This is the CT of a 43 year old male patiënt with infected necrotizing pancreatitis that will undergo a VARD procedure; Videoscopic Assisted Retroperitoneal Debridment. Two weeks before this procedure two large bore percutaneous drains were placed in the peripancreatic collection. The patient i...s placed in supine position with the left side 30 degrees elevated. A 5-7 cm subcostal incision is made in the left flank. With help of CT images and by following the percutaneous drain, the subcutaneous tissue and the fascia are dissected and we enter the retroperitoneal peripancreatic collection. First, with a regular suction device any pus encountered is removed. Two long sympathectomy hooks are inserted in order to keep in the incision open. We than insert the zero degree laparoscope. The first necrosis encountered is removed under direct sight with the use of long grasping forceps. Following the percutaneous drain deeper into the cavity, parts of loosely adherent necrotic material are removed. Gently pulling we remove the necrotic tissue. The suction device is helpful in removing any fluid obstructing the view. Complete necrosectomy is not the ultimate aim of this procedure. Only loosely adherent pieces of necrosis are removed thereby keeping the risk of tearing underlying blood vessels to a minimum. In the rare case of extensive bleeding, the retroperitoneal cavity can be easily packed, either awaiting the bleeding to definitely stop or to act as a bridge to angiographic coiling. This patient is now 6 weeks after onset of disease. We always try to postpone surgical intervention, if possible up to 30 days. On the left side of the collection is the percutaneous drain. In this patient the drain had worked well for 2 weeks. When the patient deteriorated again it was decided to perform the VARD procedure. Large pieces of necrotic pancreas can be removed with VARD. This is a big advantage ov VARD over pure endosopic or percutaneous techniques. When all the necrotic tissue is removed we clean the cavity. Two drains are left in situ as a postoperative lavage system. The VARD procedure is performed via a 6 cm incision, which is closed and continuous postoperative lavage started immediately.

An U/S showing first trimesteric scan

Breast Implant Surgery - exchanging the breast implants. In this video you can see a Plastic Surgeon performing an exchange of breast implant surgery.As breast implants become more popular more breast implant exchange procedures are being performed. This video shows breast implant removal followed by insertion of a larger breast implant.

New device claims to stimulate brain for depression treatment

This tutorial explains the difference in mechanisms between the 2 palsies. Bulbar palsy is a lower motor neuron condition and pseudobulbar palsy is an upper motor neuron condidtion.

laparoscopic management of ovarian cyst

Iron is a mineral that plays a vital role in health and well-being. Without it, many bodily functions would malfunction. “The primary role of iron is to carry oxygen in the blood to every cell in the body,” says Beth Thayer, RDN, MS, director of the Center for Health Promotion and Disease Prevention at Henry Ford Health System in Detroit. Iron is an important component of hemoglobin, the protein in red blood cells that carries oxygen from the lungs and transports it throughout the body.

Plantar warts are hard, grainy growths that usually appear on the heels or balls of your feet, areas that feel the most pressure. This pressure also may cause plantar warts to grow inward beneath a hard, thick layer of skin (callus). Plantar warts are caused by the human papillomavirus (HPV). The virus enters your body through tiny cuts, breaks or other weak spots on the bottom of your feet. Most plantar warts aren't a serious health concern and may not require treatment. But plantar warts can cause discomfort or pain. If self-care treatments for plantar warts don't work, you may want to see your doctor to have them removed.

Folic acid, which is also called folate, is a B vitamin. The best food sources of folic acid are fortified cereals. Folic acid plays an important role in the production of red blood cells and helps your baby's neural tube develop into her brain and spinal cord.

The voice box, or larynx, has three important functions. It is necessary for breathing, voice and swallowing. The vocal folds have two positions, open (apart) for breathing (picture I) and closed (together) for making sound, coughing and sealing off the lungs when swallowing (picture II). When one of the vocal folds are paralyzed, it usually rests in an in-between position (picture III), and neither opens for breathing, nor closes for voicing, coughing, or swallowing. Usually, the effects on the voice are the most dramatic. The voice becomes weak and breathy. People can only say a few words per breath, and are frequently out-of-breath, or physically tired when trying to speak for more than a few minutes straight. The voice may also get somewhat high and squeaky, with a diminished range. Swallowing may be affected as well, where you may notice some choking or coughing with certain liquids. Your cough is frequently different and very weak. This is a serious problem for patients with with vocal fold paralysis because one of the most important functions of the larynx is to keep liquids out of the lungs, and to be able to cough up mucus. When this does not happen, you are at risk for getting an "aspiration" pneumonia. The surgical procedure to restore these important functions is called "medialization laryngoplasty"

Multiple Sclerosis Multiple sclerosis (MS) affects the brain and spinal cord. Early MS symptoms include weakness, tingling, numbness, and blurred vision. Other signs are muscle stiffness, thinking problems, and urinary problems. Treatment can relieve MS symptoms and delay disease progression.

How to increase breast milk supply How to Naturally Boost & Increase your breast milk supply

Histology of Corpus Luteum 2

Chronic obstructive pulmonary disease (COPD) is defined as progressive, chronic airflow obstruction due to chronic bronchitis, emphysema, or both. The majority of patients have components of both, although one of these entities will frequently dominate the clinical picture. Emphysema�airspace enlargement distal to the terminal bronchioles due to destruction of alveolar septa. Chronic bronchitis�chronic airway inflammation and bronchospasm. Clinically defined as productive cough lasting for at least 3 mo over 2 consecutive years. Although COPD is irreversible, patients with acute exacerbations do have reversible bronchospastic and inflammatory components.

Urinary tract infections (UTIs) are infections of the urethra, bladder, ureters, or the kidneys, which comprise the urinary tract. E. coli bacteria cause the majority of UTIs, but many other bacteria, fungi, and parasites may also cause UTIs. Females have a higher risk for UTIs than most males, probably because of their anatomy; other risk factors for UTIs include any condition that may impede urine flow (e.g., enlarged prostate, kidney stones, congenital urinary tract abnormalities, and inflammation). Patients with catheters or those who undergo urinary surgery and men with enlarged prostates are at higher risk for UTIs.

Management of postpartum hemorrhage at vaginal delivery. The approach to treatment of postpartum hemorrhage (PPH) differs somewhat depending on the cause and whether hemorrhage occurs after a vaginal birth or after a cesarean delivery.

After a bad fall, a patient suffering from spinal fusion seeks help from a DMC Neurosurgery specialist.
~ Detroit Medical Center

Perdre Du Ventre, Comment Maigrir Des Cuisses, Regime Soupe, Prendre Du Muscle, Maigrir Des Hanches ---- http://perte-poids-rapide.info-pro.co --- Comment maigrir pour un homme ? Les régimes ne sont pas une exclusivité féminine et les hommes ont eux aussi des comptes à rendre à leur balance. Pour séduire, pour se sentir mieux dans leur corps, pour leur travail, ils ont eux aussi des raisons pour se délester de quelques kilos. Hommes et femmes : différentes face aux kilos Les hommes et les femmes ne réagissent pas de la même manière face au poids. Le corps non plus. La première différence est au niveau de la silhouette. La gente féminine va accumuler les kilos en trop au niveau des fesses et des cuisses alors que pour les hommes, la prise de poids se situe surtout au niveau du visage, du cou et du ventre. L’autre différence entre les hommes et les femmes est la faculté à perdre du poids. Si vous avez décidé de suivre un régime en couple, sachez Mesdames que les hommes maigrissent plus vite ! Cette « injustice » est expliquée par le fait que les hommes ou plutôt leur organisme, va brûler plus de calories au repos et à l’effort que les femmes grâce à leur masse corporelle plus importante. Par contre, ces dames sont plus motivées à tenir un régime sur la longueur. Les hommes et les régimes, c’est toute une histoire ! C’est pourquoi ils doivent faire un régime qui leur corresponde et qui est adapté à leur vie au quotidien ! Maigrir lorsque l’on est un homme Les hommes sont de plus en plus nombreux à vouloir perdre du poids. Surtout entre 40 et 45 ans. Mais même s’ils maigrissent plus vite que les femmes, la partie est loin d’être gagnée. Pourquoi ? Parce qu’il est plus compliqué pour eux de modifier leurs habitudes alimentaires. En effet, ce sont les vrais champions d’une alimentation riche en matières grasses, peu variée et très déséquilibrée. Il faut donc qu’ils adoptent de nouvelles habitudes alimentaires tout en conservant une certaines notion de plaisir et qu’ils combattent certaines mauvaises habitudes, souvent responsable de leurs kilos en trop. "Découvrez comment jean-jacques a réussi à perdre 3,2 kilos et 7 cm de tour de taille en 2 semaines, sans peser les aliments ni compter les calories." Cliquez ici: http://perte-poids-rapide.info-pro.co

Watch that video to know What is Trypophobia? Do You Have it ?