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If your kidney function is declining and medications and other treatments aren’t working, dialysis can offer life-saving care. UVA has one of the largest dialysis programs in the country. Nephrologist Daphne Knicely, MD, explains the types of home dialysis and how they can work to fit your life.
Find out more at: https://uvahealth.com/services/dialysis
Transcript
Dialysis is just a way to replace the kidneys when they're not working anymore. So when the kidneys stop working, they stop getting rid of water, stop balancing the chemistry, stop getting rid of the toxins. Then dialysis does its job by balancing the chemistries, getting rid of the toxins, and help remove fluid. It doesn't fix the kidneys. It just replaces them.
I usually think of dialysis as two components. There's hemodialysis and peritoneal dialysis. So peritoneal dialysis can only be done at home. Hemodialysis can be done in a center, or it can be done at home.
Hemodialysis is where you have some sort of access to the blood. Either some sort of shunt in the arm that connects an artery and vein, or a catheter. And it allows for blood to leave you, go through a machine, get cleaned, chemistries balanced, and then comes back to you.
For home hemodialysis, the patient actually learns how to do that treatment. It's a very simple machine, very user-friendly. Training is usually about anywhere from four weeks up to eight weeks, and you work one-on-one with a nurse. You still see the physician. You come in about once a month, maybe twice a month, to get labs. You'll see a social worker, and a nutritionist at the same time.
Peritoneal dialysis takes place by putting a tube into your abdomen. And we take dialysis fluid that's chemically balanced. When we put it into the abdomen, it uses those little blood vessels to pull toxins out, to balance chemistries, kind of like little filters. Now, after it sits in there for several hours, we drain it out.
Anyone that needs dialysis is a candidate for home dialysis. There's not one type of dialysis that's going to make you live longer. They're all equal. The goal is to pick the type of dialysis that fits with your life.
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.
Whether the result of an accident or biting on a piece of food that’s too hard, mouth injuries can cause teeth to become cracked, broken, or knocked out/dislodged. It is important to see a dentist because if left untreated, a dental emergency can lead to serious complications.
Bone tumors include abnormal healing of an injury, inherited conditions, radiation therapy. It can also be caused by bone cancer or another cancer that has spread to the bone from other parts of the body. A bone tumor may cause a painless mass. Some people have dull, aching pain. And in some cases, minor injury causes a fracture near the tumor. Treatments include surgery and radiation. Some noncancerous tumors go away without treatment
Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly. Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any. Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).
The most common position of the uterus is anteverted (cervix angles forward) and anteflexed (body is flexed forward). The position of the uterus in the adult is liable to considerable variation, depending chiefly on the condition of the bladder and rectum. Adnexa: In gynecology, the appendages of the uterus, namely the ovaries, the Fallopian tubes, and the ligaments that hold the uterus in place.
Indications for endovascular repair of the iliac artery are: Stenosis or (short-segment) occlusion of iliac artery (TASC type A and B, TASC C lesions are controversial) with ipsilateral lower extremity ischemia (lifestyle-limiting, progressive claudication, rest pain, gangrene). Patients with asymptomatic aneurysm greater than 4 cm in diameter. An iliac aneurysm which has also increased in size by 0.5 cm in last six months. Symptomatic iliac artery aneurysms mandate endovascular (or open) repair regardless of size. Patients with long occluded lesions/poor run-off/acute limb ischemia are poor endovascular candidates.
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Inguinal and femoral hernias need not be confusing. In this tutorial you will be presented with colourful diagrams and animations to cover important areas, such as the anatomy of what goes on in these two conditions, the examination of groin hernias and a simple explanation of the difference between incarceration, strangulation and obstruction, in and amongst a systematic look at the clinical topic. More tutorials at www.boxmedicine.com.
Frostbite is an injury caused by freezing of the skin and underlying tissues. First your skin becomes very cold and red, then numb, hard and pale. Frostbite is most common on the fingers, toes, nose, ears, cheeks and chin. Exposed skin in cold, windy weather is most vulnerable to frostbite. But frostbite can occur on skin covered by gloves or other clothing. Frostnip, the first stage of frostbite, doesn't cause permanent skin damage. You can treat very mild frostbite with first-aid measures, including rewarming your skin. All other frostbite requires medical attention because it can damage skin, tissues, muscle and bones. Possible complications of severe frostbite include infection and nerve damage.