Atrial fibrillation (also called AFib or AF) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. Some people refer to AF as a quivering heart. An estimated 2.7 million Americans are living with AF.

Hypertensive emergencies encompass a spectrum of clinical presentations in which uncontrolled blood pressures (BPs) lead to progressive or impending end-organ dysfunction. In these conditions, the BP should be lowered aggressively over minutes to hours. Neurologic end-organ damage due to uncontrolled BP may include hypertensive encephalopathy, cerebral vascular accident/cerebral infarction, subarachnoid hemorrhage, and/or intracranial hemorrhage.[1] Cardiovascular end-organ damage may include myocardial ischemia/infarction, acute left ventricular dysfunction, acute pulmonary edema, and/or aortic dissection. Other organ systems may also be affected by uncontrolled hypertension, which may lead to acute renal failure/insufficiency, retinopathy, eclampsia, or microangiopathic hemolytic anemia.[1] With the advent of antihypertensives, the incidence of hypertensive emergencies has declined from 7% to approximately 1% of patients with hypertension.[2] In addition, the 1-year survival rate associated with this condition has increased from only 20% (prior to 1950) to a survival rate of more than 90% with appropriate medical treatment

Urinary Bladder Medical Exam

Giant cell tumour is a locally aggressive primary bone tumour, located eccentrically in the metaphysis and epiphysis of a long bone. It commonly affects distal end of Femur, proximal end of Tibia and distal end of Radius. It is occasionally reported in small bones of hand and foot[1], spine[2] and pelvis[3]. Though it occurs in 20 - 35 year old individuals commonly, it can also be seen in children as young as 2 years[4] and also in older individuals

STDs are infections that are transmitted during vaginal, anal, and oral sex. They are very common and many people who have them don't show any symptoms.

Endoscopy in Hiatal Hernia.

MRCPCH Clinical Revision - more videos at http://mrcpch.paediatrics.co.uk

Revise for your MRCPCH Clinical exam, with videos and high quality content created by the London Paediatrics Trainees Committee.

Video Credits: Dr Caroline Fertleman, Dr Hermione Race, Dr Camilla Sen, Dr Chloe Macaulay, Dr Emma McLaren, Chris Knapp

Signs and symptoms of colon cancer include: A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool, that lasts longer than four weeks Rectal bleeding or blood in your stool Persistent abdominal discomfort, such as cramps, gas or pain A feeling that your bowel doesn't empty completely Weakness or fatigue Unexplained weight loss Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they'll likely vary, depending on the cancer's size and location in your large intestine.

Thoracic Epidural Placement Paramedian Approach

Learn Basic Laparoscopic Surgery, the components of a laparoscopic surgical setup, optimal positioning and ergonomics in laparoscopic surgery, and much more. Check out the full course for free here: https://www.incision.care/free-trial

What is Laparoscopic Surgery:
Laparoscopic surgery describes procedures performed using one or multiple small incisions in the abdominal wall in contrast to the larger, normally singular incision of laparotomy. The technique is based around principles of minimally invasive surgery (or minimal access surgery): a large group of modern surgical procedures carried out by entering the body with the smallest possible damage to tissues. In abdominopelvic surgery, minimally invasive surgery is generally treated as synonymous with laparoscopic surgery as are procedures not technically within the peritoneal cavity, such as totally extraperitoneal hernia repair, or extending beyond the abdomen, such as thoraco-laparoscopic esophagectomy. The term laparoscopy is sometimes used interchangeably, although this is often reserved to describe a visual examination of the peritoneal cavity or the purely scopic component of a laparoscopic procedure. The colloquial keyhole surgery is common in non-medical usage.

Surgical Objective of Laparoscopic Surgery:
The objective of a laparoscopic approach is to minimize surgical trauma when operating on abdominal or pelvic structures. When correctly indicated and performed, this can result in smaller scars, reduced postoperative morbidity, shorter inpatient durations, and a faster return to normal activity. For a number of abdominopelvic procedures, a laparoscopic approach is now generally considered to be the gold-standard treatment option.
Definitions

Developments of Laparoscopic Surgery:
Following a number of smaller-scale applications of minimally invasive techniques to abdominopelvic surgery, laparoscopic surgery became a major part of general surgical practice with the introduction of laparoscopic cholecystectomy in the 1980s and the subsequent pioneering of endoscopic camera technology. This led to the widespread adoption of the technique by the early- to mid-1990s. The portfolio of procedures that can be performed laparoscopically has rapidly expanded with improvements in instruments, imaging, techniques and training — forming a central component of modern surgical practice and cross-specialty curricula [2]. Techniques such as laparoscopically assisted surgery and hand-assisted laparoscopic surgery have allowed the application of laparoscopic techniques to a greater variety of pathology. Single-incision laparoscopic surgery, natural orifice transluminal endoscopic surgery, and minilaparoscopy-assisted natural orifice surgery continue to push forward the applications of minimally invasive abdominopelvic techniques; however, the widespread practice and specific indications for these remain to be fully established. More recently, robotic surgery has been able to build on laparoscopic principles through developments in visualization, ergonomics, and instrumentation.

This Basic Laparoscopic Surgery Course Will Teach You:
- Abdominal access techniques and the different ways of establishing a pneumoperitoneum
- Principles of port placement and organization of the operative field
- Key elements of laparoscopic suturing, basic knotting and clip application

Specific attention is paid to the following hazards you may encounter:
- Fire hazard and thermal injury
- Lens fogging
- Contamination of insufflation system
- Complications from trocar introduction
- Limitations of Veress needle technique
- Limitations of open introduction technique
- Complications of the pneumoperitoneum
- Gas embolism
- Mirroring and scaling of instrument movements
- Firing clip applier without a loaded clip

The following tips are designed to improve your understanding and performance:
- Anatomy of a laparoscope
- Checking for optic fiber damage
- "White balance" of camera
- Checking integrity of electrosurgical insulation
- Access at Palmer's point
- Lifting abdominal wall before introduction
- Confirming position of Veress needle
- Umbilical anatomy
- Identification of inferior epigastric vessels under direct vision
- Translumination of superficial epigastric vessels
- Selection of trocar size
- Aiming of trocar
- Working angles in laparoscopic surgery
- Choice of suture material
- Instruments for suturing
- Optimal ergonomics for suturing
- Extracorporeal needle positioning
- Optimal suture lengths
- "Backloading" needle
- Intracorporeal needle positioning
- Hand movements when suturing
- Optimal positioning of scissors
- Extracorporeal knot tying
- Visualization of clip applier around target structure
- Common clip configurations

Anytime you're having unprotected sex, there's always a chance that a woman can get pregnant. Pregnancy requires sperm and egg to meet up together so a woman needs to be during her most fertile time of the month, which is usually 6 days out of the month; 5 days leading up to ovulation and on the day of ovulation. For most women, ovulation happens 12-16 days before her period's going to start. So a woman is usually most fertile for a week to a week and a half after her period has ended generally speaking, if you don't want to count each and every single day. So if you have unprotected intercourse during this time, then there's a high probability that a woman can get pregnant. Now, you mentioned that your girlfriend is supposed to start her period in about five days or so. If you've had intercourse any time leading up to this, there's always a chance that she could get pregnant. But as for the mechanics of it all, in order to get pregnant, semen needs to be inserted inside the vaginal canal where the egg and sperm can then meet. So if that did not happen, then the chances of her getting pregnant are slim. But if that has happened, the chances of her getting pregnant are great. So it would be best for you and her to just wait until her period is supposed to start and if she's late, then take an over-the-counter pregnancy test and if it's positive, congratulations to both of you! If it's negative and she still doesn't start her period, then tell her to wait about 5-7 days. Take another test and then maybe at that point, it will be positive if she is indeed pregnant. If she continues to not have a period or she's concerned about anything, it would be best for her to follow up with her doctor and they can decide if further investigation or treatment is warranted. If you have any other questions for me, feel free to ask them on our Facebook page at facebook.com/intermountainmoms and recommend us to your friends and family, too.

For more information about Mohs surgery, please visit https://cle.clinic/3x7CRTy

Mohs surgery is a highly effective skin cancer removal procedure that takes just a few hours. It is most often used to treat basal cell and squamous cell carcinomas, the two most common skin cancers.

Chapters:
0:00 How effective is Mohs Surgery?
0:23 When is Mohs Surgery used?
0:50 How does Mohs Surgery work?
1:55 Does Mohs Surgery cure skin cancer?
2:06 How long is the recovery period after Mohs Surgery?

Resources:
Skins Cancer: https://cle.clinic/3G2MMM8
How Skin Cancer Is Found and Removed — At the Same Appointment: https://cle.clinic/3r9Wzu6
The Best Strategies To Reduce Your Risk of Skin Cancer: https://cle.clinic/38Bazqn

The information in this video was accurate as of 4.8.2022 and is for information purposes only. Consult your local medical authority or your healthcare practitioner for advice.

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Testicular Self Exam

Hepatitis and chronic alcohol abuse are frequent causes. Liver damage caused by cirrhosis can't be undone, but further damage can be limited. Initially patients may experience fatigue, weakness, and weight loss. During later stages, patients may develop jaundice (yellowing of the skin), gastrointestinal bleeding, abdominal swelling, and confusion. Treatments focus on the underlying cause. In advanced cases, a liver transplant may be needed.

A Pap smear (also called a Pap test) is a screening procedure for cervical cancer. It tests for the presence of precancerous or cancerous cells on the cervix, the opening of the uterus. It's named after the doctor who determined that this was a useful way to detect signs of cervical cancer.

An untreated hepatic abscess is nearly uniformly fatal as a result of complications that include sepsis, empyema, or peritonitis from rupture into the pleural or peritoneal spaces, and retroperitoneal extension. Treatment should include drainage, either percutaneous or surgical. Antibiotic therapy as a sole treatment modality is not routinely advocated, though it has been successful in a few reported cases. It may be the only alternative in patients too ill to undergo invasive procedures or in those with multiple abscesses not amenable to percutaneous or surgical drainage. In these instances, patients are likely to require many months of antimicrobial therapy with serial imaging and close monitoring for associated complications.

The spleen is an organ in the upper far left part of the abdomen, to the left of the stomach. The spleen varies in size and shape between people, but it’s commonly fist-shaped, purple, and about 4 inches long. Because the spleen is protected by the rib cage, you can’t easily feel it unless it’s abnormally enlarged. The spleen plays multiple supporting roles in the body. It acts as a filter for blood as part of the immune system. Old red blood cells are recycled in the spleen, and platelets and white blood cells are stored there. The spleen also helps fight certain kinds of bacteria that cause pneumonia and meningitis.

In this video, Dr. Robert Rozbruch, chief of Limb Lengthening and Complex Reconstruction at Hospital for Special Surgery performs an osseointegration after a primary amputation. The patient, a 40 year old woman, had chronic nerve pain and compromised function of her residual limb.

For more information, visit: https://www.limblengthening.com/

https://www.hss.edu/limblengthening
https://www.hss.edu/LSARC
https://www.facebook.com/limblengtheningNYC
https://www.instagram.com/limblengthening
https://www.twitter.com/limblengthen
https://www.youtube.com/channe....l/UC-JL_X6ALjZXiXtcP

key words: Osseointegration, Amputee, Amputation, Limb Replacement, Tibia, Osseointegration

popliteal embolectomy; medial approach using a 4 f fogarty catheter