Top videos
The management of acute ischemic stroke has advanced greatly over the past 2 decades. New interventions, including intravenous and endovascular treatment strategies, have evolved to recanalize arteries and salvage the ischemic brain. The evolution of interventional approaches to the treatment of acute stroke has been prompted by the limitations of intravenous therapy and intended to extend the treatment window, improve recanalization rates, and subsequently long-term clinical outcomes. The major techniques that have defined the current field of interventional acute stroke management and the relevant past and current data, and ongoing clinical trials on interventional stroke therapy will be reviewed. New issues, such as futile recanalization, and time to microcatheter, will also be discussed.
The occurrence and extent of cerebral infarction is determined by three basic factors: i) site of arterial occlusion, ii) the rapidity of arterial occlusion, and iii) the presence or absence of collateral circulation. Grossly, infarcts are usually divided into pale (non-hemorrhagic) and hemorrhagic types. Infarcts evolve over time, thus their gross appearance gives a clue to when they occurred. The temporal evolution of an infarct occurs in three stages: i) acute (1 day – 1 week) – the involved area is soft and edematous and there is a blurring of anatomic detail; ii) subacute (1 week – 1 month) – there is obvious tissue destruction and liquefactive necrosis of the involved brain; iii) chronic (>1 month) – the damaged tissue has been phagocytized and there is cavition with surrounding gliosis. Microscopically there is also a temporal evolution of cerebral infarcts. During the earliest phase of infarction (0-48 hours) chromatolysis and swollen eosinophilic neurons are seen. Neuronal cell necrosis and an acute inflammatory response are usually seen from 24-72 hours. This response is typically followed by an influx of mononuclear cells which begin to phagocytize necrotic debris (3-5 days). From 1-2 weeks after the infarct there is vascular proliferation and reactive astrocytosis. Over time (>1 month) the necrotic tissue will be completely removed and a cystic cavity surrounded by a glial scar will be formed.
Odor is a topic that’s not only embarrassing to discuss for many, but it’s simply embarrassing to live with for anyone who may be experiencing it. Oftentimes, it’s the result of a vaginal yeast infection, but that’s not always the case — which is why it’s important to find the root cause. Having a healthy vagina is extremely important to overall health, healthy births and healthy marriages, and vaginal odor can be a signal that there might be a health issue at play. How this affects a woman’s self-esteem is another side effect, not to mention how it can affect her relationship with her significant other due to the impact it may have on their sex life. While there are many causes, most of the time it can be resolved through natural remedies. But where does this incredibly uncomfortable vaginal odor come from, and what is it in the first place? Vaginal odor is defined as any odor that originates from the vagina. It’s normal for your vagina to have a slight odor given it’s an opening to the interior of the body, but a strong vaginal smell, such as a fishy vaginal odor, could indicate a bigger problem and should be checked out with your physician.
Dizziness is a word that is often used to describe two different feelings. It is important to know exactly what you mean when you say "I feel dizzy," because it can help you and your doctor narrow down the list of possible problems. Lightheadedness is a feeling that you are about to faint or "pass out." Although you may feel dizzy, you do not feel as though you or your surroundings are moving. Lightheadedness often goes away or improves when you lie down. If lightheadedness gets worse, it can lead to a feeling of almost fainting or a fainting spell (syncope). You may sometimes feel nauseated or vomit when you are lightheaded. Vertigo is a feeling that you or your surroundings are moving when there is no actual movement. You may feel as though you are off balance, spinning, whirling, falling, or tilting. When you have severe vertigo, you may feel very nauseated or vomit. You may have trouble walking or standing, and you may lose your balance and fall.
A broken bone requires emergency medical care. Your child might have a broken (fractured) bone if he or she heard or felt a bone snap, has difficulty moving the injured part, or if the injured part moves in an unnatural way or is very painful to the touch. A sprain occurs when the ligaments, which hold bones together, are overstretched and partially torn. A strain is when a muscle or tendon is overstretched or torn. Sprains and strains generally cause swelling and pain, and there may be bruises around the injured area. Most sprains and strains, after proper medical evaluation, can be treated at home.
Common types of fractures include: Stable fracture. The broken ends of the bone line up and are barely out of place. Open, compound fracture. The skin may be pierced by the bone or by a blow that breaks the skin at the time of the fracture. ... Transverse fracture. ... Oblique fracture. ... Comminuted fracture.
How to Use Wash your hands. Check the drug label to be sure it is what your doctor prescribed. ... Remove pen cap. Look at the insulin. Wipe the tip of the pen where the needle will attach with an alcohol swab or a cotton ball moistened with alcohol.
Thyroiditis is a general term that refers to “inflammation of the thyroid gland”. Thyroiditis includes a group of individual disorders causing thyroidal inflammation but presenting in different ways. For example, Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the United States. Postpartum thyroiditis, which causes temporary thyrotoxicosis (high thyroid hormone levels in the blood) followed by temporary hypothyroidism, is a common cause of thyroid problems after the delivery of a baby. Subacute thyroiditis is the major cause of pain in the thyroid. Thyroiditis can also be seen in patients taking the drugs interferon and amiodarone.
Urinary tract infections (UTIs) are infections of the urethra, bladder, ureters, or the kidneys, which comprise the urinary tract. E. coli bacteria cause the majority of UTIs, but many other bacteria, fungi, and parasites may also cause UTIs. Females have a higher risk for UTIs than most males, probably because of their anatomy; other risk factors for UTIs include any condition that may impede urine flow (e.g., enlarged prostate, kidney stones, congenital urinary tract abnormalities, and inflammation). Patients with catheters or those who undergo urinary surgery and men with enlarged prostates are at higher risk for UTIs.
To understand high blood cholesterol (ko-LES-ter-ol), it helps to learn about cholesterol. Cholesterol is a waxy, fat-like substance that’s found in all cells of the body. Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs. However, cholesterol also is found in some of the foods you eat. Cholesterol travels through your bloodstream in small packages called lipoproteins (lip-o-PRO-teens). These packages are made of fat (lipid) on the inside and proteins on the outside. Two kinds of lipoproteins carry cholesterol throughout your body: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Having healthy levels of both types of lipoproteins is important. LDL cholesterol sometimes is called “bad” cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. (Arteries are blood vessels that carry blood from your heart to your body.) HDL cholesterol sometimes is called “good” cholesterol. This is because it carries cholesterol from other parts of your body back to your liver. Your liver removes the cholesterol from your body.
A ventricular septal defect (VSD) is an opening or hole in the wall that separates the two lower chambers of the heart. This wall is called the ventricular septum. The hole causes oxygen-rich blood to leak from the left side of the heart to the right side. This causes extra work for the right side of the heart, since more blood than necessary is flowing through the right ventricle to the lungs. The hole is usually closed with surgery. However, in certain situations, your child's cardiologist and surgeon may think it is best to close the hole with a special device. This procedure is done in the heart catheterization lab.
Cancer, also called malignancy, is an abnormal growth of cells. There are more than 100 types of cancer, including breast cancer, skin cancer, lung cancer, colon cancer, prostate cancer, and lymphoma. Symptoms vary depending on the type. Cancer treatment may include chemotherapy, radiation, and/or surgery.
Wound healing is the process by which skin or other body tissue repairs itself after trauma. ... This process is divided into predictable phases: blood clotting (hemostasis), inflammation, tissue growth (proliferation) and tissue remodeling (maturation).
Shoulder dystocia is a rare emergency that can happen during the end of the second stage of labour. It's all to do with how your baby moves down through your vagina and out into the world. Shoulder dystocia happens when your baby's head has been born, but one of her shoulders becomes stuck.
Ebola virus disease (EVD; also Ebola hemorrhagic fever, or EHF), or simply Ebola, is a viral hemorrhagic fever of humans and other primates caused by ebolaviruses. Signs and symptoms typically start between two days and three weeks after contracting the virus with a fever, sore throat, muscular pain, and headaches.
Cardiac cath is performed to find out if you have disease of the heart muscle, valves or coronary (heart) arteries. During the procedure, the pressure and blood flow in your heart can be measured. Coronary angiography is done during cardiac catheterization.
Sialorrhea or excessive drooling is a major issue in children with cerebral palsy and adults with neurodegenerative disorders. In this review, we describe the clinical features, anatomy and physiology of sialorrhea, as well as a review of the world literature on medical treatment using Yale University’s search engine; including but not limited to Medline and Erasmus. Level of drug efficacy is defined according to the guidelines of American Academy of Neurology. Current medical management is unsatisfactory. Topical agents (scopolamine and tropicamide) and oral agents (glyccopyrolate) combined render a level B evidence (probably effective); however, this treatment is associated with troublesome side effects. Double-blind and placebo-controlled studies of botulinum toxin (BoNT) provide a level A evidence for type B (two class I studies; effective and established) and both overall and individual B level of evidence for OnabotulinumtoxinA (A/Ona) and AbobotulinumtoxinA (A/Abo); these are probably effective. For IncobotulinumtoxinA (A/Inco), the level of evidence is U (insufficient) due to lack of blinded studies. Side effects are uncommon; transient and comparable between the two types of toxin. A clinical note at the end of this review comments on fine clinical points. Administration of BoNTs into salivary glands is currently the most effective way of treating sialorrhea.