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.

Watch that Large Jelly Like Hematoma Extraction

-Rapidly progressive weakness of the lower extremities following an upper respiratory infection, accompanied by sensory loss and urinary retention, is characteristic for transverse myelitis.

There are a few different kinds of emergency contraception. The best kind for you depends on a few factors — when you had sex, your weight, whether you’re breastfeeding, and what kind is easiest for you to get. Here’s what you need to know.

Shamika Burrage survived a near-fatal car accident two years ago, but not without losing something pretty important: her left ear. Now, thanks to a novel procedure performed at an Army medical center in Texas, Burrage is getting that ear back in a most unusual way. Plastic surgeons harvested cartilage from Burrage's ribs to create a new ear and then grew it under the skin of her forearm. Then the doctors at William Beaumont Army Medical Center in El Paso successfully transplanted the ear from her arm to her head. The technique -- a first time in the Army -- is called prelaminated forearm free flap, said Lt. Col. Owen Johnson III, chief of plastic and reconstructive surgery at William Beaumont Army Medical Center. Some of the big advantages of it is that it reduced the chance of more scarring around Burrage's ear. Also, growing the ear under the skin of her forearm allows new blood vessels to form. "(The ear) will have fresh arteries, fresh veins and even a fresh nerve so she'll be able to feel it," Johnson said on the US Army's website. Burrage, a 21-year-old private, still has to endure two more surgeries, but she's feeling more optimistic about the future than ever in the years since her accident. "It's been a long process for everything, but I'm back," said Burrage.

A thyroid biopsy is a procedure in which a small sample of tissue is removed from the thyroid gland and looked at under a microscope for cancer, infection, or other thyroid problems. The thyroid gland is found in front of the windpipe (trachea), just below the voice box (larynx). A sample of thyroid tissue can be taken by: Fine-needle biopsy. Your doctor puts a thin needle through the skin and into the thyroid gland. Many thyroid specialists like to use a needle biopsy method rather than surgery. Open biopsy. Your doctor makes a cut (incision) through the skin to see the thyroid gland. This method is done when other tests have not found the cause of your symptoms. Core needle biopsy. Your doctor inserts a needle with a special tip and removes a sample of tissue about the size of a grain of rice.

Eye Lid Partial Tarsectomy Surgery

The hepatitis E virus, responsible for major epidemics of viral hepatitis in subtropical and tropical countries, was cloned only 7 years ago.1 Hepatitis E was found to belong to the family of Caliciviridae, which includes the Norwalk virus—a common cause of gastroenteritis in humans—and consists of a single, plus-strand RNA genome of approximately 7.2 kb without an envelope (Fig. 1). The virus contains at least three open reading frames encoding viral proteins against which antibodies are made on exposure. These antibodies, especially those against the capsid protein derived from the second open reading frame2 and a protein of unknown function derived from the third open reading frame, are detected by currently available serologic assays. Retrospective studies on stored sera of past epidemics of viral hepatitis in Mexico, Africa, Afghanistan, Pakistan, India, Bangladesh, Burma, Nepal, and Borneo have revealed that all were caused by strains of hepatitis E. In addition, hepatitis E was found to be responsible for the hepatitis epidemic in the southern part of Xinjiang, China, in which 120,000 persons became infected between September 1986 and April 1988.3 Hepatitis E predominantly affects young adults (15 to 40 years old). The symptoms of hepatitis E are similar to those of hepatitis A. Frequently, a prodrome consisting of anorexia, nausea, low-grade fever, and right upper abdominal pain is present 3 to 7 days before jaundice develops. Aminotransferase levels peak (usually between 1,000 and 2,000 U/L) near the onset of symptoms; bilirubin levels (10 to 20 mg/dL) peak later. Jaundice usually resolves after 1 to 2 weeks. In about 10% of cases, the disease is fulminant—especially in pregnant women, among whom mortality rates as high as 20% due to hemorrhagic and thrombotic complications have been reported. No evidence has suggested that hepatitis E can cause chronic infection. Transmission is by the fecal-oral route, predominantly through fecally contaminated drinking water supplies. In addition, however, preliminary reports have suggested transmission of the hepatitis E virus through blood transfusions. Volunteer studies confirmed the presence of the virus in serum and feces before and during clinical disease.4 The virus is shed into feces approximately 1 week before symptoms develop. The incubation period varies from 2 to 9 weeks (mean duration, approximately 45 days). Until now, a few reports had described symptomatic hepatitis E acquired in Europe;5, 6 all patients with symptomatic hepatitis E in the United States were travelers returning from Mexico, Africa, or the Far East, in whom hepatitis E developed after their return home.7 In this issue of the Mayo Clinic Proceedings (pages 1133 to 1136), Kwo and associates describe a case of hepatitis E in a man who had not left the United States during the previous 10 years. Specific serologic tests for hepatitis E virus IgG (enzyme immunoassays and a fluorescent antibody blocking assay) and IgM8 (US strain-specific enzyme-linked immunosorbent assay with use of synthetic polypeptides deduced from the viral genome, as shown in Figure 1), developed at Abbott Laboratories (IgG and IgM) as well as at the Centers for Disease Control and Prevention (IgG), were used to prove that the patient indeed had acute hepatitis E. Researchers at Abbott Laboratories have prepared a report that describes most of the viral genome in this patient (Fig. I).8 Their results are interesting because this strain from the United States differs considerably from hepatitis E strains isolated in Mexico, Burma, Pakistan, or China. Furthermore, the sequence of the US strain is highly homologous (98% and 94% homology at the amino acid level to the second and third open reading frames, respectively) to a recently isolated hepatitis E strain from American swine.9 This finding suggests that, in the United States, hepatitis E is a zoonosis with the swine population as one of its hosts. This relationship would confirm earlier studies in Asia, where swine were also found to carry variants of the hepatitis E virus.10 Why are these two recent discoveries important for medicine in the United States? First, other sporadic, locally acquired cases of acute hepatitis may be caused by hepatitis E. Second, these back-to-back discoveries strongly suggest that a common natural host for hepatitis E is present in countries with more moderate climates. Because swine do not seem to experience any symptoms associated with infection and because symptoms in humans can be minor or absent, we now may also have an explanation for the 1 to 2% of positive hepatitis E serologic results in blood donors in the United States,11 Netherlands,12 and Italy,6 countries with large swine staples. Clearly, more research needs to be done to confirm this hypothesis. Third, in countries with more moderate climates, hepatitis E may often result in a subclinical infection. Is this variation in manifestation due to less virulent strains, and do sequence variations determine virulence? Fourth, swine may be used as an animal model for study of the disease as well as vaccine development.

posterior augmentation

Lipid-Lowering Agents HMG-CoA reductase inhibitors (statins) These agents inhibit the rate-limiting step in cholesterol biosynthesis by competitively inhibiting HMG-CoA reductase. Note the following: Low-density lipoprotein (LDL) reduction of 25%-60% Examples include Atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin Contraindications include hypersensitivity, active liver disease, pregnancy, lactation, coadministration with strong CYP3A4 inhibitors (selected statins) Vitamin B3 Vitamin B3 inhibits very-low-density lipoprotein (VLDL) synthesis. Note the following: LDL reduction of 10% High-density lipoprotein (HDL) increase of 20% Example includes Niacin (nicotinic acid) Contraindications include hypersensitivity, liver disease, active peptic ulcer, severe hypotension, arterial bleeding Fibrates Fibrates enhance lipoprotein lipase, resulting in increased VLDL catabolism, fatty acid oxidation, and triglycerides elimination. They decrease hepatic extraction of free fatty acids. Note the following: LDL reduction of 15% Triglyceride reduction of 35% Examples include Gemfibrozil, fenofibrate, fenofibrate (micronized), fenofibric acid Contraindications include active liver disease, renal disease, primary biliary cirrhosis, gallbladder disease 2-Azetidiones These agents inhibit sterol transporter at brush border and, consequently, intestinal absorption of cholesterol. LDL reduction of 15% Example includes Ezetimibe Contraindications include hypersensitivity, coadministration with statins (if active liver disease) Bile acid sequestrants These agents lower cholesterol and LDL via bile duct sequestration. Note the following: LDL reduction of 15% Examples include Cholestyramine, colesevelam, colestipol Contraindications include biliary/bowel obstruction, serum triglycerides >300-500 mg/dL, history of hypertriglyceridemia-induced pancreatitis

Future Baby

Reconstruction of a shoulder separation or acromio-clavicular dislocation.

Carotid Stenosis and what it means. The detection and treatment of carotid artery disease for the prevention of stroke is one of the most effective treatments in all of medicine.

FemTouch Vaginal Rejuvenation Laser

A vaginoplasty is a surgical procedure that tightens the vagina. This is done by removing excess vaginal lining and tightening the surrounding soft tissues and muscles. During delivery of a baby the vagina and surrounding tissues and muscles become stretched. After delivery the vagina may return to a more “normal” size, but it often fails to return to its’ pre pregnancy diameter. Generally, the more vaginal deliveries, the worse the condition gets. Many women will complain of decreased sensation and sexual satisfaction during intercourse. Commonly this is due to a lack of friction. Often their partner may notice a change although he may say nothing. Kegel exercises are often recommended but rarely succeed in restoring vaginal tightness.

Watch that video to know more about the World's First Head Transplant Surgery

Nasal polyps are associated with inflammation of the lining of your nasal passages and sinuses that lasts more than 12 weeks (chronic rhinosinusitis, also known as chronic sinusitis). However, it's possible — and even somewhat more likely — to have chronic sinusitis without nasal polyps. Nasal polyps themselves are soft and lack sensation, so if they're small you may not be aware you have them. Multiple growths or a large polyp may block your nasal passages and sinuses.

腹腔镜十二指肠球部溃疡穿孔修补术

This video is intended primarily for mothers in the developing world, but may be helpful to breastfeeding mothers worldwide.