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Traumatic penile injury can be due to multiple factors. Penile fracture, penile amputation, penetrating penile injuries, and penile soft tissue injuries are considered urologic emergencies and typically require surgical intervention. The goals of treatment for penile trauma are universal: preservation of penile length, erectile function, and maintenance of the ability to void while standing. Traumatic injury to the penis may concomitantly involve the urethra.[1, 2] Urethral injury and repair is beyond the scope of this article but details can be found in Urethral Trauma. Penile fracture Penile fracture is the traumatic rupture of the corpus cavernosum. Traumatic rupture of the penis is relatively uncommon and is considered a urologic emergency.[3] Sudden blunt trauma or abrupt lateral bending of the penis in an erect state can break the markedly thinned and stiff tunica albuginea, resulting in a fractured penis. One or both corpora may be involved, and concomitant injury to the penile urethra may occur. Urethral trauma is more common when both corpora cavernosa are injured.[4] Penile rupture can usually be diagnosed based solely on history and physical examination findings; however, in equivocal cases, diagnostic cavernosography or MRI should be performed. Concomitant urethral injury must be considered; therefore, preoperative retrograde urethrographic studies should generally be performed. See the images below.
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.
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.
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.
Shut the front door: Scientists have finally found the perfect breasts. No, they weren't hiding in the Amazon or roving solo across the Sahara (although we have no doubt there are women in both the Amazon and the Sahara who have magnificent mammaries); it turns out these perfect breasts were hiding in a plastic surgeon's office this whole time! Now, before you get all worked up, the American Society of Plastic Surgeons (ASPS) would like you to know that the super-fake looking plastic breasts of yore are not actually what people think are most attractive now. According to a study published in the Journal of Plastic and Reconstructive Surgery—which involved asking over 1,300 people to look at pictures of naked boobies and rank them by hotness (stop laughing, this is serious research!)—people preferred a more "real" and "normal" look from their silicone, with the ideal breast shape having a 45:55 ratio. People said the best chests have 45 percent of the fullness above the nipple line and 55 percent of the fullness below, in a slightly teardrop shape. Researchers noted this preference remained consistent across gender, racial, and ethnic groups with the 45:55 ratio favored by 87 percent of women in their 30s, 90 percent of men, and 94 percent of plastic surgeons.
Idiopathic pulmonary fibrosis (IPF) is defined as a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown cause, primarily occurring in older adults, limited to the lungs, and associated with the histopathologic and/or radiologic pattern of usual interstitial pneumonia (UIP).[1] Signs and symptoms The clinical symptoms of idiopathic pulmonary fibrosis are nonspecific and can be shared with many pulmonary and cardiac diseases. Most patients present with a gradual onset (often >6 mo) of exertional dyspnea and/or a nonproductive cough. Approximately 5% of patients have no presenting symptoms when idiopathic pulmonary fibrosis is serendipitously diagnosed.
Brachytherapy or localized radiation treatment can be used in certain patients with breast cancer. Depending on tumor size and other factor, physicians may use APBI or accelerated partial breast irradiation. Dr. Elizabeth Tapen, a radiation oncologist, reviews brachytherapy for breast cancer.
Gallstone ileus is an important, though infrequent, cause of mechanical bowel obstruction, affecting older adult patients who often have other significant medical conditions. It is caused by impaction of a gallstone in the ileum after being passed through a biliary-enteric fistula. The diagnosis is often delayed since symptoms may be intermittent and investigations fail to identify the cause of the obstruction. The mainstay of treatment is removal of the obstructing stone after resuscitating the patient. Gallstone ileus continues to be associated with relatively high rates of morbidity and mortality.
Minimally invasive parotid surgery techniques are currently utilized here in Atlanta by our practice to allow the same operation to be performed with no permanent visible incision on the face or the neck. In addition to being more cosmetically appealing, this approach is less painful and allows the procedure to be performed as an outpatient. Most patients take pain medication for only a day or two after surgery.
Surgeons at St Mary's Hospital, part of Imperial College Healthcare have come up with a new surgical procedure that cures heartburn with a device called RefluxStop.
Mr Ahmed Ahmed, a consultant surgeon, says surgery should now be seen as an alternative to life-long drug treatment - as Sky's Thomas Moore reports.
Read more: https://news.sky.com/story/new....-nhs-heartburn-surge
#heartburncure #surgery #skynews
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