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Pediatric orthopedic surgeons at Columbia are using a new device with magnetic technology that avoids the need for multiple spine-lengthening surgeries to correct early-onset scoliosis, a severe curvature of the spine in young children. In April 2014, Michael Vitale, MD, the Ana Lucia Professor of Pediatric Orthopedic Surgery at CUMC and 1995 graduate of P&S, performed the first procedure in the New York area, using the device to treat a 5-year-old boy. When braces and casts cannot control scoliosis in young children, surgeons turn to growing rods, which help correct the curve while allowing the spine to grow. When spinal maturity is near, the rods are removed and a spinal fusion can be performed. But during years of treatment with growing rods, patients must undergo surgery every six months to lengthen the rods to keep up with the patients’ growth. A patient may undergo eight to 10 procedures, which are costly and result in lost time for parents at work and children at school. The new device—MAGEC (MAGnetic Expansion Control) rods—contains a mechanism inside the growing rods that allows surgeons to lengthen the rods with a handheld external magnet, without surgery.
Attention deficit hyperactivity disorder (ADHD) is a mental disorder of the neurodevelopmental type. It is characterized by problems paying attention, excessive activity, or difficulty controlling behavior which is not appropriate for a person's age.
When the colon and rectum are removed (due to ulcerative colitis or familial adenomatous polyposis), another reservoir must be created for bowel contents (stool) to exit the body. Surgically creating a “J” shaped reservoir (called a J-pouch) is an option for selected patients to store and pass stool.
Scar revision includes techniques that improve the appearance of an unsightly scar, regardless of its size, type or age. This is typically not covered by insurance carriers and is treated as a cosmetic procedure. Though scars can never be completely removed, the appearance of scarring can be greatly diminished. Who Should Get Scar Revision? The best candidates for scar revision are in good health and have realistic expectations. Scar revision may be used to treat: Hyperpigmented scars Large or plainly visible scars Keloid scarring Raised scars Deep depression scars After scar revision, the appearance of your scar should be greatly reduced. Scar revision can improve the size, shape and color of your scar. Multiple procedures may be needed to achieve optimal results. There are several different techniques that can be used during your scar revision. During a consultation, we can discuss the best techniques and determine if you are a suitable candidate. What to Expect During Your Scar Revision Your scar revision may involve one or more of the following techniques: Topical treatments (gels, creams, external compression) can treat mild scarring or changes in pigmentation. Injectable treatments like dermal fillers are best for filling in scar depressions. These treatment options can provide long-lasting improvements, however, they are not always permanent. Surface treatments like chemical peels, dermabrasion, laser therapy and skin bleaching can improve skin tone and texture. More than one treatment may be needed to achieve optimal results. Surgical scar revision is only used in more severe cases. Reconstructive techniques like Z-plasty, tissue expansion, or skin grafting replace a prominent scar with a less noticeable scar. After Your Surgery Scar revision recovery varies depending on the procedure you have elected. Topical and injectable treatments rarely require downtime. Surface treatments and surgical removal can require several days of recovery. You may experience some temporary bruising, swelling, or discomfort. Over-the-counter or prescription medication can be used to manage pain. Topical and injectable treatments are likely to require sustained application to maintain results. The final results of surface treatments and surgical removal may not be visible for several weeks to months. It is important to protect the treatment area from direct sun exposure for several weeks. Additional details about your specific recovery will be discussed during your consultation.
Homan’s sign test also called dorsiflexon sign test is a physical examination procedure that is used to test for Deep Vein Thrombosis (DVT). A positive Homan’s sign in the presence of other clinical signs may be a quick indicator of DVT. Clinical evaluation alone cannot be relied on for patient management, but when carefully performed, it remains useful in determining the need for additional testing (like D-dimer test, ultrasonography, multidetector helical computed axial tomography (CT), and pulmonary angiography) [1][2].