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A deep cut on the palm side of your fingers, hand, wrist, or forearm can damage your flexor tendons, which are the tissues that help control movement in your hand. A flexor tendon injury can make it impossible to bend your fingers or thumb.

An intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD or ICD) or coil, is a small, often T-shaped birth control device that is inserted into a woman's uterus to prevent pregnancy. IUDs are one form of long-acting reversible birth control (LARC).

A unique look into laboratory techniques for egg freezing, also known as oocyte cyropreservation. Take an exclusive look inside one of the most advanced, state-of-the-art in vitro fertilization (IVF) laboratories to see how RMA of New York performs egg freezing procedures using strict identification standards. Medical and laboratory video footage documents egg retrieval, egg identification from follicular fluid, preparation for preservation, and the cyropreservation and storage process for egg freezing. RMA of New York is proud to partner with Extend Fertility ™ to offer egg freezing services. To learn more, please visit Reproductive Medicine Associates of New York www.rmany.com/fertility-hope Or Extend Fertility http://www.extendfertility.com 635 Madison Avenue, 10th floor New York, New York 10022 Telephone: (212) 756-5777 Facsimile: (212) 756-5770 15 North Broadway, Garden Level - Suite G White Plains, New York 10601 Telephone: (914) 997-6200 Facsimile: (914) 997-8111 Reproductive Medicine Associates of New York, Long Island 400 Garden City Plaza, Suite 107 Garden City, NY 11530 Telephone: (516) 746-3633 Facsimile: (516) 746-3622 Reproductive Medicine Associates International Mexico, S.C. Prolongacion Paseo de la Reforma 1232, Oficina 1213 Colonia Lomas de Bezares Delegacion Miguel Hidalgo Mexico, Distrito Federal 11910 Telephone: 011-52-55-2167-2515 Fax: 011-52-55-2167-6434

Superficial Palpation of the Abdomen

Factitious disorder is the term used to describe a pattern of behavior centered on the exaggeration or outright falsifications of one’s own health problems or the health problems of others. Some people with this disorder fake or exaggerate physical problems; others fake or exaggerate psychological problems or a combination of physical and psychological problems. Factitious disorder differs from a pattern of falsified or exaggerated behavior called malingering. While malingerers make their claims out of a motivation for personal gain, people with factitious disorder have no such motivation.

If left untreated, these “brain blisters” can lead to stroke. Get unprecedented access inside the angiosuite to see how Babak Jahromi, MD, PhD, treats a cerebral aneurysm without ever opening the skull. #InsideTheOR

Dr. Neel Joshi, Clinical Chief, Department of Surgery at Cedars Sinai, describes his technique for trocar removal at the end of laparoscopic cholecystectomy.

#medicaleducation #laparoscopicsurgery

HPV causes genital warts and cervical and other anogenital cancers. The HPV vaccine is recommended for girls and women 9 to 26 years of age to reduce infections, but information on safety in pregnant women is limited.

This animated video covers statins, fibrates, niacin, bile resins, and ezetimibe. We will discuss mechanisms of action, which part of the lipid profile is affected by each drug, and common side effects.

Vaginoplasty is any surgical procedure that results in the construction or reconstruction of the vagina. It is a type of genitoplasty. Pelvic organ prolapse is often treated with one or more surgeries to repair the vagina.

Retropharyngeal abscess (RPA) produces the symptoms of sore throat, fever, neck stiffness, and stridor. RPA occurs less commonly today than in the past because of the widespread use of antibiotics for suppurative upper respiratory infections. The incidence of RPA in the United States is rising, however. Once almost exclusively a disease of children, RPA is observed with increasing frequency in adults. It poses a diagnostic challenge for the emergency physician because of its infrequent occurrence and variable presentation.

Sickle cell anemia (sickle cell disease) is a disorder of the blood caused by an inherited abnormal hemoglobin (the oxygen-carrying protein within the red blood cells). The abnormal hemoglobin causes distorted (sickled) red blood cells.

Skin changes are among the most visible signs of aging. Evidence of increasing age includes wrinkles and sagging skin. Whitening or graying of the hair is another obvious sign of aging. Your skin does many things. It: Contains nerve receptors that allow you to feel touch, pain, and pressure Helps control fluid and electrolyte balance Helps control your body temperature Protects you from the environment Although skin has many layers, it can generally be divided into three main parts: The outer part (epidermis) contains skin cells, pigment, and proteins. The middle part (dermis) contains blood vessels, nerves, hair follicles, and oil glands. The dermis provides nutrients to the epidermis. The inner layer under the dermis (the subcutaneous layer) contains sweat glands, some hair follicles, blood vessels, and fat. Each layer also contains connective tissue with collagen fibers to give support and elastin fibers to provide flexibility and strength.

Interstitial cystitis is a clinical syndrome characterized by daytime and nighttime urinary frequency, urgency, and pelvic pain of unknown etiology. Interstitial cystitis has no clear etiology or pathophysiology, and diagnostic criteria for the syndrome remain undefined. Despite considerable research, universally effective treatments do not exist; therapy usually consists of various supportive, behavioral, and pharmacologic measures. Surgical intervention is rarely indicated. The International Continence Society has coined the term painful bladder syndrome (suprapubic pain with bladder filling associated with increased daytime and nighttime frequency, in the absence of proven urinary infection or other obvious pathology) and reserves the diagnosis of interstitial cystitis for patients with characteristic cystoscopic and histologic features of the condition.[1] An international consensus panel was able to generally agree on the following definition of interstitial cystitis/bladder pain syndrome (IC/BPS): unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder and associated with lower urinary tract symptoms of more than 6 weeks duration, in the absence of infection or other identifiable causes. American Urological Association (AUA) guidelines published in 2011 and amended in 2014 use an evidence-based approach to provide a clinical framework for the diagnosis and management of this condition.[2, 3, 4] In 1887, Skene initially described a condition characterized by inflammation that destroyed the urinary bladder "mucous membrane partly or wholly and extended to the muscular parietes." Guy Hunner popularized the disease with the description of characteristic bladder wall ulcers in association with a symptom complex of chronic bladder inflammation.[5] The first comprehensive epidemiologic description of interstitial cystitis is credited to Hand, who in 1949 described the widespread, small, submucosal bladder hemorrhages and the significant variation in bladder capacity characteristic of the condition. Despite years of intensive research, there are no specific clinical or urinary markers currently clinically available; no absolutely specific radiographic, laboratory, or serologic findings; and no biopsy patterns that are pathognomonic for interstitial cystitis. Some research suggests that the following may all play a role in the disease pathophysiology: (1) pelvic floor dyfunction, (2) dysregulated immune or inflammatory signals, (3) neural hypersensitivity, and (4) disruption of the proteoglycan/glycosaminoglycan (GAG) layer.[6] Interstitial cystitis, howerver, remains a diagnosis of exclusion (see Presentation, DDx, and Workup.) Intensive study has been done to attempt to identify biomarkers for IC/BPS. Some interesting studies have shown that bladder nitric oxide is an accurate marker for Hunner lesions, but these are not present in all patients, and the test requires specific equipment, which has limited widespread clinical use.[7] Differences in levels of cytokines and chemokines, specifically CXCL-10, have shown some ability to differentiate patients with and without Hunner lesions.[8] Other studies of ulcerative IC/BPS have shown that numerous other cytokines and chemokines are up-regulated as well, heralding a possible urinary test to identify patients.[9] An additional substance shown to be up-regulated in IC/BPS patients is antiproliferative factor (APF). This small 8–amino-acid peptide has been associated with suppression of cell growth, increases in transcellular permeability, and lowering of levels of proteins that form intercellular junctional complexes. It is synthesized and secreted from bladder epithelial cells from patients with IC/BPS and may play a key role in pathophysiology.[10] In vitro studies have shown that removal of APF from cell culture media restored cell proliferation and membrane integrity.[11] Studies have also suggested APF in the therapeutic effect of hydrodistension in patients with IC/BPS, although further confirmatory studies are necessary.[12] The most important element in treating patients with interstitial cystitis is education and emotional support. Periodic exacerbations are managed as they occur because no long-term therapy has been shown to prevent or delay recurrent episodes. Therefore, the purpose of treatment is to palliate and alleviate symptoms. Because no discrete pathognomonic pathologic criteria exist for assessing and monitoring disease severity, indications and goals for treatment are based on the degree of patient symptoms. Assessing patient response to treatment is also complicated because of the subjective nature of symptoms; the waxing and waning nature of symptoms without treatment; and the lack of objective serologic, physical, or histopathologic findings. Conservative measures and oral or intravesical treatments are considered first-line treatment. (See Treatment.)

Symptoms of hepatic encephalopathy differ depending on the underlying cause of the liver damage. Symptoms and signs of hepatic encephalopathy may include: difficulty thinking. personality changes. poor concentration. problems with handwriting or loss of other small-hand movements. confusion. forgetfulness. poor judgment.

Biliary Colic Examination

Thoracic Epidural Placement Paramedian Approach