An atrial septal defect (ASD) is a hole in the wall between the two upper chambers of your heart (atria). The condition is present from birth (congenital). Small atrial septal defects may close on their own during infancy or early childhood. Large and long-standing atrial septal defects can damage your heart and lungs. Small defects may never cause a problem and may be found incidentally. An adult who has had an undetected atrial septal defect for decades may have a shortened life span from heart failure or high blood pressure that affects the arteries in the lungs (pulmonary hypertension). Surgery may be necessary to repair atrial septal defects to prevent complications.

There are a number of different causes of vertigo. Vertigo can be defined based upon whether the cause is peripheral or central. Central causes of vertigo arise in the brain or spinal cord while peripheral vertigo is due to a problem within the inner ear. The inner ear can become inflamed because of illness, or small crystals or stones found normally within the inner ear can become displaced and cause irritation to the small hair cells within the semicircular canals, leading to vertigo. This is known as benign paroxysmal positional vertigo (BPPV).

The Valsalva Maneuver is any attempt to exhale with the mouth and nose closed. Named after the Italian physician and anatomist, Antonio Maria Valsalva (1666-1723), it is also known as Valsalva's Test and Valsalva's Method.

Big wart blister after freezing with liquid nitrogen.

Second-degree burns (also known as partial thickness burns) involve the epidermis and part of the dermis layer of skin. The burn site appears red, blistered, and may be swollen and painful.

Pinch air out of the tip of the condom. Unroll condom all the way down the penis. After sex but before pulling out, hold the condom at the base. Then pull out, while holding the condom in place. Carefully remove the condom and throw it in the trash.

Any independent vertical movement of the transducer or the patient will affect the hydrostatic column of this fluid-filled system and thus alter the pressure measurements. At some time before or after PAC insertion, the system must therefore be zeroed to ambient air pressure. The reference point for this is the midpoint of the left atrium (LA), estimated as the fourth intercostal space in the midaxillary line with the patient in the supine position. With the transducer at this height, the membrane is exposed to atmospheric pressure, and the monitor is then adjusted to zero. Calibration Once zeroed, the monitoring system must be calibrated for accuracy. Currently, most monitors perform an automated electronic calibration. Two methods are used to manually calibrate and check the system. If the catheter has not been inserted, the distal tip of the PAC is raised to a specified height above the LA. For example, raising the tip 20 cm above the LA should produce a reading of approximately 15 mm Hg if the system is working properly (1 mm Hg equals 1.36 cm H 2 O). Alternatively, pressure can be applied externally to the transducer and adjusted to a known level using a mercury or aneroid manometer. The monitor then is adjusted to read this pressure, and the system is calibrated. Dynamic tuning Central pressures are dynamic waveforms (ie, they vary from systole to diastole) and thus have a periodic frequency. To monitor these pressures accurately, the system requires an appropriate frequency response. A poorly responsive system produces inaccurate pressure readings, and differentiating waveforms (eg, PA from pulmonary capillary wedge pressure [PCWP]) can become difficult. When signal energy is lost, the pressure waveform is dampened. Common causes of this are air bubbles (which are compressible), long or compliant tubing, vessel wall impingement, intracatheter debris, transducer malfunction, and loose connections in the tubing. A qualitative test of the frequency response is performed by flicking the catheter and observing a brisk high-frequency response in the waveform. After insertion, the system can be checked by using the rapid flush test. When flushed, an appropriately responsive system shows an initial horizontal straight line with a high-pressure reading. Once the flushing is terminated, the pressure drops immediately, which is represented by a vertical line that plunges below the baseline. A brief and well-defined oscillation occurs, followed by return of the PA waveform. A dampened system will not overshoot or oscillate, and causes a delay in returning to the PA waveform.

Watch that video of a Newborn Baby Medical Autopsy

Claudication, which is defined as reproducible ischemic muscle pain, is one of the most common manifestations of peripheral arterial occlusive disease (PAOD) caused by atherosclerosis. Claudication occurs during physical activity and is relieved after a short rest. Pain develops because of inadequate blood flow. Examination of a patient with claudication should include a complete lower-extremity evaluation and pulse examination, including measuring segmental pressures. Attempt to palpate pulses from the abdominal aorta to the foot, with auscultation for bruits in the abdominal and pelvic regions. When palpable pulses are not present, a handheld Doppler device may be used to assess circulation.

Carpal tunnel syndrome is a hand and arm condition that causes numbness, and other symptoms. Carpal tunnel syndrome is caused by a pinched nerve in your wrist. A number of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, certain underlying health problems and possibly patterns of hand use. Bound by bones and ligaments, the carpal tunnel is a narrow passageway located on the palm side of your wrist. This tunnel protects a main nerve to your hand and the nine tendons that bend your fingers. Compression of the nerve produces the numbness, tingling and, eventually, hand weakness that characterize carpal tunnel syndrome.

Extracorporeal shock wave lithotripsy (ESWL) uses shock waves to break a kidney stone into small pieces that can more easily travel through the urinary tract camera.gif and pass from the body. See a picture of ESWL camera.gif. You lie on a water-filled cushion, and the surgeon uses X-rays or ultrasound tests to precisely locate the stone. High-energy sound waves pass through your body without injuring it and break the stone into small pieces. These small pieces move through the urinary tract and out of the body more easily than a large stone. The process takes about an hour. You may receive sedatives or local anesthesia. Your surgeon may use a stent if you have a large stone. A stent is a small, short tube of flexible plastic mesh that holds the ureter open. This helps the small stone pieces to pass without blocking the ureter.

Adult Still's disease is a rare type of inflammatory arthritis that features fevers, rash and joint pain. Some people have just one episode of adult Still's disease. In other people, the condition persists or recurs. This inflammation can destroy affected joints, particularly the wrists. Treatment involves medications, such as prednisone, that help control inflammation

Maneuver to Correct Shoulder Dystocia Birth

Pediatric surgeons at Texas Children’s Hospital West Campus perform general surgical procedures such as circumcisions, removal of foreign objects, hernia repair, and suturing of minor lacerations. While more complex surgeries take place at the Texas Children’s Main Campus, pre-operative and follow-up outpatient care for those procedures is available at the West Campus.

Everything about Texas Children’s Hospital West Campus is dedicated to the health and wellness of children. As greater Houston's first suburban hospital designed exclusively for children, we offer the expert care you've come to trust from Texas Children's Hospital coupled with a location that's convenient and accessible for area families. Our facility is located just off the westbound feeder road of the Katy Freeway (at I-10 and Barker Cypress).

For more information about Texas Children's Hospital West Campus, visit http://www.texaschildrens.org/....Locate/In-the-Commun

Meet Dr. Allen Milewicz, chief of community surgery at Texas Children's West Campus
https://www.youtube.com/watch?v=uMoCdipuKfA&index=16&list=PLiN68C9rloPBD-E9ChWhVy73h7V3SEMlm

Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly. Children who have mild scoliosis are monitored closely, usually with X-rays, to see if the curve is getting worse. In many cases, no treatment is necessary. Some children will need to wear a brace to stop the curve from worsening. Others may need surgery to keep the scoliosis from worsening and to straighten severe cases of scoliosis.

Rectal bleeding can refer to any blood that passes from your anus, although rectal bleeding is usually assumed to refer to bleeding from your lower colon or rectum. Your rectum makes up the last few inches of your large intestine. Rectal bleeding may show up as blood in your stool, on the toilet paper or in the toilet bowl. Blood that results from rectal bleeding can range in color from bright red to dark maroon to a dark, tarry color.

This procedure, and other types of soft palate surgery, targets the back of the roof of your mouth. It involves removing and repositioning excess tissue in the throat to make the airway wider. The surgeon can trim down your soft palate and uvula, remove your tonsils, and reposition some of the muscles of the soft palate. UPPP and other soft palate procedures are the most common type of surgery for sleep apnea. But UPPP alone is unlikely to cure moderate to severe sleep apnea. It may be combined with surgeries that target other sites in the upper airway.

They are the leaders of the pack when it comes to minimally invasive surgeries. Laparoscopic and robotic. Different techniques with the same benefits.

"There's significantly less blood loss, it's a quicker procedure, quicker recovery, less scarring, less chance for post operative wound complications or infections," says Dr. Darren Miter, laparoscopic surgeon with Lee Memorial Health System.

In a laparoscopic procedure surgeons operate through a series of poke holes, manually inserting thin cutting tools and a camera to provide magnified vision. It's used in a variety of surgical specialties.

"The vast majority of gallbladder surgeries are performed laparoscopically. A single incision in the belly button, one up under the breastbone and either one or two in the right upper side of the belly. Using long skinny instruments and looking up at a TV monitor, remove the gallbladder that way," says Dr. Miter.

While laparoscopic is a hands-on approach, robotic procedures are surgeon-controlled. Working at a console, surgeons direct the robotic arms, which have super-human capabilities and 3D, hi def vision.

"I mean you have to see it to believe it, that's a great tool to have. You got a very good depth perception. Plus the other thing when you're working with your hands it's more intuitive," says Dr. Nagesh Ravipati, colorectal surgeon with Lee Memorial Health System.

The robotic system performs maneuvers the human hand can't.

"Especially if you have to do any suturing, it is so much simpler with the robots because you can just turn around 360 degrees," says Dr. Ravipati.

Robotic surgery is gaining momentum in precise procedures, including the field of cancer.

"The robot is good when you're going to operate on just one field. For rectal surgery you're in one place, it's docked. It gives you the best 3 dimensional vision," says Dr. Ravipati.

Robotic and laparoscopic. Both cutting edge options, with less cutting.

View More Health Matters video segments at leememorial.org/healthmatters/

Lee Memorial Health System in Fort Myers, FL is the largest network of medical care facilities in Southwest Florida and is highly respected for its expertise, innovation and quality of care. For nearly a century, we've been providing our community with everything from primary care treatment to highly specialized care services and robotic assisted surgeries.

Visit leememorial.org

Emphysema gradually damages the air sacs (alveoli) in your lungs, making you progressively more short of breath. Emphysema is one of several diseases known collectively as chronic obstructive pulmonary disease Smoking is the leading cause of emphysema. Your lungs' alveoli are clustered like bunches of grapes. In emphysema, the inner walls of the air sacs weaken and eventually rupture — creating one larger air space instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream. When you exhale, the damaged alveoli don't work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter. Treatment may slow the progression of emphysema, but it can't reverse the damage.

Lumbar puncture is a common emergency department procedure used to obtain information about the cerebrospinal fluid (CSF) for diagnostic and, less commonly, therapeutic reasons. Please refer to the full article on Lumbar Puncture for more details on the lumbar puncture procedure. Lumbar puncture is typically performed via “blind” surface landmark guidance. The surface landmark technique is reported to be successful in a high percentage of attempted lumbar punctures; however, surface landmark identification of underlying structures has been shown to be accurate only 30% of the time. [1] Unsuccessful identification of proper landmarks often leads to increased difficulty in obtaining CSF, if the procedure is performed, and a higher rate of complications. Few alternatives are available in these cases. If available, fluoroscopic-guided lumbar puncture may be performed. If not, treatment is sometimes initiated empirically without obtaining CSF. Disadvantages of using fluoroscopy include limited availability or necessary transport of the patient outside of the emergency department, inability to directly visualize the spinal canal, and inherent radiation exposure