Top videos
Emphysema gradually damages the air sacs (alveoli) in your lungs, making you progressively more short of breath. Emphysema is one of several diseases known collectively as chronic obstructive pulmonary disease Smoking is the leading cause of emphysema. Your lungs' alveoli are clustered like bunches of grapes. In emphysema, the inner walls of the air sacs weaken and eventually rupture — creating one larger air space instead of many small ones. This reduces the surface area of the lungs and, in turn, the amount of oxygen that reaches your bloodstream. When you exhale, the damaged alveoli don't work properly and old air becomes trapped, leaving no room for fresh, oxygen-rich air to enter. Treatment may slow the progression of emphysema, but it can't reverse the damage.
Body Mass Index (BMI) is a person's weight in kilograms divided by the square of height in meters. A high BMI can be an indicator of high body fatness. BMI can be used to screen for weight categories that may lead to health problems but it is not diagnostic of the body fatness or health of an individual.May 15, 2015
As long as the ureter is large enough to allow the ureteroscope to pass, there is a good chance that the stone can be broken and removed with one surgery. Compared to SWL, a kidney or ureteral stone can be seen under direct vision by the ureteroscope, allowing lithotripsy with lasers followed by basketting and removal.
Alcoholic hepatitis is inflammation of the liver caused by drinking alcohol. Alcoholic hepatitis is most likely to occur in people who drink heavily over many years. However, the relationship between drinking and alcoholic hepatitis is complex. Not all heavy drinkers develop alcoholic hepatitis, and the disease can occur in people who drink only moderately. If you're diagnosed with alcoholic hepatitis, you must stop drinking alcohol. People who continue to drink alcohol face a high risk of serious liver damage and death.
Thrombosis of the venous channels in the brain is an uncommon cause of cerebral infarction relative to arterial disease, but it is an important consideration because of its potential morbidity. (See Prognosis.) Knowledge of the anatomy of the venous system is essential in evaluating patients with cerebral venous thrombosis (CVT), since symptoms associated with the condition are related to the area of thrombosis. For example, cerebral infarction may occur with cortical vein or sagittal sinus thrombosis secondary to tissue congestion with obstruction. (See Presentation.) Lateral sinus thrombosis may be associated with headache and a pseudotumor cerebri–like picture. Extension into the jugular bulb may cause jugular foramen syndrome, while cranial nerve palsies may be seen in cavernous sinus thrombosis as a compressive phenomenon. Cerebral hemorrhage also may be a presenting feature in patients with venous sinus thrombosis. (See Presentation.) Imaging procedures have led to easier recognition of venous sinus thrombosis (see the images below), offering the opportunity for early therapeutic measures. (See Workup.) Left lateral sinus thrombosis demonstrated on magn Left lateral sinus thrombosis demonstrated on magnetic resonance venography (MRV). This 42-year-old woman presented with sudden onset of headache. Physical examination revealed no neurologic abnormalities. View Media Gallery Axial view of magnetic resonance (MR) venogram dem Axial view of magnetic resonance (MR) venogram demonstrating lack of flow in transverse sinus. View Media Gallery The following guidelines for CVT have been provided by the American Heart Association and the American Stroke Association [1] : In patients with suspected CVT, routine blood studies consisting of a complete blood count, chemistry panel, prothrombin time, and activated partial thromboplastin time should be performed. Screening for potential prothrombotic conditions that may predispose a person to CVT (eg, use of contraceptives, underlying inflammatory disease, infectious process) is recommended in the initial clinical assessment. Testing for prothrombotic conditions (including protein C, protein S, or antithrombin deficiency), antiphospholipid syndrome, prothrombin G20210A mutation, and factor V Leiden can be beneficial for the management of patients with CVT. Testing for protein C, protein S, and antithrombin deficiency is generally indicated 2-4 weeks after completion of anticoagulation. There is a very limited value of testing in the acute setting or in patients taking warfarin. In patients with provoked CVT (associated with a transient risk factor), vitamin K antagonists may be continued for 3-6 months, with a target international normalized ratio of 2.0-3.0. In patients with unprovoked CVT, vitamin K antagonists may be continued for 6-12 months, with a target international normalized ratio of 2.0-3.0. For patients with recurrent CVT, venous thromboembolism (VTE) after CVT, or first CVT with severe thrombophilia (ie, homozygous prothrombin G20210A; homozygous factor V Leiden; deficiencies of protein C, protein S, or antithrombin; combined thrombophilia defects; or antiphospholipid syndrome), indefinite anticoagulation may be considered, with a target international normalized ratio of 2.0-3.0. For women with CVT during pregnancy, low-molecular-weight heparin (LMWH) in full anticoagulant doses should be continued throughout pregnancy, and LMWH or vitamin K antagonist with a target international normalized ratio of 2.0-3.0 should be continued for ≥6 weeks postpartum (for a total minimum duration of therapy of 6 months). It is reasonable to advise women with a history of CVT that future pregnancy is not contraindicated. Further investigations regarding the underlying cause and a formal consultation with a hematologist or maternal fetal medicine specialist are reasonable. It is reasonable to treat acute CVT during pregnancy with full-dose LMWH rather than unfractionated heparin. For women with a history of CVT, prophylaxis with LMWH during future pregnancies and the postpartum period is reasonable. Next: Etiology What to Read Next on Medscape Related Conditions and Diseases Quiz: Do You Know the Complications, Proper Workup, and Best Treatment Practices for Ischemic Stroke? Quiz: How Much Do You Know About Hypothyroidism? Quiz: Do You Know the Risk Factors, Symptoms, and Potential Treatments for Alzheimer Disease? Quiz: How Much Do You Know About Hypertension? Quiz: Test Your Knowledge of Epilepsy and Seizure-related Conditions A 25-Year-Old Man With Painless Diplopia NEWS & PERSPECTIVE Temporal Trends and Factors Associated With Diabetes Mellitus Among Patients Hospitalized With Heart Failure Watchful Waiting Tied to Worse Outcomes in LVAD Patients With Hemolysis Age of Transfused Blood Impacts Perioperative Outcomes Among Patients Who Undergo Major Gastrointestinal Surgery TOOLS Drug Interaction Checker Pill Identifier Calculators Formulary SLIDESHOW Chronic Alcohol Abuse: Complications and Consequences Most Popular Articles According to Neurologists DHA Supplements Linked to Less Progression to Alzheimer's in APOE4 Carriers Heading in Soccer Linked to CNS Symptoms 'Transient Smartphone Blindness' Misdiagnosed as Multiple Sclerosis? New Advances in Traumatic Brain Injury FDA Clears Deflazacort (Emflaza) for DMD View More Overview Background
Depending on the fracture, the bone fragments may be fixed using screws, a plate and screws, or different wiring techniques. Because there is such a wide range of injuries, there is also a wide range of people's specific recovery time for ankle fracture surgery. It takes at least 6 weeks for the broken bones to heal.
A tapeworm is a ribbon-shaped parasite that lives in human or animal intestines. They are uncommon in developed countries. There are a number of different types which all have slightly different life cycles. Tapeworm infection can come from animals such as pigs, sheep, cattle, fish, dogs and cats. Eating undercooked food contaminated with tapeworm cysts and eggs causes the infection. Tapeworm eggs are shed in stools and it is possible for infection to spread from person to person through the oral/anal route.
Frostbite is an injury caused by freezing of the skin and underlying tissues. First your skin becomes very cold and red, then numb, hard and pale. Frostbite is most common on the fingers, toes, nose, ears, cheeks and chin. Exposed skin in cold, windy weather is most vulnerable to frostbite. But frostbite can occur on skin covered by gloves or other clothing. Frostnip, the first stage of frostbite, doesn't cause permanent skin damage. You can treat very mild frostbite with first-aid measures, including rewarming your skin. All other frostbite requires medical attention because it can damage skin, tissues, muscle and bones. Possible complications of severe frostbite include infection and nerve damage.
LIZ: The first time the doctor made my tip too narrow and I didnt look like myself. The second time the doctor made my tip too wide, and actually took out (removed) extra bone from the side of my nose. That didnt need to be taken out (removed)
My initial consultation with Dr. Nassif was fantastic! He treated me liker his own daughter, and was very caring and thorough. He went over everything!
DR. NASSIF: Liz came into me for a revision rhinoplasty. She told me that shes had two previous rhinoplasties. She was unhappy with the way her nose appeared on her face. She felt it was asymmetric, the tip was kind of bulbous, or large appearing, especially when she looked up, this view, it was very asymmetric. And so, her whole goal was to make it look better, hopefully make it her LAST surgery, and also to help with her breathing.
One of the things thats very important about revision rhinoplasty that you always have to consider is; What are you going to find in there? Even though you can feel the nose, you can palpate it, you can look at it, and you can guess what the other doctors have performed; your first up-hill battle is to see how much scar tissue youre going to be able to identify with. So when you have to open up the nose, you have to remove the scar tissue, identify it: whats there, whats present, whats been removed. Then after you do that, and you have cartilage now ready for grafting, or fascia, or perichondrium, you have to start rebuilding it. Rebuilding it (cartilage) is the second big stage after weve already carved everything; weve carved the cartilage. In that scenario when Im playing with the nose, in regards to staring at the profile, staring at the front of the nose, I go back and forth and look inside and outside of the nose to make sure its as symmetric as possible. That takes a long time One of Lizs main complaints was that on her profile, that her tip stuck out too far. And so one of the things I had to do in surgery is called a medial cura tuck-up, I had to push the tip back, by pushing the tip back, it can make the tip look a little bit wider. But in this situation, I was able to bring everything in as much as I can. After Im finished with everything, and Im happy, then we go ahead and we start to close the nose. Thats putting every little small stitch in perfectly, so that the scar will be minimally visible.
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.
Goiter treatment depends on the size of the goiter, your signs and symptoms, and the underlying cause. Your doctor may recommend: Observation. If your goiter is small and doesn't cause problems, and your thyroid is functioning normally, your doctor may suggest a wait-and-see approach. Medications. If you have hypothyroidism, thyroid hormone replacement with levothyroxine (Levoxyl, Synthroid, Tirosint) will resolve the symptoms of hypothyroidism as well as slow the release of thyroid-stimulating hormone from your pituitary gland, often decreasing the size of the goiter. For inflammation of your thyroid gland, your doctor may suggest aspirin or a corticosteroid medication to treat the inflammation. For goiters associated with hyperthyroidism, you may need medications to normalize hormone levels. Surgery. Removing all or part of your thyroid gland (total or partial thyroidectomy) is an option if you have a large goiter that is uncomfortable or causes difficulty breathing or swallowing, or in some cases, if you have a nodular goiter causing hyperthyroidism.