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Do you suffer with depression? Maybe you’ve recently been diagnosed or are a caregiver to someone with depression. Learn more about this common mood disorder, including depression causes, risk factors, and prevention. We’ll help you take control of your depression and live an active, healthy life.
There have been rapid and remarkable changes over the recent past in treating Parkinson's disease. The development of new drugs and an understanding of how best to use them and the older drugs have significantly improved the quality of life of people with the disease. There are two general approaches to the treatment of Parkinson's disease with medication. The first approach attempts to increase the levels of dopamine in the brain and the second approach attempts to improve the symptoms of Parkinson's disease by other means. Most patients with Parkinson's disease can initially be treated with drugs that adequately alleviate their symptoms. If or when medications are not sufficiently effective, new, highly effective and safe surgical treatments are also available.
Phacolytic glaucoma usually is associated with a mature or hypermature cataract and typically occurs in elderly patients. Today, phacolytic glaucoma is rare in the United States, found primarily in areas where access to care is poor. Will the increase in the number of under- and uninsured patients lead to an increase in this condition? Evaluation and Diagnosis Signs and symptoms. Patients typically report acute-onset pain, decreased vision, tearing and photophobia. Examination will reveal injection, corneal edema, elevated IOP, anterior chamber reaction with or without pseudohypopyon, particles on the lens capsule and anterior capsule wrinkling. Patient history. The duration of symptoms should be elicited; a delayed presentation of more than five days since onset can result in glaucomatous disc damage and poorer prognosis.¹ The ocular history may reveal that the patient decided against removal of an advanced cataract. Prior intraocular surgery or trauma may have left residual lens material that could cause phacoanaphylactic glaucoma or exacerbate infectious endophthalmitis. Visual acuity and visual potential should be assessed. Exam essentials. A complete ophthalmologic examination should be done. The eye should be inflamed, and the cornea may be edematous due to the high IOP. The anterior chamber will demonstrate massive inflammation and/ or pseudohypopyon. Gonioscopy is essential; it will help rule out angle closure due to phacomorphic glaucoma or neovascularization of the angle. Assess ment of the posterior pole should be performed to rule out vitreous hemorrhage (which can result in ghost-cell glaucoma) or vitritis (which may be associated with infectious endophthalmitis or panuveitis). If the view to the fundus is obstructed, B-scan ultrasonography also should be performed. Differential diagnosis. The differential diagnosis includes infectious endophthalmitis, phacoanaphylactic glaucoma, inflammatory glaucoma, glaucoma secondary to intraocular tumor, phacomorphic glaucoma, acute-angle closure glaucoma and neovascular glaucoma. Management Medication. Medical management is used to temporarily control the glaucoma and inflammation. Initial treatment consists of hyperosmotic agents, aqueous suppressants, anti-inflammatory drugs and cycloplegics. Surgery. Definitive treatment is removal of the lens via extracapsular cataract extraction with or without an IOL. Some ophthalmologists defer placement of an IOL until after the inflammation subsides; however, there is no significant difference in final visual acuity between those patients who did receive an IOL and those who did not.¹ If the phacolytic glaucoma is of long duration (more than seven days), a combined trabeculectomy may be needed to prevent postoperative IOP spikes.² In eyes with hypermature Morgagnian cataracts, one must be especially careful, as the capsule is fragile, the zonules are weak and the view is difficult due to the white, milky cortex. Vision limited to light perception on presentation is not a contraindication to performing cataract extraction. Surgical Tips For a planned extracapsular cataract extraction with a posterior chamber IOL, fashion a superior fornix-based conjunctival flap.³ Make a partial-thickness incision along the sclerolimbal junction superiorly for 120 degrees with a No. 69 blade. Forty-five degrees away, a paracentesis should be done to decompress the eye. The anterior chamber fluid can be withdrawn for analysis, to look for macrophages and high molecular-weight proteins. Inject balanced salt solution in a cannula to wash out any residual particulate matter, then inject Healon or viscoelastic into the anterior chamber. Make an incision entering the anterior chamber at the 12 o’clock position with a keratome. A 26-gauge cystotome mounted on a syringe is then introduced through the 12 o’clock incision and used to puncture the capsular bag. The milky cortex should be aspirated as much as possible, until the nucleus is visible. Withdraw the needle through the keratome incision, then inject Healon through the 12 o’clock incision into the capsular bag. Next, enlarge the corneoscleral keratome incision with curved Westcott scissors to 120 degrees. Perform a partial V-shaped capsulotomy; this can be done either with the cystotome or with an angled Vannas scissors. Place viscoelastic under the nucleus to float the nucleus and sever any adhesions between the nucleus and the capsule. The nuclear portion of the lens can then be removed with an irrigating vectis (lens loop) with or without gentle pressure at the inferior limbus (6 o’clock). Irrigate and aspirate the residual cortex with the Simcoe cannula. Inspect the capsular bag; if it is intact, place a posterior chamber IOL into the bag. Close the incision with several interrupted 10-0 monofilament nylon sutures and reattach the conjunctival flap. Potential Sequelae and Prognosis Postoperatively, the patient should be managed with topical steroids and/or aqueous suppressants and hyperosmotics if necessary. Vitreous opacification behind the posterior capsule occurs in a small percentage of eyes. These vitreous opacities are typically absorbed by one to two weeks postoperatively. IOP usually is controlled without antiglaucoma medications after the cataract removal. A detailed glaucoma evaluation (including repeat gonioscopy to assess for peripheral anterior synechiae, visual field and optic nerve status) should be done to assess the extent of glaucomatous damage. The prognosis is dependent on the duration of elevated IOP, PAS and optic nerve damage. In one study, patients who were older than 60 and whose glaucoma was present for more than five days did significantly worse than a comparison group of younger individuals with shorter disease duration.
Knee replacement surgery advances are improving patients' experiences and outcomes. Knee surgery -- or even partial knee replacement -- is often the solution for advanced knee arthritis. Today you can regain significant mobility and flexibility after knee replacement thanks to advances in orthopedic surgery technology, materials and techniques. Knee replacement recovery times also have improved. This knee replacement surgery video covers what you can expect out of these knee joint replacement advances. Knee replacement surgery has been around for more than 30 years and is an incredibly successful operation. In the past the past, when a person had bad arthritis of the knee, they were pretty much out of luck other than taking aspirin. They'd be debilitated and limited in their activities. So, when a person has pain, stiffness, and their life is becoming restricted by that, that's when it's time to consider knee replacement. We always do non-surgical treatment first. When that doesn't work anymore, then it's time to consider knee replacement. About 500,000 a year are done, and most patients who have gone through this basically say that they wish they had done it sooner.
If you’re considering an epidural to help manage the pain of childbirth, you’re not alone. More than 60 percent of women delivering at hospitals elect for an epidural during labor. And with good reason: An epidural is considered one of the safest methods of pain control, with just one in 3,000 pregnancies experiencing serious complications. It’s also good for you, since you’ll remain awake and alert during the birth, as well as for your baby, since the drugs will barely reach your bloodstream (so they can’t get into hers).
S-ICD leaves the heart and vasculature untouched. It may be implanted using only anatomical landmarks, thereby eliminating the need for fluoroscopy during implant and therefore reducing radiation exposure for both patients and physicians and eliminating the need for lead apron during implant.
Is Air Travel During Pregnancy Safe? Traveling by air is considered safe for women while they are pregnant; however, the following ideas might make your trip safer and more comfortable. Most airlines allow pregnant women to travel through their eighth month.
Decompression is a surgical procedure that is performed to alleviate pain caused by pinched nerves (neural impingement). During a lumbar decompression back surgery, a small portion of the bone over the nerve root and/or disc material from under the nerve root is removed to give the nerve root more space and provide a better healing environment. There are two common types of spine surgery decompression procedures: Microdiscectomy Lumbar Microdiscectomy Microdiscectomy Surgery Video A microdiscectomy (a microdecompression) is typically performed for pain from a lumbar herniated disc. The surgery is considered reliable for leg pain caused by the herniated disc, most commonly called sciatica by patients, and most commonly referred to by medical practitioners as a radiculopathy. Read more about Microdiscectomy Surgery
Kidney transplant surgery carries a risk of significant complications, including: Blood clots Bleeding Leaking from or blockage of the tube (ureter) that links the kidney to the bladder Infection Failure of the donated kidney Rejection of the donated kidney An infection or cancer that can be transmitted with the donated kidney Death, heart attack and stroke
The inflatable penile prosthesis consists of two attached cylinders -- a reservoir and a pump -- which are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of saline. The reservoir is implanted under the rectus muscles in the lower abdomen. A pump is also connected to the system and sits under the loose skin of the scrotal sac, between the testicles. This penile prosthesis is referred to as a 3-piece inflatable penile prosthesis, due to the three different components. A 2-piece inflatable penile prosthesis consists of only two components: the attached cylinders and the combined reservoir and pump unit. Instead of the reservoir being placed behind the groin, it is combined with the pump into one housing unit that fits comfortably within the scrotum. The advantage of a 2-piece prosthesis in that the surgery is shorter and less complicated and there is no device parts in the abdomen. The disadvantage of the 2-piece prosthesis is that the smaller reservoir may not result in adequate erections in some men. To inflate the prosthesis, the man presses on the pump. The pump transfers saline from the reservoir to the cylinders in the penis, inflating them and causing an erection. Pressing on a deflation valve at the base of the pump returns the fluid to the reservoir, deflating the penis and returning it to the normal flaccid state.
Carpal tunnel release is a surgery used to treat and potentially heal the painful condition known as carpal tunnel syndrome. Doctors used to think that carpal tunnel syndrome was caused by an overuse injury or a repetitive motion performed by the wrist or hand, often at work. They now know that it’s most likely a congenital predisposition (something that runs in families) – some people simply have smaller carpal tunnels than others. Carpal tunnel syndrome can also be caused by injury, such as a sprain or fracture, or repetitive use of a vibrating tool. It's also been linked to pregnancy, diabetes, thyroid disease, and rheumatoid arthritis.
Tinnitus (TIN-ih-tus) is the perception of noise or ringing in the ears. A common problem, tinnitus affects about 1 in 5 people. Tinnitus isn't a condition itself — it's a symptom of an underlying condition, such as age-related hearing loss, ear injury or a circulatory system disorder