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Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels.
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.
Diagnosis of this condition is based on clinical symptoms alone, as there are no diagnostic laboratory tests. In order to meet the criteria for Tourette syndrome, both motor and vocal tics must be present before the age of 21 , and the tics must occur many times a day for at least 12 months which is the case in this patient. Tourette syndrome is associated with several comorbid conditions, with attention-deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD) the most common. OCD is therefore the condition this child is most at risk of developing in the future.
This is a video which discusses the Vioptix tOX system of near infrared spectroscopy for the monitoring of free tissue transfer. Having information as to the health of the microvascular anastomosis is critical to improved patient outcome and free tissue survival. With better monitoring, supplementing clinical evaluation, surgeons are able to assess the health of the free tissue better and potentially improve patient outcome. The example in this video is of a free breast reconstruction where the tOX system was used to remotely monitor the free flap. The surgeon can follow the flap real time and more importantly follow trend lines to help predict flap complications.
The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column. The brain and spinal cord together make up the central nervous system (CNS).
This cyst had been slowly growing for decades and created some redundant skin on the surface. A decision was made to make a slightly bigger incision in order to remove this tissue as well. As a result of this deeper process, 2 deep dermal sutures were added before the superficial interrupted sutures were put in place.
Emergency Contraception is a way to prevent pregnancy AFTER unprotected sex. Lots of people have questions about it: What does the morning after pill do? How does emergency contraception work to prevent pregnancy? What are the different types of emergency contraception? This video answers these questions and more.
Chalazions are extremely common, and having a sound surgical technique to drain a chalazion is a fundamental in general ophthalmology and oculoplastic surgery. I believe one of the biggest downfalls in treating chalazions is inadequate local anesthetic. Please that both the outer and inner surface to the eyelid need to receive local anesthesia to make the patient totally comfortable. It is important to be careful in delivering the local anesthetic and making sure you have control of the head position, and the position of your needle is bent to minimize any possibility of contact with the globe.
What is hemodiafiltration? Hemodiafiltration, or HDF, is a renal replacement modality that combines diffusion and convection to improve removal of molecules in the middle molecular weight range versus hemodialysis.
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