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Treating osteoporosis with bisphosphonates, particularly for more than five years, has been linked to some side effects, including atypical femur fractures. Osteoporosis medications are supposed to prevent bone breaks. But if they are taken for too long, the opposite can happen. This video highlights what you need to know as a healthcare professional to educate patients
Amniotomy is the official term for artificially breaking the bag of waters during labor. It is believed that breaking the bag of waters will help to speed up an otherwise slow labor. Amniotomy is part of the Active Management of Labor practiced in some hospitals. Amniotomy is performed by a midwife or doctor. A long, thin instrument with a hook on the end is inserted into the vagina and through the cervix so it can catch and rip the bag of waters. To perform an amniotomy, the cervix must be dilated enough to allow the instrument through the cervix, generally at least a two. Why choose Amniotomy? Unlike other medical methods of starting labor, amniotomy does not add synthetic hormones to your labor. Instead it seems to stimulate your body’s own labor process. Amniotomy allows the use of an internal electronic fetal monitor. How effective is Amniotomy? Amniotomy alone is unpredictable, it may take hours for labor to start with amniotomy. Because amniotomy increases the risk for infection, most caregivers use amniotomy in combination with synthetic oxytocin. Birth does happen faster when amniotomy is combined with synthetic oxytocin than when amniotomy is used alone. Risks of Amniotomy Risks for Mother Increases the risk for infection. This risk is increased with length of time the waters are broken and with vaginal exams. Because of the infection risk, a time limit is given by which the mother must give birth. As the time limit approaches attempts to progress labor will become more aggressive. The fore waters equalize pressure on the cervix so it will open uniformly. When they are broken, the mother increases her chances of having uneven dilation. Risks for Baby Increases the risk of umbilical cord compression. The fore waters equalize pressure on the baby’s head as it presses against the cervix. When they are broken, the pressure on the baby’s head may be uneven causing swelling in some parts.
What Is a Hair Transplant? It's a type of surgery that moves hair you already have to fill an area with thin or no hair. Doctors have been doing these transplants in the U.S. since the 1950s, but techniques have changed a lot in recent years. You usually have the procedure in the doctor's office. First, the surgeon cleans your scalp and injects medicine to numb the back of your head. Your doctor will choose one of two methods for the transplant: follicular unit strip surgery (FUSS) or follicular unit extraction (FUE). With FUSS, the surgeon removes a 6- to 10-inch strip of skin from the back of your head. He sets it aside and sews the scalp closed. This area is immediately hidden by the hair around it. Next, the surgeon’s team divides the strip of removed scalp into 500 to 2,000 tiny grafts, each with an individual hair or just a few hairs. The number and type of graft you get depends on your hair type, quality, color, and the size of the area where you’re getting the transplant. If you’re getting the FUE procedure, the surgeon’s team will shave the back of your scalp. Then, the doctor will remove hair follicles one by one from there. The area heals with small dots, which your existing hair will cover. After that point, both procedures are the same. After he prepares the grafts, the surgeon cleans and numbs the area where the hair will go, creates holes or slits with a scalpel or needle, and delicately places each graft in one of the holes. He’ll probably get help from other team members to plant the grafts, too. Depending on the size of the transplant you’re getting, the process will take about 4 to 8 hours. You might need another procedure later on if you continue to lose hair or decide you want thicker hair. Expectations and Recovery After the surgery, your scalp may be very tender. You may need to take pain medications for several days. Your surgeon will have you wear bandages over your scalp for at least a day or two. He may also prescribe an antibiotic or an anti-inflammatory drug for you to take for several days. Most people are able to return to work 2 to 5 days after the operation. Within 2 to 3 weeks after surgery, the transplanted hair will fall out, but you should start to notice new growth within a few months. Most people will see 60% of new hair growth after 6 to 9 months. Some surgeons prescribe the hair-growing drug minoxidil (Rogaine) to improve hair growth after transplantation, but it’s not clear how well it works. Risks and Costs of Treatment The price of a hair transplant will depend largely on the amount of hair you’re moving, but it generally ranges from $4,000 to $15,000. Most insurance plans don’t cover it.
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An animation of blood flow inside the Hemodialysis circuit.
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Dr. Ahmad Oussama Rifai is certified by the American Board of Internal Medicine (ABIM) in the specialty of Internal Medicine and the sub-specialty of Nephrology.
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In this instructional video, Director of Critical Care Nephrology, Sevag Demirjian, MD goes over the steps for in-hospital production of ultra-pure continuous hemodialysis fluid.
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