Top videos
There is any chance that the snake is venomous The person has difficulty breathing There is loss of consciousness If you know the snake is not venomous, treat as a puncture wound. 1. Note the Snake's Appearance Be ready to describe the snake to emergency staff. 2. Protect the Person While waiting for medical help: Move the person beyond striking distance of the snake. Have the person lie down with wound below the heart. Keep the person calm and at rest, remaining as still as possible to keep venom from spreading. Cover the wound with loose, sterile bandage. Remove any jewelry from the area that was bitten. Remove shoes if the leg or foot was bitten. Do not: Cut a bite wound Attempt to suck out venom Apply tourniquet, ice, or water Give the person alcohol or caffeinated drinks or any other medications
Endotracheal intubation is a medical procedure in which a tube is placed into the windpipe (trachea) through the mouth or nose. In most emergency situations it is placed through the mouth. Whether you are awake (conscious) or not awake (unconscious), you will be given medicine to make it easier to insert the tube. After endotracheal intubation, you will likely be placed on a breathing machine. If you are awake after the procedure, your health care provider may give you medicine to reduce your anxiety or discomfort.
Antiphospholipid (AN-te-fos-fo-LIP-id) syndrome occurs when your immune system attacks some of the normal proteins in your blood. It can cause blood clots in your arteries or veins. And it can cause pregnancy complications, such as miscarriage and stillbirth. Blood clots in your leg veins cause a condition known as deep vein thrombosis (DVT). Damage from blood clots in your organs, such as your kidneys, lungs or brain, depends on the extent and location of the clot. For instance, a clot in your brain can cause a stroke. There's no cure for antiphospholipid syndrome, but medications can reduce your risk of blood clots.
Mini-Laparoscopic Cholecystectomy with Intraoperative Cholangiogram for Symptomatic Cholelithiasis (Gallstones) - Standard
Authors: Brunt LM1, Singh R1, Yee A2
Published: September 26, 2017
AUTHOR INFORMATION
1 Department of Surgery, Washington University, St. Louis, Missouri
2 Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri
DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.
ABSTRACT
Minimal invasive laparoscopic cholecystectomy is the typical surgical treatment for cholelithiasis (gallstones), where patients present with a history of upper abdominal pain and episodes of biliary colic. The classic technique for minimal invasive laparoscopic cholecystectomy involves four ports: one umbilicus port, two subcostal ports, and a single epigastric port. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has instituted a six-step strategy to foster a universal culture of safety for cholecystectomy and minimize risk of bile duct injury. The technical steps are documented within the context of the surgical video for (1) achieving a critical view of safety for identification of the cystic duct and artery, (2) intraoperative time-out prior to management of the ductal structures, (3) recognizing the zone of significant risk of injury, and (4) routine intraoperative cholangiography for imaging of the biliary tree. In this case, the patient presented with symptomatic biliary colic due to a gallstone seen on the ultrasound in the gallbladder. The patient was managed a mini-laparoscopic cholecystectomy using 3mm ports for the epigastric and subcostal port sites with intraoperative fluoroscopic cholangiogram. Specifically, the senior author encountered a tight cystic duct preventing the insertion of the cholangiocatheter and the surgical video describes how the author managed the cystic duct for achieving a cholangiogram, in addition to the entire technical details of laparoscopic cholecystectomy.
Wolff-Parkinson-White (WPW) syndrome, an extra electrical pathway between your heart's upper and lower chambers causes a rapid heartbeat. The extra pathway is present at birth and fairly rare. The episodes of fast heartbeats usually aren't life-threatening, but serious heart problems can occur. Treatment can stop or prevent episodes of fast heartbeats. A catheter-based procedure (ablation) can permanently correct the heart rhythm problems. Most people with an extra electrical pathway experience no fast heartbeat. This condition, called Wolff-Parkinson-White pattern, is discovered only by chance during a heart exam. Although WPW pattern is often harmless, doctors might recommend further evaluation before children with WPW pattern participate in high-intensity sports.
What damage does atherosclerosis cause? Plaque may partially or totally block the blood's flow through an artery in the heart, brain, pelvis, legs, arms or kidneys. Some of the diseases that may develop as a result of atherosclerosis include coronary heart disease, angina (chest pain), carotid artery disease, peripheral artery disease (PAD) and chronic kidney disease.
Shaken baby syndrome symptoms and signs include: Extreme irritability Difficulty staying awake Breathing problems Poor eating Tremors Vomiting Pale or bluish skin Seizures Paralysis Coma Other injuries that may not be initially noticeable include bleeding in the brain and eye, damage to the spinal cord and neck and fractures of the ribs, skull and bones. Evidence of prior child abuse also is common.
Initially, lead poisoning can be hard to detect — even people who seem healthy can have high blood levels of lead. Signs and symptoms usually don't appear until dangerous amounts have accumulated. Lead poisoning symptoms in children Signs and symptoms of lead poisoning in children include: Developmental delay Learning difficulties Irritability Loss of appetite Weight loss Sluggishness and fatigue Abdominal pain Vomiting Constipation Hearing loss Seizures Eating things, such as paint chips, that aren't food (pica) Lead poisoning symptoms in newborns Babies exposed to lead before birth might: Be born prematurely Have lower birth weight Have slowed growth Lead poisoning symptoms in adults Although children are primarily at risk, lead poisoning is also dangerous for adults. Signs and symptoms in adults might include: High blood pressure Joint and muscle pain Difficulties with memory or concentration Headache Abdominal pain Mood disorders Reduced sperm count and abnormal sperm Miscarriage, stillbirth or premature birth in pregnant women Causes Lead is a metal that occurs naturally in the earth's crust, but human activity — mining, burning fossil fuels and manufacturing — has caused it to become more widespread. Lead was also once used in paint and gasoline and is still used in batteries, solder, pipes, pottery, roofing materials and some cosmetics. Lead in paint Lead-based paints for homes, children's toys and household furniture have been banned in the United States since 1978. But lead-based paint is still on walls and woodwork in many older homes and apartments. Most lead poisoning in children results from eating chips of deteriorating lead-based paint. Water pipes and imported canned goods Lead pipes, brass plumbing fixtures and copper pipes soldered with lead can release lead particles into tap water. Lead solder in food cans, banned in the United States, is still used in some countries. Other sources of lead exposure Lead sometimes can also be found in: Soil. Lead particles from leaded gasoline or paint settle on soil and can last years. Lead-contaminated soil is still a major problem around highways and in some urban settings. Some soil close to walls of older houses contains lead. Household dust. Household dust can contain lead from lead paint chips or from contaminated soil brought in from outside. Pottery. Glazes found on some ceramics, china and porcelain can contain lead that can leach into food served or stored in the pottery. Toys. Lead is sometimes found in toys and other products produced abroad. Cosmetics. Tiro, an eye cosmetic from Nigeria, has been linked to lead poisoning. Herbal or folk remedies. Lead poisoning has been linked to greta and azarcon, traditional Hispanic medicines, as well as some from India, China and other countries. Mexican candy. Tamarind, an ingredient used in some candies made in Mexico, might contain lead. Lead bullets. Time spent at firing ranges can lead to exposure. Occupations. People are exposed to lead and can bring it home on their clothes when they work in auto repair, mining, pipe fitting, battery manufacturing, painting, construction and certain other fields
The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can cause a dull ache in the shoulder, which often worsens when you try to sleep on the involved side. Rotator cuff injuries occur most often in people who repeatedly perform overhead motions in their jobs or sports. Examples include painters, carpenters, and people who play baseball or tennis. The risk of rotator cuff injury also increases with age. Many people recover from rotator cuff disease with physical therapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint. Sometimes, rotator cuff tears may occur as a result of a single injury. In those circumstances, medical care should be provided as soon as possible. Extensive rotator cuff tears may require surgical repair, transfer of alternative tendons or joint replacement.
Hemophilia A, also called factor VIII (FVIII) deficiency or classic hemophilia, is a genetic disorder caused by missing or defective factor VIII, a clotting protein. Although it is passed down from parents to children, about 1/3 of cases are caused by a spontaneous mutation, a change in a gene. According to the US Centers for Disease Control and Prevention, hemophilia occurs in approximately 1 in 5,000 live births. There are about 20,000 people with hemophilia in the US. All races and ethnic groups are affected. Hemophilia A is four times as common as hemophilia B while more than half of patients with hemophilia A have the severe form of hemophilia.
Genes are the building blocks of heredity. They are passed from parent to child. They hold DNA, the instructions for making proteins. Proteins do most of the work in cells. They move molecules from one place to another, build structures, break down toxins, and do many other maintenance jobs. Sometimes there is a mutation, a change in a gene or genes. The mutation changes the gene's instructions for making a protein, so the protein does not work properly or is missing entirely. This can cause a medical condition called a genetic disorder. You can inherit a gene mutation from one or both parents. A mutation can also happen during your lifetime.
Multiple endocrine neoplasia type 2 (MEN2) is a hereditary condition associated with three primary types of tumors: medullary thyroid cancer, parathyroid tumors, and pheochromocytoma. MEN2 is classified into three subtypes based on clinical features. MEN2A, which affects 60% to 90% of MEN2 families Medullary thyroid cancer: 98% to 100% with MEN2A are affected Pheochromocytoma, a typically benign (noncancerous) tumor of the adrenal glands: 50% with MEN2A affected Parathyroid adenoma (benign tumor) or hyperplasia, meaning increased size, of the parathyroid gland: 5% to 10% with MEN2A affected MEN2B, which affects 5% of MEN2 families Medullary thyroid cancer: 98% to 100% with MEN2B affected Pheochromocytoma: 50% with MEN2B affected Mucosal neuromas, which is a benign tumor of nerve tissue on the tongue, lips and throughout the gastrointestinal tract: 95% to 98% affected Digestive problems caused by disordered nerves in the gastrointestinal tract: 75% to 90% affected Muscle, joint, and spinal problems: 95% affected Typical facial features, including swollen lips and thick eyelids: 75% to 90% affected Familial medullary thyroid cancer (FMTC), which affects 5% to 35% of MEN2 families Medullary thyroid carcinoma only Sources: Gagel RF, Marx SJ. “Multiple endocrine neoplasia.” Williams Textbook of Endocrinology, Chapter 40, 11th ed., Philadelphia, 2008, and Eng C, Clayton D, et al. Grubbs EG, Gagel RF. My, How Things Have Changed in Multiple Endocrine Neoplasia Type 2A! J Clin Endocrinol Metab 100(7):2532-5, 7/2015. PMID: 26151398. What causes MEN2? MEN2 is a genetic condition. This means that the cancer risk and other features of MEN2 can be passed from generation to generation in a family. The gene associated with MEN2 is called RET. A mutation (alteration) in the RET gene gives a person an increased risk of developing medullary thyroid cancer and other tumors associated with MEN2.