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49-years old patient complaining of cough, fever and pleuritic pain for 2 weeks. At admission he was febrile and tachypnic. Chest X-Ray showed left pleural effusion. Thoracocentesis revealed purulent fluid. Chest CT-scan showed large and loculated left pleural effusion and pleural thickening. VATS decortication was performed through three incisions.
Train with some of the region’s very best pediatric general surgeons — in a two-year, pediatric surgical fellowship training program at Nemours/Alfred I. duPont Hospital for Children. Our hospital’s Division of Pediatric Surgery is offering this program in affiliation with Sidney Kimmel Medical College at Thomas Jefferson University .
The goal of the fellowship is to give individuals who have completed an accredited general surgery residency advanced knowledge and training in the management and surgical treatment of newborns, infants and children.
Our Fellowship Program
This fellowship will help you prepare for certification by the American Board of Surgery, and is accredited by the Accreditation Council for Graduate Medical Education (ACGME).
The Pediatric Surgery Fellowship aims to:
train a well-rounded, empathetic, safe pediatric surgeon who is confident managing all aspects of the surgical care of children.
steward our fellow in quality improvement projects and methodology, and provide research opportunities.
provide a rigorous didactic curriculum for our fellow utilizing 360 degree feedback.
cultivate opportunities for our fellow to educate residents and students.
encourage our fellow to collaborate across specialties.
develop our fellow’s presentation skills during M&M conferences and multi-disciplinary educational meetings.
The program features the full participation of all nine of the pediatric surgical division’s full-time faculty members. Each of these physicians will contribute greatly to your education. Your training will include operating room and outpatient clinic experience, as well as bedside evaluation of children. You’ll also play a role in the organization of formal teaching conferences, held weekly. Formal rotations will be spent on Pediatric Urology, PICU and Neonatology during the first 12 months. The last year will be spent entirely on the Pediatric Surgical Service.
The majority of your inpatient consultative time will take place at Nemours/Alfred I. duPont Hospital for Children, a freestanding children’s hospital in Wilmington, Del. The hospital:
is nationally ranked by U.S. News & World Report in eight pediatric specialties
recently opened expansion with 260 beds
performs more than 2,800 inpatient and 9,300 outpatient surgical procedures each year in our operating rooms
has an on-site delivery center for newborns with complex congenital anomalies
receives more than 50,000 annual visits in our Emergency Department (ED)
is accredited by The American College of Surgeons as a Level One Pediatric Trauma Center
is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF)
Visit https://www.nemours.org/educat....ion/gme/fellowships/ to learn more.
This video provides a guide peforming a respiratory examination in an OSCE station, including real-time auscultation sounds of common pathology such as coarse crackles, fine crackles, wheeze and stridor.
You can access our step-by-step OSCE guide to accompany this video here: https://geekymedics.com/respiratory-examination-2/
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Chapters:
- Introduction 00:00
- General inspection 00:40
- Inspection of the hands 00:50
- Schamroth's window test 01:09
- Heart rate and respiratory rate 01:50
- Jugular venous pressure 02:02
- Face, eyes and mouth 02:13
- Anterior chest inspection 02:36
- Trachea and cricosternal distance 03:01
- Palpation of apex beat 03:16
- Chest expansion 03:28
- Lung percussion 03:50
- Auscultation of lungs 04:21
- Vocal resonance 05:03
- Lymph node palpation 05:32
- Inspection of posterior chest 06:04
- Posterior chest expansion 06:10
- Percussion of posterior chest 06:32
- Auscultation of posterior chest 06:55
- Sacral and pedal oedema 08:04
- Summary of findings 08:39
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Always adhere to your medical school/local hospital guidelines when performing examinations or clinical procedures. DO NOT perform any examination or procedure on patients based purely upon the content of these videos. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video.
Some people have found this video useful for ASMR purposes.
Special thanks to www.easyauscultation.com and Andy Howes for providing some of the respiratory sounds.
Peripheral Vascular Examination OSCE - Clinical Skills - Dr Gill
In the cardiovascular examination, particularly in the case of an OSCE station, we conclude the examination often by stating that the examiner would want to perform:
- An ECG
- Check full blood count
- and "do a peripheral vascular examination
In this video, we demonstrate that oft-talked about, but comparatively less common examination.
Starting off, with the examination of the hands, the radial, brachial and carotid pulses. before moving down to assess for a AAA, checking the femoral and popliteal pulses, before wrapping up around the ankle with the posterior tibial and dorsalis pedis pulses
For completeness, the cardiovascular examination is demonstrated here
https://www.youtube.com/watch?v=ECs9O5zl6XQ&t=2s
#PeripheralVascular #ClinicalSkills #DrGill
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).
ThermiVa is a non-surgical vaginal tightening treatment for women who want to reclaim what childbirth or aging may have taken away. Using the same technology that’s used in ThermiTight and ThermiSmooth, radiofrequency energy is sent to the desired area (internally or externally), heating the tissue and stimulating the body’s own collagen. ThermiVa is performed in three treatments over the course of three months.
Butt implants are a popular plastic surgery procedure among those who wish to enhance the appearance, shape, and size of their rear ends. Buttock augmentation involves the surgical insertion of artificial body implants into a patient’s buttocks to create a larger, shapelier, and more sensuous rear end. Patients who have underdeveloped buttocks can achieve a more proportionate figure with butt implants. Women who wish to achieve an “hour glass” figure or are unhappy with the size of their buttocks can benefit from female butt implants. Men with flat or poorly developed buttocks can enhance the shape of the area to their liking with male butt implants. Many buttock augmentation patients say that their clothes fit better, they feel more attractive, and their confidence levels have improved.
Lesson on clinical examination of a scaphoid fracture and assessment of the anatomic snuffbox. The scaphoid bone is one of the carpal bones of the wrist. A scaphoid fracture is important to rule out due to risk of avascular necrosis, which is a compromise of bone vasculature leading to death of the bone. Scaphoid fractures can occur with a FOOSH injury. In this lesson, we discuss the clinical assessment to rule out a scaphoid fracture, including assessing and localizing the anatomic snuffbox.
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Check out some of my other lessons.
Medical Terminology - The Basics - Lesson 1:
https://www.youtube.com/watch?v=04Wh2E9oNug
Fatty Acid Synthesis Pathway:
https://www.youtube.com/watch?v=WuQS_LpNMzo
Wnt/B Catenin Signaling Pathway:
https://www.youtube.com/watch?v=NGVP4J9jpgs
Upper vs. Lower Motor Neuron Lesions:
https://www.youtube.com/watch?v=itNd74V53ng
Lesson on the Purine Synthesis and Salvage Pathway:
https://www.youtube.com/watch?v=e2KFVvI8Akk
Gastrulation | Formation of Germ Layers:
https://www.youtube.com/watch?v=d6Kkn0SECJ4
Introductory lesson on Autophagy (Macroautophagy):
https://www.youtube.com/watch?v=UmSVKzHc5yA
Infectious Disease Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Dermatology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Pharmacology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Hematology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Rheumatology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Endocrinology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
Nephrology Playlist
https://www.youtube.com/playli....st?list=PLRjNoiRtdFw
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**MEDICAL DISCLAIMER**: JJ Medicine does not provide medical advice, and the information available on this channel does not offer a diagnosis or advice regarding treatment. Information presented in these lessons is for educational purposes ONLY, and information presented here is not to be used as an alternative to a healthcare professional’s diagnosis and treatment of any person/animal.
Only a physician or other licensed healthcare professional are able to determine the requirement for medical assistance to be given to a patient. Please seek the advice of your physician or other licensed healthcare provider if you have any questions regarding a medical condition.
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*Although I try my best to present accurate information, there may be mistakes in this video. If you do see any mistakes with information in this lesson, please comment and let me know.*
I am always looking for ways to improve my lessons! Please don't hesitate to leave me feedback and comments - all of your feedback is greatly appreciated! :) And please don't hesitate to send me any messages if you need any help - I will try my best to be here to help you guys :)
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JJ
UPDATE 1/30/15: Watch the updated version of this animation: https://www.youtube.com/watch?v=LVP6JngpgEE
This 3D medical animation shows how adhesions in the abdomen may cause complications. These problems may include obstruction, twisting, and dislocating areas of the small intestine. Adhesions can be separated with laparoscopic instruments.
ANH00037
VirtaMed's new laparoscopy simulator starts with patient safety.
VirtaMed LaparoS™
-Starts at the beginning and covers crucial procedure preparation steps
- Innovative skills training derived from validated concepts
- Start with patient safety: abdomen positioning and trocar placement
- Covers crucial procedure preparation steps
Numerous medical training institutions have found that integrating simulation into their curriculum both improves training outcomes and ultimately supports better patient care. Benefit from VirtaMed’s decades of experience and expertise in laparoscopy training and education.
Breast abscesses are often linked to mastitis – a condition that causes breast pain and swelling (inflammation), and usually affects women who are breastfeeding. Infections can occur during breastfeeding if bacteria enter your breast tissue, or if the milk ducts (tiny tubes) become blocked. This can cause mastitis which, if not treated, can result in an abscess forming. Women who aren't breastfeeding can also develop mastitis if bacteria enter the milk ducts through a sore or cracked nipple, or a nipple piercing. White blood cells are sent to attack the infection, which causes tissue at the site of the infection to die. This creates a small, hollow area that fills with pus (an abscess).
Descemet’s stripping automated endothelial keratoplasty (DSAEK) avoids a full-thickness corneal procedure and provides rapid visual rehabilitation. Successful graft positioning while minimizing intraoperative donor endothelial trauma may determine long-term graft survival. Previously described t...echniques for graft insertion may be problematic in some patients with intraoperative floppy iris syndrome (IFIS), anatomically shallow or unstable anterior chambers, or intraoperative increased posterior pressure. This video displays alternative method called the suture drag technique, which may facilitate lamellar endothelial graft insertion under these special circumstances.
What Is a Paronychia (Nail Infection)? An infection that develops along the edge of the fingernail or toenail is called a paronychia (pear-ah-NIK-ee-ah). It is the most common hand infection and, if left untreated, can progress to a more severe infection of the entire finger or toe. Paronychia is distinguished from other infections such as onychomycosis and herpetic whitlow by its location and appearance.
The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.
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