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A doctor explains the purpose of dialysis and explains the difference between hemodialysis and peritoneal dialysis. Learn more at https://www.niddk.nih.gov/heal....th-information/kidne

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Symptoms of serotonin syndrome include a classic triad of mental status changes (eg, anxiety, delirium, confusion, restlessness), autonomic dysregulation (eg, diaphoresis, tachycardia, hypertension, hyperthermia, diarrhea, mydriasis), and neuromuscular hyperactivity (eg, hyperreflexia, tremor, rigidity, myoclonus, ocular clonus). Serotonin syndrome is clinically diagnosed and laboratory tests are used to rule out other etiologies. It usually occurs due to inadvertent interactions between drugs, therapeutic use of multiple serotonergic agents, or serotonergic medication overdose. Treatment involves discontinuation of serotonergic drugs, supportive measures, and sedation with benzodiazepines. In severe cases, a serotonin antagonist (cyproheptadine) may be used.

The objectives of hemodialysis are to extract toxic nitrogenous substances from the blood and to remove excess water. In hemodialysis, the blood, laden with toxins and nitrogenous wastes, is diverted from the patient to a machine, a dialyzer, in which the blood is cleansed and then returned to the patient. Diffusion, osmosis, and ultrafiltration are the principles on which hemodialysis is based.

The toxins and wastes in the blood are removed by diffusion—that is, they move from an area of higher concentration in the blood to an area of lower concentration in the dialysate. The dialysate is a solution made up of all the important electrolytes in their ideal extracellular concentrations.

The electrolyte level in the patient’s blood can be brought
under control by properly adjusting the dialysate bath. The semipermeable membrane impedes the diffusion of large molecules,
such as red blood cells and proteins.

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Compartment syndrome can develop in the foot following crush injury or closed fracture. Following some critical threshold of bleeding and/or swelling into the fixed space compartments, arterial pulse pressure is insufficient to overcome the osmotic tissue pressure gradient, leading to cell death. The complicating factor is related to the magnitude of the force of the crush injury. The amount of swelling or bleeding has to be sufficient to impair arterial inflow, while not being of sufficient magnitude to produce an open injury, which decompresses the pressure within the affected compartments. When the injury is open, we then attribute the late disability primarily to the crushing injury to the involved muscles.

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A deep cut on the palm side of your fingers, hand, wrist, or forearm can damage your flexor tendons, which are the tissues that help control movement in your hand. A flexor tendon injury can make it impossible to bend your fingers or thumb.

The "great arteries" in this anomaly refer to the aorta and the pulmonary artery, the two major arteries carrying blood away from the heart. In cases of transposition of the great arteries, these vessels arise from the wrong ventricle. They are "transposed" from their normal position so that the aorta arises from the right ventricle and the pulmonary artery from the left ventricle. Other heart defects may occur along with transposition of the great arteries. About 25 percent of children with transposition will also have a ventricular septal defect (VSD) . In nearly a third, the branching pattern of the coronary arteries as they leave the transposed aorta is unusual. Infants may also have narrowing below the pulmonary valve that blocks blood flow from the left ventricle to the lungs.

Jaw surgery, also known as orthognathic (or-thog-NATH-ik) surgery, corrects irregularities of the jaw bones and realigns the jaws and teeth to improve the way they work. Making these corrections may also improve your facial appearance. Jaw surgery may be a corrective option if you have jaw problems that can't be resolved with orthodontics alone. In most cases, you also have braces on your teeth before surgery and during recovery after surgery until healing and alignment are complete. Your orthodontist can work with your oral and jaw and face (maxillofacial) surgeon to determine your treatment plan.

Is that knee pain just a sprain or a more serious ACL injury? Orthopedic surgeon Paul Fadale, M.D., offers tips on how to tell the difference. http://www.orthopedicsri.org/

Alcohol septal ablation (ASA, TASH, Sigwart procedure) is a percutaneous, minimally-invasive treatment performed by an interventional cardiologist to relieve symptoms and improve functional status in severely symptomatic patients with hypertrophic cardiomyopathy (HCM) who meet strict clinical, anatomic and physiologic ...

Lipid-Lowering Agents HMG-CoA reductase inhibitors (statins) These agents inhibit the rate-limiting step in cholesterol biosynthesis by competitively inhibiting HMG-CoA reductase. Note the following: Low-density lipoprotein (LDL) reduction of 25%-60% Examples include Atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin Contraindications include hypersensitivity, active liver disease, pregnancy, lactation, coadministration with strong CYP3A4 inhibitors (selected statins) Vitamin B3 Vitamin B3 inhibits very-low-density lipoprotein (VLDL) synthesis. Note the following: LDL reduction of 10% High-density lipoprotein (HDL) increase of 20% Example includes Niacin (nicotinic acid) Contraindications include hypersensitivity, liver disease, active peptic ulcer, severe hypotension, arterial bleeding Fibrates Fibrates enhance lipoprotein lipase, resulting in increased VLDL catabolism, fatty acid oxidation, and triglycerides elimination. They decrease hepatic extraction of free fatty acids. Note the following: LDL reduction of 15% Triglyceride reduction of 35% Examples include Gemfibrozil, fenofibrate, fenofibrate (micronized), fenofibric acid Contraindications include active liver disease, renal disease, primary biliary cirrhosis, gallbladder disease 2-Azetidiones These agents inhibit sterol transporter at brush border and, consequently, intestinal absorption of cholesterol. LDL reduction of 15% Example includes Ezetimibe Contraindications include hypersensitivity, coadministration with statins (if active liver disease) Bile acid sequestrants These agents lower cholesterol and LDL via bile duct sequestration. Note the following: LDL reduction of 15% Examples include Cholestyramine, colesevelam, colestipol Contraindications include biliary/bowel obstruction, serum triglycerides >300-500 mg/dL, history of hypertriglyceridemia-induced pancreatitis