DMC Orthopedic Specialist and Detroit Tigers team physician Dr. Stephen Lemos repairs a young patient's damaged shoulder using a minimally-invasive arthroscopic technique. ~ Detroit Medical Center

What causes rheumatic fever? Rheumatic fever is not an infection itself, but rather the result of an untreated strep infection. When your body senses the strep infection, it sends antibodies to fight it. Sometimes, these antibodies attack the tissues of your joints or heart instead. If the antibodies attack your heart, they can cause your heart valves to swell, which can lead to scarring of the valve "doors" (called leaflets or cusps). Who is at risk for rheumatic fever? Fewer than 0.3% of people who have strep throat also get rheumatic fever. Rheumatic fever is most common among children aged 5 to 15, but adults may have the condition as well. Doctors think that a weakened immune system may make some people more likely to get rheumatic fever. And, although antibiotic medicines have reduced the number of cases of rheumatic fever in developed countries, there are still thousands of reported cases. What are the symptoms of rheumatic fever and how is it diagnosed? Symptoms of rheumatic fever usually begin 1 to 6 weeks after you have had a strep infection. They are Fever Joint pain or swelling in your wrists, elbows, knees, or ankles Small bumps under the skin over your elbows or knees (called nodules) A raised, red rash on your chest, back, or stomach Stomach pain or feeling less hungry Weakness, shortness of breath, or feeling very tired Your doctor will begin by doing a throat culture to find out if you have a strep infection. Then, your doctor will use a stethoscope to listen to your heart. He or she will also look for nodules on your joints. Sometimes, blood tests, chest x-rays, or an electrocardiogram (ECG or EKG) may be needed for a more definite diagnosis. How is rheumatic fever treated? Rheumatic fever must be treated right away. If you have a sore throat that lasts longer than 3 days, or if you have a fever and headache along with your sore throat, you should see your doctor for a throat culture. Even if you do not have a sore throat but have a fever and a skin rash, this could also mean a strep infection, and you should get tested. Remember rheumatic fever can result from an untreated strep infection, so it is very important to treat the infection before it leads to a worse condition.

A video showing the examination of femoral hernia.

Today, hair transplant physicians are able to make use of different techniques to extract and transplant large numbers of hair follicles (follicular units). There are two primary techniques for hair transplantation currently in use. The FUE (Follicular Unit Extraction) and the FUT (Follicular Unit Transplantation) methods. They differ primarily in the way hair follicles are extracted from the donor area. Follicular Unit Transplantation (FUT) The FUT process involves removing a small strip of tissue from the back of the head, from which the donor hair follicles will be extracted. The hair follicles are harvested from the strip by a skilled clinical team before being individually transplanted to the recipient areas. In most cases, and especially cases of advanced hair loss, FUT is the preferred method because it allows the physician to fully utilize the scalp area to deliver results consistent with patient expectations. FUT typically allows for the greatest number of grafts to be transplanted in a single session. Pain Management Some patients report higher levels of discomfort with FUT procedures compared to FUE due the potential swelling in the area where the strip of tissue was removed, but both methods have a very manageable recovery period and pain medication can be prescribed by your physician if needed. Both techniques of hair transplantation are relatively simple. Hair transplantation procedures are outpatient surgeries with some patients going back to work as soon as the very next day. Scarring The FUT strip extraction method typically results in a very narrow linear scar in the back of the head (typically 1mm in diameter or less in size). Since the scar is very thin, it’s easily concealed by all but the shortest of haircut styles. A short to moderate crop setting on most clippers is sufficient to conceal the scar for the majority of patients, and over time the scar will become less noticeable as it fades. Costs The industry norm for pricing is on a per-graft basis. This allows each individual to pay for only what they need and receive in number of grafts, and not a flat rate that in the end may cost you more. The per-graft cost of a FUT procedure is generally lower than that of a FUE procedure. Lately however, in response to the rising popularity of the FUE technique, many hair transplantation clinics have started lowering the per graft cost on FUE procedures, so that the cost difference between the two types of procedure are not as much as most people think. The costs of medical procedures always vary by patients’ conditions, needs and objectives. For the most accurate assessment of your hair loss and the associated cost of your hair restoration, you will need to speak to a physician. Follicular Unit Extraction (FUE) In an FUE hair transplantation, each follicular unit is individually taken directly from the scalp with no strip of tissue being removed. Hair follicles are removed in a random fashion and the result is less density in the donor area that many say is not even noticeable. This is the main difference between FUE & FUT. Since follicles are removed one at a time, fewer follicles can be harvested during a typical session, making FUE a better option to restore hair in smaller cases (number of grafts) compared to the traditional FUT method. FUE is constantly evolving and what was once utilized for only smaller cases is now being utilized for larger and larger cases. Some people that prefer the FUE method may have the option of splitting their procedure into two days in order to complete their recommended transplantation goals. Pain Management With no stitches required and no linear scar left to heal, FUE procedures do have a faster healing time and less post-procedure discomfort compared to the traditional FUT procedure. Scarring Since FUE procedures involve removing hairs individually from the scalp, there is no linear scar left behind. However, there will be tiny 1mm in diameter or less puncture marks that tend to heal by themselves after scabbing-over in the days following the procedure. These tiny wounds typically heal within three to seven days. Costs Since the physician must remove each hair follicle individually, the time-sensitive nature of an FUE procedure typically makes it more expensive than an FUT procedure. As stated earlier, FUE technology is improving as well as gaining popularity and many hair restoration practices (including Bosley) have started to lower the cost per graft price for FUE procedures. Nowadays, the cost difference between a FUE and a FUT procedures is less disparate.

A pulmonary embolism (PE) usually happens when a blood clot called a deep vein thrombosis (DVT), often in your leg, travels to your lungs and blocks a blood vessel. That leads to low oxygen levels in your blood. It can damage the lung and other organs and cause heart failure, too. A PE can be life-threatening, so if you've been diagnosed with DVT, you should be aware of this risk. Follow the treatment plan for your DVT to stop the clot from getting bigger and to keep new clots from forming. Symptoms and Diagnosis PE won't always cause symptoms. You might have: Chest pain, which may get worse with a deep breath Sudden shortness of breath or rapid breathing Fast heartbeat Sudden cough Coughing up blood Lightheadedness or fainting Anxiety Call 911 if you notice these symptoms. They could also be symptoms of a heart attack, pneumonia, or other serious problems.

Watch that video to know the op 10 Signs of Ovulation in Women

A C-reactive protein (CRP) test is a blood test that measures the amount of a protein called C-reactive protein in your blood. C-reactive protein measures general levels of inflammation in your body. High levels of CRP are caused by infections and many long-term diseases.

Almost all the cells in your body were produced by mitosis. The only exception is sperm or eggs which are produced by a different type of cell division called meiosis. During fertilization the sperm and egg unite to form a single cell called the zygote which contains chromosomes from both the sperm and egg.

Watch that Human Baby Medical Abortion Surgery

a video of abdominal physical examination including all the required items:
-Inspection
-Palpation
-Percussion
-Auscultation

examination of Cranial nerves IX, X, XI & XII: Glossopharyngeal,Vagus,Accessory and hypoglossal nerves

Endometriosis (en-doe-me-tree-O-sis) is an often painful disorder in which tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis. Rarely, endometrial tissue may spread beyond pelvic organs.

Thigh pain is most often caused by injuries to bones, joints, muscles, tendons, ligaments, and other soft tissues or blood vessels. These injuries are often caused during sports competition, or strain from overuse, obesity, or pregnancy.

Pulmonary edema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe. In most cases, heart problems cause pulmonary edema. But fluid can accumulate for other reasons, including pneumonia, exposure to certain toxins and medications, trauma to the chest wall, and exercising or living at high elevations. Pulmonary edema that develops suddenly (acute pulmonary edema) is a medical emergency requiring immediate care. Although pulmonary edema can sometimes prove fatal, the outlook improves when you receive prompt treatment for pulmonary edema along with treatment for the underlying problem. Treatment for pulmonary edema varies depending on the cause but generally includes supplemental oxygen and medications.

Interlocking Continuous Suture

BACKGROUND: Clubfoot occurs in approximately one in 1000 live births and is one of the most common congenital birth defects. Although there have been several reports of successful treatment of idiopathic clubfoot with the Ponseti method, the use of this method for the treatment of other forms of clubfoot has not been reported. The purpose of the present study was to evaluate the early results of the Ponseti method when used for the treatment of clubfoot associated with distal arthrogryposis. METHODS: Twelve consecutive infants (twenty-four feet) with clubfoot deformity associated with distal arthrogryposis were managed with the Ponseti method and were retrospectively reviewed at a minimum of two years. The severity of the foot deformity was classified according to the grading system of Diméglio et al. The number of casts required to achieve correction was compared with published data for the treatment of idiopathic clubfoot. Recurrent clubfoot deformities or complications during treatment were recorded. RESULTS: Twenty-two clubfeet in eleven patients were classified as Diméglio grade IV, and two clubfeet in one patient were classified as Diméglio grade II. Initial correction was achieved in all clubfeet with a mean of 6.9 +/- 2.1 casts (95% confidence interval, 5.6 to 8.3 casts), which was significantly greater than the mean of 4.5 +/- 1.2 casts (95% confidence interval, 4.3 to 4.7 casts) needed in a cohort of 219 idiopathic clubfeet that were treated during the same time period by the senior author with use of the Ponseti method (p = 0.002). Six feet in three patients had a relapse after initial successful treatment. All relapses were related to noncompliance with prescribed brace wear. Four relapsed clubfeet in two patients were successfully treated with repeat casting and/or tenotomy; the remaining two relapsed clubfeet in one patient were treated with extensive soft-tissue-release operations.

Care must be taken to prevent stenosis at the anastomotic site. If the diameter of the anastomosis is less than 2 cm, the anastomosis should be taken down and resected. A classic end-to-end anastomosis should be performed to ensure adequate diameter to the intestine. If the posterior wall of the colon has been preserved, care should be taken to close the colostomy prior to opening the peritoneal cavity. This will reduce intraperitoneal contamination from the stoma site. Copious irrigation of the wound should be made prior to primary closure. If gross contamination has occurred, delayed closure of the wound should be considered.

Retropharyngeal abscess (RPA) produces the symptoms of sore throat, fever, neck stiffness, and stridor. RPA occurs less commonly today than in the past because of the widespread use of antibiotics for suppurative upper respiratory infections. The incidence of RPA in the United States is rising, however. Once almost exclusively a disease of children, RPA is observed with increasing frequency in adults. It poses a diagnostic challenge for the emergency physician because of its infrequent occurrence and variable presentation.

A small-bowel obstruction (SBO) is caused by a variety of pathologic processes. The leading cause of SBO in industrialized countries is postoperative adhesions (60%), followed by malignancy, Crohn disease, and hernias, although some studies have reported Crohn disease as a greater etiologic factor than neoplasia.

Repair of post-infarction ventricular septal defect (VSD) remains a challenging procedure with a high risk of VSD recurrence. In order to reduce this risk, a double patch and glue technique was introduced in the department in 1986. This surgical technique is hereunder presented. Since 1971, ninety-three patients have been operated on early (≪15 days) after the occurrence of a post-infarction VSD. This retrospective study allows to compare the results of this double patch and glue technique to those obtained with the conventional one, in terms of hospital death and VSD recurrence. The double patch and glue technique avoids recurrence of VSD and plays a part in reducing hospital mortality.