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In neonates, hypocalcemia is more likely to occur in infants born of diabetic or preeclamptic mothers. Hypocalcemia also may occur in infants born to mothers with hyperparathyroidism. Clinically evident hypocalcemia generally presents in milder forms and is usually the result of a chronic disease state. In emergency department patients, chronic or subacute complaints secondary to mild or moderate hypocalcemia are more likely to be a chief complaint than severe symptomatic hypocalcemia. Once laboratory results demonstrate hypocalcemia, the first question is whether the hypocalcemia is true—that is, whether it is representative of a decrease in ionized calcium. The presence of chronic diarrhea or intestinal disease (eg, Crohn disease, sprue, chronic pancreatitis) suggests the possibility of hypocalcemia due to malabsorption of calcium and/or vitamin D. The patient's past medical history should be explored for pancreatitis, anxiety disorders, renal or liver failure, gastrointestinal disorders, and hyperthyroidism or hyperparathyroidism. Previous neck surgery suggests hypoparathyroidism; a history of seizures suggests hypocalcemia secondary to anticonvulsants. The patient may have a recent history of thyroid, parathyroid, or bowel surgeries or recent neck trauma. The length of time that a disorder is present is an important clue. Hypoparathyroidism and pseudohypoparathyroidism are lifelong disorders. Instead, acute transient hypocalcemia may be associated with acute gastrointestinal illness, nutritional deficiency, or acute or chronic renal failure. In an elderly patient, a nutritional deficiency may be associated with a low intake of vitamin D. A history of alcoholism can help diagnose hypocalcemia due to magnesium deficiency, malabsorption, or chronic pancreatitis. Inquire about recent use of drugs associated with hypocalcemia, including the following: Radiocontrast Estrogen Loop diuretics Bisphosphonates Calcium supplements Antibiotics Antiepileptic drugs Cinacalcet Other considerations in the history include the following: Family history of hypocalcemia Low-calcium diet Lack of sun exposure

Glomerular filtration is the first step in making urine. It is the process that your kidneys use to filter excess fluid and waste products out of the blood into the urine collecting tubules of the kidney, so they may be eliminated from your body.

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The human heart has four main valves—two on the left and two on the right. The aortic valve is one of the main valves on the left side of the heart. It is the outflow valve for the left ventricle, which means that it is the valve between the heart and the body. The aortic valve opens when the left ventricle squeezes to pump out blood, and closes in between heart beats to keep blood from going backward into the heart.

Appendicitis is an inflammation of the appendix, a 3 1/2-inch-long tube of tissue that extends from the large intestine. No one is absolutely certain what the function of the appendix is. One thing we do know: We can live without it, without apparent consequences.

Cardiovascular disease (CVD) is a general term that describes a disease of the heart or blood vessels. Blood flow to the heart, brain or body can be reduced as the result of a blood clot (thrombosis), or by a build-up of fatty deposits inside an artery that cause the artery to harden and narrow (atherosclerosis).

This is a Video in Clinical Medicine from the New England Journal of Medicine. Tympanocentesis in Children with Acute Otitis Media Overview Tympanocentesis is defined as needle aspiration of fluid from the middle ear. In children with acute otitis media, drainage of pus from the middle ear results in a rapid and marked improvement in symptoms and enables the clinician to prescribe tailored antimicrobial therapy. This video will demonstrate the technique of tympanocentesis. Indications Tympanocentesis is recommended in children with refractory acute otitis media, in immunocompromised children with otitis media, and in children with suppurative complications of acute otitis media, . . . .

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Proximal Biceps Repair using SwiveLock Tenodesis

Ring System is used to correct mitral regurgitation via implantation of an annuloplasty ring

Three lower limb surgeries that you need to know about.

Broca's Aphasia (expressive) When a stroke injures the frontal regions of the left hemisphere, different kinds of language problems can occur. This part of the brain is important for putting words together to form complete sentences. Injury to the left frontal area can lead to what is called Broca's aphasia.

Scientists reveal how LSD alters your mind.

The future of education can be found within this AR tablet.

Osteomyelitis of sternum after open heart surgery

This process involves surgical removing of an #organ or tissue from one person (organ donor) & placing into another person (recipient) body. https://goo.gl/JfoN8y

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