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Lithium, a mood stabilizer used in bipolar disorder, has a narrow therapeutic index (small difference between therapeutic and toxic levels}. This patient's gradual onset of neurologic symptoms (slurred speech, confusion, tremors, and ataxia) is consistent with chronic lithium toxicity. Therapeutic lithium levels are 0.8- 1.2 mEq/L. Serum lithium levels >1.5 mEq/L confirm toxicity, and levels ;::2 .5 mEq/L require emergency management.
Benzodiazepines are a class of agents that work on the central nervous system, acting selectively on gamma-aminobutyric acid-A (GABA-A) receptors in the brain. GABA is a neurotransmitter that inhibits or reduces the activity of nerve cells (neurons) within the brain. Benzodiazepines open GABA-activated chloride channels, and allow chloride ions to enter the neuron. This makes the neuron negatively charged and resistant to excitation.
An atrioventricular septal defect (AVSD) is a heart defect in which there are holes between the chambers of the right and left sides of the heart, and the valves that control the flow of blood between these chambers may not be formed correctly. This condition is also called atrioventricular canal (AV canal) defect or endocardial cushion defect. In AVSD, blood flows where it normally should not go. The blood may also have a lower than normal amount of oxygen, and extra blood can flow to the lungs. This extra blood being pumped into the lungs forces the heart and lungs to work hard and may lead to
Jaw surgery, also known as orthognathic (or-thog-NATH-ik) surgery, corrects irregularities of the jaw bones and realigns the jaws and teeth to improve the way they work. Making these corrections may also improve your facial appearance. Jaw surgery may be a corrective option if you have jaw problems that can't be resolved with orthodontics alone. In most cases, you also have braces on your teeth before surgery and during recovery after surgery until healing and alignment are complete. Your orthodontist can work with your oral and jaw and face (maxillofacial) surgeon to determine your treatment plan.
Orthognathic surgery presented in this video in order of appearance. 1. Advancement Genioplasty 2. Maxillary Advancement 3. Maxillary impaction 4. BSSO Mandibular Advancement 5. BSSO Mandibular Set-back 6. Maxillary Posterior Impaction
Marcus Greatens, M.D., an orthopedic surgeon at Mayo Clinic Health System provides insight into a few of the things patients can expect to experience during knee replacement surgery.
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Pediatric orthopedic surgeons at Columbia are using a new device with magnetic technology that avoids the need for multiple spine-lengthening surgeries to correct early-onset scoliosis, a severe curvature of the spine in young children. In April 2014, Michael Vitale, MD, the Ana Lucia Professor of Pediatric Orthopedic Surgery at CUMC and 1995 graduate of P&S, performed the first procedure in the New York area, using the device to treat a 5-year-old boy. When braces and casts cannot control scoliosis in young children, surgeons turn to growing rods, which help correct the curve while allowing the spine to grow. When spinal maturity is near, the rods are removed and a spinal fusion can be performed. But during years of treatment with growing rods, patients must undergo surgery every six months to lengthen the rods to keep up with the patients’ growth. A patient may undergo eight to 10 procedures, which are costly and result in lost time for parents at work and children at school. The new device—MAGEC (MAGnetic Expansion Control) rods—contains a mechanism inside the growing rods that allows surgeons to lengthen the rods with a handheld external magnet, without surgery.
Simple or Total Mastectomy. The entire breast is removed, but no lymph nodes are taken in this procedure. Simple mastectomy is most frequently used for further cancer prevention or when the cancer has not spread to the lymph nodes.Oct 29, 2014