referred to this region. History and exam obviously help in making these distinctions.
Acute mesenteric ischemia (AMI) is a syndrome caused by inadequate blood flow through the mesenteric vessels, resulting in ischemia and eventual gangrene of the bowel wall. Although relatively rare, it is a potentially life-threatening condition. Broadly, AMI may be classified as either arterial or venous. AMI as arterial disease may be subdivided into nonocclusive mesenteric ischemia (NOMI) and occlusive mesenteric arterial ischemia (OMAI); OMAI may be further subdivided into acute mesenteric arterial embolism (AMAE) and acute mesenteric arterial thrombosis (AMAT). AMI as venous disease takes the form of mesenteric venous thrombosis (MVT).
Emergency Contraception is a way to prevent pregnancy AFTER unprotected sex. Lots of people have questions about it: What does the morning after pill do? How does emergency contraception work to prevent pregnancy? What are the different types of emergency contraception? This video answers these questions and more.