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Breast reconstruction 3D Animation
on Friday, December 17, 2010
The primary part of the procedure can often be carried out immediately following the mastectomy. As with many other surgeries, patients with significant medical comorbidities (high blood pressure, obesity, diabetes) and smokers are higher-risk candidates. Surgeons may choose to perform delayed reconstruction to decrease this risk. Patients expected to receive external beam radiation as part of their adjuvant treatment are also commonly considered for delayed autologous reconstruction due to significantly higher complication rates with tissue expander-implant techniques in those patients. Breast reconstruction is a large undertaking that usually takes multiple operations. Sometimes these follow-up surgeries are spread out over weeks or months. If an implant is used, the individual runs the same risks and complications as those who use them for breast augmentation but has higher rates of capsular contracture (tightening or hardening of the scar tissue around the implant) and revisional surgeries. Outcomes based research on quality of life improvements and psychosocial benefits associated with breast reconstruction served as the stimulus in the United States for the 1998 Women's Health and Cancer Rights Act which mandated health care payer coverage for breast and nipple reconstruction, contralateral procedures to achieve symmetry, and treatment for the sequelae of mastectomy. This was followed in 2001 by additional legislation imposing penalties on noncompliant insurers. Similar provisions for coverage exist in most countries worldwide through national health care programs. There are many methods for breast reconstruction. The two most common are: * Tissue Expander - Breast implants This is the most common technique used in worldwide. The surgeon inserts a tissue expander, a temporary silastic implant, beneath a pocket under the pectoralis major muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow a larger, more supple pocket for the expander at the expense of thinner lower pole soft tissue coverage. The use of acellular human or animal dermal grafts have been described as an onlay patch to increase coverage of the implant when the pectoral muscle is released, which purports to improve both functional and aesthtic outcomes of implant-expander breast reconstruction. o In a process that can take weeks or months, saline solution is percutaneously injected to progressively expand the overlaying tissue. Once the expander has reached an acceptable size, it may be removed and replaced with a more permanent implant. Reconstruction of the areola and nipple are usually performed in a separate operation after the skin has stretched to its final size. * Flap reconstruction The second most common procedure uses tissue from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. This procedure may be performed by leaving the donor tissue connected to the original site to retain its blood supply (the vessels are tunnelled beneath the skin surface to the new site) or it may be cut off and new blood supply may be connected. o The latissimus dorsi muscle flap is the donor tissue available on the back. It is a large flat muscle which can be employed without significant loss of function. It can be moved into the breast defect still attached to its blood supply under the arm pit (axilla). A latissimus flap is usually used to recruit soft-tissue coverage over an underlying implant. Enough volume can be recruited occasionally to reconstruct small breasts without an implant. o Abdominal flaps The abdominal flap for breast reconstruction is the TRAM flap or its technically distinct variants of microvascular "perforator flaps" like the DIEP/SIEP flaps. Both use the abdominal tissue between the umbilicus and the
Dumping syndrome is a condition that can develop after surgery to remove all or part of your stomach or after surgery to bypass your stomach to help you lose weight. Also called rapid gastric emptying, dumping syndrome occurs when food, especially sugar, moves from your stomach into your small bowel too quickly.Diet: Eating too much sugar can cause sugars to pass into the colon, making the bacteria there get all excited and cause diarrhea. Other things like sorbitol, a sweetener in some sugarless candy, can also cause diarrhea through osmosis. Malabsorption: Some people don't digest sugars or fats properly.
Eosinophilic granulomatosis with polyangiitis (EGPA)—or, as it was traditionally termed, Churg-Strauss syndrome—is a rare systemic necrotizing vasculitis that affects small-to-medium-sized vessels and is associated with severe asthma and blood and tissue eosinophilia. [1] Like granulomatosis with polyangiitis (Wegener granulomatosis), and the microscopic form of periarteritis (ie, microscopic polyangiitis), EGPA is an antineutrophil cytoplasmic antibody (ANCA)–associated vasculitide. [2, 3, 4, 5] In 1951, Churg and Strauss first described the syndrome in 13 patients who had asthma, eosinophilia, granulomatous inflammation, necrotizing systemic vasculitis, and necrotizing glomerulonephritis. [3] In 1990, the American College of Rheumatology (ACR) proposed the following six criteria for the diagnosis of Churg-Strauss syndrome [6] : Asthma (wheezing, expiratory rhonchi) Eosinophilia of more than 10% in peripheral blood Paranasal sinusitis Pulmonary infiltrates (may be transient) Histological proof of vasculitis with extravascular eosinophils Mononeuritis multiplex or polyneuropathy
OverviewSymptomsTestingComplicationsTreatmentPreventionTakeawayRead This Next What is gonorrhea? Highlights Some people may never develop noticeable symptoms. Gonorrhea is usually treated with an antibiotic injection or oral antibiotics. You’re at a higher risk of contracting gonorrhea if you’ve had any other STDs. Gonorrhea is a sexually transmitted disease (STD). It’s caused by infection with the bacterium Neisseria gonorrhoeae. It tends to infect warm, moist areas of the body, including the: urethra (the tube that drains urine from the urinary bladder) eyes throat vagina anus female reproductive tract (the fallopian tubes, cervix, and uterus) Gonorrhea passes from person to person through unprotected oral, anal, or vaginal sex. People with numerous sexual partners or those who don’t use a condom are at greatest risk of infection. The best protections against infection are abstinence, monogamy (sex with only one partner), and proper condom usage. Behaviors that make a person more likely to engage in unprotected sex also increase the likelihood of infection. These behaviors include alcohol abuse and illegal drug abuse, particularly intravenous drug use. Advertisement Symptoms of gonorrhea Symptoms
A detailed description of the causes and diagnosis of pleural effusion. The presentation includes a discussion of the causes and exudative and transudative pleural effusions. Light's criteria and its modification are described along with definition and clinical implication of pleural fluid acidosis, glucose, adenosine deaminase, hemorrhagic pleural effusion and protein and LDH as well.
Tourette syndrome (also called Tourette's disorder or simply, "Tourette's") is an abnormal neurological condition characterized by motor and vocal tics. Tics are involuntary, rapid, sudden repetitive movements or sounds. Tics can be classified in a variety of ways. Motor tics can affect any part of the body including the head, neck, face, arms, shoulders, hands, feet, or legs. Facial tics, especially eye blinking, are usually the first symptoms of TS. Vocal tics are sounds that are made involuntarily. Vocal tics can include clearing the throat, coughing, sniffing, grunting, yelping, or shouting. In a few cases, vocal tics can include strange, inappropriate, or obscene words and phrases (called coprolalia). Vocal tics can also appear as constantly repeating the words of others (echolalia).
Ellis demonstrates the need to drop the tip of the needle when withdrawing medication from a vial.
#NCLEX #NewGrad #ClinicalSkills #HESI #Kaplan #ATI #NursingSchool #NursingStudent #Nurse #RN #PN #Education #LPN #NurseEducator #lvn
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