Dr. Arthur Handal explains both an open and closed approach to a Rhinoplasty and which is more effective, in his opinion.

Proper placement of sutures enhances the precise approximation of the wound edges, which helps minimize and redistribute skin tension. Wound eversion is essential to maximize the likelihood of good epidermal approximation. Eversion is desirable to minimize the risk of scar depression secondary to tissue contraction during healing. Usually, inversion is not desirable, and it probably does not decrease the risk of hypertrophic scarring in an individual with a propensity for hypertrophic scars. The elimination of dead space, the restoration of natural anatomic contours, and the minimization of suture marks are also important to optimize the cosmetic and functional results.

The objective of carotid endarterectomy (CEA) is to prevent strokes. In the United States, stroke is the third leading cause of death overall and the second leading cause of death for women.[1] Among patients suffering a stroke, 50-75% had carotid artery disease that would have been amenable to surgical treatment. Several prospective randomized trials have compared the safety and efficacy of CEA with those of medical therapy in symptomatic and asymptomatic patients. Data from these prospective trials have confirmed that CEA offers better protection from ipsilateral strokes than medical therapy alone in patients presenting with either symptomatic or asymptomatic carotid artery disease.

Inflammatory bowel disease (IBD) involves chronic inflammation of all or part of your digestive tract. IBD primarily includes ulcerative colitis and Crohn's disease. Both usually involve severe diarrhea, pain, fatigue and weight loss. IBD can be debilitating and sometimes leads to life-threatening complications. Ulcerative colitis (UL-sur-uh-tiv koe-LIE-tis) is an inflammatory bowel disease that causes long-lasting inflammation and sores (ulcers) in the innermost lining of your large intestine (colon) and rectum. Crohn's disease is an IBD that cause inflammation of the lining of your digestive tract. In Crohn's disease, inflammation often spreads deep into affected tissues. The inflammation can involve different areas of the digestive tract — the large intestine, small intestine or both. Collagenous (kuh-LAJ-uh-nus) colitis and lymphocytic colitis also are considered inflammatory bowel diseases but are usually regarded separately from classic inflammatory bowel disease.

Gonorrhea is a sexually transmitted disease (STD). It’s caused by infection with the bacterium Neisseria gonorrhoeae. It tends to infect warm, moist areas of the body, including the: urethra (the tube that drains urine from the urinary bladder) eyes throat vagina anus female reproductive tract (the fallopian tubes, cervix, and uterus) Gonorrhea passes from person to person through unprotected oral, anal, or vaginal sex. People with numerous sexual partners or those who don’t use a condom are at greatest risk of infection. The best protections against infection are abstinence, monogamy (sex with only one partner), and proper condom usage. Behaviors that make a person more likely to engage in unprotected sex also increase the likelihood of infection. These behaviors include alcohol abuse and illegal drug abuse, particularly intravenous drug use.

Pulmonary embolism symptoms can vary greatly, depending on how much of your lung is involved, the size of the clots, and whether you have underlying lung or heart disease. Common signs and symptoms include: Shortness of breath. This symptom typically appears suddenly and always gets worse with exertion. Chest pain. You may feel like you're having a heart attack. The pain may become worse when you breathe deeply (pleurisy), cough, eat, bend or stoop. The pain will get worse with exertion but won't go away when you rest. Cough. The cough may produce bloody or blood-streaked sputum. Other signs and symptoms that can occur with pulmonary embolism include: Leg pain or swelling, or both, usually in the calf Clammy or discolored skin (cyanosis) Fever Excessive sweating Rapid or irregular heartbeat Lightheadedness or dizziness

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Hypertensive emergencies encompass a spectrum of clinical presentations in which uncontrolled blood pressures (BPs) lead to progressive or impending end-organ dysfunction. In these conditions, the BP should be lowered aggressively over minutes to hours. Neurologic end-organ damage due to uncontrolled BP may include hypertensive encephalopathy, cerebral vascular accident/cerebral infarction, subarachnoid hemorrhage, and/or intracranial hemorrhage.[1] Cardiovascular end-organ damage may include myocardial ischemia/infarction, acute left ventricular dysfunction, acute pulmonary edema, and/or aortic dissection. Other organ systems may also be affected by uncontrolled hypertension, which may lead to acute renal failure/insufficiency, retinopathy, eclampsia, or microangiopathic hemolytic anemia.[1] With the advent of antihypertensives, the incidence of hypertensive emergencies has declined from 7% to approximately 1% of patients with hypertension.[2] In addition, the 1-year survival rate associated with this condition has increased from only 20% (prior to 1950) to a survival rate of more than 90% with appropriate medical treatment

Pulmonary fibrosis is a lung disease that occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it more difficult for your lungs to work properly. As pulmonary fibrosis worsens, you become progressively more short of breath. The scarring associated with pulmonary fibrosis can be caused by a multitude of factors. But in most cases, doctors can't pinpoint what's causing the problem. When a cause can't be found, the condition is termed idiopathic pulmonary fibrosis. The lung damage caused by pulmonary fibrosis can't be repaired, but medications and therapies can sometimes help ease symptoms and improve quality of life. For some people, a lung transplant might be appropriate.

Choosing not to have sex provides 100 percent protection from HIV, STIs, and pregnancy. For some, this means avoiding vaginal, anal, and oral-genital intercourse altogether. Others may choose to avoid any type of sexual or intimate contact, including hugging and kissing. Choosing not to have sex is often referred to as “abstinence.” WHAT ARE THE ADVANTAGES OF CHOOSING NOT TO HAVE SEX (ABSTINENCE)? Choosing not to have sex is free and available to all. Not having sex is extremely effective at preventing both infection and pregnancy. It is the only 100% effective method of preventing sexually transmitted infections (STIs) and unintended pregnancy. Not having sex can be practiced at any time in one's life. Not having sex may encourage people to build relationships in other ways. Not having sex may be the course of action which you feel is right for you and makes you feel good about yourself.

INDICATIONS The Absorb GT1 Bioresorbable Vascular Scaffold (BVS) is a temporary scaffold that will fully resorb over time and is indicated for improving coronary luminal diameter in patients with ischemic heart disease due to de novo native coronary artery lesions (length ≤ 24 mm) with a reference vessel diameter of ≥ 2.5 mm and ≤ 3.75 mm WHAT ARE THE POTENTIAL RISKS AND COMPLICATIONS? Treatment options for CAD have become increasingly common but, as with any invasive procedure, there are potential risk factors and complications. Serious complications do not occur often, and research is ongoing to make these procedures even safer and more effective. The risk of complications from percutaneous treatment methods may be higher for individuals: 75 years of age and older Who are women Who have kidney disease or diabetes Who have serious heart disease Who have had prior cardiac interventions

ERCP is a procedure that enables your physician to examine the pancreatic and bile ducts. A bendable, lighted tube (endoscope) about the thickness of your index finger is placed through your mouth and into your stomach and first part of the small intestine (duodenum). In the duodenum a small opening is identified (ampulla) and a small plastic tube (cannula) is passed through the endoscope and into this opening. Dye (contrast material) is injected and X-rays are taken to study the ducts of the pancreas and liver.

Instead, try these natural solutions and lifestyle changes, which may help you stop snoring. Change Your Sleep Position. ... Lose Weight. ... Avoid Alcohol. ... Practice Good Sleep Hygiene. ... Open Nasal Passages. ... Change Your Pillows. ... Stay Well Hydrated.

The pain is frequently severe and is described as throbbing or pulsating. Nausea is common, and many migraine patients have a watering eye, a running nose, or congestion. If these symptoms are prominent, they may lead to a misdiagnosis of sinus headaches.

Cardiac arrest is the abrupt loss of heart function in a person who may or may not have diagnosed heart disease. The time and mode of death are unexpected. It occurs instantly or shortly after symptoms appear. Each year, more than 350,000 emergency medical services-assessed out-of-hospital cardiac arrests occur in the United States

Dysentery is an infection of the intestines causing diarrhoea that contains blood or mucus. There are two main types of dysentery: Shigellosis, or bacillary dysentery, is the most common type experienced in the UK, caused by the shigella bacteria. Amoebic dysentery, also called amoebiasis, is caused by a single-celled parasite called Entamoeba histolytica. This form of dysentery is more common abroad in tropical countries. This article focuses on amoebic dysentery, This is usually caused by poor hygiene or contaminated food or water. Amoebic dysentery is a notifiable disease, so your GP must let the local health authority know if you have contracted it. Causes of amoebic dysentery Once inside the body, amoeba clump together to form a cyst that is protected by the stomach’s digestive acid. When the cyst passes through the intestines it breaks open infecting the body. The amoebae burrow into the intestinal wall and cause small ulcers or abscesses. Cysts exit the body via faeces but are still able to live outside, which is how many people become infected. Severe dysentery is more common in developing countries due to compromised hygiene. You can get sick in a number of ways including: Eating contaminated food Drinking contaminated water Contracting dysentery from another infected person. Symptoms of amoebic dysentery Symptoms can appear as many as 10 days after exposure and infection by the parasite. Signs of infection include: Watery diarrhoea with blood or pus in it Nausea or vomiting Stomach pain High temperature Chills Bleeding from back passage (rectum) Weight loss Loss of appetite. Complications of amoebic dysentery If the parasite gets into your bloodstream it can spread to other parts of your body, including the liver. When this happens you run the risk of developing a liver abscess. Symptoms include: High temperature Weakness Cough Jaundice Nausea Loss of appetite Weight loss

The most frequent incision utilized to open the abdomen for liver surgery is called a chevron incision. In this incision a cut is made on the abdomen below the rib cage. The cut starts under the armpit below the ribs on the right side of the abdomen and continues all the way across the abdomen to the opposite arm pit thereby the whole width of the abdomen is cut to provide access to the liver. The average length of the incision is approximately 24 to 30 inches. This is one of the longest incisions is utilized in abdominal surgery. The incision is frequently associated with significant discomfort after the surgery and in some patients the discomfort can continue for many months, particularly when some of the nerves in the abdominal wall have been cut during the surgery. Laparoscopic surgery provides advantages over open surgery for the liver since the chevron incision is completely avoided and the surgery is performed through tiny incisions. As a consequence the duration of stay in hospital, the amount and duration of post operative discomfort, and the length of recovery is much shorter after the laparoscopic procedure compared to open surgery

Asthma was originally described as an inflammatory disease that predominantly involves the central airways. Pathological and physiological evidence reported during the past few years suggests that the inflammatory process extends beyond the central airways to the peripheral airways and the lung parenchyma. The small airways are capable of producing T-helper-2 cytokines, as well as chemokines, and they have recently been recognized as a predominant site of airflow obstruction in asthmatic persons. The inflammation at this distal site has been described as more severe than large airway inflammation. These findings are of great clinical significance, and highlight the need to consider the peripheral airways as a target in any therapeutic strategy for treatment of asthma.

Catheters can be placed in veins in the neck (internal jugular vein), chest (subclavian vein or axillary vein), groin (femoral vein), or through veins in the arms (also known as a PICC line, or peripherally inserted central catheters).

An unnamed Russian scientist has introduced the concept of a device that attaches to the wall of the artery. It would first stop blood flow to the area to prevent breakaway plaque. A drill would then scrape the plaque from the artery wall. The procedure of treating plaque buildup could include bypass surgery, stent replacement and balloon angioplasty. Since the plaques are of different types and locations in the body, the inventor proposed using different types of cutting mills.