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Barbed sutures first received US Food and Drug Administration approval for soft tissue approximation in 2005 and early adopters readily embraced this device to develop new techniques. It has become apparent that the advantages are more than just "skin deep." Superficial and deep fascia, cartilage, tendon, joint capsule, and fibrous periprosthetic capsules can also be manipulated. Barbed sutures have revolutionized our approach to facial rejuvenation and body contouring by enhancing our ability to quilt and powerfully lift tissue. The elimination of surgical drains and shorter surgical times has made this a true boon for plastic surgeons as well as many other surgical specialists. This article summarizes some of the current and evolving applications of this exciting new tool.
Demystify knee pain and discover nine of the most common causes of pain in this complex joint. Join Burke Selbst PT as we work through our simple screening for the most common types of problems.
Burke is the founder and clinical director of Focus Physical Therapy in Bend Oregon.
Find him:
https://focusptbend.com
https://facebook.com/focusphysio
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No condom prevents pregnancy or sexually transmitted diseases (STDs) 100% of the time. But if you and your partner are having sex, nothing protects against STDs better than a properly used condom. For those having sex, condoms must always be used to protect against STDs even when using another method of birth control.
What is an Aneurysm? A cerebral or intracranial aneurysm is an abnormal focal dilation of an artery in the brain that results from a weakening of the inner muscular layer (the intima) of a blood vessel wall. The vessel develops a "blister-like" dilation that can become thin and rupture without warning. The resultant bleeding into the space around the brain is called a subarachnoid hemorrhage (SAH). This kind of hemorrhage can lead to a stroke, coma, and/or death. Aneurysms are usually found at the base of the brain just inside the skull, in an area called the subarachnoid space. In fact, 90 percent of SAHs are attributed to ruptured cerebral aneurysms and the two terms are often used synonymously.
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.
kin grafting is a type of graft surgery involving the transplantation of skin. The transplanted tissue is called a skin graft. Skin grafting is often used to treat: Extensive wounding or trauma Burns Areas of extensive skin loss due to infection such as necrotizing fasciitis or purpura fulminans[2] Specific surgeries that may require skin grafts for healing to occur - most commonly removal of skin cancers Skin grafts are often employed after serious injuries when some of the body's skin is damaged. Surgical removal (excision or debridement) of the damaged skin is followed by skin grafting. The grafting serves two purposes: reduce the course of treatment needed (and time in the hospital), and improve the function and appearance of the area of the body which receives the skin graft.
This video provides a guide peforming a respiratory examination in an OSCE station, including real-time auscultation sounds of common pathology such as coarse crackles, fine crackles, wheeze and stridor.
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Chapters:
- Introduction 00:00
- General inspection 00:40
- Inspection of the hands 00:50
- Schamroth's window test 01:09
- Heart rate and respiratory rate 01:50
- Jugular venous pressure 02:02
- Face, eyes and mouth 02:13
- Anterior chest inspection 02:36
- Trachea and cricosternal distance 03:01
- Palpation of apex beat 03:16
- Chest expansion 03:28
- Lung percussion 03:50
- Auscultation of lungs 04:21
- Vocal resonance 05:03
- Lymph node palpation 05:32
- Inspection of posterior chest 06:04
- Posterior chest expansion 06:10
- Percussion of posterior chest 06:32
- Auscultation of posterior chest 06:55
- Sacral and pedal oedema 08:04
- Summary of findings 08:39
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Always adhere to your medical school/local hospital guidelines when performing examinations or clinical procedures. DO NOT perform any examination or procedure on patients based purely upon the content of these videos. Geeky Medics accepts no liability for loss of any kind incurred as a result of reliance upon the information provided in this video.
Some people have found this video useful for ASMR purposes.
Special thanks to www.easyauscultation.com and Andy Howes for providing some of the respiratory sounds.
• Define and use related medical terminology.
• Describe and demonstrate techniques for imaging the thyroid gland.
• Discuss functional abnormalities of the thyroid gland.
• Correlate laboratory data relevant to the thyroid and parathyroid glands.
• Describe, and recognize on images, pathologies of the thyroid gland.
• Identify the anatomy of the parathyroid glands on diagrams and sonograms.
• Describe and demonstrate techniques for imaging the parathyroid glands.
• Describe, and recognize on images, pathologies of the parathyroid glands.
• List and describe other neck masses.
• Follow relevant protocols when scanning.
• Differentiate the sonographic appearances of the female reproductive organs in relation to the menstrual cycle, the use of contraceptives and hormone replacement, and following chemotherapy.
• Explain the Patient Privacy Rule (HIPAA) and Patient Safety Act (see reference).
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This is one of the most interesting medical topics to discuss. What are the responsibilities of a doctor? What are the basic skills a doctor needs to have? and what are the responsibilities of a doctor?
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A breech birth is the birth of a baby from a breech presentation. In the breech presentation the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation.
There are either three or four main categories of breech births, depending upon the source:
* Frank breech - the baby's bottom comes first, and his or her legs are flexed at the hip and extended at the knees (with feet near the ears). 65-70% of breech babies are in the frank breech position.
* Complete breech - the baby's hips and knees are flexed so that the baby is sitting crosslegged, with feet beside the bottom.
* Footling breech - one or both feet come first, with the bottom at a higher position. This is rare at term but relatively common with premature fetuses.
* Kneeling breech - the baby is in a kneeling position, with one or both legs extended at the hips and flexed at the knees. This is extremely rare, and is excluded from many classifications.
As in labour with a baby in a normal head-down position, uterine contractions typically occur at regular intervals and gradually cause the cervix to become thinner and to open. In the more common breech presentations, the baby’s bottom (rather than feet or knees) is what is first to descend through the maternal pelvis and emerge from the vagina.
At the beginning of labour, the baby is generally in an oblique position, facing either the right or left side of the mother's back. As the baby's bottom is the same size in the term baby as the baby's head. Descent is thus as for the presenting fetal head and delay in descent is a cardinal sign of possible problems with the delivery of the head.
In order to begin the birth, internal rotation needs to occur. This happens when the mother's pelvic floor muscles cause the baby to turn so that it can be born with one hip directly in front of the other. At this point the baby is facing one of the mother's inner thighs. Then, the shoulders follow the same path as the hips did. At this time the baby usually turns to face the mother's back. Next occurs external rotation, which is when the shoulders emerge as the baby’s head enters the maternal pelvis. The combination of maternal muscle tone and uterine contractions cause the baby’s head to flex, chin to chest. Then the back of the baby's head emerges and finally the face.
Due to the increased pressure during labour and birth, it is normal for the baby's leading hip to be bruised and genitalia to be swollen. Babies who assumed the frank breech position in utero may continue to hold their legs in this position for some days after birth.
Leading cardiologists Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Herschel Sklaroff, MD, Clinical Professor of Medicine, Cardiology at Mount Sinai Heart were filmed for one-month for the “Making Rounds” documentary film as they cared for critically-ill heart patients in the Cardiac Care Unit at The Mount Sinai Hospital.
Watch Mount Sinai Heart doctors, fellows, residents, and nurses in action and saving lives demonstrating how simply listening to patients at the bedside remains medicine’s most indispensable tool over any technology.
In this film Mount Sinai Heart helps preserve the disappearing art and science of how to examine and diagnose patients at the bedside for future generations of physicians.
**This film was made possible by the generous support
of the McInerney Family.**
Copyright 2015 Middlemarch Films, Inc
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.
How to perform a Thyroid Gland Examination - Clinical Skills Revision
The thyroid examination is one of the first sessions of the clinical skills block for medical students at Warwick Medical School - largely as it touches lightly on to other clinical areas, such as the cardiac examination, and the peripheral neurological examination making it an excellent starting point for building further knowledge
This is a clinical examination of the thyroid gland is performed by Dr James Gill following the approach in Macleod’s Clinical examination.
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However, during OSCE assessments. Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical evaluation - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.
Some people may experience an ASMR effect from watching this medical clinical examination
#ThyroidExamination #ClinicalSkills #DrGill #ASMR
Inflammation of the uvula is known as uvulitis. Your uvula will appear red, puffy, and larger than normal. Other symptoms of uvulitis may include: itching burning a sore throat spots on your throat snoring difficulty swallowing trouble breathing If you have a swollen uvula along with a fever or abdominal pain, consult with your doctor right away. In rare cases, the uvula can swell enough to block your airway. Swelling of the throat is a life-threatening event. If this happens, seek immediate medical attention. What causes a swollen uvula? Causes Inflammation is your body’s response when it’s under attack. Triggers for inflammation include: environmental and lifestyle factors an infection trauma genetics Environmental and Lifestyle Factors The most common food allergies are peanuts tree nuts milk eggs wheat soy fish, including shellfish You could be having an allergic reaction to something you touched, swallowed, or breathed in. Some common allergens include: food irritants , such as dust, animal dander, or pollen medication exposure to chemicals or other toxic substances, including tobacco Infection You can get viral infections or bacterial infections. Examples of viral infections include: the common cold the flu mononucleosis chickenpox measles croup The most common bacterial infection is strep throat, which occurs due to Streptococcus pyogenes, which is a type of group A Streptococcus. If you have infected tonsils, or tonsillitis, severe inflammation can cause them to push against and irritate your uvula. Trauma Trauma to the uvula can happen if you need an intubation, such as during surgery. Your uvula can also be injured during a tonsillectomy. This is a procedure to remove your tonsils, which are located on both sides of your uvula. Your throat and uvula can also become irritated if you have acid reflux disease or if you vomit frequently. Genetics A condition called hereditary angioedema (HAE) can cause swelling of the uvula and throat, as well as swelling of the face, hands, and feet. Other symptoms include nausea, vomiting, and abdominal pain. It’s an uncommon genetic mutation that occurs in 1 in 10,000 to 1 in 50,000 people. It’s rare, but there are case reports of individuals who have an elongated uvula, which can also interfere with breathing. What are the risk factors for a swollen uvula? Risk Factors Anyone can get uvulitis, but adults get it less often than children do. You’re at increased risk if you: have allergies use tobacco products are exposed to chemicals and other irritants in the environment have a weakened immune system, making you more susceptible to infections How is a swollen uvula diagnosed? Diagnosis If you have fever or swelling of your throat, see your doctor. Be prepared to give a complete medical history. Tell your doctor: about all the over-the-counter and prescription medications you take if you’re a smoker or you chew tobacco if you’ve recently tried new foods if you’ve been exposed to chemicals or unusual substances about your other symptoms, such as abdominal pain, fever, or dehydration Your doctor may be able to make a diagnosis through a physical exam. It’s likely you’ll also need a throat swab to evaluate for strep or to obtain secretions for culture to determine if you have another bacterial or fungal infection. This test is known as the rapid strep test. You may also need a nasal swab to test for influenza. Blood testing can help identify or rule out some other infectious agents. If those tests are inconclusive, you may need to see an allergist. Blood and skin tests can help identify foods or other substances that cause a reaction. Learn more: Allergy testing » If necessary, imaging tests can provide a more detailed view of your throat and the surrounding area. What’s the treatment for a swollen uvula? Treatment When you have something like the common cold, swelling usually clears up on its own without treatment. Otherwise, treatment will depend on how severe your symptoms are, as well as what’s causing the inflammation. Infection Viral infections tend to clear up without treatment. The only upper respiratory infection for which an antiviral medication is available is influenza. Antibiotics can treat bacterial infections. Even after symptoms clear up, take all the medication as prescribed. If your condition may be contagious, stay home until your doctor tells you that you’re no longer at risk of spreading it to others. Allergy If you test positive for an allergy, try to avoid the allergen in the future. Doctors usually treat allergies with antihistamines or steroids. Anaphylaxis is a severe allergic reaction. Doctors use epinephrine to treat this reaction. Hereditary angioedema Your doctor may treat HAE with any of the following: anabolic steroids, or androgens antifibrinolytics C1 inhibitors, such as C1 esterase inhibitor (Berinert) or C1 esterase inhibitor (recombinant) (Ruconest) a plasma kallikrein inhibitor, such as ecallantide (Kalbitor) bradykinin receptor antagonist, such as icatibant injection (Firazyr) Tell your doctor if you have new or worsening symptoms, and follow up as necessary. Tips for relief home treatment If you have a swollen uvula or sore throat, it’s your body’s way of telling you that something is wrong. A few home remedies can help keep you strong and soothe your irritated throat. Make sure you’re getting enough fluids. If your throat hurts when you drink, try drinking small amounts throughout the day. Your urine should be light in color. If it’s dark yellow or brown, you’re not drinking enough and may be dehydrated. Additional tips include the following: Cool your throat by sucking on ice chips. Frozen juice bars or ice cream may also do the trick. Gargle with warm salt water to ease your dry, scratchy throat. Aim for a full night’s sleep, and nap during the day if you can. What’s the outlook? Outlook A swollen uvula isn’t a common occurrence. Most of the time it clears up without treatment. If you have an infection, prompt treatment should take care of the problem within a week or two. If you have allergies that lead to swelling of the uvula or throat, do your best to avoid that allergen. You should also be prepared to deal with an attack if you come into contact with the substance again. If you’ve ever had anaphylaxis, ask your doctor if you should carry injectable epinephrine (EpiPen) in case of emergency. People with HAE must learn to recognize triggers and early warning signs of an attack. Talk to your doctor about how to manage HAE. 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Uterine polyps are growths attached to the inner wall of the uterus that extend into the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps, also known as endometrial polyps. These polyps are usually noncancerous (benign), although some can be cancerous or can eventually turn into cancer (precancerous polyps). Uterine polyps range in size from a few millimeters — no larger than a sesame seed — to several centimeters — golf-ball-size or larger. They attach to the uterine wall by a large base or a thin stalk.