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Lipomas are slow-growing soft tissue tumours that rarely reach a size larger than 2 cm. Lesions larger than 5 cm, so-called giant lipomas, can occur anywhere in the body but are seldom found in the upper extremities. The authors present their experiences with eight patients having giant lipomas of the upper extremity. In addition, a review of the literature, and a discussion of the appropriate evaluation and management are included.
In the Dialysis Unit you have an opportunity to provide Dialysis care for a variety of patients, including those with End-Stage Chronic Kidney disease and acutely ill patients requiring dialysis and plasmapheresis.
The Chronic Dialysis Nurse focuses on patients receiving Hemodialysis, Peritoneal Dialysis, or Home Hemodialysis. Our patients range in age from newborns to young adults. The Hemodialysis patient receives their dialysis treatment in the clinic 3-5 times a week. The Peritoneal Dialysis and Home Hemodialysis treatments are provided in the patient’s home once the parent/caregiver is trained to operate the machine. They are followed monthly in clinic. The patient receiving Chronic Dialysis is supported by a multidisciplinary team that consists of a physician, nurses, social worker, nutritionist, pharmacist, child-life therapist, teacher, and counselor. The group works together to meet the medical and emotional needs of the patient and caregiver. Care is specialized to meet the needs of each individual patient.
The Acute Dialysis Nurse focuses on acute dialysis related therapies such as: Continuous Renal Replacement Therapy (CRRT); therapeutic plasmapheresis; or acute peritoneal dialysis. The acute dialysis team works with the multi-disciplinary inpatient nephrology team to provide acute dialysis services to the critically ill ICU patients. The work environment is highly technical and fast-paced.
The Dialysis Unit operates on 12hr shifts 7a – 7p; 7 days a week. Night call is required and shared by the nurses. We provide a detailed orientation plan to the nurse to become proficient in providing hemodialysis, peritoneal dialysis, continuous renal replacement therapy and plasmapheresis. Previous experience in dialysis or pediatrics is not required.
A Hundred Orgasms A Day follow the story of 3 women who were tormented every hour of everyday with the need to have orgasm. This documentary explain how Persistent Sexual Arousal Syndrome or PSAS causes this unusual condition. PSAS is a little know neurological disorder where women have symptoms of continuous uncontrollable genital arousal. This condition is unrelated to any kind of sensations of sexual desire. PSAS was initially documented by Doctor Sandra Leiblum in mid 2001, just recently recognized as a unique syndrome in medical science which has a comparable equivalent progressively more claimed by men. A few physicians makes use of the name Persistent Sexual Arousal Syndrome to reference the disorder in women; some others look at the syndrome of priapism in adult males to be a similar disorder. Most importantly, it is really not connected with hyper-sexuality, also known as nymphomania. Both hyper-sexuality, and nymphomania are not known diagnosable health conditions. Not only is it very rare, the disorder is also seldom reported by affected individual who may think it is embarrassing.
Here Drs Oetting and Shriver of the University of Iowa demonstrate the McCannel technique of fixing an IOL to the iris. In this video both the standard McCannel suture retrieval technique and the Siepser/Chang modifed technique are demonstrated. A 10-O prolene with a long curved ctc-6 needle is u...sed to place a suture through the iris and under an 3 piece IOL haptic. Using the standard technique the two ends of the suture are retrieved through a common paracentesis near the fixation site and tied externally. The other haptic is tied using the Siepser sliding knot technique as described by Chang for this indication with an internal knot. The standard technique is a bit easier but does not allow as thight a knot for fixation of the iris to the haptic.
Healthcare providers are in the best position to assess for domestic violence, yet have obstacles to doing so. See the benefits to moving beyond these obstacles for those you serve. And discover an accurate, convenient and confidential way to assess for domestic abuse.
Mastitis is inflammation of tissue in one or both mammary glands inside the breast. Mastitis usually affects lactating women - women who are breastfeeding, producing milk. Hence, it is often referred to as lactation mastitis. The patient feels a hard, sore spot inside the breast.
Shoulder Clinical Examination - Medical School Clinical Skills - Dr Gill
Personally, I find the shoulder examination the most complex examination possibly as there are so many variations and special tests. Some of which overlap and some will relate specifically to a patients presentation.
Often in a medical school syllabus, only select special tests will be used. In this shoulder exam demonstration, we include the Hawkins-Kennedy Test looking for impingement. This is dovetailed with examination for bicipital tendonitis as this is another possible cause of impingement type symptoms.
This shoulder upper limb exam follows the standard "Look, Feel, Move" orthopaedic exam approach, and overall order as set out in MacLeods Clinical Examination
Watch further orthopaedic examinations for your OSCE revision:
The Spine Examination:
https://youtu.be/pJxMHa6SCgU
Knee Examination
https://youtu.be/oyKH4EYfJDM
Hip Joint Clinical Examination
https://youtu.be/JC9GKq5nSdQ
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges, and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognized standard textbook for clinical skills.
#ShoulderExamination #ClinicalSkills #DrGill
Thyroid nodules are solid or fluid-filled lumps that form within your thyroid, a small gland located at the base of your neck, just above your breastbone. The great majority of thyroid nodules aren't serious and don't cause symptoms. Thyroid cancer accounts for only a small percentage of thyroid nodules. You often won't know you have a thyroid nodule until your doctor discovers it during a routine medical exam. Some thyroid nodules, however, may become large enough to be visible or make it difficult to swallow or breathe.
Transvenous cardiac pacing, also called endocardial pacing, is a potentially life saving intervention used primarily to correct profound bradycardia. It can be used to treat symptomatic bradycardias that do not respond to transcutaneous pacing or to drug therapy.
Wernicke's aphasia is a neurological disorder typically caused by stroke. It affects the Wernicke's region in the brain's left hemisphere which is reasoned to be responsible for processing of meaning, especially as it relates to verbal communication, hence the problems with speech witnessed in these patients