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What is the spleen and what causes an enlarged spleen (splenomegaly)? The spleen sits under your rib cage in the upper left part of your abdomen toward your back. It is an organ that is part of the lymph system and works as a drainage network that defends your body against infection. White blood cells produced in the spleen engulf bacteria, dead tissue, and foreign matter, removing them from the blood as blood passes through it. The spleen also maintains healthy red and white blood cells and platelets; platelets help your blood clot. The spleen filters blood, removing abnormal blood cells from the bloodstream. A spleen is normally about the size of your fist. A doctor usually can't feel it during an exam. But diseases can cause it to swell and become many times its normal size. Because the spleen is involved in many functions, many conditions may affect it.
"Laparoscopic Placement of a
Peritoneal Dialysis Catheter"
Houston Methodist DeBakey Heart & Vascular Center, presents a cardiovascular procedure featuring Eric K. Peden, MD, Shri Timbalia, MD, and Kenneth Livingston as they demonstrate “Laparoscopic Placement of a
Peritoneal Dialysis Catheter".
Surgery: Eric K. Peden, MD, Shri Timbalia, MD, and Kenneth Livingston
Narration: Kenneth Livingston
** This medical education program may contain graphic content. **
_________________________________
A DeBakey CV Education event
Presented by Houston Methodist DeBakey Heart & Vascular Center.
Building on Dr. Michael E. DeBakey’s commitment to excellence in education, Houston Methodist DeBakey CV Education is an epicenter for cardiovascular academic and clinical educational programs that support the provision of optimal care to patients suffering from cardiovascular conditions and diseases.
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DeBakey CV Education:
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A flail chest occurs when a segment of the thoracic cage is separated from the rest of the chest wall. This is usually defined as at least two fractures per rib (producing a free segment), in at least two ribs. A segment of the chest wall that is flail is unable to contribute to lung expansion. Large flail segments will involve a much greater proportion of the chest wall and may extend bilaterally or involve the sternum. In these cases the disruption of normal pulmonary mechanics may be large enough to require mechanical ventilation.
High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. You can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke. High blood pressure generally develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.
Bone is not a static part of the body — it's constantly being resorbed (broken down) and formed throughout your life. Your entire skeleton is replaced about every decade, according to the NIH. During your childhood and teenage years, bone formation occurs more quickly than bone resorption, resulting in growth. You reach your maximum bone density and strength around age 30, after which bone resorption slowly overtakes bone formation. Osteoporosis develops when there's an abnormal imbalance between bone resorption and formation — that is, resorption occurs too quickly, or formation too slowly.
You are most fertile at the time of ovulation, (when an egg is released from your ovaries) which usually occurs 12-14 days before your next period starts. This is the time of the month when you are most likely to get pregnant. It is unlikely that you will get pregnant just after your period, although it can happen.
A uterine fibroid (also uterine leiomyoma, myoma, fibromyoma, leiofibromyoma, fibroleiomyoma, and fibroma) (plural of ... myoma is ...myomas or ...myomata) is a benign (non-cancerous) tumor that originates from the smooth muscle layer (myometrium) and the accompanying connective tissue of the uterus. Fibroids are the most common benign tumors in females and typically found during the middle and later reproductive years. While most fibroids are asymptomatic, they can grow and cause heavy and painful menstruation, painful sexual intercourse, and urinary frequency and urgency. Uterine fibroids is the major indication for hysterectomy in the US.[2] Fibroids are often multiple and if the uterus contains too many leiomyomatas to count, it is referred to as uterine leiomyomatosis. The malignant version of a fibroid is uncommon and termed a leiomyosarcoma.
Physical assessment is taking an educated, systematic look at all aspects of an individual’s health status utilizing knowledge, skills and tools of health history and physical exam. To collect data- information about the client’s health, including physiological, psychological, sociocultural and spiritual aspects To establish actual and potential problems To establish the nurse-client relationship Method: The history is done first, then the physical examination focuses on finding data associated with the history. Health History- obtained through interview and record review. Physical exam- accomplished by tools and techniques ** A complete assessment is not necessarily carried out each time. A comprehensive assessment is part of a health screening examination. On admission, you will do an admission assessment (not necessarily including everything presented here) and document it on the admission form. You will do a daily shift assessment (patient systems review). And, if client has a specific problem, you may assess only that part of the body (focused). Data Collection: Information is organized into objective and subjective data: Subjective: Apparent only to person affected; includes client’s perceptions, feelings, thoughts, and expectations. It cannot be directly observed and can be discovered only asking questions. Objective: Detectable by an observer or can be tested against an acceptable standard; tangible, observable facts; includes observation of client behavior, medical records, lab and diagnostic tests, data collected by physical exam. ** To obtain data for the nursing health history, you must utilize good interview techniques and communications skills. Record accurately. DO NOT ASSUME. D. Frameworks for Health Assessment There are two main frameworks utilized in health assessment: Head to Toe- systematic collection of data starting with the head and working downward. Functional Health Assessment- Gordon’s 11 functional health patterns that address the behaviors a person uses to maintain health. PERSON is the ACC-ADN framework for assessment. It is similar to Gordon's functional health patterns.
Small cell lung cancer, which occurs almost exclusively in smokers, is a malignancy characterised by rapid doubling time, high growth fraction and widespread metastasis at presentation. In this presentation, we will briefly discuss the classification of pulmonary Neuro-endocrine tumours by the World Health Organisation followed by a detailed discussion of the clinical features, lab evaluation and management of SCLC, both limited and extended stage. The frontline therapy in small cell lung cancer is etoposide and cisplatin along with thoracic radiotherapy and prophylactic cranial irradiation in patients who have a good response to therapy. Hyperfractionation of radiotherapy may provide some benefit but is also associated with increase incidence of complications. Newer agents for SCLC include Vandetanib and immunotherapy molecules, such as Iplimumab and nivolumab.
What Is an Appendectomy? An appendectomy is the surgical removal of the appendix. It’s a common emergency surgery that’s performed to treat appendicitis, an inflammatory condition of the appendix. The appendix is a small, tube-shaped pouch attached to your large intestine. It’s located in the lower right side of your abdomen. The exact purpose of the appendix isn’t known. However, it’s believed that it may help us recover from diarrhea, inflammation, and infections of the small and large intestines. These may sound like important functions, but the body can still function properly without an appendix. When the appendix becomes inflamed and swollen, bacteria can quickly multiply inside the organ and lead to the formation of pus. This buildup of bacteria and pus can cause pain around the belly button that spreads to the lower right section of the abdomen. Walking or coughing can make the pain worse. You may also experience nausea, vomiting, and diarrhea. It’s important to seek treatment right away if you’re having symptoms of appendicitis. When the condition goes untreated, the appendix can burst (perforated appendix) and release bacteria and other harmful substances into the abdominal cavity. This can be life-threatening, and will lead to a longer hospital stay. Appendectomy is the standard treatment for appendicitis. It’s crucial to remove the appendix right away, before the appendix can rupture. Once an appendectomy is performed, most people recover quickly and without complications. Why Is an Appendectomy Performed? An appendectomy is often done to remove the appendix when an infection has made it inflamed and swollen. This condition is known as appendicitis. The infection may occur when the opening of the appendix becomes clogged with bacteria and stool. This causes your appendix to become swollen and inflamed. The easiest and quickest way to treat appendicitis is to remove the appendix. Your appendix could burst if appendicitis isn’t treated immediately and effectively. If the appendix ruptures, the bacteria and fecal particles within the organ can spread into your abdomen. This may lead to a serious infection called peritonitis. You can also develop an abscess if your appendix ruptures. Both are life-threatening situations that require immediate surgery. Symptoms of appendicitis include: stomach pain that starts suddenly near the belly button and spreads to the lower right side of the abdomen abdominal swelling rigid abdominal muscles constipation or diarrhea nausea vomiting loss of appetite low-grade fever Although pain from appendicitis typically occurs in the lower right side of the abdomen, pregnant women may have pain in the upper right side of the abdomen. This is because the appendix is higher during pregnancy. Go to the emergency room immediately if you believe you have appendicitis. An appendectomy needs to be performed right away to prevent complications. What Are the Risks of an Appendectomy? An appendectomy is a fairly simple and common procedure. However, there are some risks associated with the surgery, including: bleeding infection injury to nearby organs blocked bowels It’s important to note that the risks of an appendectomy are much less severe than the risks associated with untreated appendicitis. An appendectomy needs to be done immediately to prevent abscesses and peritonitis from developing. How Do I Prepare for an Appendectomy? You’ll need to avoid eating and drinking for at least eight hours before the appendectomy. It’s also important to tell your doctor about any prescription or over-the-counter medications you’re taking. Your doctor will tell you how they should be used before and after the procedure. You should also tell your doctor if you: are pregnant or believe you may be pregnant are allergic or sensitive to latex or certain medications, such as anesthesia have a history of bleeding disorders You should also arrange for a family member or friend to drive you home after the procedure. An appendectomy is often performed using general anesthesia, which can make you drowsy and unable to drive for several hours after surgery. Once you’re at the hospital, your doctor will ask you about your medical history and perform a physical examination. During the exam, your doctor will gently push against your abdomen to pinpoint the source of your abdominal pain. Your doctor may order blood tests and imaging tests if appendicitis is caught early. However, these tests may not be performed if your doctor believes an emergency appendectomy is necessary. Before the appendectomy, you’ll be hooked up to an IV so you can receive fluids and medication. You’ll likely be put under general anesthesia, which means you’ll be asleep during surgery. In some cases, you’ll be given local anesthesia instead. A local anesthetic numbs the area, so even though you’ll be awake during the surgery, you won’t feel any pain. How Is an Appendectomy Performed? There are two types of appendectomy: open and laparoscopic. The type of surgery your doctor chooses depends on several factors, including the severity of your appendicitis and your medical history. Open Appendectomy During an open appendectomy, a surgeon makes one incision in the lower right side of your abdomen. Your appendix is removed and the wound is closed with stiches. This procedure allows your doctor to clean the abdominal cavity if your appendix has burst. Your doctor may choose an open appendectomy if your appendix has ruptured and the infection has spread to other organs. It’s also the preferred option for people who have had abdominal surgery in the past. Laparoscopic Appendectomy During a laparoscopic appendectomy, a surgeon accesses the appendix through a few small incisions in your abdomen. A small, narrow tube called a cannula will then be inserted. The cannula is used to inflate your abdomen with carbon dioxide gas. This gas allows the surgeon to see your appendix more clearly. Once the abdomen is inflated, an instrument called a laparoscope will be inserted through the incision. The laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The camera will display the images on a screen, allowing the surgeon to see inside your abdomen and guide the instruments. When the appendix is found, it will be tied off with stiches and removed. The small incisions are then cleaned, closed, and dressed. Laparoscopic surgery is usually the best option for older adults and people who are overweight. It has fewer risks than an open appendectomy procedure, and generally has a shorter recovery time. What Happens After an Appendectomy? When the appendectomy is over, you’ll be observed for several hours before you’re released from the hospital. Your vital signs, such your breathing and heart rate, will be monitored closely. Hospital staff will also check for any adverse reactions to the anesthesia or the procedure. The timing of your release will depend on: your overall physical condition the type of appendectomy performed your body’s reaction to the surgery In some cases, you may have to remain in the hospital overnight. You may be able to go home the same day as the surgery if your appendicitis wasn’t severe. A family member or friend will need to drive you home if you received general anesthesia. The effects of general anesthesia usually take several hours to wear off, so it can be unsafe to drive after the procedure. In the days following the appendectomy, you may feel moderate pain in the areas where incisions were made. Any pain or discomfort should improve within a few days. Your doctor may prescribe medication to relieve the pain. They might also prescribe antibiotics to prevent an infection after surgery. You can further reduce your risk for infection by keeping the incisions clean. You should also watch for signs of infection, which include: redness and swelling around the incision fever above 101°F chills vomiting loss of appetite stomach cramps diarrhea or constipation that lasts for more than two days Although there’s a small risk of infection, most people recover from appendicitis and an appendectomy with little difficulty. Full recovery from an appendectomy takes about four to six weeks. During this time, your doctor will probably recommend that you limit physical activity so your body can heal. You’ll need to attend a follow-up appointment with your doctor within two to three weeks after the appendectomy.
nkylosing spondylitis (pronounced ank-kih-low-sing spon-dill-eye-tiss), or AS, is a form of arthritis that primarily affects the spine, although other joints can become involved. It causes inflammation of the spinal joints (vertebrae) that can lead to severe, chronic pain and discomfort
A myringotomy is a procedure in which your doctor creates a small hole in the eardrum so fluids such as water, blood, or pus can drain out. In many cases, your doctor will put in a tube so it won't get backed up again. The tube, which will usually fall out on its own in about six to 18 months, lets air flow through and keeps the middle ear dry. Tubes also: Reduce pain Improve hearing Cut down on the number of infections your child may have