Histology of Nasal Cavity

Ventricular Assist Devices

The knee joint is the largest joint in the body, consisting of 4 bones and an extensive network of ligaments and muscles. Injuries to the knee joint are amongst the most common in sporting activities and understanding the anatomy of the joint is fundamental in understanding any subsequent pathology.

New insulin therapy options are available to reduce the risk of hypoglycemia.

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Oubliez de changer constamment de médicaments prescrits, de mesurer le niveau de glucose et de vous injecter l'insuline.


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Mal Di Stomaco Rimedi, Bruciore All Esofago, Come Combattere L Acidita Di Stomaco

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Le cause del reflusso acido

La sindrome da reflusso acido, nota anche come sindrome da reflusso gastro-esofageo (GERD), si verifica a causa della coesistenza di diversi disturbi medici e di stile di vita.

Fattori fisiologici che scatenano GERD includono l'ipotonia dello sfintere esofageo inferiore (LES) (il graduale indebolimento del LES), insieme con il flusso retrogrado del contenuto dello stomaco nell'esofago, e il livello di sensibilità del muco esofagea al contenuto riflusso.


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Transpire, Stop Transpiration, Transpiration Des Aisselles, Probleme Transpiration, Transpirer Moins

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La transpiration des aisselles

La transpiration est à la fois positive et négative pour le corps humain.

Ce processus est à l’origine de l’élimination de toxines présentes dans l’organisme. Mais parfois certains sont gênés par les traces de sueur et l’odeur attachée à leurs vêtements.

Heureusement, il existe de nombreux moyen d’empêcher la transpiration des aisselles.

Des méthodes et des produits naturels peuvent se révéler tout aussi efficaces que des interventions chirurgicales.

La première mesure à prendre pour limiter la transpiration des aisselles est d’être attentif à votre hygiène.

Dès que vous sentez que vos aisselles sont humides, lavez-les avec un savon hypoallergénique et essuyez-les doucement avec un linge doux.

Certains antitranspirants contenant 20% de ce composant sont disponibles en vente libre.


Ainsi votre corps fonctionnera en harmonie car il sera mieux équilibré sur le plan hormonal.

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Ruth’s testimonial on her amazing experience with cosmetic dental procedures offered by Dr Jamil Alkhoury at Brentwood Family Dental

Dr. Arthur Handal discusses how injectable fillers can be used to restore a patient's youth.

What is Myelomeningocele and how does it affect my baby? Myelomeningocele (MMC), one of the most severe forms of spina bifida, is a condition where the fetus’ spinal cord fails to close during development. This happens between 20 and 28 days of gestation, often before a woman knows she is pregnant. Because the spinal cord does not close, many of the nerves are exposed, resulting in damage to the cord as the pregnancy continues. Spina bifida can impact the nervous system, bones and muscles, kidneys and bladder. The location on the spine where the undeveloped area occurs is called the level of the spina bifida. Because nerve damage at this site prevents function below that level, the higher the level, the greater the impact on normal development and function. The opening in the spinal cord also results in loss of the fluid surrounding the nervous system. This causes the brain to be positioned further down into the upper spinal column than normal, which is called an Arnold Chiari II malformation. When this happens, the normal flow of fluid out of the brain is obstructed, causing Hydrocephalus, an excess of cerebrospinal fluid within the brain. After birth, most children with Hydrocephalus need to have the extra fluid shunted out of the brain into the abdomen via a ventriculoperitoneal shunt. MMC affects about 1 in every 1,000 babies, and it ranges in severity. Some children, with mild cases very low on the spinal cord, can function nearly normally. More severe cases can cause leg weakness and paralysis, as well as Hydrocephalus, and the Arnold Chiari malformation. People with MMC often live long lives, especially if the condition is diagnosed and treated early. How is Myelomeningocele diagnosed? At about 15 weeks gestation, a blood test measuring the levels of alpha-fetoprotein can show the physician that there might be a problem. After that, an ultrasound is performed to detect the MMC, but also to detect the conditions that can result from it, such as Hydrocephalus, the Chiari malformation, and any problems with the lower extremities. In all cases, we perform a fetal MRI to gain more detailed information and we perform a fetal echocardiogram (echo) to rule out any problem with the heart. What is the prenatal surgery for Myelomeningocele, and how does it differ from postnatal surgery? Until recently, the only way to treat MMC was surgery after birth. But, now that the nine-year long Management of Myelomeningocele (MOMS) trial has been completed, we know that repairing the MMC before birth, in the womb, can be beneficial to the baby’s outcome. The SSM Health St. Louis Fetal Care Institute has one of the fastest growing fetal MMC repair programs in the country. The results of the trial found that prenatal treatment helps reduce, or even eliminate, the major complications of MMC—the Hydrocephalus, the Chiari malformation, and the lack of movement in the lower extremities. Diagnosis and repair of the MMC before birth can make a big difference in the way the baby develops. The MOMS trial showed that babies treated in the womb need half the VP shunts, often have reversal of the Arnold-Chiari malformation, and are more likely to walk, at least until 30 months. Long-term follow up data of children treated with prenatal surgery is still being collected, so the benefit beyond 30 months is not fully known. The operation for open fetal surgery for MMC repair involves making a small opening in the uterus, then closing the spinal cord opening just like after birth. The womb is repaired and the mother is in the hospital for four to five days. The surgery is performed between 19 and 26 weeks of the pregnancy. Mothers usually stay locally for about two weeks so that we can monitor the pregnancy. After this, they can return home for delivery. Because of the scar caused by the surgery on the uterus, the baby and all future babies have to be delivered by Cesarean birth. The benefit to the fetal repair is several fold. First, the spine is protected after the fetal repair. The spine can no longer be damaged during the pregnancy and after. Second, the leakage of CSF is stopped. We think that this causes the brain to rise back into the skull, allowing the fluid within the brain to drain normally and preventing the development of Hydrocephalus. As with any prenatal surgery, there are risks to both the mother and the baby. Our team at the Fetal Care Institute will discuss all of the risks and benefits of the surgery with you and your family, so you can make the best decision for your baby. The standard care for babies with spina bifida is to repair the defect after birth. The neurosurgeon closes the opening of the spinal cord, and restores the muscle, skin, and tissue to cover it. Unfortunately, postnatal surgery cannot restore any of the function that has been lost during the pregnancy, and the damage from Hydrocephalus, the Chiari malformation, and/or loss of movement are then permanent. How will Myelomeningocele impact my baby after birth? MMC is a disease affecting many parts of the body. There can be a major impact on a baby’s leg and hip movement, depending on the level of the defect. Problems with Hydrocephalus and the Arnold-Chiari malformation need to be followed carefully. Because the spinal cord also affects urine and bowel function, these bodily functions often need to be managed to prevent complications. Optimally, babies need to be followed in a spina bifida clinic, where a team of specialists work together to help determine the best course of treatment. At SSM Health Cardinal Glennon Children’s Hospital, a long established spina bifida clinic is available for follow up care after birth. This is a very specialized clinic in which many doctors of different specialties and nurses are dedicated to the care of these babies.

Pulmonary edema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe. In most cases, heart problems cause pulmonary edema. But fluid can accumulate for other reasons, including pneumonia, exposure to certain toxins and medications, trauma to the chest wall, and exercising or living at high elevations. Pulmonary edema that develops suddenly (acute pulmonary edema) is a medical emergency requiring immediate care. Although pulmonary edema can sometimes prove fatal, the outlook improves when you receive prompt treatment for pulmonary edema along with treatment for the underlying problem. Treatment for pulmonary edema varies depending on the cause but generally includes supplemental oxygen and medications.

Como Engravidar De Menino, Engravidar De Uma Menina, Como Faço Para Engravidar De Menina. Revelado: Maneira Incomum para Engravidar de uma MENINA! Fiquei impressionada pela grande quantidade de mulheres que possuem uma preferência para o sexo do seu bebê, e portanto vou falar hoje de como aumentar as suas chances de conceber uma menininha! Para aumentar as chances de engravidar de uma menina, devem-se considerar as características dos espermatozoides que carregam o gene X (que irá gerar uma menina) e dos que carregam o gene Y (que gerará um menino). Os espermatozoides femininos são mais lentos, porém mais resistentes que os espermatozoides masculinos. E como mencionei lá em cima a duração é diferente: os espermatozoides que carregam o gene X duram, em média, 72 horas, já os que carregam o gene Y duram menos, cerca de 24 horas. Com essas informações, a dica é ter relações sexuais dois ou três dias antes do período fértil, visto que os espermatozoides femininos são mais resistentes e conseguem “sobreviver” no corpo da mulher até que ela esteja ovulando. Para calcular o período fértil, deve-se considerar o dia da ovulação (em média, 14 dias após o primeiro dia da menstruação) e deixar uma margem de três dias antes e três dias depois da ovulação. Para saber o dia da ovulação, existem testes vendidos em farmácias, que funcionam como os testes de gravidez. Outra dica é observar o muco cervical, que fica com aspecto de clara de ovo no período fértil. Outra recomendação é adotar posições em que a penetração não seja tão profunda. É importante ainda que a mulher tenha orgasmo depois do homem, porque a secreção que ela libera quando atinge o clímax deixa a vagina menos ácida, facilitando a movimentação dos espermatozoides que carregam o gene Y (que irá gerar um menino). No caso da alimentação deve alterar o cardápio algumas semanas antes da ovulação, dando preferência para alimentos com muito cálcio e em magnésio como leite e derivados, frutas, verduras verde-escuras, como espinafre, couve e rúcula. Além disso, é necessário evitar comidas com muito sódio e potássio e reduzir o consumo de carne. Para mais dicas de como engravidar e uma menina acesse o link abaixo Dicas de como engravidar de uma MENINA Vídeo + Informações http://escolher-sexo-bebe.info-pro.co

Middle cerebral artery syndrome is a condition whereby the blood supply from the middle cerebral artery (MCA) is restricted, leading to a reduction of the function of the portions of the brain supplied by that vessel: the lateral aspects of frontal, temporal and parietal lobes, the corona radiata, globus pallidus, caudate and putamen. The MCA is the most common site for the occurrence of ischemic stroke.[1] Depending upon the location and severity of the occlusion, signs and symptoms may vary within the population affected with MCA syndrome. More distal blockages tend to produce milder deficits due to more extensive branching of the artery and less ischemic response. In contrast, the most proximal occlusions result in widespread effects that can lead to significant cerebral edema, increased intracranial pressure, loss of consciousness and could even be fatal.[1] In such occasions, mannitol (osmotic diuretic) or hypertonic saline are given to draw fluid out of the oedematus cerebrum to minimise secondary injury. Hypertonic saline is better than mannitol, as mannitol being a diuretic will decrease the mean arterial pressure and since cerebral perfusion is mean arterial pressure minus intracranial pressure, mannitol will also cause a decrease in cerebral perfusion. Contralateral hemiparesis and hemisensory loss of the face, upper and lower extremities is the most common presentation of MCA syndrome.[1] Lower extremity function is more spared than that of the faciobrachial region.[2] The majority of the primary motor and somatosensory cortices are supplied by the MCA and the cortical homunculus can, therefore, be used to localize the defects more precisely.it is important to note that middle cerebral artery lesions mostly affect the dominant hemisphere i.e. the left cerebral hemisphere.

Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis. There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer. Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact. Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

Pathologic changes in chronic obstructive pulmonary disease (COPD) occur in the large (central) airways, the small (peripheral) bronchioles, and the lung parenchyma. Most cases of COPD are the result of exposure to noxious stimuli, most often cigarette smoke. The normal inflammatory response is amplified in persons prone to COPD development. The pathogenic mechanisms are not clear but are most likely diverse. Increased numbers of activated polymorphonuclear leukocytes and macrophages release elastases in a manner that cannot be counteracted effectively by antiproteases, resulting in lung destruction. The primary offender has been found to be human leukocyte elastase, with synergistic roles suggested for proteinase-3 and macrophage-derived matrix metalloproteinases (MMPs), cysteine proteinases, and a plasminogen activator. Additionally, increased oxidative stress caused by free radicals in cigarette smoke, the oxidants released by phagocytes, and polymorphonuclear leukocytes all may lead to apoptosis or necrosis of exposed cells. Accelerated aging and autoimmune mechanisms have also been proposed as having roles in the pathogenesis of COPD.[5, 6] Cigarette smoke causes neutrophil influx, which is required for the secretion of MMPs; this suggests, therefore, that neutrophils and macrophages are required for the development of emphysema. Studies have also shown that in addition to macrophages, T lymphocytes, particularly CD8+, play an important role in the pathogenesis of smoking-induced airflow limitation. To support the inflammation hypothesis further, a stepwise increase in alveolar inflammation has been found in surgical specimens from patients without COPD versus patients with mild or severe emphysema. Indeed, mounting evidence supports the concept that dysregulation of apoptosis and defective clearance of apoptotic cells by macrophages play a prominent role in airway inflammation, particularly in emphysema.[7] Azithromycin (Zithromax) has been shown to improve this macrophage clearance function, providing a possible future treatment modality.[8] In patients with stable COPD without known cardiovascular disease, there is a high prevalence of microalbuminuria, which is associated with hypoxemia independent of other risk factors.[9] Chronic bronchitis Mucous gland hyperplasia (as seen in the images below) is the histologic hallmark of chronic bronchitis. Airway structural changes include atrophy, focal squamous metaplasia, ciliary abnormalities, variable amounts of airway smooth muscle hyperplasia, inflammation, and bronchial wall thickening.

Migraine treatments can help stop symptoms and prevent future attacks. Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories: Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms. Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines. Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions. Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Your doctor can help find the right medication for you

The term chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) has been used to identify patients with a chronically progressive or relapsing symmetric sensorimotor disorder with cytoalbuminologic dissociation and interstitial and perivascular endoneurial infiltration by lymphocytes and macrophages. It can be considered the chronic equivalent of acute inflammatory demyelinating polyradiculoneuropathy, the most common form of Guillain-Barré syndrome. Signs and symptoms CIDP typically starts insidiously and evolves slowly, in either a slowly progressive or a relapsing manner, with partial or complete recovery between recurrences; periods of worsening and improvement usually last weeks or months. Most experts consider the necessary duration of symptoms to be greater than 8 weeks for the diagnosis of CIDP to be made. Symptoms reported include the following: Preceding infection (infrequent) Initial limb weakness, both proximal and distal Sensory symptoms (eg, tingling and numbness of hands and feet) Motor symptoms (usually predominant) In about 16% of patients, a relatively acute or subacute onset of symptoms In children, usually a more precipitous onset of symptoms Symptoms of autonomic system dysfunction (eg, orthostatic dizziness) Pertinent physical findings are limited to the nervous system, except when the condition is associated with other diseases. Such findings may include the following. Signs of cranial nerve (CN) involvement (eg, facial muscle paralysis or diplopia) Gait abnormalities Motor deficits (eg, symmetric weakness of both proximal and distal muscles in upper and lower extremities) Diminished or absent deep tendon reflexes Sensory deficits (typically in stocking-glove distribution) Impaired coordination See Clinical Presentation for more detail. Diagnosis Laboratory studies that may be helpful include the following: Cerebrospinal fluid analysis: Elevated protein levels are common (80% of patients); 10% of patients also have mild lymphocytic pleocytosis and increased gamma globulin Complete blood count (CBC), erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA) level, biochemistry profile, and serum and urine immunoelectrophoresis (to exclude associated systemic disorders) In certain instances, genetic testing Other tests and procedures that may be warranted are as follows: MRI of the spine with gadolinium enhancement Electromyography (EMG) is a critical test to determine whether the disorder is truly a peripheral neuropathy and whether the neuropathy is demyelinating Peripheral (sural) nerve biopsy (see the image below): This is considered when the diagnosis is not completely clear, when other causes cannot be excluded, or when profound axonal involvement is observed on EMG; biopsy was once commonly recommended for most patients before immunosuppressive therapy, but current guidelines no longer recommend it

In neonates, hypocalcemia is more likely to occur in infants born of diabetic or preeclamptic mothers. Hypocalcemia also may occur in infants born to mothers with hyperparathyroidism. Clinically evident hypocalcemia generally presents in milder forms and is usually the result of a chronic disease state. In emergency department patients, chronic or subacute complaints secondary to mild or moderate hypocalcemia are more likely to be a chief complaint than severe symptomatic hypocalcemia. Once laboratory results demonstrate hypocalcemia, the first question is whether the hypocalcemia is true—that is, whether it is representative of a decrease in ionized calcium. The presence of chronic diarrhea or intestinal disease (eg, Crohn disease, sprue, chronic pancreatitis) suggests the possibility of hypocalcemia due to malabsorption of calcium and/or vitamin D. The patient's past medical history should be explored for pancreatitis, anxiety disorders, renal or liver failure, gastrointestinal disorders, and hyperthyroidism or hyperparathyroidism. Previous neck surgery suggests hypoparathyroidism; a history of seizures suggests hypocalcemia secondary to anticonvulsants. The patient may have a recent history of thyroid, parathyroid, or bowel surgeries or recent neck trauma. The length of time that a disorder is present is an important clue. Hypoparathyroidism and pseudohypoparathyroidism are lifelong disorders. Instead, acute transient hypocalcemia may be associated with acute gastrointestinal illness, nutritional deficiency, or acute or chronic renal failure. In an elderly patient, a nutritional deficiency may be associated with a low intake of vitamin D. A history of alcoholism can help diagnose hypocalcemia due to magnesium deficiency, malabsorption, or chronic pancreatitis. Inquire about recent use of drugs associated with hypocalcemia, including the following: Radiocontrast Estrogen Loop diuretics Bisphosphonates Calcium supplements Antibiotics Antiepileptic drugs Cinacalcet Other considerations in the history include the following: Family history of hypocalcemia Low-calcium diet Lack of sun exposure

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Cystinuria is a condition characterized by the buildup of the amino acid cystine, a building block of most proteins, in the kidneys and bladder. As the kidneys filter blood to create urine, cystine is normally absorbed back into the bloodstream. People with cystinuria cannot properly reabsorb cystine into their bloodstream, so the amino acid accumulates in their urine. As urine becomes more concentrated in the kidneys, the excess cystine forms crystals. Larger crystals become stones that may lodge in the kidneys or in the bladder. Sometimes cystine crystals combine with calcium molecules in the kidneys to form large stones. These crystals and stones can create blockages in the urinary tract and reduce the ability of the kidneys to eliminate waste through urine. The stones also provide sites where bacteria may cause infections.