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Shamika Burrage survived a near-fatal car accident two years ago, but not without losing something pretty important: her left ear. Now, thanks to a novel procedure performed at an Army medical center in Texas, Burrage is getting that ear back in a most unusual way. Plastic surgeons harvested cartilage from Burrage's ribs to create a new ear and then grew it under the skin of her forearm. Then the doctors at William Beaumont Army Medical Center in El Paso successfully transplanted the ear from her arm to her head. The technique -- a first time in the Army -- is called prelaminated forearm free flap, said Lt. Col. Owen Johnson III, chief of plastic and reconstructive surgery at William Beaumont Army Medical Center. Some of the big advantages of it is that it reduced the chance of more scarring around Burrage's ear. Also, growing the ear under the skin of her forearm allows new blood vessels to form. "(The ear) will have fresh arteries, fresh veins and even a fresh nerve so she'll be able to feel it," Johnson said on the US Army's website. Burrage, a 21-year-old private, still has to endure two more surgeries, but she's feeling more optimistic about the future than ever in the years since her accident. "It's been a long process for everything, but I'm back," said Burrage.
At each level of the spine, there is a disc space in the front and paired facet joints in the back. Working together, these structures define a motion segment (Fig. 1A). Back pain may result when injury or degenerative changes allow abnormal movement of the vertebrae to rub against one another, known as an unstable motion segment (Fig. 1B). Two vertebrae need to be fused to stop the motion at one segment. For example, an L4-L5 fusion is a one-level spinal fusion (Fig. 1C). A two-level fusion joins three vertebrae together and so on.
Beta-blockers, also known as beta antagonists, beta-adrenergic blocking agents, or beta-adrenergic antagonists, are drugs that are prescribed to treat several different types of conditions, including hypertension (high blood pressure), angina, some abnormal heart rhythms, heart attack (myocardial infarction), anxiety, migraine, glaucoma, and overactive thyroid symptoms.
The vulvar vaginal diseases service sees referrals to help women with short--and long--term problems of the outer genital area (vulva), vagina and pelvic floor muscles including: Vulvar vaginal burning, itching, irritation and pain Vulvar Vestibulitis Pain with intercourse Discharge Yeast infections Bacterial vaginosis Pelvic floor muscle dysfunction A patient must be referred by her local health care provider. Services include: Skin care education Examinations-Your healthcare provider will examine you and talk with you about recommendations for treatment and/or management of your symptoms. Some vulvar diseases require a biopsy to diagnose the condition. Referrals-Your healthcare team may refer you to other specialists, including physical therapists or health psychologists. Separate insurance authorization is necessary for these services. The clinic staff provides general education and support to help women cope with these very personal health problems. Following a clinic visit, a letter is promptly sent to your local health care provider. The letter provides the results of your exam and the plan of care.
Neurogenic shock is a distributive type of shock resulting in low blood pressure, occasionally with a slowed heart rate, that is attributed to the disruption of the autonomic pathways within the spinal cord. It can occur after damage to the central nervous system such as spinal cord injury.
Bacterial abscess of the liver is relatively rare; however, it has been described since the time of Hippocrates (400 BCE), with the first published review by Bright appearing in 1936. In 1938, Ochsner's classic review heralded surgical drainage as the definitive therapy; however, despite the more aggressive approach to treatment, the mortality remained at 60-80%.[1] The development of new radiologic techniques, the improvement in microbiologic identification, and the advancement of drainage techniques, as well as improved supportive care, have reduced mortality to 5-30%; yet, the prevalence of liver abscess has remained relatively unchanged. Untreated, this infection remains uniformly fatal. The three major forms of liver abscess, classified by etiology, are as follows: Pyogenic abscess, which is most often polymicrobial, accounts for 80% of hepatic abscess cases in the United States Amebic abscess due to Entamoeba histolytica accounts for 10% of cases [2] Fungal abscess, most often due to Candida species, accounts for fewer than 10% of cases
Sacrococcygeal teratoma (SCT) is an unusual tumor that, in the newborn, is located at the base of the tailbone (coccyx). This birth defect is more common in female than in male babies. Although the tumors can grow very large, they are usually not malignant (that is, cancerous).
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✍️Dr. Matthew Harb talks about knee replacement surgery
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Dr. Matthew Harb specializes in minimally invasive, muscle sparing, hip and knee replacement surgery. Minimally invasive surgery allows patients to recover faster and have less pain post operatively. Implants are tailored and custom fit to each patient to allow for improved performance. Dr. Harb’s expertise in rapid recovery protocols allow for quick recovery after surgery and excellent outcomes in patients with hip and knee arthritis. With minimally invasive, muscle sparing surgery patients can return to their lifestyles and get back to doing the things they love sooner. Dr. Harb performs outpatient joint replacement surgery with many of his patients walking independently and going home the day of surgery.
“My focus is excellence in patient care, expedited recovery after surgery, and getting people back to the normal activities they love. Our team focused approach is committed to superb outcomes, improving lives, and returning patients to living pain free.”
Diagnosis To determine the most appropriate treatment for your stroke, your emergency team needs to evaluate the type of stroke you're having and the areas of your brain affected by the stroke. They also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction. Your doctor may use several tests to determine your risk of stroke, including: Stroke consultation Stroke consultation Stroke consultation at Mayo Clinic Brain tissue damaged by stroke CT scan of brain tissue damaged by stroke Cerebral angiogram Cerebral angiogram Physical examination. Your doctor will ask you or a family member what symptoms you've been having, when they started and what you were doing when they began. Your doctor then will evaluate whether these symptoms are still present. Your doctor will want to know what medications you take and whether you have experienced any head injuries. You'll be asked about your personal and family history of heart disease, transient ischemic attack and stroke. Your doctor will check your blood pressure and use a stethoscope to listen to your heart and to listen for a whooshing sound (bruit) over your neck (carotid) arteries, which may indicate atherosclerosis. Your doctor may also use an ophthalmoscope to check for signs of tiny cholesterol crystals or clots in the blood vessels at the back of your eyes. Blood tests. You may have several blood tests, which tell your care team how fast your blood clots, whether your blood sugar is abnormally high or low, whether critical blood chemicals are out of balance, or whether you may have an infection. Managing your blood's clotting time and levels of sugar and other key chemicals will be part of your stroke care. Computerized tomography (CT) scan. A CT scan uses a series of X-rays to create a detailed image of your brain. A CT scan can show a hemorrhage, tumor, stroke and other conditions. Doctors may inject a dye into your bloodstream to view your blood vessels in your neck and brain in greater detail (computerized tomography angiography). There are different types of CT scans that your doctor may use depending on your situation. Magnetic resonance imaging (MRI). An MRI uses powerful radio waves and magnets to create a detailed view of your brain. An MRI can detect brain tissue damaged by an ischemic stroke and brain hemorrhages. Your doctor may inject a dye into a blood vessel to view the arteries and veins and highlight blood flow (magnetic resonance angiography, or magnetic resonance venography). Carotid ultrasound. In this test, sound waves create detailed images of the inside of the carotid arteries in your neck. This test shows buildup of fatty deposits (plaques) and blood flow in your carotid arteries. Cerebral angiogram. In this test, your doctor inserts a thin, flexible tube (catheter) through a small incision, usually in your groin, and guides it through your major arteries and into your carotid or vertebral artery. Then your doctor injects a dye into your blood vessels to make them visible under X-ray imaging. This procedure gives a detailed view of arteries in your brain and neck. Echocardiogram. An echocardiogram uses sound waves to create detailed images of your heart. An echocardiogram can find a source of clots in your heart that may have traveled from your heart to your brain and caused your stroke. You may have a transesophageal echocardiogram. In this test, your doctor inserts a flexible tube with a small device (transducer) attached into your throat and down into the tube that connects the back of your mouth to your stomach (esophagus). Because your esophagus is directly behind your heart, a transesophageal echocardiogram can create clear, detailed ultrasound images of your heart and any blood clots. Treatment Emergency treatment for stroke depends on whether you're having an ischemic stroke blocking an artery — the most common kind — or a hemorrhagic stroke that involves bleeding into the brain. Ischemic stroke To treat an ischemic stroke, doctors must quickly restore blood flow to your brain. Emergency treatment with medications. Therapy with clot-busting drugs must start within 4.5 hours if they are given into the vein — and the sooner, the better. Quick treatment not only improves your chances of survival but also may reduce complications. You may be given: Intravenous injection of tissue plasminogen activator (tPA). This injection of recombinant tissue plasminogen activator (tPA), also called alteplase, is considered the gold standard treatment for ischemic stroke. An injection of tPA is usually given through a vein in the arm. This potent clot-busting drug ideally is given within three hours. In some instances, tPA can be given up to 4.5 hours after stroke symptoms begin. This drug restores blood flow by dissolving the blood clot causing your stroke, and it may help people who have had strokes recover more fully. Your doctor will consider certain risks, such as potential bleeding in the brain, to determine if tPA is appropriate for you. Emergency endovascular procedures. Doctors sometimes treat ischemic strokes with procedures performed directly inside the blocked blood vessel. These procedures must be performed as soon as possible, depending on features of the blood clot: Medications delivered directly to the brain. Doctors may insert a long, thin tube (catheter) through an artery in your groin and thread it to your brain to deliver tPA directly into the area where the stroke is occurring. This is called intra-arterial thrombolysis. The time window for this treatment is somewhat longer than for intravenous tPA, but is still limited. Removing the clot with a stent retriever. Doctors may use a catheter to maneuver a device into the blocked blood vessel in your brain and trap and remove the clot. This procedure is particularly beneficial for people with large clots that can't be completely dissolved with tPA, though this procedure is often performed in combination with intravenous tPA. Several large and recent studies suggest that, depending on the location of the clot and other factors, endovascular therapy might be the most effective treatment. Endovascular therapy has been shown to significantly improve outcomes and reduce long-term disability after ischemic stroke. Other procedures. To decrease your risk of having another stroke or transient ischemic attack, your doctor may recommend a procedure to open up an artery that's narrowed by plaque. Doctors sometimes recommend the following procedures to prevent a stroke. Options will vary depending on your situation: Carotid endarterectomy. In a carotid endarterectomy, a surgeon removes plaques from arteries that run along each side of your neck to your brain (carotid arteries). In this procedure, your surgeon makes an incision along the front of your neck, opens your carotid artery and removes plaque that blocks the carotid artery. Your surgeon then repairs the artery with stitches or a patch made from a vein or artificial material (graft). The procedure may reduce your risk of ischemic stroke. However, a carotid endarterectomy also involves risks, especially for people with heart disease or other medical conditions. Angioplasty and stents. In an angioplasty, a surgeon usually accesses your carotid arteries through an artery in your groin. Here, your surgeon can gently and safely navigate to the carotid arteries in your neck. A balloon is then inflated to expand the narrowed artery. Then a stent can be inserted to support the opened artery. Hemorrhagic stroke Emergency treatment of hemorrhagic stroke focuses on controlling your bleeding and reducing pressure in your brain. You might also need surgery to help reduce future risk. Emergency measures. If you take warfarin (Coumadin, Jantoven) or anti-platelet drugs such as clopidogrel (Plavix) to prevent blood clots, you may be given drugs or transfusions of blood products to counteract the blood thinners' effects. You may also be given drugs to lower pressure in your brain (intracranial pressure), lower your blood pressure, prevent vasospasm or prevent seizures. Once the bleeding in your brain stops, treatment usually involves supportive medical care while your body absorbs the blood. Healing is similar to what happens while a bad bruise goes away. If the area of bleeding is large, your doctor may perform surgery to remove the blood and relieve pressure on your brain. Surgical blood vessel repair. Surgery may be used to repair blood vessel abnormalities associated with hemorrhagic strokes. Your doctor may recommend one of these procedures after a stroke or if an aneurysm or arteriovenous malformation (AVM) or other type of vascular malformation caused your hemorrhagic stroke: Surgical clipping. A surgeon places a tiny clamp at the base of the aneurysm, to stop blood flow to it. This clamp can keep the aneurysm from bursting, or it can prevent re-bleeding of an aneurysm that has recently hemorrhaged. Coiling (endovascular embolization). A surgeon inserts a catheter into an artery in your groin and guides it to your brain using X-ray imaging. Tiny detachable coils are guided into the aneurysm (aneurysm coiling). The coils fill the aneurysm, which blocks blood flow into the aneurysm and causes the blood to clot. Surgical AVM removal. Surgeons may remove a smaller AVM if it's located in an accessible area of your brain, to eliminate the risk of rupture and lower the risk of hemorrhagic stroke. However, it's not always possible to remove an AVM if its removal would cause too large a reduction in brain function, or if it's large or located deep within your brain. Stereotactic radiosurgery. Using multiple beams of highly focused radiation, stereotactic radiosurgery is an advanced minimally invasive treatment used to repair vascular malformations. Stroke recovery and rehabilitation Brain hemisphere connections Brain hemisphere connections After emergency treatment, stroke care focuses on helping you recover as much function as possible and return to independent living. The impact of your stroke depends on the area of the brain involved and the amount of tissue damaged. If your stroke affected the right side of your brain, your movement and sensation on the left side of your body may be affected. If your stroke damaged the brain tissue on the left side of your brain, your movement and sensation on the right side of your body may be affected. Brain damage to the left side of your brain may cause speech and language disorders. In addition, if you've had a stroke, you may have problems with breathing, swallowing, balancing and vision. Most stroke survivors receive treatment in a rehabilitation program. Your doctor will recommend the most rigorous therapy program you can handle based on your age, overall health and degree of disability from your stroke. Your doctor will take into consideration your lifestyle, interests and priorities, and the availability of family members or other caregivers. Your rehabilitation program may begin before you leave the hospital. After discharge, you might continue your program in a rehabilitation unit of the same hospital, another rehabilitation unit or skilled nursing facility, an outpatient unit, or your home. Every person's stroke recovery is different. Depending on your condition, your treatment team may include: Doctor trained in brain conditions (neurologist) Rehabilitation doctor (physiatrist) Nurse Dietitian Physical therapist Occupational therapist Recreational therapist Speech pathologist Social worker Case manager Psychologist or psychiatrist Chaplain Speech therapy session Speech therapy is often a part of stroke rehabilitation. Treatment outcomes One way to evaluate the care of patients diagnosed with stroke is to look at the percentage of patients receiving the timely and effective care measures that are appropriate. The goal is 100 percent. The graphs below display the percentage of eligible Mayo Clinic patients diagnosed with stroke receiving all of the appropriate care measures.
Sciatica is often characterized by one or more of the following symptoms: Constant pain in only one side of the buttock or leg (rarely in both legs) Pain that is worse when sitting Leg pain that is often described as burning, tingling, or searing (versus a dull ache) Weakness, numbness, or difficulty moving the leg, foot, and/or toes A sharp pain that may make it difficult to stand up or walk Pain that radiates down the leg and possibly into the foot and toes (it rarely occurs only in the foot) Sciatica Causes and Treatments Video Watch: Sciatica Causes and Treatments Video Sciatic pain can vary from infrequent and irritating to constant and incapacitating. Symptoms are usually based on the location of the pinched nerve. While symptoms can be painful and potentially debilitating, it is rare that permanent sciatic nerve damage (tissue damage) will result, and spinal cord involvement is possible but rare.
Overweight does not necessarily equal unhealthy. There are actually plenty of overweight people who are in excellent health (1). Conversely, many normal weight people have the metabolic problems associated with obesity (2). That’s because the fat under the skin is actually not that big of a problem (at least not from a health standpoint, it’s more of a cosmetic problem). It’s the fat in the abdominal cavity, the belly fat, that causes the biggest issues (3). If you have a lot of excess fat around your waistline, even if you’re not very heavy, then you should take some steps to get rid of it. Belly fat is usually estimated by measuring the circumference around your waist. This can easily be done at home with a simple tape measure. Anything above 40 inches (102 cm) in men and 35 inches (88 cm) in women, is known as abdominal obesity. There are actually a few proven strategies that have been shown to target the fat in the belly area more than other areas of the body.
Autoimmune hepatitis is liver inflammation that occurs when your body's immune system turns against liver cells. The exact cause of autoimmune hepatitis is unclear, but genetic and environmental factors appear to interact over time in triggering the disease. Untreated autoimmune hepatitis can lead to scarring of the liver (cirrhosis) and eventually to liver failure. When diagnosed and treated early, however, autoimmune hepatitis often can be controlled with drugs that suppress the immune system. A liver transplant may be an option when autoimmune hepatitis doesn't respond to drug treatments or when liver disease is advanced.
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This video “Epithelium” is part of the Lecturio course “Histology” ► WATCH the complete course on http://lectur.io/epithelium
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- Introduction: Epithelial Tissue
- Summary of structure and function
- Epithelium
- Three characteristics of any Epithelium
- Epithelium: Classification
- Epithelium: Epithelial Cells Exhibit Polarity
- Epithelium: How Are Epithelial Cells Joined Together?
- Epithelium: Surfaces of Epithelial Cells
- Epithelium: Basement Membrane
► THE PROF: Your lecturer is Professor Geoff Meyer. He is currently teaching at the School of Anatomy, Physiology and Human Biology at the University of Western Australia (UWA). As a leading anatomy and histology expert he is also coordinating the Federative International Program for Anatomical Terminologies (FIPAT) of the International Federation of Associations of Anatomists (IFAA). Besides medical research on the ovarian function, steroidogenesis, corpus luteum, angiogenesis, and microcirculation, Geoff Meyer’s research activities also focus on developing innovative, computer-aided learning and teaching tools. For his inventiveness, Geoff Meyer has received a number of awards, including the Australian University Teaching Award.
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