Nasal catheter YAMIK - is a new drug delivery sistem for topical treatment for sinusitis. The introduction of a large volume of the #drugsolution directly into all the paranasal #sinuses - provides new opportunities in the #treatment of #sinusitis! #YamikprocedureNasal catheter YAMIK is a new device for topical sinonasal delivery of medication during rhinosinusitis treatment. Administration of therapeutic solution with YAMIK catheter is called YAMIK procedure. The following features differs YAMIK procedure from all other topical sinonasal delivery techniques: - Medication is delivered into the all paranasal sinuses at one side of nose regardless of their involvement in the inflammatory disease. -Specific position of patient’s head. Patient should lay on the side of of the sinuses, into which solution will be administered. This position is physiological and comfortable for patients, including children and elders. The LHL position was suggested to be the most favorable position for patients to adopt - Therapeutic solutions reliably penetrates into without previous sinus surgery sinuses with natural ostia size. - Paranasal sinuses are filling with medicinal solution by gravity. To accelerate process, it is used small pressure gradient, which created by motion of syringe plunger with amplitude 1 - 2 ml during administration of solution. - It is provided contact of the whole sino-nasal mucosa with medication. - Prolonged time of the contact of sino-nasal mucosa with medicine provides administration of the therapeutically significant dose. Therapeutic solution administered into paranasal sinuses is considered as a STORE. Thanks to affect mucociliary clearance, therapeutic solution is gradually evacuated from sinuses through ostia. Thereby, prolonged nasal irrigation is performed. - Due to extended contact with saline (NaCl 0,9%), viscous colloidal pathological substance filling paranasal sinuses is dissolved. As a result, its viscosity decreases, and substance is removing by mucociliary clearance. Thereby, drainage function of the ostia are returned some time after finish YAMIK method procedure. -The procedure is performing under local anesthesia. - There is no need in active involvement of the patient. Blowing, pronouncing any sounds like “cuckoo”, holding any things and so on is unnecessary. If is performed by a qualified medical professional the procedure is more effective. - Medication contacts only with nasal passages and paranasal sinuses. Thus, it is provided topical drug therapy. - YAMIK procedure is call sinonasal delivery techniques of a therapeutic solution. It differs from nasal techniques, because medicinal solution contacts not only with nasal mucosa, but with mucous membrane of paranasal sinuses. - The only used drug formulation is a solution. - It is possible non-invasive sample extraction from mucosa of paranasal sinuses (for bacteriological, immunological, cytological and a number of others investigation methods).

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.

Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD). CHD is a disease in which a waxy substance called plaque (plak) builds up inside the coronary arteries.

New Treatment for sinusitis. Yamik procedure

During open-heart valve surgery, the doctor makes a large incision in the chest. Blood is circulated outside of the body through a machine to add oxygen to it (cardiopulmonary bypass or heart-lung machine). The heart may be cooled to slow or stop the heartbeat so that the heart is protected from damage while surgery is done to replace the valve with an artificial valve. The artificial valve might be mechanical (made of man-made substances). Others are made out of animal tissue, often from a pig.

Sepsis occurs when chemicals released in the bloodstream to fight an infection trigger inflammation throughout the body. This can cause a cascade of changes that damage multiple organ systems, leading them to fail, sometimes even resulting in death. Symptoms include fever, difficulty breathing, low blood pressure, fast heart rate, and mental confusion. Treatment includes antibiotics and intravenous fluids.

The accumulation of ascitic fluid represents a state of total-body sodium and water excess, but the event that initiates the unbalance is unclear. Although many pathogenic processes have been implicated in the development of abdominal ascites, about 75% likely occur as a result of portal hypertension in the setting of liver cirrhosis, with the remainder due to infective, inflammatory, and infiltrative conditions. Three theories of ascites formation have been proposed: underfilling, overflow, and peripheral arterial vasodilation. The underfilling theory suggests that the primary abnormality is inappropriate sequestration of fluid within the splanchnic vascular bed due to portal hypertension and a consequent decrease in effective circulating blood volume. This activates the plasma renin, aldosterone, and sympathetic nervous system, resulting in renal sodium and water retention. The overflow theory suggests that the primary abnormality is inappropriate renal retention of sodium and water in the absence of volume depletion. This theory was developed in accordance with the observation that patients with cirrhosis have intravascular hypervolemia rather than hypovolemia. The most recent theory, the peripheral arterial vasodilation hypothesis, includes components of both of the other theories. It suggests that portal hypertension leads to vasodilation, which causes decreased effective arterial blood volume. As the natural history of the disease progresses, neurohumoral excitation increases, more renal sodium is retained, and plasma volume expands. This leads to overflow of fluid into the peritoneal cavity. The vasodilation theory proposes that underfilling is operative early and overflow is operative late in the natural history of cirrhosis. Although the sequence of events that occurs between the development of portal hypertension and renal sodium retention is not entirely clear, portal hypertension apparently leads to an increase in nitric oxide levels. Nitric oxide mediates splanchnic and peripheral vasodilation. Hepatic artery nitric oxide synthase activity is greater in patients with ascites than in those without ascites. Regardless of the initiating event, a number of factors contribute to the accumulation of fluid in the abdominal cavity. Elevated levels of epinephrine and norepinephrine are well-documented factors. Hypoalbuminemia and reduced plasma oncotic pressure favor the extravasation of fluid from the plasma to the peritoneal fluid, and, thus, ascites is infrequent in patients with cirrhosis unless both portal hypertension and hypoalbuminemia are present.

Keratoplasty is the procedure whereby abnormal corneal tissue is replaced by a healthy donor cornea.

Laser- Removal of Salivary Stone

Diagnosis of HIV infection in infants is aided by HIV culture or DNA/RNA polymerase chain reaction (PCR); positive results are confirmed by repeating the test. In suspected cases, HIV testing should occur in the newborn period (ie, before the infant is 48 h old), at age 1-2 months, and again at age 3-6 months.

Osgood-Schlatter disease can cause a painful lump below the kneecap in children and adolescents experiencing growth spurts during puberty. Osgood-Schlatter disease occurs most often in children who participate in sports that involve running, jumping and swift changes of direction — such as soccer, basketball, figure skating and ballet. While Osgood-Schlatter disease is more common in boys, the gender gap is narrowing as more girls become involved with sports. Age ranges differ by sex because girls experience puberty earlier than do boys. Osgood-Schlatter disease typically occurs in boys ages 13 to 14 and girls ages 11 to 12. The condition usually resolves on its own, once the child's bones stop growing.

You're sneezing, coughing, and all stuffed up. It sounds and feels like a cold, alright. But as time goes on, you start to wonder. Is it turning into a sinus infection? They've got some things in common, but there are ways to tell them apart. The right ID lets your doctor get you the best treatment. What Is a Common Cold? It's an infection caused by a virus, a tiny living thing. You can't miss the symptoms: Nasal congestion Runny nose Post-nasal drip (drop-by-drop release of fluid from your nose into the back of the throat) Headache Fatigue You may also get a cough and a mild fever. The symptoms usually build, peak, and slowly disappear. Some medications can ease symptoms. For example, decongestants may decrease drainage and open the nasal passages. Pain relievers may help with fever and headache. Cough medicine may help, as well. Colds typically last from a few days to about a week or longer. Sometimes, a cold may cause swelling in the sinuses, hollow spaces in your skull that are connected to each other. The swelling can prevent the flow of mucus.

WHAT IS BURN DEBRIDEMENT? A burn is damage to body tissues caused by sunlight, heat, fire, electricity, friction, radiation, chemicals, hot water or steam. Burns may become infected. Infected burns and the swelling that happens as a result can cause severe damage to the organs and tissues underneath the burned area by putting pressure on the tissues, nerves, and blood vessels. To allow healthy tissue to heal and to prevent more damage or infection, burned tissue is removed in a procedure called burn debridement. Burn debridement can be done by several different methods. They include surgical, chemical, mechanical, or autolytic tissue removal. Debridement may need to be done multiple times as the burned area heals.

ACE inhibitors Email this page to a friend Print Facebook Twitter Google+ Angiotensin-converting enzyme (ACE) inhibitors are medicines. They treat heart, blood vessel, and kidney problems. How ACE inhibitors help ACE inhibitors are used to treat heart disease. These medicines make your heart work less hard by lowering your blood pressure. This keeps some kinds of heart disease from getting worse. Most people who have heart failure take these medicines. These medicines treat high blood pressure, strokes, or heart attacks. They may help lower your risk for stroke or heart attack. They are also used to treat diabetes and kidney problems. This can help keep your kidneys from getting worse. If you have these problems, ask your health care provider if you should be taking these medicines.

LAPAROSCOPIC END TO END URETERAL ANASTOMOSIS

Swelling is a typical symptom of lymphedema and commonly affects legs and arms. Compression stockings work to encourage the movement of lymph out of an affected limb. Lymphedema is incurable. However, treatment can help reduce the swelling and pain

Microscopic polyangiitis (MPA) is vasculitis of small vessels. It was initially considered as a microscopic form of polyarteritis nodosa (PAN). In 1990, the American College of Rheumatology developed classification criteria for several types of systemic vasculitis but did not distinguish between polyarteritis nodosa and microscopic polyarteritis nodosa. [1] In 1994, a group of experts held an international consensus conference in Chapel Hill, North Carolina, to attempt to redefine the classification of small vessel vasculitides. [2, 3]

The cell cycle or cell-division cycle is the series of events that take place in a cell leading to its division and duplication of its DNA (DNA replication) to produce two daughter cells.

-MEN1 syndrome is composed of hyperparathyroidism, gastrinoma (pancreatic tumor) and pituitary tum or(remember the 3 Ps). Hyperparathyroidism in MEN1 is caused by hyperplasia of the parathyroid glands. Removal of 3 1/2 glands or total parathyroidectomy with autotransplantation is necessary.

Multiple endocrine neoplasia type 2 (MEN2) (also known as "Pheochromocytoma and amyloid producing medullary thyroid carcinoma", "PTC syndrome," and "Sipple syndrome") is a group of medical disorders associated with tumors of the endocrine system. The tumors may be benign or malignant (cancer).