#dialysis #uvahealth
If your kidney function is declining and medications and other treatments aren’t working, dialysis can offer life-saving care. UVA has one of the largest dialysis programs in the country. Nephrologist Daphne Knicely, MD, explains the types of home dialysis and how they can work to fit your life.

Find out more at: https://uvahealth.com/services/dialysis

Transcript

Dialysis is just a way to replace the kidneys when they're not working anymore. So when the kidneys stop working, they stop getting rid of water, stop balancing the chemistry, stop getting rid of the toxins. Then dialysis does its job by balancing the chemistries, getting rid of the toxins, and help remove fluid. It doesn't fix the kidneys. It just replaces them.

I usually think of dialysis as two components. There's hemodialysis and peritoneal dialysis. So peritoneal dialysis can only be done at home. Hemodialysis can be done in a center, or it can be done at home.

Hemodialysis is where you have some sort of access to the blood. Either some sort of shunt in the arm that connects an artery and vein, or a catheter. And it allows for blood to leave you, go through a machine, get cleaned, chemistries balanced, and then comes back to you.

For home hemodialysis, the patient actually learns how to do that treatment. It's a very simple machine, very user-friendly. Training is usually about anywhere from four weeks up to eight weeks, and you work one-on-one with a nurse. You still see the physician. You come in about once a month, maybe twice a month, to get labs. You'll see a social worker, and a nutritionist at the same time.

Peritoneal dialysis takes place by putting a tube into your abdomen. And we take dialysis fluid that's chemically balanced. When we put it into the abdomen, it uses those little blood vessels to pull toxins out, to balance chemistries, kind of like little filters. Now, after it sits in there for several hours, we drain it out.

Anyone that needs dialysis is a candidate for home dialysis. There's not one type of dialysis that's going to make you live longer. They're all equal. The goal is to pick the type of dialysis that fits with your life.

In breech position, the baby's bottom is down. There are a few types of breech: Complete breech means the baby is bottom-first, with knees bent. Frank breech means the baby's legs are stretched up, with feet near the head. Footling breech means one leg is lowered over the mother's cervix. You are more likely to have a breech baby if you: Go into early labor Have an abnormally shaped uterus, fibroids, or too much amniotic fluid Have more than one baby in your womb Have placenta previa (when the placenta is on the lower part of the uterine wall, blocking the cervix)

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A subdural hematoma is most often the result of a severe head injury. This type of subdural hematoma is among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury and may lead to death. Subdural hematomas can also occur after a minor head injury. The amount of bleeding is smaller and occurs more slowly. This type of subdural hematoma is often seen in older adults. These may go unnoticed for many days to weeks, and are called chronic subdural hematomas. With any subdural hematoma, tiny veins between the surface of the brain and its outer covering (the dura) stretch and tear, allowing blood to collect. In older adults, the veins are often already stretched because of brain shrinkage (atrophy) and are more easily injured.

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How to Get Rid of Vaginal Discharge - Treating Normal Discharge.

This particular video is intended as a demonstration of Neurologic Examination. This demonstration is intended as an example of a neurologic exam which may be used as part of the initial evaluation of patients with complaints that may have an underlying neurologic origin. This video is solely for educational purposes and intended for use to prepare for OSCEs incorporating standardized patient encounters. It is not intended as a demonstration of a comprehensive neurologic examination and is not intended as medical advice or medical guidelines.

It is not intended as a complete instructional video and should not be considered a source of complete physical examination instruction.

Instead, it should be treated as a supplement to independent learning using primary Osteopathic Clinical Skills instructional resources. Clinical skills are best learned and developed with support from faculty in the context of a complete Osteopathic Medical School Curriculum.

Osteopathic Clinical Skills is a channel dedicated to discussing and exploring Osteopathic Clinical Skills concepts for medical students, residents, and clinicians and presenting them in an easy to understand manner.

Attributions:
Many thanks to the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC - TCOM) for permitting use of the Simulation facilities and equipment during the production of this video.

Additional thanks to the UNTHSC-TCOM standardized patient and faculty volunteers who participated in this production and provided permission for the use of their image in this video.

A Pap smear (also called a Pap test) is a screening procedure for cervical cancer. It tests for the presence of precancerous or cancerous cells on the cervix, the opening of the uterus. It's named after the doctor who determined that this was a useful way to detect signs of cervical cancer.

Vaginal discharge serves an important housekeeping function in the female reproductive system. Fluid made by glands inside the vagina and cervix carries away dead cells and bacteria. This keeps the vagina clean and helps prevent infection. Most of the time, vaginal discharge is perfectly normal. The amount can vary, as can odor and hue (its color can range from clear to a milky white-ish), depending on the time in your menstrual cycle. For example, there will be more discharge if you are ovulating, breastfeeding, or are sexually aroused. The smell may be different if you are pregnant or you haven't been diligent about your personal hygiene. None of those changes is cause for alarm. However, if the color, smell, or consistency seems significantly unusual, especially if it accompanied by vaginal itching or burning, you could be noticing an infection or other condition. What causes abnormal discharge? Any change in the vagina's balance of normal bacteria can affect the smell, color, or discharge texture. These are a few of the things that can upset that balance:

When diving into a Breast Reduction procedure, there are many things to consider. Even as a patient, being aware of any concerns and how the procedure works is important. Therefore, when a plastic surgeon operates on a patient, the results are clear. Dr. Linder, a Breast surgeon specialist in Beverly Hills, helps explain what goes into a Breast Reduction Procedure.

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Describe pre-procedure considerations for administering a subcutaneous injection.

Describe and demonstrate the preparation for administering a subcutaneous injection.

Describe and demonstrate needle and blood safety.

Describe and demonstrate suitable injection sites for subcutaneous injections.

Discuss the appropriate needle and syringe sizes for subcutaneous injection.

Describe and demonstrate the preparation of the substance to be injected.

Describe and demonstrate safe and correct administration of a subcutaneous injection.

Understand and apply Occupational Safety and Health Administration (OSHA) guidelines.

Understand and apply drug administration safety guidelines (seven rights).

Understand correct post-procedure considerations.

Describe and demonstrate correct documentation.

Define and demonstrate correct recording and reporting procedures.

Define and use related medical terminology.

Explain the Patient Privacy Rule (HIPAA), Patient Safety Act, and Patients' Bill of Rights.

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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.

A biopsy is a diagnostic test that involves collecting small pieces of tissue, usually through a needle, for examination with a microscope. A kidney biopsy can help in forming a diagnosis and in choosing the best course of treatment.

Multiple sclerosis causes many different symptoms, including vision loss, pain, fatigue, and impaired coordination. The symptoms, severity, and duration can vary from person to person. Some people may be symptom free most of their lives, while others can have severe chronic symptoms that never go away.