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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.
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).
Over one million Americans have the sexually transmitted virus, HIV, which can lead to the deadly disease known as AIDS.
HIV can be transmitted in the sexual fluids, blood or breast milk of an infected person. HIV prevention therefore involves a wide range of activities including prevention of mother-to-child transmission, needle exchanges and harm reduction for injecting drug users, and precautions for health care workers.
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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.
Acromegaly is usually caused by a noncancerous tumor. Middle-aged adults are most commonly affected. Symptoms include enlargement of the face, hands, and feet. Prompt treatment is needed to avoid serious illness. Drugs can reduce the effects of growth hormone. If needed, surgery and radiation may be used to remove tumor cells.
The Arthrex® Achilles SpeedBridge™ repair is a surgical technique system that combines fully threaded SwiveLock® anchors with FiberTape® suture. The surgeon may use the Achilles SpeedBridge to reattach the Achilles tendon to the heel bone after repairing the damaged portion of the Achilles tendon. The Achilles tendon connects the two large muscles at the back of the calf to the heel. Insertional Achilles tendinitis is a painful and disabling condition where the tendon attaches to the heel bone causing redness, pain and swelling. Patients who do not respond to the initial treatment may require surgical treatment.
Chalazions are extremely common, and having a sound surgical technique to drain a chalazion is a fundamental in general ophthalmology and oculoplastic surgery. I believe one of the biggest downfalls in treating chalazions is inadequate local anesthetic. Please that both the outer and inner surface to the eyelid need to receive local anesthesia to make the patient totally comfortable. It is important to be careful in delivering the local anesthetic and making sure you have control of the head position, and the position of your needle is bent to minimize any possibility of contact with the globe.
So you want to be a cardiothoracic surgeon. You like the idea of open heart surgery and the glory that comes with being a CT surgeon. Let’s debunk the public perception myths of what it means to be a cardiothoracic surgeon, and give it to you straight. This is the reality of cardiothoracic surgery.
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TIME STAMPS:
00:41 - What is Cardiothoracic Surgery?
04:08 - How to Become a Cardiothoracic Surgeon
06:29 - Subspecialties within Cardiothoracic Surgery
07:49 - What You’ll Love About Cardiothoracic Surgery
09:10 - What You Won’t Love About Cardiothoracic Surgery
10:04 - Should You Become a Cardiothoracic Surgeon?
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#medicalschool #cardiothoracicsurgery #soyouwanttobe
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Cholelithiasis involves the presence of gallstones (see the image below), which are concretions that form in the biliary tract, usually in the gallbladder. Choledocholithiasis refers to the presence of 1 or more gallstones in the common bile duct (CBD).
Neck Examination - Cervical Spine Assessment - Clinical Skills - Dr Gill
Compose a new pain within athletes is cervical spine discomfort, thankfully in the vast majority of cases when the neck is examined the cause of the neck pain is found to be muscular.
However, pain can also refer from the neck to the arm, in which case it is important to be able to assess for cervical radiculopathy prior to gaining more information which may indicate an MRI is needed
We assess for radiculopathy by doing Spurling's test, an often overlooked part of the neck examination, but it should be included for completeness and reassurance of the patient - not forgetting the athlete or not, neck pain can be a considerable source of distress, so it's vital to be able to get information from the neck examination which allows you to safely reassure a patient when appropriate, or comment that neck exam found evidence that needs further investigation
#DRGill #neck #asmr