Thoracoscopic Management of Lung Abscess Before Empyema

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This video details the layered closure of a through-and-through facial laceration

WARNING: Explicit and Educational Surgical Content.

Visage Clinic's Dr. Marc DuPéré - located in Toronto, Ontario, Canada discusses Liposuction (upper bra, back rolls, lower back rolls, love handles & abdomen) and "Tummy Tuck" (Abdominoplasty): Skin excision, muscle repair and umbilicoplasty.

For more info and to book a consultation visit www.VisageClinic.com/cosmetic-....surgery/mommy-makeov or call (416) 929-9800.

Scissor gait is a form of gait abnormality primarily associated with spastic cerebral palsy.

At one time, women who had delivered by cesarean section in the past would usually have another cesarean section for any future pregnancies. The rationale was that if allowed to labor, many of these women with a scar in their uterus would rupture the uterus along the weakness of the old scar. Over time, a number of observations have become apparent: Most women with a previous cesarean section can labor and deliver vaginally without rupturing their uterus. Some women who try this will, in fact, rupture their uterus. When the uterus ruptures, the rupture may have consequences ranging from near trivial to disastrous. It can be very difficult to diagnose a uterine rupture prior to observing fetal effects (eg, bradycardia). Once fetal effects are demonstrated, even a very fast reaction and nearly immediate delivery may not lead to a good outcome. The more cesarean sections the patient has, the greater the risk of subsequent rupture during labor. The greatest risk occurs following a “classical” cesarean section (in which the uterine incision extends up into the fundus.) The least risk of rupture is among women who had a low cervical transverse incision. Low vertical incisions probably increase the risk of rupture some, but usually not as much as a classical incision. Many studies have found the use of oxytocin to be associated with an increased risk of rupture, either because of the oxytocin itself, or perhaps because of the clinical circumstances under which it would be contemplated. Pain medication, including epidural anesthetic, has not resulted greater adverse outcome because of the theoretical risk of decreasing the attendant’s ability to detect rupture early. The greatest risk of rupture occurs during labor, but some of the ruptures occur prior to the onset of labor. This is particularly true of the classical incisions. Overall successful vaginal delivery rates following previous cesarean section are in the neighborhood of 70 This means that about 30of women undergoing a vaginal trial of labor will end up requiring a cesarean section. Those who undergo cesarean section (failed VBAC) after a lengthy labor will frequently have a longer recovery and greater risk of infection than had they undergone a scheduled cesarean section without labor. Women whose first cesarean was for failure to progress in labor are only somewhat less likely to be succesful in their quest for a VBAC than those with presumably non-recurring reasons for cesarean section. For these reasons, women with a prior cesarean section are counseled about their options for delivery with a subsequent pregnancy: Repeat Cesarean Section, or Vaginal Trial of Labor. They are usually advised of the approximate 70successful VBAC rate (modified for individual risk factors). They are counseled about the risk of uterine rupture (approximately 1in most series), and that while the majority of those ruptures do not lead to bad outcome, some of them do, including fetal brain damage and death, and maternal loss of future childbearing. They are advised of the usual surgical risks of infection, bleeding, anesthesia complications and surgical injury to adjacent structures. After counseling, many obstetricians leave the decision for a repeat cesarean or VBAC to the patient. Both approaches have risks and benefits, but they are different risks and different benefits. Fortunately, most repeat cesarean sections and most vaginal trials of labor go well, without any serious complications. For those choosing a trial of labor, close monitoring of mother and baby, with early detection of labor abnormalities and preparation for

Health Assessment: Musculoskeletal System- Nursing Skills

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Health Assessment: Musculoskeletal System- Nursing Skills:

In this video we’re going to review a Musculoskeletal Assessment. The Musculoskeletal system involves the muscles, bones, and joints. This means we must assess structure AND function! If the patient cannot stand, assessments should be performed in the bed to the best of your ability. If they cannot perform Active Range of Motion (ROM), use Passive movements to determine ROM.
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Bookmarks:
0.05 Introduction
0:34 Spine assessment
1:02 Range of motion
1:39 Extremity assessment
1:52 Shoulder range of motion
2:10 Elbow & wrist range of motion
2:25 Hand range of motion
2:34 Upper extremity strength
2:54 Lower extremity range of motion
3:02 Hips range of motion
3:20 Knees range of motion
3:30 Ankles range of motion
3:38 Toes range of motion
3:42 Lower extremity strength
4:05 Outro

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nkylosing spondylitis (pronounced ank-kih-low-sing spon-dill-eye-tiss), or AS, is a form of arthritis that primarily affects the spine, although other joints can become involved. It causes inflammation of the spinal joints (vertebrae) that can lead to severe, chronic pain and discomfort

Chronic obstructive pulmonary disease (COPD) is defined as progressive, chronic airflow obstruction due to chronic bronchitis, emphysema, or both. The majority of patients have components of both, although one of these entities will frequently dominate the clinical picture. Emphysema�airspace enlargement distal to the terminal bronchioles due to destruction of alveolar septa. Chronic bronchitis�chronic airway inflammation and bronchospasm. Clinically defined as productive cough lasting for at least 3 mo over 2 consecutive years. Although COPD is irreversible, patients with acute exacerbations do have reversible bronchospastic and inflammatory components.

About Us Contact Disclaimer Get Published! Follow Us Epomedicine Medical Students Clinical Discussion Cases Emergencies Blog Medical Mnemonics Clinical Skills Search Subjects Clinical examination Gastrointestinal system Internal medicine Updated on January 31, 2017 Percussion of Spleen Traube’s semilunar space Borders: Superiorly: Left 6th rib superiorly Laterally: Left midaxillary line or Left anterior axillary line Inferiorly: Left costal margin Method: Patient’s position: supine with left arm slightly abducted. Percuss: from medial to lateral Interpretation: Resonance (Normal) and Dullness (Splenomegaly) Also: Pleural effusion or mass in stomach may cause dullness in Traube’s space.

-Tibial stress fractures are common in athletes and nonathletes who suddenly increase their physical activity. Clinical features include pain, localized tenderness, and swelling. Plain x-ray is <50% sensitive for stress fractures, especially in the first 2-3 weeks after the onset of symptoms. MRI is preferred over bone scan or ultrasound as it can show the fracture line that extends through the cortex into the medullary line. MRI can also identify ligament, muscle, and cartilage injuries. However, MRI findings may be persistently abnormal for up to 1 year after the stress fracture has healed.

Dr. Daniel Del Vecchio, Harvard trained plastic surgeon, performs his breast lift technique, filling the upper portion of the breast for added volume

When you’re trying to conceive a baby it is worth giving anything a go which you think will boost your chances. This includes considering that there may be better positions for getting pregnant. But it pays to bear in mind that the human race has been around for over 200,000 years and most of us were probably conceived without our ancestors investing too much thought into the mechanics. Science has proven that successful conception isn’t so much about sexual position as the frequency of sex between a fertile couple. Basically, if you want to fall pregnant, don’t use contraception and have frequent, active and enjoyable sex. Importantly, don’t stress too much about whether you’re doing it the right way. Women can, and do, conceive in any position. Nature has a way of making sure of that.

Full Obstetric examination and normal delivery by Egyptian doctor Hussein Sulayman and the video is in English showing:

Obstetric Examination
Episiotomy
Obstetric Forceps
Obstetric Instruments

Lumbar puncture is a common emergency department procedure used to obtain information about the cerebrospinal fluid (CSF) for diagnostic and, less commonly, therapeutic reasons. Please refer to the full article on Lumbar Puncture for more details on the lumbar puncture procedure. Lumbar puncture is typically performed via “blind” surface landmark guidance. The surface landmark technique is reported to be successful in a high percentage of attempted lumbar punctures; however, surface landmark identification of underlying structures has been shown to be accurate only 30% of the time. [1] Unsuccessful identification of proper landmarks often leads to increased difficulty in obtaining CSF, if the procedure is performed, and a higher rate of complications. Few alternatives are available in these cases. If available, fluoroscopic-guided lumbar puncture may be performed. If not, treatment is sometimes initiated empirically without obtaining CSF. Disadvantages of using fluoroscopy include limited availability or necessary transport of the patient outside of the emergency department, inability to directly visualize the spinal canal, and inherent radiation exposure

Shane Shapiro, M.D., orthopedic physician at Mayo Clinic in Florida, performs a bone marrow aspiration and concentration for BMAC/stem cell injection into arthritic knees. This procedure is part of a Mayo Clinic IRB approved, FDA monitored clinical research trial which can be searched on at http://ClinicalTrials.gov.

Mayo Clinic and the Mayo Center for Regenerative Biotherapeutics is studying biologically based non-surgical treatments for osteoarthritis. One such treatment is the harvesting of the patient's own stem cells from their bone marrow.

"In our procedure we draw cellular rich bone marrow from both sides of the pelvis. We then filter the resulting product and concentrate the stem cells and their corresponding growth factors. Using an ultrasound to image the knee joint, we are then able to precisely inject the cells into the arthritic knee. We are currently demonstrating that this procedure is safe and can relieve pain. We also hope to be able to slow the progression of the degenerative joint disease and perhaps one day regrow cartilage in the arthritic joint."

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Hear Dr. Shapiro discus this procedure in detail here: http://youtu.be/8Djpsc66hKI

Learn more about the Mayo Clinic Center for Regenerative Biotherapeutics here: http://goo.gl/rnRdtU
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A new well designed randomized study has suggested that long term baby aspirin usage may aid in fight against cancer. The suggested mechanism is that cancers induce inflammatory responses so the anti-inflammatory mechanism of prostaglandins inhibitors may cease the progress of many cancers. There are some concerns about the study because despite the well-designed randomized study; the study didn't include a satisfying number of female participants. The study was also conducted on esophageal, colorectal and lung cancers.

A central venous catheter (CVC), also known as a central line, central venous line, or central venous access catheter, is a catheter placed into a large vein. Catheters can be placed in veins in the neck (internal jugular vein), chest (subclavian vein or axillary vein), groin (femoral vein), or through veins in the arms (also known as a PICC line, or peripherally inserted central catheters). It is used to administer medication or fluids that are unable to be taken by mouth or would harm a smaller peripheral vein, obtain blood tests (specifically the "central venous oxygen saturation"), and measure central venous pressure.

For a full Surgical Airway Techniques resource: https://bit.ly/2rb9Nud
Video courtesy of Gauri Mankekar, MBBS, MS, PhD