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Patient Greg Grindley communicates with host Bryant Gumbel and his wife for the first time while undergoing deep brain stimulation surgery at University Hospital's Case Medical Center in Cleveland, Ohio.
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Greg's First In-Surgery Conversation | Brain Surgery Live
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32 year old Dede Kosawa, also known as 'Tree Man', is one of the world's most extraordinary people. He lives in a remote village in Indonesia with his two children, trying to care for them. Dede, a former fisherman, has an incredible skin condition: he has root like structures growing out of his body - branches that can grow up to 5cm a year and which protrude from his hands and feet, and welts covering his whole body.
He is known locally as ‘Tree Man’ and his condition has baffled local doctors for 20 years. In an attempt to earn a living to support his family, he is part of a circus troupe, displaying his 'Tree Man' limbs along with others afflicted with skin deformities in ‘freak’ shows.
Dr Anthony Gaspari, a world expert in skin conditions from the University of Maryland travels to Indonesia to attempt to diagnose 'Tree Man' Dede’s mysterious condition. He takes skin samples for biopsies back in the USA. What will he discover?
We go on an intimate journey with the extraordinary 'Tree Man' Dede, as he tries to eek out a living in a circus troupe to support his family, and as he is given medical help by Dr Gaspari. The identification and possible cure of his condition, could change his whole life.
Half way across the world, in Romania, farmer Ion Toader is discovered to have a similar extraordinary ‘Tree Man’ condition, with growths all over his hands. He has not been able to drive a tractor for five years. A Romanian surgeon offers to give him an operation to remove his growths.
Will it be successful, and how will it change Ion’s life?
Patient 65-year-old of age who comes to the medical consultation with pain moderated pain in the right hypochondrium of “several years of evolution” but that it increased one week ago. Also, she shows pain in the umbilical region of “many years of evolution”, that is supported according to the patient - in a constant way.rnTo the examination, we observe an umbilical hernia, apparently divided into two parts. The hernia of the external region measures 25.1 centimeters x 18.0 centimeters and the one that occupies the average region measures 12.0 centimeters x 10.0 centimeters.rnPatient who comes to the medical consultation with moderated pain in the right hypochondrium of one year of evolution but it increased one week ago after eat duck.rnIn the ultrasound scan of the region of the right hypochondrium (patient came having breakfast, that is to say, without previous preparation ) we can observe the liver of 123.8 millimeters high, as well as the porta vein with a diameter of 7.3 millimeters.rnOn having observed the Gallbladder, we think that a side wall is increased in 2.7 mm (hyperechogenic) with several “echogenics points” in the interior (”Biliary Mud”).
The measurements of the gallbladder were: 39.0 x 17.4 millimeters.rnWe can appreciates an echogenic image in the interior that it would make think about stone. The stones are identified as echogenic foci casting acoustic shadowing but but this image did not appear and a re-evaluation is decided in 15 days.
Acalculous cholecystopathy which means disease or condition of the gallbladder without the presence of gallstones. You might also call it functional gallbladder disorder or impaired gallbladder emptying. Some causes may be chronic inflammation, a problem with the smooth muscles of the gallbladder or the muscle of the Sphincter of Oddi being too tight.
REMEMBER:
Umbilical hernia is a congenital malformation, especially common in infants of African descent, and more frequent in boys. An Acquired umbilical hernia directly results from increased intra-abdominal pressure and are most commonly seen in obese individuals.
Presentation:A hernia is present at the site of the umbilicus (commonly called a navel, or belly button) in the newborn; although sometimes quite large, these hernias tend to resolve without any treatment by around the age of 5 years. Obstruction and strangulation of the hernia is rare because the underlying defect in the abdominal wall is larger than in an inguinal hernia of the newborn. The size of the base of the herniated tissued is inversely correlated with risk of strangulation (i.e. narrow base is more likely to strangulate).
Babies are prone to this malformation because of the process during fetal development by which the abdominal organs form outside the abdominal cavity, later returning into it through an opening which will become the umbilicus.
Differential diagnosisrnImportantly this type of hernia must be distinguished from a paraumbilical hernia which occurs in adults and involves a defect in the midline near to the umbilicus, and from omphalocele.
Sexually Transmitted Diseases (STDs) affect millions of people each year. The most common STDs are gonorrhea, chlamydia and trichomoniasis. While even thinking about STDs and whether you may have one is scary, knowing the facts can make a big difference in your long-term health. Here is what you need to know:
People who are sexually active with multiple partners and are not using barrier protection are at most risk. Teenagers are a large part of this group, because they dont always practice safe sex and they are more likely to have multiple partners. It is recommended that women who are sexually active with multiple partners get screened yearly or immediately after they have engaged in unprotected sex. If you discover that you have an STD, both you and your partner would most likely be treated with antibiotics.
Gonorrhea
Approximately 350,000 cases of gonorrhea were reported to the CDC in 2006, but because not everyone is getting tested for STDs, experts believe the actual numbers are twice that.
The symptoms for gonorrhea are burning with urination, abnormal discharge or pelvic pain. Pelvic pain indicates a very severe infection. Untreated gonorrhea can lead to a serious infection as the disease may spread to a womans fallopian tubes and cause infertility.
Chlamydia
There were 1,000,000 cases of chlamydia reported to the CDC in 2006; experts think the actual rate of infection is as high as 2,000,000 cases.
Chlamydia is often called the silent disease because many people with chlamydia have no symptoms. Chlamydia can affect the urethra, the vagina, the cervix and the fallopian tubes. Symptoms include burring with urination, abnormal discharge and pelvic pain. If you are experiencing any of these systems you should see your doctor to determine if you have chlamydia. Women with chlamydia who arent treated are likely to develop pelvic inflammatory disease. Pelvic inflammatory disease occurs when the infection spreads and causes scarring to the uterus and fallopian tubes. Untreated chlamydia can result in infertility.
Trichomoniasis
Trichomoniasis is the most common STD. About 7 million women and men have trichomoniasis. Women who have trichomoniasis will often experience a frothy yellow or green discharge coming from their vagina. But some people wont have any symptoms.
Understanding STDs, what causes them, and how to treat them will help you stay in control of your health.
Amyotrophic lateral sclerosis The disorder causes muscle weakness and atrophy throughout the body caused by degeneration of the upper and lower motor neurons. Unable to function, the muscles weaken and atrophy. Affected individuals may ultimately lose the ability to initiate and control all voluntary movement, although bladder and bowel sphincters and the muscles responsible for eye movement are usually, but not always, spared. Cognitive function is generally spared for most patients although some (~5%) also have frontotemporal dementia.A higher proportion of patients (~30-50%) also have more subtle cognitive changes which may go unnoticed but are revealed by detailed neuropsychological testing. Sensory nerves and the autonomic nervous system, which controls functions like sweating, are generally unaffected but may be involved for some patients. The earliest symptoms of ALS are typically obvious weakness and/or muscle atrophy. Other presenting symptoms include muscle fasciculation (twitching), cramping, or stiffness of affected muscles; muscle weakness affecting an arm or a leg; and/or slurred and nasal speech. The parts of the body affected by early symptoms of ALS depend on which motor neurons in the body are damaged first. About 75% of people contracting the disease experience "limb onset" ALS i.e. first symptoms in the arms ("upper limb", not to be confused with "upper motor neuron") or legs ("lower limb", not to be confused with "lower motor neuron"). Patients with the leg onset form may experience awkwardness when walking or running or notice that they are tripping or stumbling, often with a "dropped foot" which drags along the ground. Arm-onset patients may experience difficulty with tasks requiring manual dexterity such as buttoning a shirt, writing, or turning a key in a lock. Occasionally, the symptoms remain confined to one limb for a long period of time or for the whole course of the illness; this is known as monomelic amyotrophy. About 25% of cases are "bulbar onset" ALS. These patients first notice difficulty speaking clearly or swallowing. Speech may become slurred, nasal in character, or quieter. Other symptoms include difficulty swallowing, and loss of tongue mobility. A smaller proportion of patients experience "respiratory onset" ALS where the intercostal muscles that support breathing are affected first. Regardless of the part of the body first affected by the disease, muscle weakness and atrophy spread to other parts of the body as the disease progresses. Patients experience increasing difficulty moving, swallowing (dysphagia), and speaking or forming words (dysarthria). Symptoms of upper motor neuron involvement include tight and stiff muscles (spasticity) and exaggerated reflexes (hyperreflexia) including an overactive gag reflex. An abnormal reflex commonly called Babinski's sign (the big toe extends upward and other toes spread out) also indicates upper motor neuron damage. Symptoms of lower motor neuron degeneration include muscle weakness and atrophy, muscle cramps, and fleeting twitches of muscles that can be seen under the skin (fasciculations). Around 15–45% of patients experience pseudobulbar affect, also known as "emotional lability", which consists of uncontrollable laughter, crying or smiling, attributable to degeneration of bulbar upper motor neurons resulting in exaggeration of motor expressions of emotion.