We herein describe endoscopic treatment of symptomatic pancreatic pseudocyst with significant necrosis and a fistula. Fifty eight year old man had presented to us with a large pseudocyst following an episode of acute pancreatitis. He was complaining of significant abdominal pain for two months. A... CT scan abdominal had revealed a large retro-gastric pseudocyst with necrosis and portal venous thrombosis. An upper GI endoscopy had revealed small linear fundal varcies. Endoscopic as well as surgical treatment for the cyst was discussed with the patient. Patient wished not to undergo surgical treatment and therefore endoscopic treatment was selected after a proper consent. EUS was performed to see for the interposed vessel prior to the pseudocyst puncture. Needle knife puncture was made and a guide wire was passed in the pseudocyst cavity. After confirming the wire placement in the cyst, the tract was dilated up to 20 mms using a CRE balloon. Fluid from the cyst was emptied out in the stomach. An ERCP scope was passed in to the cyst cavity, which revealed a significant necrotic material (much more than what the CT scan had revealed). All the free lying necrotic material was taken out with the help of a snare and a dormia basket. A lot of necrotic was stuck to the cyst wall, which was removed with the help of water jet, mechanical scooping and cutting through using a needle knife papillotome. Three 10 fr. Pigtail stents were placed at the end of the procedure. Further necrosectomy was carried out on alternate days for three more sessions. Dilation was required prior to each session three pigtail trans-gastric stents were placed at the end of each session. Single stent was kept in situ during each procedure to guide the path (the position of the stoma changed dramatically once the cyst was empty). During the last lesion (session four), a pancreatogram was taken. It revealed a mildly dilated CBD in the head, normally duct in the proximal body with a leak from the distal body, and contrast was seen going in to the pseudocyst cavity. The duct could not be opacified distally. A 7 fr. 15 cms stent was placed trans-papillary. When the cyst cavity was reentered through trans-gastric route, the trans-papillary pancreatic stent was clearly visible with soft necrotic material around it. In fact, the stent guided further necrosis removal. It also helped in diverting the pancreatic juice to the duodenum rather than in the pseudocyst cavity. Patient was discharged after this session and was followed up regularly. A CT scan was obtained after three months, which revealed a complete resolution of the necrosis and pseudocyst. There was a possibility of a persistent fistula after the removal of trans-papillary stent and a recurrence of the pseudocyst. Fistula closure with cyanoacrylate glue is well described in the literature. The procedure can have obvious complications secondary to accidental blockage of the main pancreatic duct. So, we thought it prudent to use a safer alternative to treat the condition. We removed the longer pancreatic stent and replaced it with a shorter pancreatic stent occupying only the head region. The patient was followed up after a month; sonography of the abdomen did not reveal any recurrence of the pseudocyst. All the stents were removed at this examination.

We will present technique of lifting a corneal flap, 10 months post IntraLASIK surgery, after epithelial nest. The nest changed in size and started to grow. The technique is minimal invasive and included partial flap lifting.

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Bat Ears Correction Plastic Surgery

DMC Heart Imaging Specialist Doctor Hamid Sattar uses the 64-slice Coronary CTA to find coronary artery disease before symptoms even appear. ~ Detroit Medical Center

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DRE

Toxin is a protein produced by the bacterium Clostridium botulinum, and is extremely neurotoxic.

Amyotrophic lateral sclerosis The disorder causes muscle weakness and atrophy throughout the body caused by degeneration of the upper and lower motor neurons. Unable to function, the muscles weaken and atrophy. Affected individuals may ultimately lose the ability to initiate and control all voluntary movement, although bladder and bowel sphincters and the muscles responsible for eye movement are usually, but not always, spared. Cognitive function is generally spared for most patients although some (~5%) also have frontotemporal dementia.A higher proportion of patients (~30-50%) also have more subtle cognitive changes which may go unnoticed but are revealed by detailed neuropsychological testing. Sensory nerves and the autonomic nervous system, which controls functions like sweating, are generally unaffected but may be involved for some patients. The earliest symptoms of ALS are typically obvious weakness and/or muscle atrophy. Other presenting symptoms include muscle fasciculation (twitching), cramping, or stiffness of affected muscles; muscle weakness affecting an arm or a leg; and/or slurred and nasal speech. The parts of the body affected by early symptoms of ALS depend on which motor neurons in the body are damaged first. About 75% of people contracting the disease experience "limb onset" ALS i.e. first symptoms in the arms ("upper limb", not to be confused with "upper motor neuron") or legs ("lower limb", not to be confused with "lower motor neuron"). Patients with the leg onset form may experience awkwardness when walking or running or notice that they are tripping or stumbling, often with a "dropped foot" which drags along the ground. Arm-onset patients may experience difficulty with tasks requiring manual dexterity such as buttoning a shirt, writing, or turning a key in a lock. Occasionally, the symptoms remain confined to one limb for a long period of time or for the whole course of the illness; this is known as monomelic amyotrophy. About 25% of cases are "bulbar onset" ALS. These patients first notice difficulty speaking clearly or swallowing. Speech may become slurred, nasal in character, or quieter. Other symptoms include difficulty swallowing, and loss of tongue mobility. A smaller proportion of patients experience "respiratory onset" ALS where the intercostal muscles that support breathing are affected first. Regardless of the part of the body first affected by the disease, muscle weakness and atrophy spread to other parts of the body as the disease progresses. Patients experience increasing difficulty moving, swallowing (dysphagia), and speaking or forming words (dysarthria). Symptoms of upper motor neuron involvement include tight and stiff muscles (spasticity) and exaggerated reflexes (hyperreflexia) including an overactive gag reflex. An abnormal reflex commonly called Babinski's sign (the big toe extends upward and other toes spread out) also indicates upper motor neuron damage. Symptoms of lower motor neuron degeneration include muscle weakness and atrophy, muscle cramps, and fleeting twitches of muscles that can be seen under the skin (fasciculations). Around 15–45% of patients experience pseudobulbar affect, also known as "emotional lability", which consists of uncontrollable laughter, crying or smiling, attributable to degeneration of bulbar upper motor neurons resulting in exaggeration of motor expressions of emotion.

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Removing ArterioVenous Malformation in Brain

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Male 19 y. age victim of penetrating brain injury. All the criteria for the encephalic death diagnosis were present. The presence of this complex spinal reflex doesn't exclude the brain death diagnosis and must be known and understood by the professionals involved in this very important diagnosis

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Remedios Caseros Para La Gastritis, Remedio Para La Gastritis, Jugos Para La Gastritis

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La cura natural comienza desde el interior revirtiendo las causas que la originan.

“La gastritis” se da por problemas digestivos y la deficiente función del sistema inmunológico, resultado de una incorrecta alimentación y de malos hábitos.

Se debe curar la raíz, “La Raíz Son Los Hábitos En El Estilo De Vida”, de lo contrario nada efectivo sucederá por más antiácidos, antibióticos o simples remedios caseros que tomemos. E incluso ni una cirugía la soluciona. Al contrario todo esto complica el problema.

La cura natural y definitiva se logra aplicando un conjunto de técnicas como las siguientes:

. Incorporando una correcta nutrición con alimento físico y otros elementos importantes de la naturaleza.

. Incorporando hábitos saludables.

. Infusión de hierbas.

. El consumo de minerales naturales.

. Evitando el consumo alimentos tóxicos y dañinos.

. Eliminando el consumo de medicamentos.


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Comment Avoir Un Ventre Plat, Rajeuni, Rajeunir De 10 Ans En 3 Mois, Bruleur De Graisse Musculation

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5 Raisons pourquoi le Cardio Long-Lent n’est PAS bon.

En passant à travers les e-mails de clients au cours des derniers jours, j'ai remarqué que beaucoup de gens font encore du cardio longue durée, à faible intensité, beurk!

Voici l'affaire: si vous cherchez à obtenir un bénéfice maximal du temps que vous mettez dans vos séances d'entraînement, le cardio de longue durée à faible intensité n'est pas la voie à suivre, et pour de nombreuses raisons.

En fait, je n’ai le temps pour faire que quelques heures d'exercice par semaine, et vous savez quoi? C'est tout ce dont vous avez besoin. En fait, la recherche a montré que plus de 90 minutes par semaine peuvent être nuisibles! (Plus d'infos ici)


Ces 5 étapes Révèlent Les Choses Que Vous Devez ABSOLUMENT ÉVITER Si Vous Voulez Ralentir Le Processus De Vieillissement, Récupérer Votre Santé Et Atteindre Un Corps Idéal.

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http://123-paleo.info-pro.co Gesunde Ernährung, Ernährung Umstellen, Marcumar Ernährung, Paleo Lebensmittel, Paleo Rezept. Wahrscheinlich wirst du dich als Paleo-Anhänger schon einmal gefragt haben, warum die Steinzeiternährung Getreide meidet wie die Pest. Gut, die Begründung, dass Menschen vor Tausenden von Jahren ebenfalls kein Getreide hatten, ist ja schön. Aber das kann ja nicht alles sein. Ist es auch nicht. Wie immer liegt der Teufel im Detail. Hauptverantwortlich für die große „Angst“ vor Getreideprodukten sind vor allem Gluten, sogenannte Anti-Nährstoffe. Bereits dieser Name ist angsteinflößend. Und das durchaus zu Recht. Denn Gluten besitzen nur wenige positive, dafür jedoch umso mehr negative Eigenschaften, die sich längerfristig schlecht auf deine Gesundheit auswirken können. Was ist Gluten und welche Lebensmittel enthalten Gluten? Gluten ist ein Eiweiß mit besonders starken Klebeeigenschaften. Dies ist auch der Grund, weswegen beispielsweise Brotteig so gut zusammenklebt. Gluten findet sich hauptsächlich in Getreide, beispielsweise ein Roggen oder Gerste, Dinkel oder Weizen und Hafer. Hieraus ergibt sich zwangsläufig, dass auch viele Lebensmittel des täglichen Lebens jede Menge Gluten enthalten. Hierzu gehören nicht nur Schokolade oder Bier, Reis oder Nudeln, sondern auch Pommes oder Milcherzeugnisse. Auch in den meisten Fertiggerichten ist Gluten vorzufinden.

ERCP is most commonly performed to diagnose conditions of the pancreas or bile ducts, and is also used to treat those conditions. It is used to evaluate symptoms suggestive of disease in these organs, or to further clarify abnormal results from blood tests or imaging tests such as ultrasound or CT scan. The most common reasons to do ERCP include abdominal pain, weight loss, jaundice (yellowing of the skin), or an ultrasound or CT scan that shows stones or a mass in these organs. ERCP may be used before or after gallbladder surgery to assist in the performance of that operation. Bile duct stones can be diagnosed and removed with an ERCP. Tumors, both cancerous and noncancerous, can be diagnosed and then treated with indwelling plastic tubes that are used to bypass a blockage of the bile duct. Complications from gallbladder surgery can also sometimes be diagnosed and treated with ERCP. In patients with suspected or known pancreatic disease, ERCP will help determine the need for surgery or the best type of surgical procedure to be performed. Occasionally, pancreatic stones can be removed by ERCP.