What's helping me become a better doctor

Flexor compartment synovectomy in a patient with rheumatoid arthritis presenting with loss of finger movement and local pain due to synovitis. Performed at the Queen Victoria Hospital, East Grinstead.

Preventing heart attacks and stroke can involve extensive surgery to remove plaque from your arteries, but as FOX17's Nick Paranjape shows us, there's a new procedure in Middle Tennessee that is less invasive and substantially cuts down on your recovery time. At 76, Jimmy Wilkie of Hendersonville exercises on his treadmill 3-4 times a week. Recently, he started having pain in his left leg. It was so bad, he couldn't even walk. Turned out, Mr. Wilkie had a blocked artery in his leg. In years past, this would've required major bypass surgery. Not anymore!"The Turbohawk Catheter has really opened a new door for us," says Dr. Dan Wunder.Dr. Wunder, an Interventional Radiologist at Premier Radiology in Madison, is talking about the Turbohawk. It's a device which is inserted into the blocked artery, and inside the Turbohawk are 4 tiny blades."It can cut the plaque and with that shape of the disc it cuts with it pushes it forward into the catheter," says Dr. Wunder.The one-hour procedure doesn't just push the plaque to the sides where it can re-grow, but instead grabs it and removes it!"We pull it back out and it fills up," says Dr. Wunder. "Empty it out, go back down and we can cut some more out."Before and after images really say it all."They used a roto rooter as he called it," says Wilkie.A roto rooter, Turbohawk, call it what you want, but Wilkie says all he knows is the procedure worked right away!"There wasn't any pain at all in my leg," says Wilkie.It's rare, but the outpatient procedure can have complications like plaque getting pushed down in the leg. Dr. Wunder says the main symptoms of a blockage in your legs is having severe pain or cramping when you're walking or exercising.

University Hospitals Neurological Institute will host a live webcast to demonstrate the removal of a brain tumor that doctors believe is causing epileptic seizures in a middle-aged man.

An MRI showed what appears to be a glioma (tumor) near a part of the brain that controls muscle movement, called the motor strip. Studies have shown that complete removal can cure the seizures and improve quality of life and survival, but this is difficult to do with conventional technology without harming the surrounding normal brain because it's difficult to determine where tumor ends and normal brain begins.

Calcified Brain Abscess complete removal

This procedure describes one of the most versatile approaches to the anterior skull base for large tumors of the sinonasal cavity. It may be used with or without a craniofacial resection. The benefits of this approach are: wide access around the tumor; good postoperative cosmesis; & decreased operative & postoperative morbidity. We have used this approach for many bilateral tumors of the nasal & sinus cavities that approach &/or invade the skull base & brain. This video show the resection of a large esthesioneuroblastoma.

Лечение гайморита. Заполнение ОНП во время ЯМИК процедуры 4 (1)

The goal of breast cancer surgery is to remove the entire tumor from the breast. Some of the lymph nodes in the underarm area (axillary nodes) may also be removed to see if cancer cells are present.

Unbelievable Bladder Stone Removal

Bartter syndrome has traditionally been classified into three main clinical variants, as follows: Neonatal (or antenatal) Bartter syndrome Classic Bartter syndrome Gitelman syndrome Advances in molecular diagnostics have revealed that Bartter syndrome results from mutations in numerous genes that affect the function of ion channels and transporters that normally mediate transepithelial salt reabsorption in the distal nephron segments. Hundreds of mutations have been identified to date. Such advances may result in the development of new therapies (see the image below). [2] (See Pathophysiology and Etiology.)

The pathobiology of MM is complex and the root underlying cause of myeloma is the multistep genetic changes in the postgerminal center B cell. In addition, the bone marrow microenvironment plays a crucial role.[2] The interaction between myeloma cells and the microenvironment is mediated through adhesive interactions via cell-surface receptors, paracrine loops involving several cytokines, such as IL-6, VEGF and IL-10, and suppression of cell-mediated immunity.[2–4] IMiDs modulate many of these interactions leading to decreased myeloma cell growth and survival. Thalidomide was the first IMiD introduced to treat MM. It was initially synthesized in Germany in the late 1950s to treat insomnia and morning sickness. It was withdrawn from the market in 1961 because of its teratogenic effects. Its immunomodulatory properties were realized when it was observed to improve erythema nodosum leprosum, a painful immunologic reaction of leprosy, leading to its approval by the FDA in 1998 with tight prescribing and marketing regulations. Subsequent research showed the diverse mechanism of action of thalidomide including its immunomodulatory effect by inhibition of de novo IgM antibody synthesis,[5] modulation of the T-cell subset by increasing the T-helper cells, inhibitory effects on the TNF-α and antiangiogenic activity leading to its use in MM. Significantly higher response rates in combination with dexamethasone led to its approval in the treatment of newly diagnosed MM in 2006. Lenalidomide, a second-generation IMiD, was developed from the structural backbone of the thalidomide molecule by the addition of an amino group (NH2-) at position 4 of the phthaloyl ring and removal of the carbonyl group (C = O) of the 4-amino-substituted phthaloyl ring (Table 1).[6] In addition to immunomodulatory effects, other mechanisms of action have been described such as direct cytotoxicity via induction of apoptosis, inhibition of cell adhesion molecules and inhibition of growth signals that promote bone marrow angiogenesis

Thyroid Exam Physical Exam

Acupuncture Weight Loss

This medication is used in emergencies to treat very serious allergic reactions to insect stings/bites, foods, drugs, or other substances. Epinephrine acts quickly to improve breathing, stimulate the heart, raise a dropping blood pressure, reverse hives, and reduce swelling of the face, lips, and throat.

AZT Mechanism of Antiviral Activity

Anatomy of The Shoulder and Arm Muscles

One man is speaking out about the potential risks of laser eye surgery, after he says the procedure left his vision permanently impaired.

Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis.

A simple test of fingernail clippings could replace a blood draw as a way to diagnose and monitor type 2 diabetes mellitus (T2DM), with huge implications for tracking the disease in the developing world. Research on this method by a team of Belgian researchers was reported July 28, 2015, at the 2015 American Association for Clinical Chemistry (AACC) Annual Meeting and Clinical Lab Expo in Atlanta. The team, led by Joris R. Delanghe, MD, PhD, of the Department of Global Chemistry, Microbiology and Immunology at Ghent University, collected nail clippings from 25 people with T2DM and 25 without the disease. The clippings were ground into a powder and tested with an inexpensive FT-IR photometer to measure how much the protein in the nails had bonded with sugar molecules, a process known as glycation. “We found a striking difference in the measurements between the control group and the patients with diabetes,” Delanghe said. In an interview with Evidence-Based Diabetes Management, he said replacing the standard blood test to measure glycated hemoglobin is a huge advantage. In many cultures, he said, “Taking blood is something that cannot be tolerated.” - See more at: http://www.ajmc.com/journals/evidence-based-diabetes-management/2015/september-2015/fingernail-tests-may-offer-cheap-simple-way-to-diagnose-diabetes#sthash.XQxnBcNO.dpuf

Insert the needle into the rubber stopper of the insulin bottle. Push the plunger down to inject air into the bottle (this allows the insulin to be drawn more easily). Leave the needle in the bottle. Turn the bottle and syringe upside-down.