Keyhole surgery can be helpful for patients with brain, pituitary and skull base tumors. With cutting edge technology and a proven track record in keyhole and endonasal endoscopic approaches, we make surgery safer, less invasive and more effective.

The most reliable clinical sign to detect ascites is checking for bilateral flank dullness. If a patient with ascites is lying supine, fluid accumulates in the flank regions, leading to dullness on percussion. At the same time, the air-filled bowel loops are forced upwards by the free fluid due to buoyancy, resulting in tympanitic percussion. To locate specifically where dullness shifts to tympany, or the air-fluid level, percussion should be performed from the sides towards the middle. To confirm that the dullness is caused by ascites, ask the patient to switch to a lateral decubitus position. If ascites is present, the air-filled bowel loops will shift accordingly and remain at the surface of the fluid. As a result, the air-fluid level will shift as well. This is known as shifting dullness.

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This video shows the delivery of the placenta after delivery of the fetus

When placement of a urethral catheter is contraindicated or unsuccessful, percutaneous suprapubic urinary bladder catheterization is a commonly performed procedure to relieve urinary retention. [1, 2] This topic describes the Catheter over needle technique. The Seldinger technique is described in the Clinical Procedures topic Suprapubic Aspiration.

Encephalitis (en-sef-uh-LIE-tis) is inflammation of the brain. Viral infections are the most common cause of the condition. Encephalitis can cause flu-like symptoms, such as a fever or severe headache. It can also cause confused thinking, seizures, or problems with senses or movement. However, many cases of encephalitis result in only mild flu-like symptoms or even no symptoms. Severe cases of encephalitis, while relatively rare, can be life-threatening. Because the course of any single case of encephalitis can be unpredictable, it's important to get a timely diagnosis and treatment.

Bacterial meningitis is very serious and can be deadly. Death can occur in as little as a few hours. While most people with meningitis recover, permanent disabilities such as brain damage, hearing loss, and learning disabilities can result from the infection. There are several types of bacteria that can cause meningitis. Some of the leading causes of bacterial meningitis in the United States include Streptococcus pneumoniae, group B Streptococcus, Neisseria meningitidis, Haemophilus influenzae, and Listeria monocytogenes.

This video is really sad. You can literally watch this man dying. He was shot in the chest and rushed to the emergency room. His heart has stopped beating or has arrested. As a last resort, surgeons did an extreme procedure called an open thoracotomy which is that crazy tool you see there that basically splits the ribs open and allows easy open access to the heart. They did this so they could give him a cardiac massage. A cardiac massage is when surgeons are manually trying to pump the heart after it has stopped working on its own (cardiac arrest). Unfortunately he lost so much blood from his gun shot wound and he was pronounced dead. There are cases of patients surviving after having this kind of invasive resuscitation but it is rare.

This is the incredible moment a new-born baby arrived still inside its amniotic sac, completely intact. The tiny infant can be seen moving and stretching still inside the sac, as medics prepare to snip the new born free. The amniotic sac is a thin but durable membrane filled with fluid which helps keep a baby warm and safe from bumps during pregnancy. When it breaks, this is typically referred to as a woman's 'waters breaking' shortly before she gives birth. But in rare cases, less than 1-in-80,000 births, the baby is delivered with the membranes still intact and this is known as a 'caul birth'. Some babies are born with part of the membrane still attached to them, but to be born completely encased in the intact membrane is incredibly rare. Many people still believe the phenomenon to be a good omen for the child's infancy and it is has even been suggested, but not proven, that caul babies will always have a natural affinity for water. The video was taken in Spain on Saturday and captures the rare moment the baby was born with the membrane covering its entire body, just minutes after its twin was delivered normally.

Masturbating is totally healthy, and totally normal. There are tons of myths out there meant to scare you into thinking masturbation is wrong or bad. But the truth is masturbation is perfectly safe. Masturbating won't make you blind, crazy, or stupid. It won’t damage your genitals, cause pimples, or stunt your growth. It doesn’t use up all your orgasms or ruin other kinds of sex. In fact, masturbation can actually be good for you. Here are some benefits of masturbation: Masturbation is safer than any other type of sex. You can’t get pregnant or get any sexually transmitted infections from masturbating. Masturbation can help you learn what you like and don’t like sexually. And if you decide to have sex with someone, you can know what you do/don’t want to do. BONUS: getting comfortable talking about sex and your body with your partner makes it easier to talk about protecting yourself against STDs and pregnancy, too. Exploring your body and learning how to give yourself sexual pleasure can be empowering and help improve your body image. Masturbation can lower stress and help you relax. It even helps some people fall asleep. Having an orgasm releases endorphins — feel good chemicals in your brain. Orgasms can be a natural painkiller and can even help with period cramps. Mutual masturbation (masturbating with a partner) is a really safe way to have sex and let the other person know what feels good to you. If you share a sex toy, use condoms on the toy and clean it before swapping. And if you touch each other’s genitals, wash your hands before touching your own. Can I get an STD from masturbating? Nope. Masturbating is the safest sexual activity out there. There is virtually NO chance of getting an STD or any other infection from touching your own genitals (and there’s also no chance of pregnancy). STDs have to be passed from one person to another, so you can’t give yourself an STD. The one exception to this is herpes - so if you have any cold sores on your mouth and touch them, make sure to wash your hands before masturbating. But it IS possible to get an STD if you’re masturbating with another person and touching each other’s genitals. Anytime semen (cum) or vaginal fluids are spread to someone else’s body, or your genitals rub against each other, there’s a risk of STDs. So if you touch each other’s genitals, wash your hands before touching your own. STDs can also be spread by sharing sex toys with another person. You can help protect yourself by using condoms on any toys that you share (even if they’re not shaped like a penis). Put a new condom on anytime a different person uses it. If you’re the only one using your sex toys, you don’t have to worry about STDs. But if you use them with other people, protect those sex toys just like you’d protect your own genitals — put a condom on ‘em! It’s possible for masturbation to cause irritation or infections if your body is sensitive to the way you masturbate or the things you masturbate with — but this isn’t the same thing as an STD. Lotions, Vaseline, oils, and scented or flavored stuff may irritate your vulva and vagina. Masturbating roughly and not using lubrication can also lead to irritation because of friction. And germs from the anus can cause vaginal infections — so never put something in your vagina that’s been in your butt without washing it or covering it with a condom. If you’re worried that you have an STD because of pain, itching, or discomfort in your genitals, go to your doctor or your local Planned Parenthood health center.

LDL (Bad) Cholesterol LDL cholesterol is considered the “bad” cholesterol because it contributes to plaque, a thick, hard deposit that can clog arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, heart attack or stroke can result. Another condition called peripheral artery disease can develop when plaque buildup narrows an artery supplying blood to the legs. View an animation of cholesterolHDL (Good) Cholesterol HDL cholesterol is considered “good” cholesterol because it helps remove LDL cholesterol from the arteries. Experts believe HDL acts as a scavenger, carrying LDL cholesterol away from the arteries and back to the liver, where it is broken down and passed from the body. One-fourth to one-third of blood cholesterol is carried by HDL. A healthy level of HDL cholesterol may also protect against heart attack and stroke, while low levels of HDL cholesterol have been shown to increase the risk of heart disease.

Possible causes include a combination of biological, psychological, and social sources of distress. Increasingly, research suggests these factors may cause changes in brain function, including altered activity of certain neural circuits in the brain. The persistent feeling of sadness or loss of interest that characterizes major depression can lead to a range of behavioral and physical symptoms. These may include changes in sleep, appetite, energy level, concentration, daily behavior, or self-esteem. Depression can also be associated with thoughts of suicide. The mainstay of treatment is usually medication, talk therapy, or a combination of the two. Increasingly, research suggests these treatments may normalize brain changes associated with depression.

The brachial plexus is the network of nerves that sends signals from your spine to your shoulder, arm and hand. A brachial plexus injury occurs when these nerves are stretched, compressed, or in the most serious cases, ripped apart or torn away from the spinal cord. Minor brachial plexus injuries, known as stingers or burners, are common in contact sports, such as football. Babies sometimes sustain brachial plexus injuries during birth. Other conditions, such as inflammation or tumors, may affect the brachial plexus. The most severe brachial plexus injuries usually result from auto or motorcycle accidents. Severe brachial plexus injuries can leave your arm paralyzed, with a loss of function and sensation. Surgical procedures such as nerve grafts, nerve transfers or muscle transfers can help restore function.

The gold standard treatment for bladder outlet obstruction.This is an endoscopic procedure in which a resectoscope is placed transurethrally and the obstructing lobes of the prostate are removed as chips of tissue. TURP results in improvement of flow rate, and symptom scores are superior to that of other minimally invasive therapies

Functional endoscopic sinus surgery is a minimally invasive surgical treatment which uses nasal endoscopes to enlarge the nasal drainage pathways of the paranasal sinuses to improve sinus ventilation.

Warren Pettaway of Detroit knew he needed to have his left knee checked out when he could no longer keep up while officiating basketball. The pain got so bad that running up and down the court or quickly changing directions was too much for him to continue doing what he loved.Only three weeks post-surgery, Warren is ready to get back in the game. He is able to move without issue and is getting things done around the house. He makes sure to do his therapy as directed and is exercising on his own in the gym. To learn more visit https://www.henryford.com/serv....ices/joint-replaceme

A leg ulcer is simply a break in the skin of the leg, which allows air and bacteria to get into the underlying tissue. This is usually caused by an injury, often a minor one that breaks the skin. In most people such an injury will heal up without difficulty within a week or two. However, when there is an underlying problem the skin does not heal and the area of breakdown can increase in size. This is a chronic leg ulcer.

Dr. Debbie Song at Gillette Children's describes in detail selective rhizotomy surgery.

A selective dorsal rhizotomy is an operation performed to treat spasticity. It is thought that high tone and spasticity arise from abnormal signals that are transmitted through sensory or dorsal nerve roots to the spinal cord. In a selective dorsal rhizotomy we identify and cut portions of the dorsal nerve roots that carry abnormal signals thereby disrupting the mechanisms that lead to spasticity. Potential patients go through a rigorous assessment that includes an in-depth gait and motion analysis as well as a physical therapy evaluation.

They are evaluated by a multidisciplinary team that includes a pediatric rehabilitation doctor, a neurosurgeon, and an orthopedist, Appropriate patient selection is vital. Ideal candidates for selective dorsal rhizotomy are children who are between four and ten years of age, have a history of being born prematurely, and have a diagnosis of diplegia cerebral palsy. These patients usually walk independently or with the assistance of crutches or a walker. They typically function at a level one, two, or three in the gross motor function classification system or gmfcs. A selective dorsal rhizotomy involves the coordinated efforts of the neurosurgery, physiatry, anesthesia and nursing teams. The operation entails making an incision in the lower back that is approximately six to eight inches long. We perform what we call a laminoplasty in which we remove the back part of the spinal elements from the lumbar one or l1 to l5 levels. At the end of the procedure the bone is put back on. We identify and open up the Dural sac that contain the spinal fluid spinal cord and nerve roots. Once the Dural sac is opened ,we expose the lumbar and upper sacral nerve roots that transmit information to and from the muscles of the lower extremities.

At each level we isolate the dorsal nerve root, which in turn is separated into as many as 30 smaller thread light fruitlets.

Each rootlet is then electrically stimulated. Specialized members of the physiatry team look for abnormal responses in the muscles of the legs as each rootless is being stimulated. If an abnormal response is observed then the rootlet is cut.

If a normal response is observed, then the rootlet is not cut. We usually end up cutting approximately 20 to 40 percent of the rootlets. The Dural sac is sutured closed and the l1 through l5 spinal elements are put back into anatomic position, thus restoring normal spinal alignment. The overlying tissues and skin are then closed and the patient is awoken from surgery. The entire operation takes between four and five hours. A crucial component to the success of our rhizotomy program is the extensive rehabilitation course following surgery. With their tone significantly reduced after a rhizotomy, patients relearn how to use their muscles to walk more efficiently through stretching, strengthening, and gait training. Approximately one to two years after a rhizotomy patients undergo repeat gait and motion analysis. The orthopedic surgeons assess the need for interventions to correct bone deformities, muscle contractures, poor motor control, impaired balance, or other problems related to cerebral palsy.

At Gillette we work closely with patients and families to ensure that our selective dorsal rhizotomy program meets their goals for enhancing their function and improving their quality of life.

VISIT https://www.gillettechildrens.org/ to learn more

0:00 Why choose selective dorsal rhizotomy?
0:56 Who is a good candidate for selective dorsal rhizotomy?
1:31 What does a selective dorsal rhizotomy entail?
3:26 What is recovery from selective dorsal rhizotomy like?

Dont worry sister!

World-renowned surgeons at Shriners Hospitals for Children – Northern California provide complex pediatric surgery for children one-year and older with congenital and acquired conditions. Children from throughout the Western United States with chest wall malformations, gastro-intestinal disease, ano-rectal disorders, urologic conditions and other complex surgical needs benefit from the expert care. The pediatric surgery team is devoted to the development of innovative and minimally invasive surgical techniques.