A decade ago we thought that Chikungunya was a tropical disease restricted to the rain forests. However, after the 2007 epidemic in Italy and later in the Reunion islands, this dreaded condition has now spread to the Carribean and the Americas. Its an arthropod borne alpha virus which causes fever, polyarthralgia and arthritis. There could be serious complications in the adult such as meningoencephalitis or GBS as well as in neonates. This presentation discusses in detail the clinical features, diagnosis and management of Chikungunya fever. A detailed discussion of its complications is also included. Check out our other videos

En Bloc Esophageal Mucosectomy, an experimental technique for the endolumenal management of Barrett's related dysplasia and neoplasia. High grade dysplasia is in indication for esophagectomy; however esophagectomy has a mortality rate up to 12 percent, and up to 56 percent of patients may develop s...erious post-operative complications. Multiple ablated lesions can progress under the neo-squamous layer, leading to buried Barrett's mucosa. With conventional piecemeal EMR, cautery effect limits evaluation in areas of interest, Barrett's epithelium is left behind, tissue is not evaluated in situ and invasive lesions may be missed due to incomplete sampling. A new technique, en bloc esophageal mucosectomy, or EEM, was developed. The technique begins with conventional EMR in the proximal esophagus to access the submucosal space. Conventional EMR is being performed here. The mucosa is resected using an electrothermal snare. The mucosal defect from the first EMR is seen here. EMR is then repeated on the opposing wall. Sequential EMR creates a complete concentric mucosal defect. In the following sequence the completely detached column of mucosa can be seen, bounded by submucosa and muscularis propria layers. Here in the stomach, the endoscope is retroflexed and is covered by a sleeve of esophageal mucosa which has been freed to the GE junction and inverted. This sequence demonstrates a double snare technique. This snare is alongside the endoscope. The snare has been passed through the working channel. The working channel snare is pulled back, and the snare alongside the scope is used to grasp the mucosal column. With tension on the column the working channel snare can be threatened and advanced. This sequence shows the snare as it is being passed down to the GE junction. At the GE junction, the snare is tightened and cautery is applied. This frees the column of mucosal tissue from the remaining attachment. The endoscope is then withdrawn. Then detached mucosal column can be grasped with a snare and retrieved. In the following sequence, the long column of mucosa is being withdrawn via the overtube. Here, endoscopic forceps have been passed through the column to demonstrates the concentric nature of the specimen. The length of mucosa can be seen here alongside 2 conventional EMR specimens. Approximately 15cm of tissues was removed in this case. On endoscopy immediately following the resection, there is no bleeding or evidence of perforation in the area of resection. The endoscope is advanced and the exposed submucosa can be appreciated down to the GE junction. This is the low power view of the histologic specimen generated by EEM. Metaplastic tissue adjacent to a dysplastic focus would be completely removed. With a high power view, the layers of the esophagus can be appreciated. The epithelium, lamina propria, muscularis mucosa and submucosa are visible, with no cautery artifact in the area of interest. The technique would remove metplasia, low grade dysplasia, high grade dysplasia, and intramucosal carcinoma, as well a T 1 a lesions. All the animals in this series tolerated the procedure well. A total of five non-survival procedures and 4 survival procedures were performed. In the survival procedures, all four swine thrived in the post-operative period. Two swine were then survived for 9 days following the procedure. On post —op day nine, after passing into the upper esophagus, the proximal margin of the mucosectomy is seen here. Healing appears to be occurring. There is no evidence of leak, and no stricting is seen at 9 days down to the GE junction Passing into the stomach, some residual feed can be seen. Two swine were then survived for 13 days. On this follow-up endoscopy, the area of the mucosectomy is again healing. There was a loose stricture in both animals and both were easily traversed with a 9.8 mm gastroscope. There was a gross appearance of re-epitheliazation in some areas. It is notable that the stricture was present in the proximal esophagus with no narrowing distally. At necropsy there was not eviden

Alimentos Para Controlar La Presion Arterial, Arterial Hypertension, Prevencion De Hipertension

http://bajar-presion-arterial.good-info.co

Para obtener los mismos beneficios que los medicamentos prescritos más comúnmente
sin los efectos secundarios negativos existen alternativas naturales. La dieta es la principal manera de aumentar las reacciones deseables, pero el ejercicio contribuye en gran medida también.

Por ejemplo, la misma reacción causada por los vasodilatadores puede ocurrir cuando usted obtiene suficiente L-Arginina. Este aminoácido permite que las paredes de los vasos sanguíneos se relajen. Usted puede tomar un suplemento o conseguirla a través de proteínas de origen animal, el maní y la soja.

http://bajar-presion-arterial.good-info.co


https://www.youtube.com/watch?v=SFUGz4IqbA0
Alimentos Para Controlar La Presion Arterial, Arterial Hypertension, Prevencion De Hipertension, Arterial Pdf, Hipertension Esencial, Hipertension Pulmonar Tratamiento,Tension Alta Sintomas, Dieta Hipertension, Guia Clinica Hipertension, Sal Marina Hipertension,
Sintomas De Tension Alta, Hipertension Portal Pdf, Hipertension Arterial Clasificacion, Hipertension Intracraneal, Tension Alta En, El Embarazo, Hipertension Primaria

Endometrial Ablation

Always consult your doctor and seek help early enough to prevent complications

Intramedullary nailing of the tibia with suprapatellar entry and semi-extended positioning makes it technically easier to nail the proximal and distal fractures. The purpose of this article was to describe a simple method for suprapatellar nailing (SPN). A step-by-step run through of the surgical technique is described, including positioning of the patient. There are as yet only a few clinical studies that illustrate the complications with this method, and there has been no increased frequency of intraarticular damage. Within the body of the manuscript, information is included about intraarticular damage and comments with references about anterior knee pain.

His father, Dr. Joseph Dello Russo, helped turn Lasik eye surgery into the widespread procedure it is today. Now he explains a new technique and how it differs.

Watch that Female Foley Catheter Insertion Procedure

-Traumatic amputation of a body part requires rapid transport of the appendage, which should be wrapped in a saline-moistened gauze, placed in a plastic bag, and transported in a container filled with ice mixed with either saline or sterile water to best preserve the body part and attempt replantation.

Watch that Ectopic Pregnancy Medical Abortion Procedure

Depression is a very serious mental illness that affects millions worldwide. Could a small brain implant cure it?

Bone healing can be divided into four stages: inflammation; soft callus formation; hard callus formation; remodeling.

Addison's disease is a disorder that occurs when your body produces insufficient amounts of certain hormones produced by your adrenal glands. In Addison's disease, your adrenal glands produce too little cortisol and often insufficient levels of aldosterone as well. Also called adrenal insufficiency, Addison's disease occurs in all age groups and affects both sexes. Addison's disease can be life-threatening. Treatment for Addison's disease involves taking hormones to replace the insufficient amounts being made by your adrenal glands, in order to mimic the beneficial effects produced by your naturally made hormones.

Watch that video of The World's Biggest Jigger Removal

small bowel anastomosis (the luminescent material check for leaks, and good flow)

The menstrual cycle is the regular natural change that occurs in the female reproductive system that makes pregnancy possible. The cycle is required for the production of oocytes, and for the preparation of the uterus for pregnancy.

G-Shot (G-Spot Amplification)

A successful cardiovascular exam includes visual examination, palpation of the apical impulse, auscultation of Erb's point, auscultation of the carotids, and auscultation over the four different heart valve locations (aortic, pulmonic, tricuspid, and mitral). Additionally, the radial pulse is palpated while auscultating to distinguish whether a murmur is diastolic or systolic.

Video Index:
0:13 - Inspection of the thorax
0:29 - Palpation of the apex heart beat
0:59 - Auscultation of the heart
1:16 - Auscultation of the Erb’s point
1:33 - Using Erb’s point to check the heart rate
1:45 - Systolic and diastolic heart sound identification
2:01 - Ascultating individual valves: aortic, pulmonary, tricuspid, mitral
2:41 - Ascultation of the carotids
2:54 - Ascultating the pulmonary and aortic valves
3:04 - Ascultation of the mitral valve
3:16 - Mitral valve murmurs

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Thoracentesis is a procedure used to obtain a sample of fluid from the space around the lungs. Normally, only a thin layer of fluid is present in the area between the lungs and chest wall. However, some conditions can cause a large amount of fluid to accumulate. This collection of fluid is called a pleural effusion.

Stress-relaxation is a well-established mechanism for laboratory skin stretching, with limited clinical application in conventional suturing techniques due to the inherent, concomitant induction of ischemia, necrosis and subsequent suture failure. Skin defects that cannot be primarily closed are a common difficulty during reconstructive surgery. The TopClosure tension-relief system (TRS) is a novel device for wound closure closure, providing secured attachment to the skin through a wide area of attachment, in an adjustable manner, enabling primary closure of medium to large skin defects. The aim of this study was to evaluate the efficiency of the TopClosure TRS as a substitute for skin grafting and flaps for primary closure of large soft tissue defects by stress-relaxation. We present three demonstrative cases requiring resection of large to huge tumors customarily requiring closure by skin graft or flaps. TRS was applied during surgery serving as a tension-relief platform for tension sutures, to enable primary skin-defect closure by cycling of stress-relaxation, and following surgery as skin-secure system until complete wound closure. All skin defects ranging from 7 to 26 cm in width were manipulated by the TRS through stress-relaxation, without undermining of skin, enabling primary skin closure and eliminating the need for skin grafts and flaps. Immediate wound closure ranged 26 to 135 min. TRS was applied for 3 to 4 weeks. Complications were minimal and donor site morbidity was eliminated. Surgical time, hospital stay and costs were reduced and wound aesthetics were improved. In this case series we present a novel technology that enables the utilization of the viscoelastic properties of the skin to an extreme level, extending the limits of primary wound closure by the stress-relaxation principle. This is achieved via a simple device application that may aid immediate primary wound closure and downgrade the complexity of surgical procedures for a wide range of applications on a global scale.