The average time from symptom onset to diagnosis has been reported to be approximately 2 years. Despite recent attempts at increasing the awareness of pulmonary arterial hypertension (PAH), especially associated PAH (APAH), this delay in diagnosis has not changed appreciably in recent years. Early symptoms are nonspecific. Often, neither the patient nor the physician recognizes the presence of the disease, which leads to delays in diagnosis. Complicating matters, idiopathic PAH (IPAH) requires an extensive workup in an attempt to elucidate an identifiable cause of the elevated pulmonary artery pressure. The most common symptoms and their frequency, reported in a national prospective study, are as follows: Dyspnea (60% of patients) Weakness (19%) Recurrent syncope (13%) Additional symptoms include fatigue, lethargy, anorexia, chest pain, and right upper quadrant pain. Cough, hemoptysis, and hoarseness are less common symptoms. Women are more likely to be symptomatic than men.

A flail chest occurs when a segment of the thoracic cage is separated from the rest of the chest wall. This is usually defined as at least two fractures per rib (producing a free segment), in at least two ribs. A segment of the chest wall that is flail is unable to contribute to lung expansion. Large flail segments will involve a much greater proportion of the chest wall and may extend bilaterally or involve the sternum. In these cases the disruption of normal pulmonary mechanics may be large enough to require mechanical ventilation.

Dr. Erik Beyer, Florida Medical Center's chief of cardiac surgery, discusses performed a procedure called a micro-thoracotomy.

Alcoholic hepatitis is inflammation of the liver caused by drinking alcohol. Alcoholic hepatitis is most likely to occur in people who drink heavily over many years. However, the relationship between drinking and alcoholic hepatitis is complex. Not all heavy drinkers develop alcoholic hepatitis, and the disease can occur in people who drink only moderately. If you're diagnosed with alcoholic hepatitis, you must stop drinking alcohol. People who continue to drink alcohol face a high risk of serious liver damage and death.

http://www.landging.com/accident-animation-sports-injury-soccer.html
This accident animation demonstrates sports injury in soccer game.

It flattens the natural curve of the spine, which can lead to lower back pain. Sleeping all night with the head turned to one side also strains the neck. If this is the preferred position, try using pillows to gradually train the body to sleep on one side

Meningitis is a common life-threatening medical emergency caused by infectious and non-infectious agents. Rapid and accurate evaluation by history and clinical examination is helpful to guide further specific investigation and treatment. Kernig's sign, Brudzinski's sign, and nuchal rigidity are bedside diagnostic signs used to evaluate suspected cases of meningitis. The presence of meningeal irritation, however, is not pathognomonic for meningitis.

Four-point gait crutches walking pattern demonstration review for
NCLEX assistive devices and nurses.

One of the gaits that you'll have to learn for crutches is the 4-point gait. An example of a four point gait crutch pattern would be the patient moving the right crutch first (on the injured side), followed by the left foot, then the left crutch, and then the right foot. Then, you'll repeat this pattern.

In addition to this video, we have an entire compilation that features the various crutch gait patterns, as well as walkers and canes:

https://www.youtube.com/watch?v=k2-w3LZlCVk

#crutches
#nclex
#nursing
#nurse

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Are most spiders poisonous? The majority of the 3,000 spiders in the United States aren’t poisonous. Even if most spiders did bite, their fangs are too small or weak to puncture human skin. Their bites may leave itchy, red wounds that heal within a week or so. The spiders that do manage to bite through our skin and insert toxic venom can cause serious health complications. Read on to learn what spider bites look like, what spider varieties leave certain bites, and how to treat spider bites. What do spider bites look like? Identifying a spider bite is easier if you saw the spider that bit you, but it’s possible that you won’t notice the wound until hours later. Look for things like: swelling a red welt skin damage any troubling symptoms that accompany the bite Other possible symptoms that may accompany a spider bite include: itching or rash pain around the area of the bite muscle pain or cramping blister that’s red or purple in color sweating difficulty breathing headache nausea and vomiting fever chills anxiety or restlessness rashes swollen lymph glands high blood pressure Spider bites often take longer to heal than other insect bites, and they may affect skin tissues. It’s important to keep the bite clean to reduce the risk of infection. How to treat a spider bite at home In some cases, you can treat spider bites at home. For nonvenomous spider bites, follow these steps: Apply an ice pack on and off the bite for 10 minutes at a time. Elevate the area to reduce swelling. Take an antihistamine, such as diphenhydramine (Benadryl), to help with itching. Clean the area with soap and water to prevent infection. Apply antibiotic ointment to the area if blisters develop. Seek medical attention if you’re showing symptoms of a spider bite or if the symptoms don’t go away over time. Always seek medical attention if you suspect you’ve been bitten by one of the following species: brown recluse black widow hobo spider tarantula Brazilian wandering spider

Not every woman undergoes a traditional vaginal delivery with the birth of her child. Under conditions of fetal or maternal distress, or in the case of breech presentation (when a baby is turned feet first at the time of delivery), or if the woman’s first baby was born by cesarean delivery, a procedure called a cesarean section may be required. During a cesarean, a doctor will make either a lateral incision in the skin just above the pubic hair line, or a vertical incision below the navel. As the incision is made, blood vessels are cauterized to slow bleeding. After cutting through the skin, fat, and muscle of the abdomen, the membrane that covers the internal organs is opened, exposing the bladder and uterus. At this time the physician will generally insert his or her hands into the pelvis in order to determine the position of the baby and the placenta. Next, an incision is made into the uterus and any remaining fluids are suctioned from the uterus. The doctor then enlarges the incision with his or her fingers. The baby’s head is then grasped and gently pulled with the rest of its body from the mother’s uterus. Finally, the abdominal layers are sewn together in the reverse order that they were cut. The mother is allowed to recover for approximately three to five days in the hospital. She will also be quite sore and restricted from activity for the following several weeks. There are several potential complications associated with this procedure that should be discussed with a doctor prior to surgery.

Laparoscopic surgery is minimally-invasive (keyhole) surgery and it is performed through very small incisions, using a camera to guide the surgeon during the procedure. Miss Sarah Mills, a top colorectal surgeon, explains why laparoscopic surgery is performed over alternative methods.

Make an appointment with Miss Sarah Mills here: https://www.topdoctors.co.uk/doctor/sarah-mills

If you have a lung disease, a type of surgery called a lobectomy is one treatment option your doctor may suggest. Your lungs are made up of five sections called lobes. You have three in your right lung and two in your left. A lobectomy removes one of these lobes. After the surgery, your healthy tissue makes up for the missing section, so your lungs should work as well or better than they did before.

Lumpectomy means that a focal area of cancer is going to be removed. A lot of patients with a lumpectomy don’t need any specific breast reconstruction, explains Dr. Miguel Angel Medina, Director of Microsurgery with Miami Cancer Institute.
Al the end of surgical treatment, all those patients go on to need radiation therapy. For patients who have large breasts, physicians have to take a larger lumpectomy than normal.

Talley + O'Connor's essential video guide to Abdominal Examination is here! Brush up on your skills and be sure to ace your OSCEs!

The type of operation performed for removal of pancreatic cancer is based on the location of the tumor. For tumors of the head and neck of the pancreas a Whipple procedure, (also called a pancreaticoduodenectomy) is performed. This is a complex operation perfected at Johns Hopkins. This video will explain the surgery and what patients can expect.

Learn more about the Whipple procedure at Johns Hopkins:
http://www.hopkinsmedicine.org..../pancreatic_cancer_c

Curious about LASIK eye surgery? NVISION's Dr. Richard Mauer talks risks, life-changing benefits, and outcomes (plus why he loves what he does!).

Want to start your journey to better vision? Schedule your complimentary consult today! https://bit.ly/3H2i0FU

NVISION: The Eye Doctors' #1 Choice in LASIK and Laser Cataract Surgery

Microcalcifications in the breast can be the first sign of cancer. They are, as the name says, very small and clustered. A precise biopsy without pain under stereotactic guidance is the standard procedure. What makes this Spirotome different from the vacuum assisted biopsies is that only a few biopsies are needed and that the approach of the needle towards the microcalcifications is direct and frontal. There is no damage to the surrounding tissues making this procedure rather painfree and with minimal bleeding.

The moment doctors at University Hospital's Case Medical Center activate the electrode they implanted in patient Greg Grindley’s brain, the tremor in his right hand stops immediately.
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Tremor Relief at Last | Brain Surgery Live
https://youtu.be/iX-QKDnUbhg

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How to perform a Thyroid Gland Examination - Clinical Skills Revision

The thyroid examination is one of the first sessions of the clinical skills block for medical students at Warwick Medical School - largely as it touches lightly on to other clinical areas, such as the cardiac examination, and the peripheral neurological examination making it an excellent starting point for building further knowledge


This is a clinical examination of the thyroid gland is performed by Dr James Gill following the approach in Macleod’s Clinical examination.


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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.


However, during OSCE assessments. Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical evaluation - you should concentrate on THEIR marks schemes for your assessments.


The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.


Some people may experience an ASMR effect from watching this medical clinical examination

#ThyroidExamination #ClinicalSkills #DrGill #ASMR

To learn more about coronary artery bypass grafting (CABG), please visit https://cle.clinic/3b7dqpE

Cardiac surgeons Faisal Baaeen, MD and Edward Soltesz, MD talk about coronary artery bypass graft (CABG) surgery in this informative video.

They describe:
• how blockages are bypassed
• how vessels are used for the bypass graft
• reoperation experiences
• the importance of complete revascularization
• and options such as off pump bypass surgery and minimally invasive surgery

Dr. Bakaeen is the Director of the Coronary Artery Bypass Center at Cleveland Clinic. To learn more about him, please visit https://cle.clinic/2INN9AV

Dr. Soltesz is a cardiovascular and heart transplant surgeon. To learn more about him, please visit https://cle.clinic/3o86RMt

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#clevelandclinic #coronaryartery #bypasssurgery #heartsurgery #heartcare #cardiacsurgery