Robot-Assisted Laparoscopic Rectal resection for Endometriosis.Operation performed by D.Vitobello, director of divisione of Gynaecology, and G.Baldazzi,director of Surgical department. Abano Terme Hospital Padova (Italy)

Endometrial Biopsy of Uterus

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.

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

Teratomas are tumors made up of tissues, such as hair, muscle, and bone. They occur most often in the ovaries in women, and the testicles in men. They may be benign or malignant. Symptoms vary depending on the location. A painful lump or swelling may be apparent. Some babies have a mass that can be seen on an ultrasound before birth. Treatment often involves surgery. In rare cases when a teratoma is malignant, chemotherapy or radiation may be needed.

Fistulotomy - Removal of Seton

Niemann-Pick disease is a condition that affects many body systems. It has a wide range of symptoms that vary in severity. Niemann-Pick disease is divided into four main types: type A, type B, type C1, and type C2. These types are classified on the basis of genetic cause and the signs and symptoms of the condition. Infants with Niemann-Pick disease type A usually develop an enlarged liver and spleen (hepatosplenomegaly) by age 3 months and fail to gain weight and grow at the expected rate (failure to thrive). The affected children develop normally until around age 1 year when they experience a progressive loss of mental abilities and movement (psychomotor regression). Children with Niemann-Pick disease type A also develop widespread lung damage (interstitial lung disease) that can cause recurrent lung infections and eventually lead to respiratory failure. All affected children have an eye abnormality called a cherry-red spot, which can be identified with an eye examination. Children with Niemann-Pick disease type A generally do not survive past early childhood.

Let's ask this 12 year old kid which tool he prefers to successfully intubate a difficult airway in less than 20 seconds..."

NC EMS Show - Dad gives permission for us to film his son, after seeing how easy the Vie Scope is to use. And he nailed it!

Breech Baby Position Exercise

Watch that video to know if it is safe to have anal sex

Watch that video of The Most Invasive Parasites in the World

Ellie was born with a rare condition which stopped her jawbones from growing properly. At first, her parents didn't realize there was a problem, apart from the fact that her teeth were not aligned. But when she went to have braces fitted to straighten her teeth when she was 14, orthodontist Joy Hickman realized her jaw had not grown since she was eight. Over the next six years Hickman worked with a maxillofacial surgeon to transform Ellie's looks. Ellie, who is now 20, said the surgery was painful but paid almost immediate dividends. "About six months after it was my year 11 prom and it looked good." Ellie told the Daily Post the change in her appearance has been matched by an increase in confidence.

Revision knee replacement. After removal of the old implants, bone is prepared for re-implantation.

Hemothorax is the presence of blood in the pleural space. The source of blood may be the chest wall, lung parenchyma, heart, or great vessels. Although some authors state that a hematocrit value of at least 50% is necessary to differentiate a hemothorax from a bloody pleural effusion, most do not agree on any specific distinction. Hemothorax is usually a consequence of blunt or penetrating trauma. Much less commonly, it may be a complication of disease, may be iatrogenically induced, [1] or may develop spontaneously. [2] Prompt identification and treatment of traumatic hemothorax is an essential part of the care of the injured patient. The upright chest radiograph is the ideal primary diagnostic study in the evaluation of hemothorax (see Workup). In cases of hemothorax unrelated to trauma, a careful investigation for the underlying source must be performed while treatment is provided.

Narrated animation of stroke intervention. Video supplied by Covidien, showing the Solitaire mechanical thrombectomy device, which was the first FDA-approved device for such an indication.

What is idiopathic intracranial hypertension??? Idiopathic intracranial hypertension (IIH) is a disorder that results from an increase in the pressure of the Cerebro-Spinal Fluid (CSF) that cushions and protects the brain and spinal cord. The CSF is constantly produced in the brain and reabsorbed back into the bloodstream at a fairly constant rate. This allows the fluid pressure around the brain to remain constant. What are the symptoms of idiopathic intracranial hypertension? Headaches that are generally nonspecific in location, type and frequency and can be associated with nausea and vomiting. Pulsatile tinnitus is a rhythmic or pulsating ringing heard in one or both ears. Horizontal double vision can be a sign of pressure on the 6th cranial nerve(s). Nonspecific radiating pain in the arms or legs (radicular pain). Transient obscurations of vision (TOV), which are temporary dimming or complete blacking out of vision. Visual field defects. These defects can occur in the central as well as the peripheral vision. Loss of color vision. What causes idiopathic intracranial hypertension? The cause is usually not known. A common explanation for increased pressure is a problem with the reabsorption of this fluid back into the body, which causes the pressure to increase. Sometimes the cause is determined and is referred to as “secondary” intracranial hypertension.

Ejaculating into a partner’s mouth is a common practice during oral sex/fellatio. In a safe situation (where there is no danger of catching an STD), the semen-receiving partner may choose to spit the semen out, or to swallow it. Before you engage in fellatio, I’d recommend that you and your partner both get tested for sexually transmitted infections (STIs). If not, please use barriers for oral sex and abstaining from making contact with ejaculate. Semen is mostly water, but also contains amino acids and protein, sugars such as fructose and glucose, minerals such as zinc and calcium, vitamin C, and a few other nutrients. Sperm cells themselves make up less than one percent of semen. Semen is edible, and if swallowed, will travel down the esophagus and into the stomach, where it will be digested in the same way that food is. You can never get pregnant by swallowing semen. Some people accept the taste of semen, but others complain that swallowing semen can give them an upset stomach. In rare cases, you may have an allergy to the proteins found in semen. What does It Taste Like? The taste of semen varies. Bitter, sweet, metallic. So, one may expect to find the taste of semen anywhere from enjoyable to tasteless to disgusting. But there is a way of controlling the taste of semen, which is through diet. Keep track of the diet, and communicate with the partner about when it tastes better or worse.

Elbow Exam - Orthopaedic OSCE - Clinical Skills - Dr Gill

The elbow examination is a core skill - in this video, we demonstrate how to perform an elbow EXAM for an Orthopaedic Clinical Skills OSCE, which should be one of the more accessible examination stations for medical students.

For a passing grade in your Clinical Skills OSCE, an elbow assessment should follow the LOOK, FEEL, MOVE approach

Initially looking for erythema, scars, swelling and position

Palpating the elbow - specifically the olecranon, medial and lateral epicondyles, and radial head for heat, oedema and crepitus

Finally assess range of movement with flexion and extension at the elbow, before determining for tennis and golfers' elbows

Watch further orthopaedic examinations for your OSCE revision:

The Elbow - Deep Dive
https://youtu.be/SX5buhtCVDw

The Spine Examination:
https://youtu.be/pJxMHa6SCgU

The Knee examination
https://youtu.be/oyKH4EYfJDM

The Hip examination
https://youtu.be/JC9GKq5nSdQ

The GALS examination
https://youtu.be/5qJaf7gW-B0 - Gait, Arms, Legs, Spine - GALS screen

------------

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 assessment - 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 viewing this medical examination video may experience an ASMR effect

#clinicalskills #Elbow #DrGill

Watch that Human Fat Body Medical Autopsy

Medical Examination of the Lower Limbs