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Pediatric febrile seizures, which represent the most common childhood seizure disorder, exist only in association with an elevated temperature. Evidence suggests, however, that they have little connection with cognitive function, so the prognosis for normal neurologic function is excellent in children with febrile seizures. [1] Epidemiologic studies have led to the division of febrile seizures into 3 groups, as follows: Simple febrile seizures Complex febrile seizures Symptomatic febrile seizures Essential update: Starting MMR/MMRV vaccination earlier may reduce seizure risk In a case-series analysis of a cohort of 323,247 US children born from 2004 to 2008, Hambidge et al found that delaying the first dose of measles-mumps-rubella (MMR) or measles-mumps-rubella-varicella (MMRV) vaccine beyond the age of 15 months may more than double the risk of postvaccination seizures in the second year of life. [2, 3] In infants, there was no association between vaccination timing and postvaccination seizures. [3] In the second year of life, however, the incident rate ratio (IRR) for seizures within 7-10 days was 2.65 (95% confidence interval [CI], 1.99-3.55) after first MMR doses at 12-15 months of age, compared with 6.53 (95% CI, 3.15-13.53) after first MMR doses at 16-23 months. For the MMRV vaccine, the IRR for seizures was 4.95 (95% CI, 3.68-6.66) after first doses at 12-15 months, compared with 9.80 (95% CI, 4.35-22.06) for first doses at 16-23 months.

Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm inside a woman's uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization.

The DASH diet is a lifelong approach to healthy eating that's designed to help treat or prevent high blood pressure (hypertension). The DASH diet encourages you to reduce the sodium in your diet and eat a variety of foods rich in nutrients that help lower blood pressure, such as potassium, calcium and magnesium.

Removal of 5 Releasable sutures from the Eye

1500 mg of sodium amounts to 0.75 teaspoons or 3.75 grams of salt per day, while 2300 mg amounts to one teaspoon or 6 grams of salt per day. Most people today are eating much more than that. The average intake of sodium is about 3400 mg, most of it coming from processed foods.

Occiput or cephalic — the baby's head is down, and the baby is facing the mother's abdomen. This position results in back pain and a prolonged labor. Transverse — the baby is lying crosswise in the uterus, side-to-side over the mother's pelvis, in a horizontal position rather than vertical.

Bone tumors include abnormal healing of an injury, inherited conditions, radiation therapy. It can also be caused by bone cancer or another cancer that has spread to the bone from other parts of the body. A bone tumor may cause a painless mass. Some people have dull, aching pain. And in some cases, minor injury causes a fracture near the tumor. Treatments include surgery and radiation. Some noncancerous tumors go away without treatment

Cerebral palsy refers to brain damage that occurs before a child is five years old. Therefore, adults cannot develop cerebral palsy. However, cerebral palsy does not get better or worse with age, so when a child has the condition, he or she will continue to have the condition into adulthood.

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Loyola Respiratory System Exam Part 1 A video from Loyola Medical School, Chicago showing the medical and clinical examination of the respiratory system.

“Neurosurgery necessitates a very high level of detail involving complex procedures. I’m a very intense person inside the hospital and I feel like neurosurgery matched that level of intensity.”

It’s that intensity that made Dr. Jonathan Pindrik want to become a neurosurgeon. But it’s his certainty and skill inside the operating room that make him one of the best pediatric neurosurgeons in the country.

Dr. Pindrik is a neurosurgeon at Nationwide Children’s Hospital. While he performs multiple complex brain and spinal procedures each week, he also specializes in surgical intervention for children with epilepsy. Dr. Pindrik serves as co-director of the Epilepsy Surgery Program at Nationwide Children’s Epilepsy Center. It’s level-four accreditation means we offer the highest level of epilepsy care including advanced epilepsy surgery.

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Meet our Chief of Neurosurgery: https://bit.ly/2GJSuYm

The exam should be performed in an orderly fashion as follows: 1. Have the patient stick out their tongue so that you can examine the posterior pharynx (i.e. the back of the throat). Ask the patient to say "Ah", which elevates the soft palate, giving you a better view. If you are still unable to see, place the tongue blade � way back on the tongue and press down while the patient again says "Ah," hopefully improving your view. This causes some people to gag, particularly when the blade is pushed onto the more proximal aspects of the tongue. It may occasionally be important to determine whether the gag reflex is functional (e.g. after a stroke that impairs CNs 9 or 10; or to determine if a patient with depressed level of consciousness is able to protect their airway from aspiration). This is done by touching a q-tip against the posterior pharynx, uvula or tongue. It is not necessary to do this during your routine exam as it can be quite noxious!
2. Note that the uvula hangs down from the roof of the mouth, directly in the mid-line. With an "Ah," the uvula rises up. Deviation to one side may be caused by CN 9 palsy (the uvula deviates away from the affected side), a tumor or an infection. CN9 Pasly Cranial Nerve 9 Dysfunction: Patient has suffered stroke, causing loss of function of left CN 9. As a result, uvula is pulled towards the normally functioning (ie right) side. 3. The normal pharynx has a dull red color. In the setting of infection, it can become quite red, frequently covered with a yellow or white exudate (e.g. with Strep. Throat or other types of pharyngitis).
4. The tonsils lie in an alcove created by arches on either side of the mouth. The apex of these arches are located lateral to and on a line with the uvula. Normal tonsils range from barely apparent to quite prominent. When infected, they become red, are frequently covered by whitish/yellow discharge. In the setting of a peritonsilar abscess, the tonsils appear asymmetric and the uvula may be pushed away from the affected side. When this occurs, the tonsil may actually compromise the size of the oral cavity, making breathing quite difficult.
5. Look carefully along the upper and lower gum lines and at the mucosa in general, which can appear quite dry if the patient is dehydrated.
6. Examine the teeth to get a sense of general dentition, particularly if the patient has a dental complaint. Pain produced by tapping on a tooth is commonly caused by a root abscess. Tooth Abscess: Tooth abscess involving left molar region. Associated inflammation of left face can clearly be seen. 7. Have the patient stick their tongue outside their mouth, which allows evaluation of CN 12. If there is nerve impairment, the tongue will deviate towards the affected side. Any obvious growths or abnormalities? Ask them to flip their tongue up so that you can look at the underside. If you see something abnormal, grasp the tongue with gauze so that you can get a better look. Left CN 12 Dysfunction: Stroke has resulted in L CN 12 Palsy. Tongue therefore deviates to the left.
8. Make note of any growths along the cheeks, hard palate (the roof of the mouth between the teeth), soft palate, or anywhere else. In particular, patients who smoke or chew tobacco are at risk for oral squamous cell cancer. Any areas which are painful or appear abnormal should also be palpated. Put on a pair of gloves to better explore these regions. What do they feel like? Are they hard? To what extent does a growth involve deeper structures? If the patient feels something that you cannot see, try to get someone else to hold the light source, freeing both your hands to explore the oral cavity with two tongue depressors.

After the diagnosis of primary melanoma of pectoral region had been established, the patient was referred to lymphoscintigraphy with gamma camera (techencium; nanno colloid). Two hours after the administration of the contrast medium, the operation commenced. During the operation the primary tumor wa...s excised, and the sentinel node was detected with the use of gamma probe and also excised.

Neurosyphilis is an infection of the brain or spinal cord caused by the spirochete Treponema pallidum. It usually occurs in people who have had chronic, untreated syphilis, usually about 10 to 20 years after first infection and develops in about 25%–40% of persons who are not treated. The United States' Centers for Disease Control and Prevention (CDC) advises that neurosyphilis can occur at any stage of a syphilis infection.

Loyola Respiratory System Exam Part 2 A video from Loyola Medical School, Chicago showing the medical and clinical examination of the respiratory system.

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