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For more than 25 years, The Children's Hospital of Philadelphia — the first Level 1 Pediatric Trauma Center in Pennsylvania — has provided unparalleled medical and surgical care for all injured children, including those with the most severe injuries.
Learn what makes the Trauma Center at CHOP a Level 1 Pediatric Trauma Center, and how our work toward trauma prevention, research advances and overall trauma awareness provides hope for reduced injuries in the future.
Learn more about the Trauma Center at CHOP: http://www.chop.edu/trauma.
Breast Cancer spreads by 3 mechanisms- local spread, by lymph nodes, or through the blood. Dr. Lorraine Champion, and Dr. Lisa Bailey discuss how breast cancer spreads. They discuss the different methods of spread and how this will affect the treatment of breast 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:
Symptoms of blood clots in specific body locations are as follows: Symptoms of blood clots in legs (deep vein thrombosis (DVT) are pain, redness, and swelling. Symptoms of an arterial blood clot in a limb (leg or arm) include pain, pale color, and coolness to the touch. and the leg is cool and pale.
In a small but promising Phase II clinical trial of breast cancer treatment, cryoablation killed 25 early-stage tumors in 13 women. The tumors ranged in size from .5 cm (very small) to 5.8 cm (very large), with an average size of 1.7cm. Patients were first given a local anesthesia with mild sedation before physicians used ultrasound with or without computed tomography (CT) imaging to guide needle-like probes to deliver very low temperature gas to the tumor site. The ultra-cold gas forms a ball of ice around the probe tip, then expands and destroys surrounding tumor cells. A harmless saline solution was first injected into the chest wall and skin of the breast to protect the tissue surrounding the tumor from the freezing effects. Patients experienced very little pain and most healed completely within six months with no complications and with little or no scarring. The cryotherapy margins of each participant were biopsied immediately after the procedures, and all were negative, with no evidence of cancerous tissue. All 13 patients were without recurrence at an average of 18 months and up to five years following the procedure. These results are promising, but larger studies with lengthier follow-up are needed to determine whether cryotherapy as effective as lumpectomy. A study involving cryoablation of mouse tumors at the University of Michigan Comprehensive Cancer Center found that the freezing procedure also works like a vaccine, boosting the immune system to reduce the likelihood of recurrence. Just how quickly the tumor was frozen made a difference: a 30-second freeze killed tumors and also boosted the immune system, inhibiting metastases to the lungs. A slower freezing lasting several minutes destroyed tumors just as effectively, but actually suppressed the immune system, resulting in greater metastases to the lungs.
A 76 year-old, female, presented with a three day history of melena without any abdominal pain. She had one episode of hematemesis (about 100 ml blood) in the emergency room, patient has a strong alcoholic drink abuse.
An upper endoscopy with magnification was performed.
multiple ulcers were detected across of the gastric camera,
esophageal varices was also detected
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.
Glass ampules are often used to store medication, and as a nurse, you'll need to know how to use them.
In this video, I demonstrate how to clean an ampule using alcohol prep, how to open (or break) an ampule, as well as how to dispose of the ampule.
In addition, I show how to use an ample filter straw while drawing up (withdrawing) medication, how to use the syringe, and how to remove the air bubbles in the syringe.
This is another video in our series on clinical nursing skills.
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