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Surgical site infections (SSIs) remain a prevalent threat to patient safety. Proper surgical hand scrub or rub techniques are essential to decreasing the incidence of SSIs. This video provides instructions on the anatomical surgical hand scrub procedure using the brushstroke method. Learn more from the Department of Hospital Epidemiology and Infection Control (HEIC) at The Johns Hopkins Hospital: http://www.hopkinsmedicine.org/heic
The diffuse lung diseases tend to cause infiltrative opacification in the periphery of the lung. As the name of the group of diseases suggests, they are diffuse. While the consolidation or ground-glass change is usually bilateral, it may be localised, e.g. radiation pneumonitis.
UPDATE 2/6/15: A new version of this animation is now available! https://www.youtube.com/watch?v=E1ljClS0DhM
This 3D medical animation depicts the surgical removal of the appendix (appendectomy) using laparoscopic instruments. The surgery animation begins by showing an inflamed appendix (appendicitis), followed by the placement of the laparoscope. Afterward, one can see the surgical device staple, cut and remove the inflamed appendix. Following the removal of the appendix the abdomen is flushed with a sterile saline solution to ensure all traces of infection have been removed.
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Angioplasty is a procedure to restore blood flow through the artery. You have angioplasty in a hospital. The doctor threads a thin tube through a blood vessel in the arm or groin up to the involved site in the artery. The tube has a tiny balloon on the end.
Macrobiopsy of breast lesions is a complicated procedure when performed with vacuum assisted biopsy tools. The Spirotome is a hand-held needle set that doesn't need capital investment, is ready to use and provides tissue samples of high quality in substantial amounts. In this way quantitative molecular biology is possible with one tissue sample. The Coramate is an automated version of this direct and frontal technology.
Intra-abdominal abscess continues to be an important and serious problem in surgical practice. Appropriate treatment is often delayed because of the obscure nature of many conditions resulting in abscess formation, which can make diagnosis and localization difficult. Associated pathophysiologic effects may become life threatening or lead to extended periods of morbidity with prolonged hospitalization. Delayed diagnosis and treatment can also lead to increased mortality; therefore, the economic impact of delaying treatment is significant.
This video demonstrates a manual small incision cataract surgery using a Blumenthal technique, in a white cataract.
Surgeon: Dr. Rishi Swarup, FRCS, Medical Director & Senior Consultant, Swarup Eye Centre, India
Upper gastrointestinal bleeding (sometimes upper GI, UGI bleed, Upper gastrointestinal hemorrhage, gastrorrhagia) refers to bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. In fact, the proportion of UGIB cases caused by peptic ulcer disease has declined, a phenomenon that is believed to be due to the use of proton pump inhibitors (PPIs) and H pylori therapy. Duodenal ulcers are more common than gastric ulcers, but the incidence of bleeding is identical for both.
At one time, women who had delivered by cesarean section in the past would usually have another cesarean section for any future pregnancies. The rationale was that if allowed to labor, many of these women with a scar in their uterus would rupture the uterus along the weakness of the old scar. Over time, a number of observations have become apparent: Most women with a previous cesarean section can labor and deliver vaginally without rupturing their uterus. Some women who try this will, in fact, rupture their uterus. When the uterus ruptures, the rupture may have consequences ranging from near trivial to disastrous. It can be very difficult to diagnose a uterine rupture prior to observing fetal effects (eg, bradycardia). Once fetal effects are demonstrated, even a very fast reaction and nearly immediate delivery may not lead to a good outcome. The more cesarean sections the patient has, the greater the risk of subsequent rupture during labor. The greatest risk occurs following a “classical” cesarean section (in which the uterine incision extends up into the fundus.) The least risk of rupture is among women who had a low cervical transverse incision. Low vertical incisions probably increase the risk of rupture some, but usually not as much as a classical incision. Many studies have found the use of oxytocin to be associated with an increased risk of rupture, either because of the oxytocin itself, or perhaps because of the clinical circumstances under which it would be contemplated. Pain medication, including epidural anesthetic, has not resulted greater adverse outcome because of the theoretical risk of decreasing the attendant’s ability to detect rupture early. The greatest risk of rupture occurs during labor, but some of the ruptures occur prior to the onset of labor. This is particularly true of the classical incisions. Overall successful vaginal delivery rates following previous cesarean section are in the neighborhood of 70 This means that about 30of women undergoing a vaginal trial of labor will end up requiring a cesarean section. Those who undergo cesarean section (failed VBAC) after a lengthy labor will frequently have a longer recovery and greater risk of infection than had they undergone a scheduled cesarean section without labor. Women whose first cesarean was for failure to progress in labor are only somewhat less likely to be succesful in their quest for a VBAC than those with presumably non-recurring reasons for cesarean section. For these reasons, women with a prior cesarean section are counseled about their options for delivery with a subsequent pregnancy: Repeat Cesarean Section, or Vaginal Trial of Labor. They are usually advised of the approximate 70successful VBAC rate (modified for individual risk factors). They are counseled about the risk of uterine rupture (approximately 1in most series), and that while the majority of those ruptures do not lead to bad outcome, some of them do, including fetal brain damage and death, and maternal loss of future childbearing. They are advised of the usual surgical risks of infection, bleeding, anesthesia complications and surgical injury to adjacent structures. After counseling, many obstetricians leave the decision for a repeat cesarean or VBAC to the patient. Both approaches have risks and benefits, but they are different risks and different benefits. Fortunately, most repeat cesarean sections and most vaginal trials of labor go well, without any serious complications. For those choosing a trial of labor, close monitoring of mother and baby, with early detection of labor abnormalities and preparation for