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A pancreas transplant is a surgical procedure to place a healthy pancreas from a deceased donor into a person whose pancreas no longer functions properly. Your pancreas is an organ that lies behind the lower part of your stomach. One of its main functions is to make insulin, a hormone that regulates the absorption of sugar (glucose) into your cells. If your pancreas doesn't make enough insulin, blood sugar levels can rise to unhealthy levels, resulting in type 1 diabetes. Most pancreas transplants are done to treat type 1 diabetes. A pancreas transplant offers a potential cure for this condition. But it is typically reserved for those with serious diabetes complications, because the side effects of a pancreas transplant are significant. In some cases, pancreas transplants may also treat type 2 diabetes. Rarely, pancreas transplants may be used in the treatment of pancreatic, bile duct or other cancers. A pancreas transplant is often done in conjunction with a kidney transplant in people whose kidneys have been damaged by diabetes.
The hepatitis E virus, responsible for major epidemics of viral hepatitis in subtropical and tropical countries, was cloned only 7 years ago.1 Hepatitis E was found to belong to the family of Caliciviridae, which includes the Norwalk virus—a common cause of gastroenteritis in humans—and consists of a single, plus-strand RNA genome of approximately 7.2 kb without an envelope (Fig. 1). The virus contains at least three open reading frames encoding viral proteins against which antibodies are made on exposure. These antibodies, especially those against the capsid protein derived from the second open reading frame2 and a protein of unknown function derived from the third open reading frame, are detected by currently available serologic assays. Retrospective studies on stored sera of past epidemics of viral hepatitis in Mexico, Africa, Afghanistan, Pakistan, India, Bangladesh, Burma, Nepal, and Borneo have revealed that all were caused by strains of hepatitis E. In addition, hepatitis E was found to be responsible for the hepatitis epidemic in the southern part of Xinjiang, China, in which 120,000 persons became infected between September 1986 and April 1988.3 Hepatitis E predominantly affects young adults (15 to 40 years old). The symptoms of hepatitis E are similar to those of hepatitis A. Frequently, a prodrome consisting of anorexia, nausea, low-grade fever, and right upper abdominal pain is present 3 to 7 days before jaundice develops. Aminotransferase levels peak (usually between 1,000 and 2,000 U/L) near the onset of symptoms; bilirubin levels (10 to 20 mg/dL) peak later. Jaundice usually resolves after 1 to 2 weeks. In about 10% of cases, the disease is fulminant—especially in pregnant women, among whom mortality rates as high as 20% due to hemorrhagic and thrombotic complications have been reported. No evidence has suggested that hepatitis E can cause chronic infection. Transmission is by the fecal-oral route, predominantly through fecally contaminated drinking water supplies. In addition, however, preliminary reports have suggested transmission of the hepatitis E virus through blood transfusions. Volunteer studies confirmed the presence of the virus in serum and feces before and during clinical disease.4 The virus is shed into feces approximately 1 week before symptoms develop. The incubation period varies from 2 to 9 weeks (mean duration, approximately 45 days). Until now, a few reports had described symptomatic hepatitis E acquired in Europe;5, 6 all patients with symptomatic hepatitis E in the United States were travelers returning from Mexico, Africa, or the Far East, in whom hepatitis E developed after their return home.7 In this issue of the Mayo Clinic Proceedings (pages 1133 to 1136), Kwo and associates describe a case of hepatitis E in a man who had not left the United States during the previous 10 years. Specific serologic tests for hepatitis E virus IgG (enzyme immunoassays and a fluorescent antibody blocking assay) and IgM8 (US strain-specific enzyme-linked immunosorbent assay with use of synthetic polypeptides deduced from the viral genome, as shown in Figure 1), developed at Abbott Laboratories (IgG and IgM) as well as at the Centers for Disease Control and Prevention (IgG), were used to prove that the patient indeed had acute hepatitis E. Researchers at Abbott Laboratories have prepared a report that describes most of the viral genome in this patient (Fig. I).8 Their results are interesting because this strain from the United States differs considerably from hepatitis E strains isolated in Mexico, Burma, Pakistan, or China. Furthermore, the sequence of the US strain is highly homologous (98% and 94% homology at the amino acid level to the second and third open reading frames, respectively) to a recently isolated hepatitis E strain from American swine.9 This finding suggests that, in the United States, hepatitis E is a zoonosis with the swine population as one of its hosts. This relationship would confirm earlier studies in Asia, where swine were also found to carry variants of the hepatitis E virus.10 Why are these two recent discoveries important for medicine in the United States? First, other sporadic, locally acquired cases of acute hepatitis may be caused by hepatitis E. Second, these back-to-back discoveries strongly suggest that a common natural host for hepatitis E is present in countries with more moderate climates. Because swine do not seem to experience any symptoms associated with infection and because symptoms in humans can be minor or absent, we now may also have an explanation for the 1 to 2% of positive hepatitis E serologic results in blood donors in the United States,11 Netherlands,12 and Italy,6 countries with large swine staples. Clearly, more research needs to be done to confirm this hypothesis. Third, in countries with more moderate climates, hepatitis E may often result in a subclinical infection. Is this variation in manifestation due to less virulent strains, and do sequence variations determine virulence? Fourth, swine may be used as an animal model for study of the disease as well as vaccine development.
Nasal polyps are linked to allergic rhinitis, asthma, aspirin allergy, sinus infections, acute and chronic infections, something stuck in the nose, and cystic fibrosis. But many times the cause is unknown. Sometimes, people get them before they develop asthma or sinusitis
Most people develop several moles (nevi) throughout adulthood. Moles can be found anywhere on the body, usually in sun-exposed areas, and are usually brown, smooth, and slightly raised. In most cases, a nevus is benign and doesn't require treatment. Rarely, they turn into melanoma or other skin cancers. A nevus that changes shape, grows bigger, or darkens should be evaluated for removal.
The MINI tummy-tuck is a lesser variant of the classic tummy tuck. The MINI tummy-tuck always involved skin excision (often a scar revision and skin excision of the flabby skin over a C-section scar or hysterectomy or laparotomy scar) but may also involve liposuction, umbilical floating, etc. Commonly it will not include any muscle repair otherwise it it now a classic tummy tuck (aka abdominoplasty). Cost varies depending on the components involved. Here, Toronto Aesthetic Plastic Surgeon Dr Marc DuPéré describes a MINI tummy-tuck done on a patient who had a Brazilian Butt Lift before (and skin harvesting from abdomen) and a recent 20 lbs weight loss, a patient who wants more liposuction to abdomen and flanks and whose skin has now lost elasticity, hence the requirement for this small skin excision. Dr DuPéré also explains what UMBILICAL floating means. Dr DuPéré performs more than 5 different techniques of tummy-tucks in Toronto and the technique chosen reflects the patient’s expectations and anatomy. Call us if interested in learning about YOUR options for a flatter tummy! 📱 416-929-9800
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Visage Clinic Toronto
https://www.visageclinic.com/
(416) 929-9800
101-133 Hazelton Avenue, Toronto, ON M5R 0A6
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You may have heard that some positions, such as your partner on top (missionary position), are better than others for getting pregnant. In fact, there's no evidence to back these theories up. Experts just haven't done the research yet. What experts have done, though, is use scanning to show what's going on inside when you're doing the deed. The research looked at two positions: the missionary position and doggy style. (Doggy style being when you're on all fours, and your partner enters you from behind). Common sense tells us that these positions allow for deep penetration. This means that they're more likely to place sperm right next to your cervix (the opening of your uterus). The scans confirm that the tip of the penis reaches the areas between the cervix and vaginal walls in both of these positions. The missionary position allows the penis to reach the area at the front of the cervix. The rear entry position reaches the area at back of the cervix. It's amazing what some experts spend their time doing, isn't it! Other positions, such as standing up, or woman on top, may be just as good for getting sperm right next to the cervix. We just don't know yet. So, in the meantime, enjoy some variety in your sex life and keep it fun while you're trying for a baby. And talk to others who are hoping to get pregnant by joining our Actively trying group. Do I have to have an orgasm to conceive? Obviously, it's very important for your partner to reach orgasm if you are trying for a baby. There is no evidence, however, that you need to orgasm to conceive. The female orgasm is all about pleasure and satisfaction. It doesn't really help to get the sperm to the egg. Gentle contractions in your uterus can help the sperm along, but these happen without you having an orgasm. So, it's really not vital for you to reach orgasm after your partner, or even to reach orgasm at all, for you to conceive.