Psoriatic arthritis is a chronic arthritis. In some people, it is mild, with just occasional flare ups. In other people, it is continuous and can cause joint damage if it is not treated. Early diagnosis is important to avoid damage to joints. Psoriatic arthritis typically occurs in people with skin psoriasis, but it can occur in people without skin psoriasis, particularly in those who have relatives with psoriasis. Psoriatic arthritis typically affects the large joints, especially those of the lower extremities, distal joints of the fingers and toes, and also can affect the back and sacroiliac joints of the pelvis. For most people, appropriate treatments will relieve pain, protect the joints, and maintain mobility. Physical activity helps maintain joint movement. Psoriatic arthritis is sometimes misdiagnosed as gout, rheumatoid arthritis or osteoarthritis. - See more at: http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Psoriatic-Arthritis#sthash.VsBTUw76.dpuf

During 34 week of pregnancy, the baby is getting ready for delivery, you may feel less wriggling and kicking. Watch out this video to learn more about being 34 weeks pregnant.

Inguinal hernia Diagram of an indirect, scrotal inguinal hernia ( median view from the left). Diagram of an indirect, scrotal inguinal hernia ( median view from the left). By far the most common hernias (up to 75% of all abdominal hernias) are the so-called inguinal hernias. For a thorough understanding of inguinal hernias, much insight is needed in the anatomy of the inguinal canal. Inguinal hernias are further divided into the more common indirect inguinal hernia (2/3, depicted here), in which the inguinal canal is entered via a congenital weakness at its entrance (the internal inguinal ring), and the direct inguinal hernia type (1/3), where the hernia contents push through a weak spot in the back wall of the inguinal canal. Inguinal hernias are more common in men than women while femoral hernias are more common in women.

Excision of breast cancer that is visible only on mammogram. diagnosis is typically established on stereotactic biospy and excision is done with wire localization. This techniques involves localization by sonography of the hematoma that is left behind at the time of biopsy. It provides not only accu...rate location of the tumor but ensures adequate margins of excision.

Neonatal resuscitation skills are essential for all health care providers who are involved in the delivery of newborns. The transition from fetus to newborn requires intervention by a skilled individual or team in approximately 10% of all deliveries. This figure is concerning because 81% of all babies in the United States are born in nonteaching, nonaffiliated level I or II hospitals. In such hospitals, the volume of delivery service may not be perceived as sufficient economic justification for the continuous in-hospital presence of personnel with high-risk delivery room experience, as recommended by the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG). [1] Perinatal asphyxia and extreme prematurity are the 2 complications of pregnancy that most frequently necessitate complex resuscitation by skilled personnel. However, only 60% of asphyxiated newborns can be predicted ante partum. The remaining newborns are not identified until the time of birth. Additionally, approximately 80% of low-birth-weight infants require resuscitation and stabilization at delivery. Nearly one half of newborn deaths (many of which involve extremely premature infants) occur during the first 24 hours after birth. Many of these early deaths also have a component of asphyxia or respiratory depression as an etiology. For the surviving infants, effective management of asphyxia in the first few minutes of life may influence long-term outcome. Even though prenatal care can identify many potential fetal difficulties ante partum, allowing maternal transfer to the referral center for care, many women who experience preterm labor are not identified prospectively and therefore are not appropriately transferred to a tertiary perinatal center. Consequently, many deliveries of extremely premature infants occur in smaller hospitals. For this reason, all personnel involved in delivery room care of the newborn should be trained adequately in all aspects of neonatal resuscitation. Additionally, equipment that is appropriately sized to resuscitate infants of all gestational ages should be available in all delivering institutions, even if the institution does not care for preterm or intensive care infants. Along with the necessary skills, the practitioner should approach any resuscitation with a good comprehension of transitional physiology and adaptation, as well as an understanding of the infant's response to resuscitation. Resuscitation involves much more than possessing an ordered list of technical skills and having a resuscitation team; it requires excellent assessment skills and a grounded understanding of physiology.

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LASIK, or "laser-assisted in situ keratomileusis," is the most commonly performed laser eye surgery to treat myopia, hyperopia and astigmatism. The goal of the treatment is to reshape the cornea to correct the refractive error of the eye.
The cornea is the transparent dome-shaped structure in front of the eye. The cornea refracts light and accounts for about two-thirds of the eye's total optical power. Altering the curvature of the cornea changes the way light rays enter the eye. As a result, the light rays can be focused properly onto the retina for clearer vision.
For nearsighted people, the laser is used to flatten the cornea. For farsighted people, the cornea is made steeper. For patients with astigmatism, the laser is used to smooth the irregularly-shaped cornea into a more regular shape.
The outer layer of the cornea - the epithelium – is capable of replacing itself within a few days after being damaged or removed. The deeper layer of the cornea – the stroma, on the contrary, is a permanent corneal tissue with very limited regenerative capacity. The stroma, if reshaped by a laser, will remain that way permanently.
In this procedure, a thin, circular "FLAP" is created in the surface of the cornea to gain access to the permanent corneal tissue. This can be done with a mechanical cutting tool called a microkeratome, OR, for a blade-free experience, by a femtosecond laser. An excimer laser is then used to remove some corneal tissue to reshape the cornea. Excimer laser uses cool ultraviolet light beams to vaporize microscopic amounts of tissue in a precise manner to accurately reshape the cornea. The excimer laser is computer-controlled and is programmed based on the patient’s refractive error. The flap is then laid back in place and is allowed to heal.
LASIK eye surgery is mostly painless and can be completed within minutes. Improved vision can usually be seen overnight.

PRK, or photorefractive keratectomy, was the first type of laser eye surgery for vision correction and is the predecessor to the popular LASIK procedure. In PRK, NO flap is created. Rather, the epithelial cells on the eye surface are simply removed. An excimer laser is then used to reshape the cornea just like it does in LASIK.
The vision correction outcomes of PRK surgery are comparable to those of LASIK, but the recovery period is longer. This is because the epithelium is completely removed in PRK and it takes a few days to regenerate. PRK patients also have more discomfort and haziness of vision in the first few days after the surgery. Improved vision also takes longer to achieve.
PRK does, however, offer certain advantages. Because PRK does not involve creation of a flap, which contains both epithelial and deeper stromal tissue, the entire thickness of the stroma is available for treatment. The treatment range is therefore higher. This is particularly useful for patients with high levels of myopia or for those whose cornea is too thin for LASIK. PRK is also free of flap-related complication risks.

Step-by-step process of performing endoscopic sinus surgery.

Red blood cells, most white blood cells, and platelets are produced in the bone marrow, the soft fatty tissue inside bone cavities. Two types of white blood cells, T and B cells (lymphocytes), are also produced in the lymph nodes and spleen, and T cells are produced and mature in the thymus gland.

Gonorrhea is a sexually transmitted disease (STD). It’s caused by infection with the bacterium Neisseria gonorrhoeae. It tends to infect warm, moist areas of the body, including the: urethra (the tube that drains urine from the urinary bladder) eyes throat vagina anus female reproductive tract (the fallopian tubes, cervix, and uterus) Gonorrhea passes from person to person through unprotected oral, anal, or vaginal sex. People with numerous sexual partners or those who don’t use a condom are at greatest risk of infection. The best protections against infection are abstinence, monogamy (sex with only one partner), and proper condom usage. Behaviors that make a person more likely to engage in unprotected sex also increase the likelihood of infection. These behaviors include alcohol abuse and illegal drug abuse, particularly intravenous drug use.

At Hutzel Women's Hospital, Dr. Giancarlo Mari performs breakthrough in-utero surgery to save the lives of high-risk twins developing with a rare "shared" circulatory problem. ~ Detroit Medical Center

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.

Shut the front door: Scientists have finally found the perfect breasts. No, they weren't hiding in the Amazon or roving solo across the Sahara (although we have no doubt there are women in both the Amazon and the Sahara who have magnificent mammaries); it turns out these perfect breasts were hiding in a plastic surgeon's office this whole time! Now, before you get all worked up, the American Society of Plastic Surgeons (ASPS) would like you to know that the super-fake looking plastic breasts of yore are not actually what people think are most attractive now. According to a study published in the Journal of Plastic and Reconstructive Surgery—which involved asking over 1,300 people to look at pictures of naked boobies and rank them by hotness (stop laughing, this is serious research!)—people preferred a more "real" and "normal" look from their silicone, with the ideal breast shape having a 45:55 ratio. People said the best chests have 45 percent of the fullness above the nipple line and 55 percent of the fullness below, in a slightly teardrop shape. Researchers noted this preference remained consistent across gender, racial, and ethnic groups with the 45:55 ratio favored by 87 percent of women in their 30s, 90 percent of men, and 94 percent of plastic surgeons.

The key difference between monophasic and biphasic defibrillator is that the monophasic defibrillator is a type of defibrillation waveform where a shock is delivered to the heart from one vector as shown below. Whereas, in biphasic defibrillation, shock is delivered to the heart via two vectors.

A stress ulcer is a single or multiple mucosal defect which can become complicated by upper gastrointestinal bleeding during the physiologic stress of serious illness.

Function and Anatomy: The hip is a ball and socket type joint, formed by the articulation of the head of the femur with the pelvis. Normal range of motion includes: abduction 45 degrees, adduction 20-30 degrees, flexion 135 degrees, extension 30 degrees, internal and external rotation. Hip pathology can cause symptoms anywhere around the joint, though frequently pain is anterior and radiates to the groin region. Additionally, pathology outside of the hip can be referred to this region. History and exam obviously help in making these distinctions.

Inflammatory bowel disease (IBD) involves chronic inflammation of all or part of your digestive tract. IBD primarily includes ulcerative colitis and Crohn's disease. Both usually involve severe diarrhea, pain, fatigue and weight loss. IBD can be debilitating and sometimes leads to life-threatening complications. Ulcerative colitis (UL-sur-uh-tiv koe-LIE-tis) is an inflammatory bowel disease that causes long-lasting inflammation and sores (ulcers) in the innermost lining of your large intestine (colon) and rectum. Crohn's disease is an IBD that cause inflammation of the lining of your digestive tract. In Crohn's disease, inflammation often spreads deep into affected tissues. The inflammation can involve different areas of the digestive tract — the large intestine, small intestine or both. Collagenous (kuh-LAJ-uh-nus) colitis and lymphocytic colitis also are considered inflammatory bowel diseases but are usually regarded separately from classic inflammatory bowel disease.

A small-bowel obstruction (SBO) is caused by a variety of pathologic processes. The leading cause of SBO in industrialized countries is postoperative adhesions (60%), followed by malignancy, Crohn disease, and hernias, although some studies have reported Crohn disease as a greater etiologic factor than neoplasia.

Thoracentesis is a procedure used to obtain a sample of fluid from the space around the lungs. Normally, only a thin layer of fluid is present in the area between the lungs and chest wall. However, some conditions can cause a large amount of fluid to accumulate. This collection of fluid is called a pleural effusion.

There are many factors that will determine how quickly, or completely you recover from your meniscal tear surgery. Key elements include your age, weight, and activity demands. The older you are, the heavier you are, the longer your recovery will be. The type of surgery you had will also impact upon your recovery. In some cases we only remove the torn piece — in general you will progress faster than someone who had sutures placed to repair the meniscus tear. Whether or not arthritis was found at the time of your meniscus surgery will also significantly influence your recovery from meniscus surgery. If you have arthritis then you are missing some or all of the cartilage on the ends of the bones. Knees with arthritis are prone to being more “cranky” during the recovery process. In those cases, a knee ice compression device can provide relief of pain/swelling. Many patients note they feel better wearing a compression sleeve during recovery. People with arthritis sometimes report improvement in their symptoms with supplements like Glucosamine, Curcumin, or Hyaluronic Acid which they believe (not proven) will smooth out the surface of the joint. Many try Tart Cherry juice because of its natural anti-inflammatory properties.. In the first few months following surgery, a knee compression sleeve does actually help many feel better. Some of the variables affecting your recovery from meniscus surgery are under your surgeon’s control. We can improve your immediate response after surgery with the use of various medications we inject within the knee before the surgery. We can also block a nerve on the side of your leg which will improve your pain for 18-24 hours after surgery. Many of you will purchase a ice compression sleeve to help minimize the pain after the surgery. In general, young, healthy active people with no evidence of osteoarthritis will experience a much more rapid recovery. Typically measured in days or a few weeks. Most people are off crutches in a day, and stop taking pain medicine within a day or two. In contrast, if you are a older, heavier and have arthritis as well as a meniscus tear, then you may take longer to recover — and may not experience a “full” recovery. This group can take weeks to months to improve. To ensure a good response to surgery, we also need to look at your health before surgery. Smoking leads to an increased infection rate and poorer healing. Diabetics with poor sugar control are at higher risk for infection and delays in healing as well. Obesity is a potential problem with anesthesia, the recovery from surgery and it may lead to more rapid progression of arthritis after surgery. The better shape you are in prior to surgery can influence your recovery.

Clinical Anatomy Lecture Illustrate The Anatomy Of The Abdominal Wall