Cytomegalovirus (CMV) continues to have a tremendous impact in solid organ transplantation despite remarkable advances in its diagnosis, prevention and treatment. It can affect allograft function and increase patient morbidity and mortality through a number of direct and indirect effects. Patients may develop asymptomatic viremia, CMV syndrome or tissue-invasive disease. Late-onset CMV disease continues to be a major problem in high-risk patients after completion of antiviral prophylaxis. Emerging data suggests that immunologic monitoring may be useful in predicting the risk of late onset CMV disease. There is now increasing interest in the development of an effective vaccine for prevention. Novel antiviral drugs with unique mechanisms of action and lesser toxicity are being developed. Viral load quantification is now undergoing standardization, and this will permit the generation of clinically relevant viral thresholds for the management of patients. This article provides a brief overview of the contemporary epidemiology, clinical presentation, diagnosis, prevention and treatment of CMV infection in solid organ transplant recipients.

Face Lift Surgery Proceure

They are the leaders of the pack when it comes to minimally invasive surgeries. Laparoscopic and robotic. Different techniques with the same benefits.

"There's significantly less blood loss, it's a quicker procedure, quicker recovery, less scarring, less chance for post operative wound complications or infections," says Dr. Darren Miter, laparoscopic surgeon with Lee Memorial Health System.

In a laparoscopic procedure surgeons operate through a series of poke holes, manually inserting thin cutting tools and a camera to provide magnified vision. It's used in a variety of surgical specialties.

"The vast majority of gallbladder surgeries are performed laparoscopically. A single incision in the belly button, one up under the breastbone and either one or two in the right upper side of the belly. Using long skinny instruments and looking up at a TV monitor, remove the gallbladder that way," says Dr. Miter.

While laparoscopic is a hands-on approach, robotic procedures are surgeon-controlled. Working at a console, surgeons direct the robotic arms, which have super-human capabilities and 3D, hi def vision.

"I mean you have to see it to believe it, that's a great tool to have. You got a very good depth perception. Plus the other thing when you're working with your hands it's more intuitive," says Dr. Nagesh Ravipati, colorectal surgeon with Lee Memorial Health System.

The robotic system performs maneuvers the human hand can't.

"Especially if you have to do any suturing, it is so much simpler with the robots because you can just turn around 360 degrees," says Dr. Ravipati.

Robotic surgery is gaining momentum in precise procedures, including the field of cancer.

"The robot is good when you're going to operate on just one field. For rectal surgery you're in one place, it's docked. It gives you the best 3 dimensional vision," says Dr. Ravipati.

Robotic and laparoscopic. Both cutting edge options, with less cutting.

View More Health Matters video segments at leememorial.org/healthmatters/

Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we've been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries.

Visit leememorial.org

Things nurses should know about their patients. As a new nurse, it can be hard trying to determine what information you need to know during your shift. In addition, nurses can get extremely busy and strapped for time, so how do you keep up with all of the things you need to know?

🟣Nursing Resume Templates and Job Guide🟣
eBook: https://registerednursern.creator-spring.com/
Paperback: https://amzn.to/3QvzH3W (affiliate ad)

Free Report Sheet Templates: https://www.registerednursern.....com/nursing-report-s

In this video, Nurse Sarah explains some of the most important things nurses need to know about their patients. However, these things can vary depending on your specialty and patient population. These tips are designed to help new nurses begin to think like a nurse.

Some examples of thing nurses should know about their patients include their allergies, code status, diagnosis, medications, vital signs, and much more.

Website: https://www.registerednursern.com/

More Videos: https://www.youtube.com/watch?v=R2XMro13dD0&list=UUPyMN8DzkFl2__xnTEiGZ1w
Nursing Gear: https://teespring.com/stores/registerednursern
Instagram: https://www.instagram.com/registerednursern_com/
Facebook: https://www.facebook.com/RegisteredNurseRNs
Twitter: https://twitter.com/NursesRN

Popular Playlists:

NCLEX Reviews: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Fluid & Electrolytes: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf
Nursing Skills: https://www.youtube.com/playli....st?list=PLQrdx7rRsKf

A video showing Two port laparoscopic Cholecystectomy

Full clinical and physical assessment of the knee and the knee joint

Basic shock and resuscitation video

How to measure blood pressure

demonstrates the use of an oropharyngeal device to maintain the patient's airway

General appearance inspection and assessment of vital signs as blood pressure pulse...etc

Removal of pregnancy within the fallopain tube using laparoscopic keyhole surgery. A segment of the tube together with the pregnancy within is removed.

Part 2: from Loyola Medical School, Chicago showing clinical examination of the neurological system.

Pilonidal disease with lateral extension - Follicle removal (Bascon's technique)

Ultra Sound-Guided Interscalene Block

Background: The number of patients demanding endoscopic neck surgery is rising. The access trauma of the axillary, breast and chest approaches is bigger than in open or video assisted surgery. We tested the feasibility of he sublingual transoral access which is in our opinion the only real minimally...-invasive extracollar endoscopic access to the thyroid gland Methods: We performed an experimental investigation in a porcine model. In 10 pigs we made 10 endoscopic transoral thyroidectomys with a modified axilloscope with the help of ultrasonic scissors and a neuro-monitoring system for identification of the recurrent laryngeal nerve. Results: The average operation time from the introduction to the removal of the obturator just above the larynx was 57 seconds. The mean operation time was 43 minutes. With the help of the neuro-monitoring system we proved in all cases the function of the recurrent laryngeal nerve on both sides. The pigs were observed for another two hours after operation. During and after the operation no complications appeared. Conclusions: We could show that the endoscopic transoral thyroid resection in pigs is possible and save. Our results might be useful for using this access for endoscopic thyroid resection in humans.

lesions at the anterior skull base invading the paranasal area and the paracavernous area can be reached without brain retraction by the shown subfrontal approach. it enables to control the paranasal sinus, optic nerve, periorbital tissue, carotid artery and pituary gland. reconstruction is not easy... but cosmetically appealing. CSF leaks are rare with the use of fascia lata and tissucol ( fibrin glue). osseous reconstruction is done by microsrews and calciumpyrophosphate ( norian, synthes).

The infection prevention and control training DVD is based on international guidelines from The World Health Organisation and the Centres for Disease Control and Prevention. It sets out best practice in international standard precautions for infection prevention and control. Email hmi@shrc.ie for details.

Laparoscopy in acute bowel obstruction following previous surgery is a difficult procedure and avoided by most of the surgeons due to the difficulty in obtaining pneumoperitoneum, port placement, lack of working space, adhesions and risk of bowel injury.
Here is a patient who had a previous laparotomy for trauma with a midline incision from xyphysternum to pubis; after unsuccessful conservative management he underwent a laparoscopy; a prior CT scan showed adhesions in the left side and a distal-mid small bowel obstruction. The pneumoperitoneum was obtained with the Visiport placed in the right lower quadrant; although the abdomen was grossly distended, under significant tension and distended loops of small bowel were occupying most the peritoneal cavity, with muscle relaxation there is usually enough space to perform a thorough inspection of the abdominal cavity. Port placement has to be done with special care as there is no room to push and usually a blunt trocar directed away from the bowel is employed in my practice. The collapsed loops of small bowel point quickly to the site of obstruction -- it is better to avoid manipulating the distended bowel as it is heavy, oedematous and prone to be lacerated with the instruments; once the pathology is identified, in this case the obstructive band, light packing is performed in order to expose the working space and protect the bowel from instruments like scissors or diathermy. In this case the band adhesion was slightly more difficult to separate from the bowel and required a combination of sharp and gentle blunt dissection.
Once the obstruction is release and the transit of contents is confirmed in the collapsed bowel the procedure is terminated. No abdominal drainage is usually necessary.