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arteriovenous hemodialysis access has been the "gold standard" for patients needing hemodialysis for the past 30 years. Despite the reported advantages of autologous access, the availability of prosthetic graft material, coupled with the challenging dialysis candidate, has led to a trend of primary prosthetic graft dialysis access in the 1980s and 1990s. In recognition of this unfortunate trend, the National Kidney Foundation Dialysis Outcomes Quality Initiative (DOQI) used evidence from published studies and summary articles to generate clinical practice guidelines, emphasizing a shift back to autologous arteriovenous fistula (AVF) as the key to long-term successful hemodialysis.[1,2] These initial guidelines proposed a goal of 50% autologous AVF as the initial access, with a 40% prevalence of autologous access for a given practice or unit.
Lesson on clinical examination of a scaphoid fracture and assessment of the anatomic snuffbox. The scaphoid bone is one of the carpal bones of the wrist. A scaphoid fracture is important to rule out due to risk of avascular necrosis, which is a compromise of bone vasculature leading to death of the bone. Scaphoid fractures can occur with a FOOSH injury. In this lesson, we discuss the clinical assessment to rule out a scaphoid fracture, including assessing and localizing the anatomic snuffbox.
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Check out some of my other lessons.
Medical Terminology - The Basics - Lesson 1:
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Lesson on the Purine Synthesis and Salvage Pathway:
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Gastrulation | Formation of Germ Layers:
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Introductory lesson on Autophagy (Macroautophagy):
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Infectious Disease Playlist
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Dermatology Playlist
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**MEDICAL DISCLAIMER**: JJ Medicine does not provide medical advice, and the information available on this channel does not offer a diagnosis or advice regarding treatment. Information presented in these lessons is for educational purposes ONLY, and information presented here is not to be used as an alternative to a healthcare professional’s diagnosis and treatment of any person/animal.
Only a physician or other licensed healthcare professional are able to determine the requirement for medical assistance to be given to a patient. Please seek the advice of your physician or other licensed healthcare provider if you have any questions regarding a medical condition.
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JJ
Detailed examination of the joints is usually not included in the routine medical examination. However, joint related complaints are rather common, and understanding anatomy and physiology of both normal function and pathologic conditions is critically important when evaluating the symptomatic patient. By gaining an appreciation for the basic structures and functioning of the joint, you'll be able to "logic" your way thru the exam, even if you can't remember the eponym attached to each specific test!
Sex reassignment surgery for male-to-female involves reshaping the male genitals into a form with the appearance of, and, as far as possible, the function of female genitalia. Prior to any surgeries, patients usually undergo hormone replacement therapy (HRT), and, depending on the age at which HRT begins, facial hair removal. There are associated surgeries patients may elect to, including facial feminization surgery, breast augmentation, and various other procedures.
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
This animation demonstrates how a unilateral complete cleft lip repair is performed. This video is meant for educational purposes for patients and families. There are many ways to fix a complete cleft lip, but the technique shown here is the most common known as the Millard Rotation Advancement Repair.
Detailed examination of the joints is usually not included in the routine medical examination. However, joint related complaints are rather common, and understanding anatomy and physiology of both normal function and pathologic conditions is critically important when evaluating the symptomatic patient. By gaining an appreciation for the basic structures and functioning of the joint, you'll be able to "logic" your way thru the exam, even if you can't remember the eponym attached to each specific test!
When the colon and rectum are removed (due to ulcerative colitis or familial adenomatous polyposis), another reservoir must be created for bowel contents (stool) to exit the body. Surgically creating a “J” shaped reservoir (called a J-pouch) is an option for selected patients to store and pass stool.
Multiple studies demonstrate the safety of propofol in pediatric EDPS. Each has identified a drop in blood pressure and transient hypoxemia as the most frequent complications. In all of the studies in which hypotension was identified there was no evidence of poor perfusion. The hypoxemia in all of these studies quickly responded to minimal intervention with no apparent lasting complications. Although these were pediatric studies, the results were very similar to ours in complication rates and sedation times. Our study did not demonstrate the frequency of decreased blood pressure seen in these pediatric studies but had similar hypoxemia rates.
A uterine fibroid (also uterine leiomyoma, myoma, fibromyoma, leiofibromyoma, fibroleiomyoma, and fibroma) (plural of ... myoma is ...myomas or ...myomata) is a benign (non-cancerous) tumor that originates from the smooth muscle layer (myometrium) and the accompanying connective tissue of the uterus. Fibroids are the most common benign tumors in females and typically found during the middle and later reproductive years. While most fibroids are asymptomatic, they can grow and cause heavy and painful menstruation, painful sexual intercourse, and urinary frequency and urgency. Uterine fibroids is the major indication for hysterectomy in the US.[2] Fibroids are often multiple and if the uterus contains too many leiomyomatas to count, it is referred to as uterine leiomyomatosis. The malignant version of a fibroid is uncommon and termed a leiomyosarcoma.
A hematoma is a collection of blood outside of a blood vessel. There are several types of hematomas and they are often described based on their location. Examples of hematomas include subdural, spinal, under the finger or toenail bed (subungual), ear, and liver (hepatic). Some causes of hematomas are as pelvic bone fractures, fingernail injuries (subungual), bumps, passing blood clots, blood clot in the leg (DVT), blood cancers, and excessive alcohol use. Symptoms of hematomas depend upon their location and whether adjacent structures are affected by the inflammation and swelling associated with the bleeding and may include