Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux is the abnormal flow of urine from your bladder back up the tubes (ureters) that connect your kidneys to your bladder. Normally, urine flows only down from your kidneys to your bladder. Vesicoureteral reflux is usually diagnosed in infants and children. The disorder increases the risk of urinary tract infections, which, if left untreated, can lead to kidney damage. Vesicoureteral reflux can be primary or secondary. Children with primary vesicoureteral reflux are born with a defect in the valve that normally prevents urine from flowing backward from the bladder into the ureters. Secondary vesicoureteral reflux is due to a urinary tract malfunction, often caused by infection. Children may outgrow primary vesicoureteral reflux. Treatment, which includes medication or surgery, aims at preventing kidney damage.

Amenorrhea is the absence of menstrual bleeding.[1] Amenorrhea is a normal feature in prepubertal, pregnant, and postmenopausal females. In females of reproductive age, diagnosing amenorrhea is a matter of first determining whether pregnancy is the etiology. In the absence of pregnancy, the challenge is to determine the exact cause of absent menses.[2] Primary amenorrhea is the failure of menses to occur by age 16 years, in the presence of normal growth and secondary sexual characteristics. If by age 13 menses has not occurred and the onset of puberty, such as breast development, is absent, a workup for primary amenorrhea should start. Secondary amenorrhea is defined as the cessation of menses sometime after menarche has occurred. Oligomenorrhea is defined as menses occurring at intervals longer than 35 days apart. No consensus has been reached regarding the point at which oligomenorrhea becomes amenorrhea. Some authors suggest the absence of menses for 6 months constitutes amenorrhea, but the basis for this recommendation is unclear. For a post-menarchal girl or a reproductive-aged woman to experience a menstrual cycle interval of more than 90 days is statistically unusual. Practically speaking, this should be an indication for an evaluation to seek the cause.

This video demonstrates the Retrograde Wire Intubation

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Tonsillectomy using coblation technique by wand Evac 70

In a small but promising Phase II clinical trial of breast cancer treatment, cryoablation killed 25 early-stage tumors in 13 women. The tumors ranged in size from .5 cm (very small) to 5.8 cm (very large), with an average size of 1.7cm. Patients were first given a local anesthesia with mild sedation before physicians used ultrasound with or without computed tomography (CT) imaging to guide needle-like probes to deliver very low temperature gas to the tumor site. The ultra-cold gas forms a ball of ice around the probe tip, then expands and destroys surrounding tumor cells. A harmless saline solution was first injected into the chest wall and skin of the breast to protect the tissue surrounding the tumor from the freezing effects. Patients experienced very little pain and most healed completely within six months with no complications and with little or no scarring. The cryotherapy margins of each participant were biopsied immediately after the procedures, and all were negative, with no evidence of cancerous tissue. All 13 patients were without recurrence at an average of 18 months and up to five years following the procedure. These results are promising, but larger studies with lengthier follow-up are needed to determine whether cryotherapy as effective as lumpectomy. A study involving cryoablation of mouse tumors at the University of Michigan Comprehensive Cancer Center found that the freezing procedure also works like a vaccine, boosting the immune system to reduce the likelihood of recurrence. Just how quickly the tumor was frozen made a difference: a 30-second freeze killed tumors and also boosted the immune system, inhibiting metastases to the lungs. A slower freezing lasting several minutes destroyed tumors just as effectively, but actually suppressed the immune system, resulting in greater metastases to the lungs.

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Video demonstrates the action of the isolated lumbar multifidis muscle

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Lysis of E. Coli bacteria with penicillin

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When food is taken, it is broken down into smaller components. Sugars and carbohydrates are thus broken down into glucose for the body to utilize them as an energy source. The liver is also able to manufacture glucose. In normal persons the hormone insulin, which is made by the beta cells of the pancreas, regulates how much glucose is in the blood. When there is excess of glucose in blood, insulin stimulates cells to absorb enough glucose from the blood for the energy that they need. Insulin also stimulates the liver to absorb and store any excess glucose that is in the blood. Insulin release is triggered after a meal when there is a rise in blood glucose. When blood glucose levels fall, during exercise for example, insulin levels fall too. High insulin will promote glucose uptake, glycolysis (break down of glucose), and glycogenesis (formation of storage form of glucose called glycogen), as well as uptake and synthesis of amino acids, proteins, and fat. Low insulin will promote gluconeogenesis (breakdown of various substrates to release glucose), glycogenolysis (breakdown of glycogen to release gluose), lipolysis (breakdown of lipids to release glucose), and proteolysis (breakdown of proteins to release glucose). Insulin acts via insulin receptors.

LCHI - Hernia repair done by medical students with guidance and assistance of Professor Luiz Eduardo C. Miranda. Description of surgery is in portuguese.