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Hemophagocytic lymphohistiocytosis is a rare but life threatening condition characterised by activation of macrophages which result in phagocytosis of RBCs and cytokine mediated tissue damage. This presentation aims to discuss the genetic basis, clinical features, diagnostic criteria and management options in this serious condition. The management options in HLH include Etoposide, Dexamethasone, Cyclosorine, Tacrolimus, Alemtuzumab and stem cell transplant.
You may have heard that some positions, such as your partner on top (missionary position), are better than others for getting pregnant. In fact, there's no evidence to back these theories up. Experts just haven't done the research yet. What experts have done, though, is use scanning to show what's going on inside when you're doing the deed. The research looked at two positions: the missionary position and doggy style. (Doggy style being when you're on all fours, and your partner enters you from behind). Common sense tells us that these positions allow for deep penetration. This means that they're more likely to place sperm right next to your cervix (the opening of your uterus). The scans confirm that the tip of the penis reaches the areas between the cervix and vaginal walls in both of these positions. The missionary position allows the penis to reach the area at the front of the cervix. The rear entry position reaches the area at back of the cervix. It's amazing what some experts spend their time doing, isn't it! Other positions, such as standing up, or woman on top, may be just as good for getting sperm right next to the cervix. We just don't know yet. http://www.babycentre.co.uk/sex-for-getting-pregnant#ixzz4XKnPLbxL
Interventional Nephrology is a new and emerging subspecialty of Nephrology that mainly deals with ultrasonography of kidneys and ultrasound-guided renal biopsy, insertion of peritoneal dialysis catheters, tunneled dialysis catheters as a vascular access for patients undergoing hemodialysis as well as percutaneous ...
Indications for intervention in patients with a renal artery aneurysm (RAA) include the following [20, 8, 13, 14] : Rupture Symptomatic RAA - Hypertension (from associated renal artery stenosis, refractory to medical management), pain, renal ischemia or infarction secondary to embolization from the aneurysm sac RAAs in females who are pregnant or are contemplating pregnancy Diameter greater than 2 cm Enlarging RAA RAA associated with acute dissection Currently, there is no consensus regarding the size at which an RAA should be repaired in an asymptomatic patient. Experts have recommended RAA repair at diameters ranging from 1.5 to 3 cm, [8] though most suggest 2 cm. Some reports have even suggest that larger asymptomatic saccular aneurysms may be managed expectantly. Note that aneurysm rupture at a diameter of 1.5 cm has been reported. Complete calcification of the wall of the aneurysm sac manifests in about 40% of patients. This was once believed to confer protection against rupture [21] ; however, this belief has since been questioned. [30] Asymptomatic, small (<2 cm in diameter) RAAs do not usually require treatment. One notable exception is an RAA in a woman who is pregnant or contemplating pregnancy. In view of the increased risk of rupture in such cases, even small asymptomatic aneurysms should be repaired in this population. For diagnosis and preinterventional planning, gadolinium-enhanced magnetic resonance angiography (MRA) and computed tomography (CT) angiography (CTA) with three-dimensional (3D) reconstruction have essentially replaced conventional arteriography. Regular follow-up examination with ultrasonography (US) or CT) is recommended in patients who are treated expectantly. Spontaneous cure by thrombosis of small aneurysms has been described. Further refinements in endovascular techniques may allow more RAAs to be treated in this manner. So far, excellent short- and intermediate-term results have been described in the literature [40] ; however, there remains a need for further long-term outcome data.
Scleroderma (skleer-oh-DUR-muh) is a group of rare diseases that involve the hardening and tightening of the skin and connective tissues — the fibers that provide the framework and support for your body. In some people, scleroderma affects only the skin. But in many people, scleroderma also harms structures beyond the skin — such as blood vessels, internal organs and the digestive tract. Signs and symptoms vary, depending on which structures are affected. Scleroderma affects women more often than men and most commonly occurs between the ages of 30 and 50. While there is no cure for scleroderma, a variety of treatments can ease symptoms and improve quality of life.
Dumping syndrome is a condition that can develop after surgery to remove all or part of your stomach or after surgery to bypass your stomach to help you lose weight. Also called rapid gastric emptying, dumping syndrome occurs when food, especially sugar, moves from your stomach into your small bowel too quickly.Diet: Eating too much sugar can cause sugars to pass into the colon, making the bacteria there get all excited and cause diarrhea. Other things like sorbitol, a sweetener in some sugarless candy, can also cause diarrhea through osmosis. Malabsorption: Some people don't digest sugars or fats properly.