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Upper gastrointestinal bleeding (sometimes upper GI, UGI bleed, Upper gastrointestinal hemorrhage, gastrorrhagia) refers to bleeding in the upper gastrointestinal tract, commonly defined as bleeding arising from the esophagus, stomach, or duodenum. In fact, the proportion of UGIB cases caused by peptic ulcer disease has declined, a phenomenon that is believed to be due to the use of proton pump inhibitors (PPIs) and H pylori therapy. Duodenal ulcers are more common than gastric ulcers, but the incidence of bleeding is identical for both.
The baby will move head down if there is room or if there is tone in the support to the uterus to direct baby head down. Before 24-26 weeks most babies lie diagonal or sideways in the Transverse Lie position. Between 24-29 weeks most babies turn vertical and some will be breech.
Prostate biopsy is a procedure in which small hollow needle-core samples are removed from a man's prostate gland to be examined microscopically for the presence of cancer. It is typically performed when the result from a PSA blood test rises to a level that is associated with the possible presence of prostate cancer.
Stress-related mucosal disease (SRMD) is an acute, erosive gastritis representing conditions ranging from stress-related injury to stress ulcers (1, 2). Stress-related injury is superficial mucosal damage that presents primarily as erosions, whereas stress ulcers are deep, focal mucosal damage penetrating the submucosa with high risk for gastrointestinal bleeding (2, 3). Mucosal damage has been reported to occur during the first 24 hours of hospital admission in 75% to 100% of intensive care unit (ICU) patients (4, 5). Clinically important gastrointestinal bleeding can cause hemodynamic instability and increase the need for red blood cell transfusions (1). Significant bleeding may also increase the length of stay in the ICU and mortality (1).
For patients in extremis from respiratory failure or shock, securing vascular access is crucial, along with establishing an airway and ensuring adequacy of breathing and ventilation. Peripheral intravenous catheter insertion is often difficult, if not impossible, in infants and young children with circulatory collapse. Intraosseous (IO) needle placement, shown in the images below, provides a route for administering fluid, blood, and medication. An IO line is as efficient as an intravenous route and can be inserted quickly, even in the most poorly perfused patients.
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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Shoulder Clinical Examination - Medical School Clinical Skills - Dr Gill
Personally, I find the shoulder examination the most complex examination possibly as there are so many variations and special tests. Some of which overlap and some will relate specifically to a patients presentation.
Often in a medical school syllabus, only select special tests will be used. In this shoulder exam demonstration, we include the Hawkins-Kennedy Test looking for impingement. This is dovetailed with examination for bicipital tendonitis as this is another possible cause of impingement type symptoms.
This shoulder upper limb exam follows the standard "Look, Feel, Move" orthopaedic exam approach, and overall order as set out in MacLeods Clinical Examination
Watch further orthopaedic examinations for your OSCE revision:
The Spine Examination:
https://youtu.be/pJxMHa6SCgU
Knee Examination
https://youtu.be/oyKH4EYfJDM
Hip Joint Clinical Examination
https://youtu.be/JC9GKq5nSdQ
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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 assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.
#ShoulderExamination #ClinicalSkills #DrGill
If you notice a patient beginning to fall, follow these steps to help lower them safely to floor. Always stay with the patient and call for additional help.
Download the CNA Mastery app: https://onelink.to/cnamastery
Download the My Mastery nursing app: https://mynursingmastery.com/get-started
Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm inside a woman's uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization
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Thoracentesis is a procedure in which a needle is inserted into the pleural space between the lungs and the chest wall. This procedure is done to remove excess fluid, known as a pleural effusion, from the pleural space to help you breathe easier. It may be done to determine the cause of your pleural effusion. Some conditions such as heart failure, lung infections, and tumors can cause pleural effusions.