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Pericardial window is used diagnostically and, more often, therapeutically for drainage of accumulated pericardial fluid (a condition that most often occurs after cardiac surgery but has many other possible causes). The pericardium envelops the heart like a cocoon; its cardiac filling can be impaired when this cavity fills with excess fluid. When the limited space between the noncompliant pericardium and heart is acutely filled with blood or fluid, cardiac compression and tamponade may result. Pericardial window in combination with systemic chemotherapy may also prevent accumulation of large fluid volumes in patients with neoplastic pericardial disease. [1, 2] Indications The following are indications for a pericardial window [6] : Symptomatic pericardial effusions Asymptomatic pericardial effusions that warrant a pericardial window for diagnosis Hemodynamically stable patients with an undiagnosed pericardial effusion (a thoracoscopic approach is ideal) Coexisting pericardial, pleural, or pulmonary pathology that requires diagnosis or therapy (a thoracoscopic approach is ideal) Known benign effusions that reaccumulate after aspiration Drainage of a purulent pericardial effusion Early fungal or tuberculous pericarditis in which resection of the pericardium is required to prevent future pericardial constriction Use as part of the mediastinal debridement, in patients with descending mediastinitis
Surgery is an elective procedure done in people who have had extensive testing to decide if they are potential candidates. The following criteria are considered when determining if a person may be a good candidate for surgery. Person has failed adequate trials of two first-line seizure medicines (ones that are commonly effective in controlling the type of seizures the person is experiencing) and one combination of at least two drugs. A trial of a medication is considered adequate when it has been increased gradually to the maximum dosage that does not cause serious side effects. If the person has frequent seizures, any improvement will be obvious after a short time. If the seizures generally occur far apart, however, it may take months to determine whether a medication is helping. At some epilepsy centers, patients are offered additional conventional or experimental medications before surgery is considered. But research suggests that each time a trial of medication fails to control a person's seizures, it becomes less likely that a different medicine or combination will be successful. Since uncontrolled seizures present serious physical risks and social and psychological consequences, the trend these days is to proceed with surgery much sooner than in the past if it seems appropriate for that person.
Smoking causes: Chronic obstructive pulmonary disease (COPD), a disease that gets worse over time and causes wheezing, shortness of breath, chest tightness, and other symptoms. Emphysema, a condition in which the walls between the air sacs in your lungs lose their ability to stretch and shrink back.
Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern, most women don't experience blood loss severe enough to be defined as menorrhagia. With menorrhagia, you can't maintain your usual activities when you have your period because you have so much blood loss and cramping. If you dread your period because you have such heavy menstrual bleeding, talk with your doctor. There are many effective treatments for menorrhagia.
The Distal Femoral Osteotomy System utilizes the same principles of design featured in the Tibial Osteotomy System. Specifically designed femoral osteotomy plates take into account the anatomical differences between the distal femur and proximal tibia.
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This is one of the most interesting medical topics to discuss. What are the responsibilities of a doctor? What are the basic skills a doctor needs to have? and what are the responsibilities of a doctor?
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A pneumothorax (noo-moe-THOR-aks) is a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse. In most cases, only a portion of the lung collapses.
hemothorax is most often defined as rapid accumulation of ≥ 1000 mL of blood. Shock is common. Patients with large hemorrhage volume are often dyspneic and have decreased breath sounds and dullness to percussion (often difficult to appreciate during initial evaluation of patients with multiple injuries).
Dr. Kathryn Baerman is a Board Certified General Surgeon specializing in Women's Health and Breast Care. She shares with us that in women, hernias present differently than in men. If you are experiencing groin pain, it may be a hernia.
To visit Dr. Baerman in Apex, Chapel Hill, or Durham, North Carolina, call 919-281-1699 to schedule an appointment with her at EmergeOrtho.
A glucagonoma is a rare tumor of the alpha cells of the pancreas that results in the overproduction of the hormone glucagon. Alpha cell tumors are commonly associated with glucagonoma syndrome, though similar symptoms are present in cases of pseudoglucagonoma syndrome in the absence of a glucagon-secreting tumor.
ADC was first identified early in the AIDS epidemic as a common and novel CNS syndrome.(4,5) The three components of the term, AIDS dementia complex embody central features of the condition. AIDS emphasizes its morbidity and poor prognosis, particularly when its severity is at stage 2 or greater (see Table 1), a severity comparable to other clinical AIDS-defining complications of HIV-1 infection. Dementia designates the acquired and persistent cognitive decline with preserved alertness that usually dominates the clinical presentation and determines its principal disability. Complex emphasizes that this disease not only impairs the intellect, but also concomitantly alters motor performance and, at times, behavior. This involvement of the nervous system beyond cognition is evidence of a wider involvement of the CNS than occurs in some other types of dementia such as Alzheimer's disease. Additionally, myelopathy may be an important, indeed predominating, aspect of ADC, and organic psychosis may also be a feature in a subset of patients (see Rheumatologic and Musculoskeletal Manifestations of HIV). These manifestations are therefore also encompassed within this term. By contrast, neither neuropathy nor functional psychiatric disturbance are included in ADC.