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This patient presented to the ER for umbilical pain and had a history of umbilical hernia. He was concerned about the possibility of incarceration of the hernia.
In this video we explain how the clinical exam helps to differentiate a simple painful hernia from an incarcerated one.
***Thanks to the patient for sharing his history and exam with YouTube world***
Childbirth (also called labour, birth, partus or parturition) is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus. The process of normal human childbirth is categorized in three stages of labour: the shortening and dilation of the cervix, descent and birth of the infant, and birth of the placenta. In many cases, with increasing frequency, childbirth is achieved through caesarean section, the removal of the neonate through a surgical incision in the abdomen, rather than through vaginal birth. In the U.S. and Canada it represents nearly 1 in 3 (31.8%) and 1 in 4 (22.5%) of all childbirths, respectively.
For the first few days after giving birth, a new mother’s breasts remain soft. They will produce colostrum. Colostrum, the first milk, is available in just the right amount, and is rich in immune factors that protect newborns. Sometime during the next few days, the breasts will become full, firm, warm, and perhaps tender. When this occurs, people say: “the milk is coming in!” The scientific term for this event is: engorgement. Engorgement is normal, and lasts for various periods of time depending on the individual woman. Some women experience only a day or so of mild, easy-to-manage engorgement. For other women, engorgement may be more intense, and can last from several days to two weeks.
Protopic Vitiligo, Weiße Flecken Am Rücken, Pigmentflecken Im Gesicht Entfernen, Flecken Haut--- http://vitiligo-heilung.info-pro.co --- Weiße Flecken auf der Haut: Vitiligo, Die Entwicklung weißer Flecken auf der Haut ist ist ein Symptom einer Hautstörung, die Vitiligo genannt, im deutschen Sprachgebrauch aber auch häufig als "Weißfleckenkrankheit" bezeichnet wird. Man bringt den Zustand mit der Zerstörung oder Fuktionsstörung der Hautzellen in Verbindung, die für die Herstelleung des Hautpigmentes (Melanin) zuständig sind, welches dem Menschen seine Hautfarbe verleiht. Meistens entwickeln sich die Flecken dabei an Stellen, die oft der Sonne ausgesetzt sind, also z.B. die Hände, Arme, Füße, Beine und das Gesicht. Bisweilen treten die Flecken aber auch in den Achselhöhlen, im Genitalbereich und um den Bauchnabel herum auf. Von Vitiligo betroffene erleben häufig auch ein vorzeitiges Ergrauen der Haare. Es wird geschätzt, dass mindestens 1 % der Bevölkerung der Vereinigten Staaten an Vitiligo leidet; in Europe sind die Zahlen ähnlich. Weltweit leiden gegenwärtig mehr als 100 Millionen Menschen an der Hauterkrankung. Die Ursache von Vitiligo Die genaue Ursache der Erkrankung ist noch immer unbekannt. Eine der populärsten Theorien ist jedoch, dass es sich bei Vitiligo um eine Autoimmunstörung handelt. Sie veranlasst das Immunsystem, die Melanozyten (die Hautpigmente produzierenden Hautzellen) anzugreifen. In der Tat haben Menschen, die an einer anderen Autoimmunstörung, wie adrenocorticaler Unterfunktion or Schilddrüsenüberfunktion leiden, ein weitaus höheres Risiko, auch an Vitiligo zu erkranken. Manche Mediziner sind auch der Auffassung, dass Sonnenbrände, emotionaler Stress und bestimte Medikamente die weißen hautflecken hervorrufen könnten. Es wird außerdem geglaubt, dass Vitiligo is also believed eine genetisch vererbte Erkrankung darstellt. Behandlungsoptionen für Vitiligo Für Vitiligo gibt es unterschiedliche Behandlungsmöglichkeiten. Allerdings sind sie allesamt praktisch wirkungslos und beinhalten dazu noch das Risiko, ernsthafte Nebenwirkungen hervorzurufen. Krankenversicherer übernehmen zudem die vollen Behandlungskosten. Das allein macht eine Vitiligo-Behandlung bereits zu teuer für die meisten Patienten, denn es sind üblichwerweise zwei bis drei Besuche wöchentlich in ener Spezialklinik nötig. Ein Paradebeispiel für eine solche Behandlung ist die sogenannte PUVA-Therapie, die ausgesprochen häufig eingesetzt wird. "Gratis-Präsentation enthüllt einen ziemlich ungewöhnlichen Tipp zur Beseitigung von Vitiligo für alle Zeiten und in nur 45-60 Tagen - Garantiert!" http://vitiligo-heilung.info-pro.co Erfahren Sie mehr darüber, indem Sie diese Webseite besuchen: http://vitiligo-heilung.info-pro.co
Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions — such as heavy bleeding — or to clear the uterine lining after a miscarriage or abortion.
A breech birth is the birth of a baby from a breech presentation. In the breech presentation the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation.
There are either three or four main categories of breech births, depending upon the source:
* Frank breech - the baby's bottom comes first, and his or her legs are flexed at the hip and extended at the knees (with feet near the ears). 65-70% of breech babies are in the frank breech position.
* Complete breech - the baby's hips and knees are flexed so that the baby is sitting crosslegged, with feet beside the bottom.
* Footling breech - one or both feet come first, with the bottom at a higher position. This is rare at term but relatively common with premature fetuses.
* Kneeling breech - the baby is in a kneeling position, with one or both legs extended at the hips and flexed at the knees. This is extremely rare, and is excluded from many classifications.
As in labour with a baby in a normal head-down position, uterine contractions typically occur at regular intervals and gradually cause the cervix to become thinner and to open. In the more common breech presentations, the baby’s bottom (rather than feet or knees) is what is first to descend through the maternal pelvis and emerge from the vagina.
At the beginning of labour, the baby is generally in an oblique position, facing either the right or left side of the mother's back. As the baby's bottom is the same size in the term baby as the baby's head. Descent is thus as for the presenting fetal head and delay in descent is a cardinal sign of possible problems with the delivery of the head.
In order to begin the birth, internal rotation needs to occur. This happens when the mother's pelvic floor muscles cause the baby to turn so that it can be born with one hip directly in front of the other. At this point the baby is facing one of the mother's inner thighs. Then, the shoulders follow the same path as the hips did. At this time the baby usually turns to face the mother's back. Next occurs external rotation, which is when the shoulders emerge as the baby’s head enters the maternal pelvis. The combination of maternal muscle tone and uterine contractions cause the baby’s head to flex, chin to chest. Then the back of the baby's head emerges and finally the face.
Due to the increased pressure during labour and birth, it is normal for the baby's leading hip to be bruised and genitalia to be swollen. Babies who assumed the frank breech position in utero may continue to hold their legs in this position for some days after birth.
A torn meniscus is one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting your full weight on it, can lead to a torn meniscus. Each of your knees has two menisci — C-shaped pieces of cartilage that act like a cushion between your shinbone and your thighbone. A torn meniscus causes pain, swelling and stiffness. You also might feel a block to knee motion and have trouble extending your knee fully. Conservative treatment — such as rest, ice and medication — is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgical repair.