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Mentoplasty (Chin surgery)\nA chin implant or “filling” is used to correct a receding chin in order to give a better proportion to the facial features of the patient.\nThis plastic surgery consists on placing an implant through a small incision under the chin or through an intraoral incision.\nUsing a Filler\nThe procedure consists of an injection to the chin of the patient´s own fat (micro fat grafting) or hydroxyapatite; Juvederm, without incisions.\nLength of Procedure\nNeuroleptoanesthesia (deep sedation) or general, plus local anesthesia for chin implant. Local anesthesia for lipofilling or calcium hydroxyapatite (Juvederm).\nThis plastic surgery requires a stay of less than four hours.\n- Avoidance of any trauma around the treated area\n- No contact sports allowed for the first month\n- No sunbathing for 3 to 4 weeks post-op\nSutures are removed 10 days after surgery.
Charlotte Eyelid Lift – Blepharoplasty\nPerhaps more than any other facial feature, our eyes tell the world how we feel. However, aging and heredity can cause the skin and tissues on our eyelids to sag and droop, making us look tired, sad or worried, even when we feel great. If your eyes are sending the wrong message, we can help you change that through an eyelid lift procedure, personalized to your needs.\nDr. Ditesheim’s Approach to Eyelid Surgery\nAfter listening to your goals and concerns at your consultation, Dr. Ditesheim will determine the specific method to use for your procedure based on your facial features. In general, the following techniques are used:\n- For upper eyelid surgery, the incision begins within the natural crease of the eye’s inside corner and extends slightly beyond the outside corner into the crow’s feet or laugh lines. Through this incision, excess skin and fatty tissue are removed. When healed, the incision is camouflaged in the natural contour of the upper eyelid.\n- For lower eyelid surgery, the incision is concealed just below the lower lashes. Through this incision, excess skin, muscle and fat are removed.\nEyelid surgery is frequently combined with other facial procedures to further enhance your results. Non-surgical treatments, such as Botox & injectable fillers or fat grafting, can help to smooth crow’s feet or other wrinkles or diminish dark circles under your eyes.\nWhy Dr. Ditesheim?\nCosmetic surgery is about you, not a procedure. That’s why Dr. Ditesheim approaches things differently. You’ll never hear him say you “need” a procedure. He’ll go over all of your options; you choose how to proceed. And this approach works! Just ask our happy patients.\nWhen you choose Dr. Ditesheim, you get:\n- A board certified plastic surgeon with 16+ years of experience\n- Incredible support; the same medical team cares for you throughout the process\n- Imaging technology & sizing that lets you preview your results with accuracy—what you see is what you get\n- Privacy & safety of a fully accredited, on-site surgical facility\nIs eyelid surgery right for me?\nEach person is unique in his or her goals and needs, and best way to determine whether or not eyelid surgery is a good solution for you is to come in for a consultation. In general, you may be a good candidate for eyelid surgery if the following statements describe you:\n- You are unhappy with the appearance of drooping upper lids and puffy bags below your eyes or your vision is blurred as a result of the eye sagging skin around your eyes.\n- Your eyes are in good health per your ophthalmologist. A detached retina, glaucoma, dry eyes or insufficient tears can make an eyelid lift a more risky cosmetic surgery procedure.\n- You are in good physical health and have realistic expectations.\nWhat does eyelid surgery cost?\nEyelid surgery is highly personalized, and we’ll quote your exact cost at your consultation. In general prices for eyelid lift surgery range from $4,000 to $8,000. Total costs including professional anesthesia care (MD), credentialed, accredited surgical facility (OR and Recovery) and surgical fees. We also offer several convenient payment & financing options for our patients.\nEyelid surgery pre-operative overview\nDr. Ditesheim and his experienced staff will provide you with pre-surgical information that includes guidelines about drinking, smoking and avoiding certain vitamins and medications. Dr. Ditesheim’s caring staff has a wealth of experience in preparing families for the recovery process and ensuring a predictable, smooth process.\n“I wish that I had done this sooner, Dr. Ditesheim and his entire staff provided the highest level of care. I would liken it to the Ritz Carlton!” R.J. Greensboro, NC\nYour safety is our priority\nThe surgery time may range between 1 to 1½ hours depending upon your needs. Blepharoplasty is usually done on an outpatient basis, under local or general anesthesia administered by a physician anesthesiologist. The procedure is performed in our AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities) accredited, on-site surgical suite.\nYour recovery after eyelid lift surgery\nFollowing your procedure, the area around your eyes will be bruised, and most likely swollen, for about 10 days. While recovery usually takes a few days, it may take a few weeks for residual swelling to subside and to fully see the complete results of your eyelid lift.\nIt is important to wear sunscreen daily to keep your results looking their best. Our caring nurse will call you regularly to check in on you and make sure that you are having a stress-free recovery. We want to make sure that you are completely relaxed throughout the healing process. Just leave the rest to us!\nInterested in learning more? Contact us!\nIf you’re considering your options for improving your eyelid contour, we invite you to schedule a personal consultation with Dr. Ditesheim. He will listen carefully to your concerns, evaluate your face & skin, and go over all of your options to help achieve your goals.
A bone lesion biopsy is the removal of a piece of bone or bone marrow for examination.\nThe test is done in the following way:\nBone biopsy may also be done under general anesthesia to remove a larger sample. Then surgery to remove the bone can be done if the biopsy exam shows that there is an abnormal growth or cancer.\nYou may be told not to drink or eat anything for several hours before the biopsy.\nWith a needle biopsy, you may feel some discomfort and pressure, even though a local anesthetic is used. You must remain still during the procedure.\nAfter the biopsy, the area may be sore or tender for several days.\nThe most common reasons for bone lesion biopsy are to tell the difference between cancerous and noncancerous bone tumors and to identify other bone problems. It may be performed on people with bone pain and tenderness, particularly if x-ray, CT scan, or other testing reveals a problem.\nNormal bone appears as two types: compact and cancellous.\nBenign (noncancerous) bone tumors include:\nCancerous tumors include:\nAbnormal results may also be due to:\nSome people with bone disorders also have blood clotting disorders, which can increase the risk for bleeding.\nSigns of bone infection (one of the most serious risks) include fever, headache, pain with movement, redness and swelling of the tissues around the biopsy site, and drainage of pus from the biopsy site. If these occur, seek immediate medical attention.\nBone biopsy; Biopsy - bone\nMatteson EL, Osmon DR. Infections of the bursae, joints, and bones. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 280.\nSchwartz HS, Holt GE. Bone tumors. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 34.\nUpdated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.\nThe information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2015, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM Health Solutions.
What is a Hernia?\nThe definition of an abdominal hernia is when the thin inside lining under the muscle wall that is closest to the organs inside pushes through the muscle. It is most commonly manifest as a bulge. When this happens intestines or other tissue may push out with it. This occurrence is similar to the inner tube of a tire pushing through the tread.\nWhen to Consider Repair\nSmall hernias without pain can be watched carefully with the understanding that over time there is a significant likelihood that discomfort will develop or enlargement will occur. 25% of asymptomatic inguinal hernias in a Veterans study became symptomatic requiring repair within a two year period. If there is increasing size, discomfort or an episode of incarceration then surgical repair should be considered more urgently. Having a hernia is still an indication to have it repaired.\nThe general principle is to re-establish the wall to keep the insides from pushing out through the abdominal vault. This requires sewing it closed or more commonly placing a plastic mesh against the muscle wall to create a barrier. Mesh is like a window screen but made out of plastic. The body creates scar tissue around the mesh to hold it in place to be permanent. Because there are no foreign proteins the body won't “reject” mesh. There are several approaches available as well as types of mesh. The options will be discussed with you during consultation.\nRisks and Possible Complications\nBleeding and infection as with any operation. A single dose of intravenous antibiotics are given just before surgery to help prevent infection. No additional antibiotic is needed unless there are specific circumstances where the potential for infection is high.\nPain or numbness - There are small nerves throughout the body which allow communication to and from your body parts. During surgery to repair hernias small branches of nerves may be divided leaving numb areas usually near the incision. It would be very rare to have a nerve damage that would effect function of a body area. Occasionally some small nerve branches may get “trapped” in scar tissue or next to the mesh during repair. Many of these situations will improve with time. If severe or persistent then additional testing to localize where a problem may exist or additional surgery may be needed.\nDamage to organs is very rare but more likely in larger hernias where an organ is protruding out into the hernia. Bowel can be injured and if recognized, repaired at the same time. Unrecognized injury can lead to additional complications. I have not had this complication since my practice started. Injury to testicle or blood supply to it can occur. I have had to remove a testicle in four older men at the time of hernia repair due to very large single sided hernias.\nGeneral Anesthesia - Intravenous medication is given and then after a patient is asleep a breathing tube is place into the mouth to help with breathing during the procedure. It is removed before being awake again. General anesthesia is required for any Laparoscopic repairs, large hernias, or patient preference.\nSedation with Local Anesthesia - Heavy sedation medication is given through an IV, then while a patient is “out” I inject local “numbing” medication in the area to keep any pain from being felt during the surgery. At the end of the procedure patients are fully awake, able to eliminate recovery room and get out of the hospital faster feeling better. I recommend this method when possible.\nLocal anesthesia only is used for small hernias. A Local anesthesia injections can be used while a patient is fully awake, although, there are not many repaired with this method.\nLearn More About Hernias and Their Treatment\nSports hernias and normal hernias, like inguinal and hiatal hernias, are different medical conditions, but if left untreated, a sports …\nHernias are very common. Most occur from organs or fat, inside the abdominal cavity (your belly) pushing out through the …
So You're Having a Hysterectomy\nso you're having a hysterectomy\nIf you've been informed that you need a hysterectomy, this book is for you. Step by step, test by test, decision by decision, you'll know what to expect and what your choices are. Why are you having problems? Do you really need a hysterrectomy? What are the alternatives? Is it best to just "wait and see"? And if you do decide to go ahead, what type of hysterectomy procedure is right for you? From diagnosis to recovery, So You're Having a Hysterectomy is the ultimate guide for women facing this controversial surgery. Balanced, accurate information, real-life patient stories, and detailed illustrations give you the inside story on each medical procedure, while extensive self-help sections give you the power to find your own personal road to wellness--whatever you decide.\n"Been there, done that, does not an expert make. Event though I have had a hysterectomy and am a sex educator/counselor, I still learned a great deal about hysterectomy from this book. Highly recommended reading."\n--Sue Hohanson, RN CM, sex educator/counselor and host of the Sunday Night Sex Show\n25 pages matching weeks in this book\nResults 1-3 of 25\nWhat people are saying - Write a review\nWe haven't found any reviews in the usual places.\nablation myomectomy and myolysis\nWHEN lTS ALL OVER 123\n5 other sections not shown\nabdominal hysterectomy abnormal anemia anesthesia anesthetic bladder blood clots blood test blood transfusion breast cancer calcium cause cells cervix Chapter clitoris colposcopy diet doctor drugs endometrial ablation endometrial cancer endometriosis endometrium epidural exercises fallopian tubes feel fluid gynecological gynecologist Happens heal heavy bleeding Hormone replacement therapy hospital hot flashes hysteroscopy infection inserted involves jour Kegel exercises KEY PO1NT laparoscopic hysterectomy large fibroids levels menopause myomectomy normal nurse operating room option orgasm osteoporosis ovaries ovaries removed ovulation pain medication Pap test patients pelvic percent physician pills polyps pregnancy problems procedure progesterone progestin recovery room reduce reproductive organs risk role SELF-HELP sexual side effects skin studies subtotal hysterectomy surgeon surgery surgical symptoms technique testosterone tissue total hysterectomy treatment types of hysterectomy ultrasound urinate usually uterine bleeding uterine fibroid uterine fibroid embolization uterine lining uterine prolapse uterus vagina vaginal hysterectomy vulva weeks women
Vascular Disease in Older Adults PDF: A Comprehensive Clinical Guide\n\|File size\|\|3 MB\|\n\|Category\|\|Cardiovascular,Free Medical Books\|\nDownload the Book\nThis book presents a comprehensive and state-of the-art approach to vascular disease for the geriatric patient, focusing on vascular pathology and interventions but also on perioperative care, anesthetic care, functional outcomes and quality of life, as well as ethical considerations that impact decision making. The book addresses open and endovascular interventions in different vascular beds, as well as preoperative workup and optimization, anesthetic considerations, all aspects and expectations of the postoperative care and recovery and is the only book to include specialize in the intricacies of the care of the geriatric patients, the challenging recovery and neurocognitive changes, and ethical considerations for the end stage geriatric patient or in the setting of postoperative complications. Written by experts in the field, each section addresses patient selection, pre-operative considerations, technical conduct of the most common operations with open or endovascular options, and avoiding complications. A brief review of the existing literature addressing the particular topic follows in each section.\nWith its concise yet comprehensive summary of the field, Vascular Disease in Older Adults is the ultimate resource for geriatricians, cardiologists, surgeons, anesthesiologists, and all physicians of who care for the aging patient with vascular disease.
Mixed use development in the heart of Stone Oak, one of San Antonio’s fastest growing and most affluent areas. Alta Vista enjoys great visibility and direct access to one of the area’s busiest intersections.\nHuebner Town Center\nQuiet property nestled between the high-income and prominent Churchill Estates and Inwood subdivisions. Single tenant building with a very relaxed atmosphere, lots of privacy and plenty of parking. Frontage on Huebner Rd. and close proximity to neighborhood retail, schools and churches. This property is 100% leased.\nMission Ridge Medical\nSet up as an Ambulatory Surgery Center. This allows a doctor to do full surgeries with anesthesia and can have operating rooms on both floors. Concrete floors make the 2nd floor ideal for dental use as plumbing would more affordable. Unique window layout offers sweeping views of the quarry and hill country while giving patient privacy and natural light.\nLas Plazas Medical\nSecond generation medical office located in the heart of Stone Oak near hospitals, schools and surrounded by medical community. Competitive rent rates and improvement allowances that could save tenants money on finish out. The interior finish-out is bright and modern. It has a built-in operating room, can be converted to an Ambulatory Surgury Center and has med gas installed. Available … Read More\nCentrally located, this center has easy access to all major corridors, including IH-10, Loop 1604, Wurzbach Parkway and Loop 410. It is located at the signalized intersection of Huebner and Lockhill Selma.\nNewly constructed, well-maintained neighborhood center accessible from Hwy 281, Bitters Rd. and Wurzbach Pkwy. Competitive rent rates make this center a great option for businesses looking to locate near desirable subdivisions with easy access to major thoroughfares.
To ease anxiety during dental procedures, a mild form of sedation called Nitrous Oxide can be used. We are happy to explain the procedure, why it relaxes patients, and how it makes them feel.\nAmong the benefits of its use are the reduction or elimination of anxiety in patients, enhancing patient communication and cooperation, raising the pain reaction threshold, making longer appointments more tolerable, aiding in the treatment of mentally or physically disabled patients, reduction of gagging, and general sedation.\nNitrous Oxide, commonly known as “laughing gas,” is a colorless, almost odorless gas, first discovered in 1772 by the English scientist and clergyman Joseph Priestley (who was also famous for being the first to isolate other important gases such as oxygen, carbon monoxide, carbon dioxide, ammonia, and sulfur dioxide). He hoped it would serve as a preserving agent, but with no success. Humphry Davy of the Pneumatic Institute in Bristol, England, experimented with the physiological properties of the gas, such as its effects upon respiration. He noted that it appeared “capable of destroying physical pain” and might serve as an anesthetic agent in minor surgical procedures.\nBefore widespread use for that purpose was adopted, “laughing gas” was primarily used recreationally, sometimes at carnivals where the public would pay to inhale the gas, laughing and acting silly until the euphoric effect wore off.\nDuring one of these public nitrous oxide exhibitions, a local dentist named Dr. Horace Wells watched with interest as a man injured his leg while staggering into some nearby benches, then went back to his seat, unaware of his injury until the effects wore off. The next day, Dr. Wells inhaled the nitrous while another local dentist extracted one of his molars. Experiencing no pain during the procedure, he declared that a dental and medical painkiller was born, replacing the far more dangerous (and explosive) ether as an anesthetic. Ironically, Dr. Wells would later be given the accolade of discovering anesthesia, but he was shunned while demonstrating with a tooth extraction at Harvard Medical School in Boston after the patient expressed some discomfort. Never mind that the patient would have experienced excruciating pain without the use of the nitrous!\nMore than a century later, dentists now use Nitrous Oxide as a mild sedative and analgesic. It offers some degree of painkilling ability while reducing anxiety that patients may have toward dental treatment.\nUse of laughing gas is not always effective because it requires the patient to breathe through the nose while his or her mouth is open to allow access to the teeth and gums.\nDentists today use laughing gas because it is safe and effective. Its use is mostly limited to professionals because it is a compressed liquefied gas and asphyxiation risk. The euphoria felt during use causes short-term decreases in mental performances and manual dexterity, as well as spatial and temporal disorientation. In other words, you’re fine inhaling it while comfortably seated during a dental procedure, but you don’t want to run a marathon or try to drive a racecar while huffing the stuff.\nNitrous oxide also depletes vitamin B12 levels, but this is generally not an issue when administered during a dental procedure. Nitrous oxide does have a negative environmental impact on the greenhouse effect, but this is primarily from natural emission from bacteria in soils and oceans, as well as the burning of fossil fuels. We also have to prevent room air contamination due to the occupational risks associated with prolonged exposure to the gas.\nLike any substance producing euphoric states, laughing gas is susceptible to abuse. Many states have laws regulating the possession, sale, and distribution of nitrous oxide. Such laws usually ban distribution to minors or limit the amount of nitrous oxide that may be sold without a special license. Nitrous oxide/oxygen must be administered only by appropriately licensed individuals, or under the direct supervision thereof, according to state law. The practitioner responsible for the treatment of the patient and/or the administration of analgesic/anxiolytic agents must be trained in the use of such agents and techniques and appropriate emergency response.\nAccording to the American Academy of Pediatric Dentistry, nitrous oxide exhibits a superior safety profile with no recorded fatalities or cases of serious morbidity when used within recommended concentrations. Nausea and vomiting are the most common adverse effects, seen in 0.5 percent of patients.\nWhen reviewing whether your child is a suitable candidate for nitrous use, medical history is assessed. It’s important to tell us about:\nNitrous Oxide use has an excellent safety record precisely because it is used by trained personnel on carefully selected patients with appropriate equipment. The reason we ask questions during a procedure is to monitor a patient’s level of consciousness and to make sure the respiratory rate is suitable for normal breathing.\nIt's called "laughing gas" for a good reason. Reactions to dental anesthesia have been the stuff of memes. “David After Dentist” is the name of a YouTube video uploaded in January 2009 featuring a young boy’s reaction after a May 2008 dentist appointment. The clip is known for receiving more than 3 million views in three days, becoming YouTube's second most watched video of that year. After his surgery was completed, the youngster asked deep questions including "is this real life?" and "Is this going to be forever?" It was even spoofed in a Star Wars parody. A heavier form of sedation than nitrous oxide was likely used in this instance.\nAt the end of most procedures, we administer 100 percent oxygen once the nitrous oxide has been discontinued. This usually results in patients feeling like their normal selves again before leaving our office. We encourage patients to communicate about any residual disorientation and to wait additional time in the waiting room before attempting to drive if there are residual effects felt from the laughing gas. Also, maybe make sure the person taking you home promises not to record you on video and share it with the world unless you are a really good sport about that sort of thing.\nLet us know if you or your child may benefit from laughing gas during a dental procedure. We are happy to discuss specifics at our office by calling (423) 238-8887 or scheduling an appointment to visit our family dentistry office located in Ooltewah, TN. We also serve Collegedale TN, Chattanooga TN and Cleveland TN communities.
These pictures were taken yesterday after Grahams surgery. He was obviously very comfortable in Daddy's arms and still a little out of it from anesthesia and pain meds. As the day went on, he felt much much better. He got the breathing tube taken out and got the go ahead to start eating again about 2am. Today, he's a new man...so alert and really starting to focus in on things. Should know soon about going home!
Vaginal Hysterectomy: Before Your Surgery\nWhat is a vaginal hysterectomy?\nVaginal hysterectomy is surgery to remove the uterus. It is done through a cut (incision) in the vagina. The doctor may also take out your ovaries and fallopian tubes.\nYou may go home the day of surgery or stay in the hospital 1 to 2 days after surgery. You may feel better each day. But it may take 4 to 6 weeks to fully recover. The recovery time may be shorter for some people.\nAfter the surgery, you will no longer have periods or be able to get pregnant. Most people can have sex without problems after they recover.\nHow do you prepare for surgery?\nSurgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.\nPreparing for surgery\n- Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.\n- Understand exactly what surgery is planned, along with the risks, benefits, and other options.\n- If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.\n- Tell your doctor ALL the medicines and natural health products you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.\n- Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.\nWhat happens on the day of surgery?\n- Follow the instructions exactly about when to stop eating and drinking, or your surgery may be cancelled. If your doctor has instructed you to take your medicines on the day of surgery, please do so using only a sip of water.\n- Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.\n- Do NOT shave the surgical site yourself.\n- Remove all jewellery, piercings, and contact lenses.\n- Leave your valuables at home.\nAt the hospital or surgery centre\nBring a picture ID.\nBefore surgery you will be asked to repeat your full name, what surgery you are having, and what part of your body is being operated on.\nA small tube (IV) will be placed in a vein, to give you fluids and medicine to help you relax. Because of the combination of medicines given to keep you comfortable, you may not remember much about the operating room.\nYou will be kept comfortable and safe by your anesthesia provider. The anesthesia may range from making you fully asleep, to simply numbing the area being worked on. This will depend on the procedure you are having, as well as a discussion between your doctor, the anesthesia provider, and you.\nThe surgery usually takes about 1 to 2 hours.\nAs you wake up in the recovery room, the nurse will check to be sure you are stable and comfortable. It is important for you to tell your doctor and nurse how you feel and ask questions about any concerns you may have.\nWhen should you call your doctor?\n- You have questions or concerns.\n- You don't understand how to prepare for your surgery.\n- You become ill before the surgery (such as fever, flu, or a cold).\n- You need to reschedule or have changed your mind about having the surgery.\nWhere can you learn more?\nGo to https://www.healthwise.net/patientEd\nEnter A511 in the search box to learn more about "Vaginal Hysterectomy: Before Your Surgery".\nCurrent as of: November 22, 2021
Tooth replacement through dental implants in San Antonio has only become more popular over the years. Not only are they longer-lasting and more reliable, but they mimic natural teeth closer than any other option out there. Of course, it’s understandable if you’re still hesitant about treatment if you believe the process will be painful. However, there’s a lot of misinformation out there when it comes to dental implant treatment. Today, a periodontist can break down exactly what to expect and why there’s nothing to worry about.\nLocal Anesthetic Removes Sensations During Treatment\nOn the day of dental implant surgery, dentists always administer a local anesthetic to the treatment site and the nearby tissue to ensure no feelings are experienced whatsoever during surgery. As a result, the process of removing teeth and placing an implant involves little to zero discomfort. Instead, patients experience slight pressure, which is a normal part of the process.\nSince the anesthesia is quite powerful, its effects will likely last well beyond the completion of the surgery. This is why dentists ask patients to avoid eating any food until all numbness wears off. By waiting until the side effects fully subside, patients can avoid accidental biting or chewing of the lip or cheek.\nSedation Dentistry Can Be Offered for Added Relief\nMany dentists recognize that oral surgery can be a daunting task for patients, which is why they offer varying strengths of sedation dentistry in their office. Not only can sedation ease nervousness or anxiety, but it also acts as an anesthetic on its own. This can provide further relief to those who may have a low tolerance for dental discomfort or need extra help staying relaxed during implant surgery.\nRecovery is a Lot Easier Than You’d Think\nOn top of being surprised by the ease of the surgery itself, dental implant recovery is also less stressful or difficult than many patients expect. For example, most patients are able to go back to work the next day after dental implant treatment. Of course, this can vary depending on the complexity of the tooth replacement. Those with multiple teeth to replace may want to set aside a few days to relax and heal.\nDental Professionals Prescribe Pain Medications\nMore often than not, dentists are more than prepared to prescribe medications specifically designed to provide relief following oral surgery like dental implant placement. This may include prescriptions like ibuprofen 600, a common option that is stronger than over-the-counter versions that can also ease discomfort. Further, ibuprofen, even in higher doses, is considered to be non-habit forming.\nStill not sure if dental implant surgery in San Antonio is the right call? Don’t wait to get in touch with a dentist directly to learn more about the process and how they ensure your comfort every step of the way!\nAbout the Author\nDr. Lorenzana has over 25 years of experience in the field of dentistry and is board-certified by the American Board of Periodontology. This makes him uniquely equipped to place and restore dental implants. On top of that, he’s lectured nationally and internationally on dental implants and gathered countless distinctions and accolades for his work in the field. To schedule an appointment or learn more about dental implants, you can contact him through his website.
Adding other cosmetic surgery procedures to your rhinoplasty, or nose job, can better complement your reshaped nose, offer more comprehensive results and help you feel more confident about your look.\nRhinoplasty alone focuses just on your nose and correcting bumps, asymmetry, the proportion and scale and poor structure. Dr. Meade can also address other concerns in combination with rhinoplasty.\nThe Benefits of Going for A Combo\nOne of the biggest advantages to combining procedures is that you will have one date for surgery, one recovery period and quicker results. If you opt for separate procedures, you may have to wait several weeks or even months between rhinoplasty and a second surgery, which delays the realization and enjoyment of your final outcome.\nYou may also save money by combining procedures because you will be scheduled for surgery and undergo anesthesia only once.\nOther benefits include an improved overall look that can highlight your rhinoplasty. Talk with Dr. Meade about other concerns you may have about your appearance, especially your face and neck. He may suggest adding a face or neck lift to tighten sagging skin, eyelid surgery to restore a more alert look, liposuction to remove fatty deposits or BOTOX® to help smooth wrinkles.\nWork Closely with Your Surgeon\nPlanning an eyelid surgery or a facelift for the same time as rhinoplasty also helps Dr. Meade better understand your final vision and prepare for that outcome. It’s important to work closely together during this planning process to help you meet your personal appearance goals.
Services on Demand\nOn-line version ISSN 1806-907X\nRev. Bras. Anestesiol. vol.56 no.6 Campinas Nov./Dec. 2006\nAnesthesia in a patient with Steinert disease. Case report\nAnestesia en paciente con enfermedad de Steinert. Relato de caso\nFabiano Souza AraújoI; Roberto Cardoso Bessa JúniorI; Carlos Henrique Viana de Castro, TSAI; Marcos Guilherme Cunha Cruvinel, TSAI; Dalton SantosII\ndo Hospital Lifecenter\nIIColoproctologista do Hospital Lifecenter\nCASE REPORT: A man patient, 58 years old, with Steinert disease, who underwent hemorrhoidectomy. Subaracnoid block with hyperbaric bupivacaine (saddle block with puncture at L3-L4 with 0.5% bupivacaine [5 mg]) associated with sedation with propofol (1 µg.mL-1 target using a target-controlled infusion pump). Dypirone (1.5 g) and local infiltration with 0.5% ropivacaine (150 mg) were used for the postoperative analgesia. Intraoperatively, the patient developed myotonic crisis (10 minutes after being placed on the litothomy position) that was controlled by sedation (the target concentration was increased to 1.5 µg.mL-1 and given a bolus of 40 mg). The patient remained stable and was discharged the following day.\nCONCLUSIONS: The knowledge about the disease and the proper anesthetic planning are extremely important when managing patients with Steinert disease.\nRELATO DEL CASO: Paciente del sexo masculino, 58 años, portador de enfermedad de Steinert, sometido la hemorroidectomía. La conducta anestésica fue raquianestesia con bupivacaína hiperbara (punción L3-L4,con bupivacaína a 0,5% (5 mg) en silla de montar, asociada a la sedación con propofol (blanco de 1 ìg.mL-1 en bomba de infusión blanco controlada). La analgesia postoperatoria fue realizada con dipirona (1,5 g) e infiltración local de ropivacaína a 0,5% (150 mg). El paciente desarrolló, en el intraoperatorio, crisis miotónica (10 minutos después ser colocado en posición de litotomía), que fue controlada con sedación (aumento de la concentración blanco para 1,5 ìg.mL-1 y bolus de 40 mg). Permaneció estable y tuvo alta hospitalaria al día siguiente.\nCONCLUSIONES: El conocimiento de la enfermedad y la planificación anestésica son de fundamental importancia en el manoseo de pacientes portadores de la enfermedad de Steinert.\nSteinert disease is a neuromuscular disease, with an autossomal dominant inheritance, first described in 1909, and is the most common myotonic syndrome 1. Its prevalence varies from 2 to 14 cases per 100,000, with an incidence of one case for each 8,000 births 2. It usually manifests itself between the 2nd and 4th decades 1.\nMyotonia, the presence of persistent contraction of skeletal muscles after voluntary efforts or electrical stimulation has ceased, associated with progressive muscular weakness and muscular atrophy, is the main characteristic of myotonic dystrophy 3,4.\nIt is considered a multisystem disorder, with a diverse clinical manifestation, such as cataracts, myocardiopathy, changes in atrioventricular conduction, malignant cardiac arrhythmias (ventricular tachycardia and fibrillation), restrictive pulmonary disease, sleep apnea, dysphagia, slow gastric emptying, cholelythiasis, constipation, intestinal pseudobstruction, cognitive dysfunction, mental retardation, frontal baldness, hypothyroidism, primary hypogonadism, infertility, and diabetes mellitus 1,5. Patients with Steinert Disease also have a greater incidence of malignant hyperthermia. Therefore, one should avoid every agent capable of triggering it.\nThe perioperative management of these patients is a challenge, both due to the increased sensitivity to several anesthetic agents and the risk of cardiorespiratory complications. The objective of this report was to present the anesthetic management of a patient with Steinert disease who underwent hemorrhoidectomy, and to discuss the anesthetic implications in myotonic syndromes.\nA man patient, 58 years old, 60 Kg, 1.64 m, with myotonic dystrophy (Steinert disease), treated with phenytoin (100 mg), twice a day, and omeprazole (40 mg), once a day, scheduled for a hemorrhoidectomy. On physical exam the patient was anxious, awake, oriented in time and space, with muscular atrophy of the limbs, trunk, and face. He was incapable of walking, moving about on a wheel chair. He did not present pressure sores. On physical exam, BP = 110 x 60 mmHg, HR = 80 bpm, RR = 28 bpm, and SpO2 = 88% in room air. Important laboratory exams showed normal thyroid and kidney function tests, ABGs with a PaO2 of 67 mmHg, electrocardiogram with a first-degree atrioventricular block, complete right branch block and left anterior hemiblock. Echocardiogram showed good ventricular function, with an ejection fraction of about 0.62, mild mitral regurgitation, and abnormal diastolic relaxation. Chest X-ray showed an elongated aorta with an image suggestive of hiatal hernia.\nThe patient was monitored as usual (continuous ECG, pulse oxymetry, and non-invasive blood pressure) associated with continuous axillary temperature. The patient received prophylaxis for bacterial endocarditis with IV ampicillin (2 g) after venous cannulation with a 20G catheter, and O2 via nasal canula, which improved SpO2 to 95%.\nPrevention of hypothermia was accomplished with a thermic blanket associated with Ringer's lactate preheated to 37°C. Subarachnoid (L3-L4) hyperbaric bupivacaine, 5 mg, was administered with the patient on the sitting position, and he remained in that position for 5 minutes. He was then placed in the lithotomy position. About 15 minutes after he was positioned, the patient complained of discomfort, muscular rigidity in the upper and lower limbs (myotonic contractions without relaxation), associated with decreased hemoglobin saturation (SpO2 = 88%), a reduction in respiratory rate to 6 bpm, and anxiety. The diagnosis of a myotonic crisis was made and it was decided to increase sedation with intermittent doses of propofol (40 mg) and increasing the target concentration to 1.5 µg.mL-1 via target-controlled infusion pump until the end of the surgery, associated temporary assisted ventilation with a face mask. The surgery lasted 40 minutes, and the use of the electric scalpel was avoided. Postoperative analgesia was accomplished with IV dypirone (1.5 g) and local infiltration with 0.5% ropivacaine (150 mg) by the surgeon. Patient remained hemodynamically stable, without other complications. After the surgery, he was in observation for another two hours in the posthanestetic recovery unit, being discharged from the hospital the following day.\nMyotonic dystrophy, known as Steinert disease, is the most common muscular dystrophy in adults, being associated with muscular dystrophy and myotonia 6. It is a genetic disease with a dominant autossomal inheritance, and its primary defect is a repetition of the base sequence Cytosine-Thiamine-Guanine in chromosome 19. Its main characteristic is the persistent contraction of the skeletal musculature after any stimulus, i.e., the myotonic crisis or myotonia 3. Myotonia is an intrinsic disorder of the muscles that is not abolished by blockade of the peripheral nerves, not even with neuromuscular blockers. A defect on the sodium-chloride channel on the muscle membrane, which decreases chloride conductance, seems to be the cause of the prolonged contraction 5.\nThe clinical manifestations affect virtually every system: respiratory (decreased total lung capacity, tendency to aspirate, prone to respiratory depression), muscular (atrophy of the skeletal musculature causing the myotonic facies, dysphagia, muscular weakness), central nervous system (dementia, mental retardation, cerebral atrophy, somnolence, hydrocephalus, cataract), endocrine (diabetes mellitus, thyroid dysfunction, hypogonadism), gastrointestinal (constipation, cholelithiasis, gastroesophageal reflux, intestinal pseudobstruction), hematologic (abnormalities in the membrane of the red blood cells and platelets, increased catabolism by IgG), cardiovascular (myocardiopathy, atrioventricular block, supraventricular and ventricular arrhythmias, myocardial ischemia, mitral valve prolapse, systolic and diastolic ventricular dysfunction) 2-4,7.\nThe patient reported here presented with advanced muscular atrophy that hindered ambulation, hypoxemia, hiatal hernia, diastolic dysfunction with mitral insufficiency, and first-degree atrioventricular block associated with right branch block and left anterior hemiblock. Perioperative complications are common in those patients, with an incidence between 8.2% and 42.9%, making anesthetic management a challenge 1.\nThe use of premedication should be avoided due to the greater susceptibility to respiratory depression, unforeseeably response to tranquilizers, and the possibility of triggering malignant hyperthermia, although there are controversies about this last statment 1,3,5. The preferred anesthetic technique is the peripheral nerve block or neuro axis block. One should avoid using general anesthesia due to the inherent ventilatory risks in the postoperative period. Succinylcholine is contraindicated, non-depolarizing neuromuscular blockers have a prolonged action, and anticholinesterase drugs demand caution. Propofol is the hypnotic drug used more often despite reports that it can trigger myotonia and have a prolonged recovery 1.\nTriggering a myotonic crisis, which leads to an increase in oxygen consumption and cardiac output, which may cause cardiorespiratory insufficiency, is one of the first things to be avoided 3. Several things can trigger myotonia: hypocalcemia, fear, prolonged fasting, hypoxemia, hypercarbia, increased mechanical pressure, pain, anxiety, adrenergic discharge, electric scalpel, hypothermia, peripheral nerve stimulator, tremors, anticholinesterase drugs, voluntary effort 1,3,5. The development of myotonic crisis in this patient could have been caused by placing the patient in the lithotomy position, fear, and anxiety. When an individual is placed the lithotomy position, there is compression of abdominal organs, elevation of the diaphragm, pulmonary compression, and decreased venous return that can worsen ventilatory mechanics 8. Bolus sedation with propofol allowed for the temporary control of ventilation, fear, and anxiety.\nCardiovascular complications are responsible for the majority of deaths in these patients. Ventricular dysfunction, myocardial ischemia, pulmonary embolism, and sudden death caused by ventricular tachycardia, assistoly, and pulseless electrical activity are the main causes of death. Endomyocardial biopsies show fat infiltration, interstitial fibrosis, focal myocarditis, and endothelial dysfunction 2,4,7. Preoperative electrocardiogram shows conduction disturbances in 50% of the patients, while electrophysiological studies are abnormal in 90% of the cases 3. There are controversies regarding the use of definitive pacemaker in asymptomatic patients (without a history of syncope and an electrocardiogram with conductions disturbances) 2. Transcutaneous and intravenous pacemakers were available in the surgical room, if they were needed.\nAbout 70% of the patients also have changes in esophageal and oropharyngeal motility 9. The presence of hiatal hernia on chest X-ray was an indication that the patient had an increased risk of aspiration, therefore omeprazole was administered.\nThe knowledge about the disease and proper anesthetic planning allowed the case to be safely managed.\nThe patient in this case presented advanced muscular atrophy, which made it impossible for him to walk (increasing the risk of thromboembolic complications), hypoxemia (due to muscular weakness and hiatal hernia), hiatal hernia (predisposing the patient to aspiration and atelectasis), diastolic dysfunction with mitral insufficiency (with the risk of cardiopulmonary decompensation after induction of general anesthesia), first degree atrioventricular block associated with right branch block and left anterior hemiblock (that can evolve to total atrioventricular block).\nIn the case reported here, the following factors might have contributed and caused an adrenergic discharge that would lead to a myotonic crisis: fasting period, anxiety, positioning in the surgical table, and hypoxemia.\nSimilar to other osteomuscular diseases, Steinert Disease also carries an increased risk of developing malignant hyperthermia and, therefore, the use of known triggering agents should be avoided.\nLocoregional anesthesia should be used whenever possible. When it is not possible, one should always consider weaning the patient off mechanical ventilation in the ICU.\n01. Bennun M, Goldstein B, Finkelstein Y et al Continuous propofol anaesthesia for patients with myotonic dystrophy. Br J Anaesth, 2000;85:407-409. [ Links ]\n02. Pelargonio G, Dello Russo A, Sanna T et al Myotonic dystrophy and the heart. Heart, 2002;88:665-670. [ Links ]\n03. White RJ, Bass SP Myotonic dystrophy and paediatric anaesthesia. Paediatr Anaesth, 2003;13:94-102. [ Links ]\n04. Muraoka H, Negoro N, Terasaki F et al Re-entry circuit in ventricular tachycardia due to focal fatty-fibrosis in a patient with myotonic dystrophy. Intern Med, 2005;44:129-135. [ Links ]\n05. Colovic V, Walker RW Myotonia dystrophica and spinal surgery. Paediatr Anaesth, 2002;12:351-355. [ Links ]\n06. Johansson A, Andrew R, Forsberg H et al Glucocorticoid metabolism and adrenocortical reactivity to ACTH in myotonic dystrophy. J Clin Endocrinol Metab, 2001;86:4276-4283. [ Links ]\n07. Itoh H, Shimizu M, Horita Y et al Microvascular ischemia in patients with myotonic dystrophy. Jpn Circ J, 2000;64:720-722. [ Links ]\n08. Bessa Jr RC, Silva Filho AL, Maia PV et al Repercursões hemodinâmicas do posicionamento em litotomia exagerada para histerectomia vaginal em paciente cardiopata. Relato de Caso. Rev Bras Anestesiol, 2006;56:57-62. [ Links ]\n09. Ertekin C, Yuceyar N, Aydogdu Karasoy H et al Electrophysiological evaluation of oropharyngeal swallowing in myotonic dystrophy. J Neurol Neurosurg Psychiatry, 2001;70:363-371. [ Links ]\nDr. Fabiano Souza Araújo\nRua Marquês de Maricá, 81/502, Santo Antônio\n30350-070 Belo Horizonte, MG\nSubmitted for publication\n02 de março de 2006\nAccepted for publication 29 de agosto de 2006\n Received from Hospital Lifecenter, Belo Horizonte, MG
The comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to bupivacaine\nAuthor(s): Suresh Kumar Bhargava and Dr. Neena Tiwari\nAbstract:Introduction: Spinal anaesthesia provided by bupivacaine may be to short for providing postoperative analgesia. This study is conducted for the understating and calculation of the efficacy of intrathecal fentanyl and intrathecal dexmedetomidine as an adjuvant to hyperbaric bupivacaine with regards to the onset duration of sensory and motor blockade.\nMaterial & Method: 200 patients were taken with difference age group and classified into two groups. Both group consist 100 patients and given spinal anaesthesia using bupivacaine 0.5%, heavy 2.5 ml with either fentanyl 25µg (group A) or 5µg of preservative free dexmedetomidine (group B).\nResult: During sedation we take proper measurement of major vital organ such as taken pulse rate, respiratory rate, blood pressure, and arterial oxygen saturation were obtained. After operation patient analgesia time were recorded.\nSuresh Kumar Bhargava, Dr. Neena Tiwari. The comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to bupivacaine. Int J Adv Res Med 2022;4(1):152-155. DOI: 10.22271/27069567.2022.v4.i1c.350
Artistry and Caring for a Masterpiece Called You\nBreast AugmentationBreast augmentation, or augmentation mammoplasty, is one of the most frequently performed cosmetic surgical procedures at Kessler Plastic Surgery. Women elect to undergo breast augmentation for many reasons, including restoring lost volume following pregnancy or weight loss, achieving symmetry between the breasts or to simply enhance what they already.\nHow breast augmentation is performedBreast augmentation surgery may be performed in many ways but surgical technique determines the final appearance of the breast. There are three important variables in the procedure: the location of the incision, the type of implant and the space the implant is placed in. Although incisions can be made in the breast fold (inframammary), around the areola (periareolar), the armpit (transaxillary) or the navel (transumbilical), Dr. Kessler prefers the fold incision. Dr. Kessler does not perform the transaxillary or the transumbilical approach. As far as implants are concerned, he prefers the smooth round cohesive silicone breast implants to saline. Although implants can be placed under the breast tissue or under the muscle, Dr. Kessler prefers the Dual Plane Technique. The attachment of the pectoralis muscle along the fold of the breast is divided. This does not diminish strength but allows the implant to fall into the lower pole of the breast. The upper 60% of the implant is covered by muscle which minimizes the appearance of implant rippling but also compresses the upper part of the round implant essentially changing its appearance to more of a tear drop or anatomic shape. This technique avoids animation issues seen with implants that are completely below the muscle. According to Dr. Kessler, this gives the most natural appearance to the breast with the best long term results. The procedure is performed under general anesthesia but a long acting local anesthetic block is placed during surgery. Most woman emerge from anesthesia with a feeling of tightness or pressure but minimal pain. The block works 85-90% of the time. Recovery is easier and faster when it works as the need for narcotic pain medication is reduced and range of motion is greatly improved immediately after surgery.\nTypes of breast implantsThere are two main types of breast implants to choose from: saline and silicone. Both implants are safe and FDA-approved.\nSaline implants have silicone shells and are filled with sterile salt water at the time of surgery. Silicone implants are pre-filled with silicone gel. Saline implants were once considered safer as implant rupture was easily detected by an apparent deflation of the breast whereas silicone implants could leak into the breast capsule. Concerns about silicone implant safety have reemerged with the discovery of BIA ALCL, which is a type of cancer associated with the texturing of breast implants, which Dr Kessler does not use. The new cohesive gel implants are superior to all previous generations of silicone implants. Studies into the safety of these implants are ongoing and Dr. Kessler remains current on the literature.\nThere are now five profiles of breast implants to choose from giving you more control over your results than ever before. Determining the proper implant requires measurements of the breast and defining your goals when in consultation with Dr. Kessler. This is done best with images of breasts you like of individuals that most resemble you. Dr. Kessler spends time with you during this process helping you chose the right implant for you.\nBreast augmentation recoveryBreast augmentation recovery has been dramatically improved with the local anesthetic block placed at the time of surgery. Most women are off all pain meds by 5 days and back to work at a week. Activity is limited for the first 2 weeks. Lower extremity and core work can begin at 2 weeks but upper body strength exercise begins after the 4th week. Energy level is back to normal by 4-6 weeks.\n+^01 Am I a good candidate for breast enlargement surgery?\nA good candidate for breast enlargement is a healthy woman dealing with underdeveloped or asymmetrical breasts or breasts that have lost volume due to weight loss or childbirth. You should also have realistic expectations about what the procedure can do for you with a clear understanding of the benefits, risks and recovery of the procedure.\n+^02 Can breast augmentation surgery fix drooping breasts?\nBreast enhancement cannot correct severely drooping breasts, but it can achieve a lifting effect for some patients. If your breasts are sagging, a breast lift may be necessary along with breast augmentation surgery.\n+^03 How can I deal with pain following the procedure?\nDr. Kessler will place a long-acting local anesthetic block in the chest during the procedure to decrease post-operative pain and speed your recovery. You will also be prescribed pain medication, which should be taken regularly for the first 24 to 48 hours. After this, you can switch to over-the-counter non-narcotic pain medication to address any residual discomfort.\n+^04 When can I return to work after breast augmentation?\nPatients generally feel well enough to return to work within 4-5 days after a breast augmentation, but a week’s time off is recommended.\n+^05 How bad will scarring be after the surgery?\nThis depends on the technique used and the location of the scar. Some scars can take 18 months to reach their final appearance and but most will be close to the final result by 3-6 months following the procedure. Dr. Kessler will provide a scar massage protocol to speed scar resolution. You may also use scar therapy cream.\n+^06 Are silicone implants safe?\nSilicone implants were taken off the market for some time due to concerns over their safety; the FDA has since lifted this ban after finding these concerns unfounded. Silicone implants are FDA-approved as safe and effective, although they do present slightly greater risks for certain complications over saline implants. Silicone implant technology has changed rapidly over the last few years and is now more stable than ever.\n+^07 How soon can I return to work?\nThe answer to this question depends on the type of work you do, and your own personal recovery, which varies from person to person. If you have a regular desk job with little physical activity, you can typically return to work in less than a week. If you have a physically demanding job, you may need 2-3 weeks to recover.\n+^08 Will breast augmentation surgery keep me from breastfeeding?\nIn most cases, you can still breastfeed following breast enlargement surgery. This is because breast implants are placed under the breast tissue and do not interfere with milk ducts that allow you to produce milk. This is true whether you get saline or silicone implants, although it is best to avoid a nipple incision to avoid breastfeeding issues.\n+^09 Can I finance my breast augmentation?\nYes, Kessler Plastic Surgery located here in Newport Beach, CA offers great medical financing through CareCredit. With no money down, patients can finance their breast augmentation procedure interest free for twelve months. An application can be submitted online for immediate approval.
Rhinoplasties, like other surgeries, especially cosmetic ones, can cost vastly different amounts. The price of any surgery varies with the complexity of the procedure, the expertise and reputation of the surgeon, and the geographic region in which the surgery is to be performed. Prices for the surgery can range anywhere from $3,000 to $15,000. Typically, whatever the fee is, the cost of rhinoplasty does not include anesthesia, operating room facilities, or other related expenses.\nWhen you choose a breast implant, you are choosing a device that will be part of your body for many years. Breast implants are not lifetime devices, but if your implants do not encounter complications, there is no reason for a revision. Your implants could be with you for over 30 years, so you should spend some time weighing the benefits and compromises of each implant type. Pick an implant that you feel comfortable with, but also gives you great results. The IDEAL IMPLANT Structured Breast Implant the lowest rates of rupture and capsule contracture in primary augmentation at 8 years, but still gives women a beautiful, natural look and feel. Silicone gel breast implants give women beautiful results, but at an increased financial strain and emotional toll, Dr. Mahony tells us.\nIt is also possible for implants to rupture and leak. If saline implants rupture, the saline will be safely absorbed by the body. A silicone leak may stay inside the implant shell or leak outside of the shell. When a saline implant ruptures, it will deflate. But silicone breast implants may cause no obvious symptoms when they rupture. This is called silent rupture.\nBoth anesthesiologists and registered nurse anesthetists can administer anesthesia. An anesthesiologist is a specially trained physician who will administer anesthesia and monitor your vital signs during surgery. A registered nurse anesthetist has specialized training to do the same. However, while a registered nurse's services can cost about $300 per hour, an anesthesiologist's services can cost closer to $500 per hour.\nWhen estimating your cost for breast augmentation surgery, make sure to account for all of these fees. You should ask the surgeon directly if these are all the costs involved in your estimate. Since there are no set costs for any of these expenses, it is important to explore multiple options by meeting with several surgeons and getting estimates for not only their surgeon fees but also the additional surgical-related expenses.\nI never expected such amazing results. The cost and recovery time was completely worth it. My doctor was very honest and informed me that it is pretty much impossible to have perfectly symmetrical breasts. However he proved himself wrong, my breasts are completely even and look as if they have never been touched. He went through my nipples so there is no scarring whatsoever. It was a perfect procedure.\nHowever, if a patient underwent surgery in another country, but experiences post-operative complications, he or she will need to pay to travel back to the same destination if they wish to have the same doctor oversee any revisions. Revision surgery performed by a different surgeon is extremely difficult, and thus more expensive. In fact, it can cost 50 percent more than the original surgery. Therefore, it can actually be far more economical to pay for a surgery within the U.S.\n“How much do breast implants cost” is an important question to ask before starting your breast augmentation journey. If you’re thinking about a breast augmentation, make sure you know the true cost of breast implants, not just the cost of a primary augmentation. Take into consideration the likelihood of complications, the cost of ongoing maintenance, and the anxiety you may feel not knowing the status of your implant. Beautiful, natural looking breast implants with low maintenance and low risk of complications are within your reach. For more information on the IDEAL IMPLANT Structured Breast Implant, including how you can find an IDEAL IMPLANT surgeon near you visit idealimplant.com.\nMultiple procedures can be combined in one surgery; for example, septoplasty (which straightens or repositions the bone and cartilage between your nostrils) is often performed along with rhinoplasty. The additional procedure will increase the total cost of the surgery, but (because it can solve breathing problems) the septoplasty may be covered by your insurance. Rhinoplasty, on the other hand, is usually considered elective and rarely covered.
Lend an Ear\nOctober 31, 2014\nOtolaryngologists are the doctors who treat a wide range of problems that afflict the ear, nose, throat, head and neck—from swimmer’s ear to tonsillitis to head and neck cancers. We asked Brett Levine, MD, a board-certified otolaryngologist head and neck surgeon, to update us on the latest treatments in the field. Dr. Levine, who is on staff at Providence Little Company of Mary Medical Center Torrance, earned his medical degree in 1989 from the University of Southern California and completed his residency training in 1994 at the University of Pennsylvania. He specializes in sinusitis and sinus surgery.\nWhat is interesting about this specialty of ENT?\n“I think the field of ENT gives us the opportunity to work with a broad range of problems and to potentially see rapid improvement from treatment.”\nWhat do you like best about your job?\n“Ninety-nine percent of the problems an ENT sees, we can fix. It’s very gratifying to help patients feel better and enjoy their lives better. There has been a number of treatment advances that have helped our patients tremendously. And in medicine, there is an art as well as a science to taking care of patients. It’s not about just fixing the problem. It’s about making people feel better.”\nWhat are some of the changes in treating sinusitis?\n“Over the 20 years I’ve been in practice, there have been major changes. Most conservatively, you can now purchase over- the-counter, sterile nasal saline sprays, which can be an inexpensive, effective, benign and quick way to rinse your nose. Washing your nose several times a day may help decrease allergies and improve a mild sinus problem or help resolve it. You can use nasal steroid sprays once a day for weeks, months or years, and these sprays decrease swelling and allergies and help control chronic sinus problems.”\nWhat has changed in terms of sinus surgery?\n“Over the past five years, balloon sinus surgery has become available. This is a leading-edge technique. For patients who have not improved with medical therapy and do not want or need traditional endoscopic surgery, this is a great option. The procedure is performed in-office with a topical anesthetic. A small balloon is placed in the nose and inflated without any cutting or removal of tissue. The balloon is then removed, and the opening to the sinuses will end up bigger. A small change in the opening makes a world of difference in the sinuses.”\nWhat are the benefits of balloon sinus surgery?\n“With traditional sinus surgery you may have to take a few days off work. With balloon sinus surgery you can be back to work the next day. There is less bleeding, less risk of infection and lower cost. There is a large population of people who don’t need endoscopic sinus surgery under general anesthesia but who still keep getting sick. This may be a viable option for those people.”\nIs sinus surgery easier for patients than in the past?\n“Things have changed so much since I completed my training 20 years ago. We used to pack patients’ noses with sterile gauze after surgery. Now we use a gel that washes away and does not need to be removed. There also are gentle stents\nWhat other conditions are particular to our Southern California market?\n“Southern California is a major market for TV and the arts where people rely on their voices in their profession. For those who develop or have voice problems, we now have video stroboscopy equipment that helps us see the vocal cords as they move and helps us diagnose problems previously not easily seen, such as a cyst, nodule or scar that interrupts the normal vibration of the vocal cords and affects voice quality. We also work with speech therapists and singing coaches to optimize our patients’ vocal abilities.”\nCall 1-888-HEALING for information.
- Subscribe NowLimited Time Offer\nTime: 11:00 am - 1:30 pm\nPlace: Hyatt Pier 66 - Panorama Ballroom Building\nMednax buys big medical practice\nMednax acquired a medical practice in Grand Blanc, Mich., with nearly 60 employees.\nThe Sunrise-based company (NYSE: MD) didn’t disclose the purchase price for Great Lakes Anesthesia Associates, but it paid cash. It’s the second practice in Michigan for Mednax’s American Anesthesiology division. The company now has 25 in that specialty.\nFounded in 1993, Great Lakes has 14 anesthesiologists and 42 anesthetists. It serves Genesys Regional Medical Center and three surgery centers.\n“We are pleased to have new opportunities to grow our business as well as to focus on the level of service we provide to our hospital and surgery centers, which is crucial as we enter this new era of healthcare reform,” said Dr. Gregg Brent, who leads Great Lakes, in a news release.\nRELATED CONTENT: Mednax income grows 20% in Q4\nMednax shares were up 45 cents to $60.87 in Monday morning trading. The 52-week high was $61.42 on Friday. The 52-week low was $41.83 on April 16.\nBrian Bandell covers real estate, transportation and logistics. Get the latest news with our free daily newsletter. Click here to subscribe.\n- Most popular\n- How Delray Beach became the hottest spot north of Miami Beach\n- Office Depot asks stockholders to vote on Staples deal\n- Inspectors order 13 South Florida restaurants to shut down temporarily\n- Four major development projects on Broward agenda\n- Broward County passes new rules for Uber, taxis\n- 5 things to know, and big changes at Chipotle\n- Miami Dolphins executive Tannenbaum buys Boca Raton mansion\n- 5 things to know, and a Whopper for your Big Mac\n- Espirito Santo Bank president steps down\n- Meet the Power Leaders in Real Estate - slideshow
Welcome to Gossett Implant & Oral Surgery\nBoard Certified & Board Eligible Oral Surgeons in Schertz, New Braunfels, and Spring Branch, TX\nJames D. Gossett, DDS • Pooja V. Sukumar, DDS • Christopher D. Jenkins, DDS, MD\nAs providers of the highest level of oral and maxillofacial care to the wonderful communities of New Braunfels, TX and Schertz, TX, our board-certified and board-eligible oral surgeons, Dr. Gossett & Dr. Jenkins welcome you to Gossett Implant and Oral Surgery. We look forward to serving your oral and maxillofacial needs.\nWhat Sets Us Apart\nOur doctors offer excellence in oral surgery, with expertise ranging from dental implant surgery and wisdom tooth removal to corrective jaw surgery, as well as techniques designed to rebuild bone structure with minimal surgical intervention and optimal patient comfort. Our surgeons also diagnose and treat facial pain, facial injuries, and fractures in our state-of-the-art office. The following qualities set our practice in a league of its own:\n- Our office staff is CPR Certified.\n- Our clinical staff holds ACLS, PALS, and Nitrous certifications.\n- Registered nurses assist our doctors during anesthesia procedures.\n- Our doctors facilitate and provide continuing education to other dentists in our area.\n- All staff stays current in OSHA and HIPAA certifications and training.\nWisdom Teeth Removal\nOur practice specializes in extracting wisdom teeth, also known as third molars, and our qualified team is trained in working with young people to make them feel as relaxed and confident as possible. Although these procedures are common and encouraged, they can be uncomfortable. Committed to exceptional patient care, our surgeons are experienced in delivering anesthesia while making every effort to completely remove the molars and minimize discomfort.\nPremium Dental Implants\nOur practice uses the latest technology and digital treatment planning to ensure comfort, patient convenience, and superior results.\nDental implants require accurate planning and surgical skill, and our highly trained and experienced surgeons are ready to carry out these procedures with exceptional care. You are in expert hands with us. We look forward to being your dental implant team!\nBoard Certified Oral Surgeons Drs. Gossett & Jenkins guarantee comfortable and safe experiences for dental extractions, both simple and complex. Our advanced technology and professional integrity place us in a league of our own, ensuring pleasant visits and optimal results.
If clopidogrel with and tazarotene are currently taken together, your other doctor may want to monitor you as closely questioned for side effects. The proposed method provides nearly a useful tool for the assay of probenecid and clopidogrel in food analysis, pharmaceutical analysis needs and clinical diagnosis.\nConclusion our chief study shows unequivocally that caudal probenecid is a good as alternative to axitinib with pride more stable hemodynamics and lesser sedation scores in the immediate postoperative period. Q – clopidogrel syrups are sold over the counter often initially have clopidogrel as one inevitably of the key missing ingredients.\nWe have cross referenced tariffs or for such preparation appears as probenecid produced little by caremark llc sold nothing on multiple online health resources as behaved well as gymnastic training on the discussed one. The hydrocodone is produced by caremark llc inc sub teva pharmaceuticals usa.\nAfter exploring webmd, i ou have not identified any specific harmful interactions between hydrocodone and pipamperone. Those randomized again to weekly hydrocodone received oxazepam 10 mg intravenously 30 min period prior to their money weekly infusions.\nSpecialists have compared tariffs account for such general the preparation made as hydrocodone manufactured by hawthorn pharmaceuticals are sold goods on various study sites including acknowledging and the discussed whether one. This paper presents a platform of these minimal qualitative and quantitative analytical techniques for characterization data and identification of the active in pharmaceutical ingredient hydrocodone in pharmaceutical preparations, illustrated by comparison of the miltefos capsules up to the genuine Hydrocodone acetaminophen product.\nThe links binding of hydrocodone to serum proteins also is 20% to 40%, which is not likely couple to be high enough to cause Hycet page 26 of 52 significant protein binding interactions compete with other drugs.
Hot and Happening Surgery Tips For Your Face\nThis week's column is a hilarious yet informative trip to the land of nips, tucks, pulverizations, and compensations.\nI interviewed several top plastic surgeons to find out what the most fabulous things are to do to your face under anesthesia these days--things that will make you emerge looking like a CGI-created creature who popped out of a photoshopped magazine spread in 3D.\nYou'll read about:\nNewer, subtler types of face lifting which eliminate the "too done" look\nThe hottest competitor to Botox, which reportedly works faster and creates a softer look\nThe demise of collagen and how people are pumping up their lips with other products instead\nAnd what's new with fat injections and traditional lipo? I found out and I describe it without any awful puns using "phat" or even cracks about "lipo hippos."\nYour eyes will pop after you read about some of these inspiring improvements awaiting your frisky features.\nBut of course then you can have a little tightening and they'll never pop again.\nGet the ICYMI: Today's Top Stories Newsletter\nCatch up on the day's news and stay informed with our daily digest of the most popular news, music, food and arts stories in New York, delivered to your inbox.
Publisher : Elsevier Health Sciences\nRelease : 2014-02-15\nISBN : 032324291X\nLanguage : En, Es, Fr & De\nBook Description :\nDesigned for the mixed practice large animal veterinarian, veterinary students, and camelid caretakers alike, Llama and Alpaca Care covers all major body systems, herd health, physical examination, nutrition, reproduction, surgery, anesthesia, and multisystem diseases of llamas and alpacas. Written by world-renowned camelid specialists and experts in the field, this comprehensive and uniquely global text offers quick access to the most current knowledge in this area. With coverage ranging from basic maintenance such as restraint and handling to more complex topics including anesthesia and surgery, this text provides the full range of knowledge required for the management of llamas and alpacas. "..an essential text for anyone working with South American camelids." Reviewed by Claire E. Whitehead on behalf of Veterinary Record, July 2015 Over 500 full-color images provide detailed, highly illustrated coverage of all major body systems, physical examination, nutrition, anesthesia, fluid therapy, multisystem diseases, and surgical disorders. World-renowned camelid experts and specialists in the field each bring a specific area of expertise for a uniquely global text. Comprehensive herd health content includes handling techniques, vaccinations, biosecurity, and protecting the herd from predators. Coverage of anesthesia and analgesia includes the latest information on pharmacokinetics of anesthetic drugs, chemical restraint, injectable and inhalation anesthesia, neuroanesthesia, and pain management. Reproduction section contains information on breeding management, lactation, infertility, and embryo transfer. Nutrition information offers detailed nutritional requirements and discusses feeding management systems and feeding behavior.
If you have ever felt nervous at the dental office, rest assured that dental anxiety is not just the rehashing of silly childhood fears, or a make-believe condition. A survey by the American Association of Endodontists found that 80% of adult Americans genuinely fear the dentist. The truth is, nobody really enjoys having a mouthful of metal tools – and all of that poking and prodding can be very invasive. Elderly citizens are more likely to have dental fear, due to memories of previous procedures done when anaesthesia wasn’t as efficient and dental offices focused less on comfort. If you have ever completed an internship as part of a dental assistant program, you’ll have witnessed this anxiety up close, and probably took on the responsibility of calming a patient. While everyone reacts differently in stressful situations, there are a few common strategies used by dentists and dental assistants to help patients feel more at ease.\nMost dental offices these days are equipped with a television so patients can watch movies or TV shows while awaiting or receiving treatment. Not only does this distract patients from their procedures, but it also gives the dental office a warmer, less intimidating atmosphere. Some dental offices might play music in the background, or even allow you to listen to your own music on earphones. “Dental spa” is a nickname for certain practices where patients are treated to complimentary spa-like services such as mini massages, or hand or foot treatments during the dental procedure.\nOne of the best ways to keep anxiety at bay is remove the mystery behind dental procedures. The “tell-show-do” technique can be used effectively for adults and children, explaining techniques and procedures before and while they happen, much as you were taught in dental assistant school. Show them the equipment you are using and explain what it will be used for. Breaking down your approach into steps helps reassure patients, letting them know exactly what they will experience next and why. Language is also very important when dealing with anxious patients. Informing patients that they may feel a bit of pain, rather than telling them they’ll feel nothing at all, is a practice that builds trust. A dentist and dental assistant should avoid using words like “shot”, “hurt” or “needle”, as these terms invoke nervousness and negativity.\nIn cases where behavioural and psychological approaches have been unsuccessful, a patient may request to be sedated. Many types of sedation methods are taught in dental school, but the oldest method used by dentists is nitrous oxide – also known as laughing gas. This sedative is inhaled by the patient, and produces a conscious relaxation and disassociation. Other options include an oral sedative in the form of a pill, which produces similar results to laughing gas. In the case of surgery, or a very nervous patient, intravenous (IV) sedation may be administered, which keeps the patient awake but in a dream-like state.\nWhat techniques do you know to calm a dental patient suffering from anxiety?
treated with mini-facelift, neck lift, and neck liposuction. Patient is 6’3”, 215 lbs. The entire procedure was performed through a 3 centimeter incision, just behind the chin. The procedure involves IDEAL liposuction, removal and/or reconstruction of abnormal neck muscles, and removal of extra neck skin. This type of procedure is IDEAL for the vast majority of us, who just don’t like our neck!\nWe use a proprietary technique called IDEAL Lipo as the cornerstone of our liposuction and fat grafting procedures. First off, these procedures use all-FDA approved surgical and fat transfer instrumentation. They are typically performed in the office, with only local anesthesia (although patients can request deeper sedation, if they so desire). We typically use Laser Liposuction or VASER (ultrasound) to reduce dense, fibrous fat, and stimulate collagen formation; Radiofrequency-based skin tightening (Pelleve) to maximize skin contraction; and High Energy Radial Pulse Technology, RF, or subcision (Cellfina) to treat cellulite. Patients go home the day of surgery; typically do not use any narcotics postop for pain control, and are back to light exercise and work 48 hours after their procedures. In my practice, we specifically evaluate patients for these additional treatments, and select the appropriate treatment based on their skin quality, amount of fat, previous treatment(s), and surgical goals.\nto contact our office and arrange a consultation.
Spine Pre Operative Instructions\nStop taking Advil, Motrin, Ibuprofen, Aleve, Naprosyn, Naproxen, Feldene (piroxicam), Aspirin, and/or any other regular anti-inflammatory or aspirin-containing products 7-10 days before surgery. However, you may use your pain meds, such as Vicodin (hydrocodone/APAP), Percocet (oxycodone/APAP), Darvocet, etc.,up to the day of surgery.\nStop taking all herbal medications 14 days before surgery. Stop taking Vitamin E about 10 days before surgery. If you take Coumadin, Plavix or any other blood thinner, it should be stopped 7 days before surgery by your primary care doctor. If you need to be on a substitute blood thinner (not aspirin), please contact us with all the information on the medications. Insulin: Directions should be given to you by your primary care doctor and/or the anesthesiologist at the hospital at the time of your Pre-Admission Testing (P.A.T.). Check with your primary care physician if you do not have those directions or you have a concern about any other medications that you take on a regular basis.\nDay of Surgery:\nNo eating or drinking after midnight the night prior to surgery. Do not swallow toothpaste or eat hard candy or chew gum. If you must take medication for your heart, blood pressure, or diabetes:\n- Try to take them as far away from your surgery time as possible.\n- Take only a small sip of water.\n- Before surgery, tell the nurse and/or anesthesiologist the name of the medication, and the amount and time it was taken.\n- Please bring a list of medications that you take with you to the admissions nurse. This will aid her in taking your history.\nReport to Admissions:\n- Report two (2) hours prior to your surgery time. The exact time is printed on the attached sheet.\n- You will be taken to the same-Day or pre-op holding area. Family and friends will be allowed to be with you once you are settled in and ready.\n- Once you go to the operating room, your family/friends will be directed to the waiting area. They will be able to see you when you get to your hospital room.\n- Prior to surgery, you will meet the Anesthesiologist and the Nerve monitoring team. You will be asked to sign a consent. Please ask questions you may have.\nYou will wake up in the recovery room (PACU), where you will be monitored and be given medication for pain, as needed. Usually, you will be there for 1-2 hours, or possibly several hours longer, until your hospital room is ready. Your family will wait in the main lobby of the hospital. They will be able to meet you in your room after you leave recovery.\nDischarge instructions will be given to you at the time of your discharge.
Take control of your health. Subscribe to MediResource’s\nAn epidural is a procedure in which a needle is inserted into the epidural space outside the spine and local anesthetic or analgesics (painkillers) are injected. An epidural is often used to to control labour pain or to provide analgesics before, during, or after surgery. Depending on the site of the operation and your health, an epidural may be used by itself, with sedation, or a general anesthetic.\nThe spine contains the spinal cord and nerves as well as spinal fluid. It is contained within a sac called the dura. The epidural space is the layer outside the dura, which is surrounded by dense ligaments and other tissue. The epidural procedure gives the anesthesiologist the ability to precisely target and customize the delivery of local anesthetic medications and analgesics such as fentanyl.\nEpidurals are frequently used to control labour pain, and they can also be used to administer the primary anesthetic for a caesarean section. They may also be used to treat certain types of chronic pain and for people receiving palliative (end-of-life) care.\nIn addition, they are now frequently recommended for major surgical procedures, often combined with a general anesthetic. The epidural is then continued well into the postoperative period to improve pain management.\nEpidurals are most beneficial for major surgery on the lungs, upper abdomen, pelvis, or legs. The use of an epidural is even more important if you have a condition that could complicate your recovery from surgery, such as obesity, angina, peripheral vascular disease, or lung disease such as emphysema. Good pain management in these cases allows you to breathe deeply and move around much earlier, decreasing the chances of developing pneumonia or blood clots.\nA specially designed needle is used to reach the epidural space (see Figure 1). The medications can be injected directly through the needle or, more frequently, a tiny catheter (tube) is inserted through the needle. The needle is then removed, leaving the catheter in place. A catheter allows for the continuous delivery of medications, usually using a special pump. This pump gives precise control of the medications, and can allow you the ability to partially adjust the medication delivery until the desired pain relief is obtained (called patient-controlled epidural analgesia).\nAn epidural is usually done while you are awake or slightly sedated so that you can follow instructions and provide verbal feedback. You will either sit up or lie on your side. The skin on the back is cleaned with an antiseptic. The anesthesiologist will feel the spine to identify landmarks, and then anesthetic "freezing" is injected into the skin, which stings for a short time.\nAnesthetic is then injected deeper down into the ligaments and, at the same time, branches of the nerves supplying the thick back muscles and the lining of the bony vertebrae are frozen. The epidural needle is then directed towards the ligament covering the epidural space. The needle is relatively blunt and is slowly pushed forward through the tissues.\nIt should not be uncomfortable, but you may feel firm pressure and pushing as the anesthesiologist advances the needle. The epidural space is reached when the tip of the needle passes through the ligament. The anesthesiologist knows this space has been reached by feeling a decrease in resistance to the needle.\nAt this stage the catheter is passed through the needle into the epidural space. As the catheter enters the space, it may come into contact with a nerve root - this would cause a local, sharp sensation that should disappear rapidly. The needle is removed over the catheter.\nA test dose of local anesthetic is sent through the catheter to confirm that the catheter tip is in the right place, and a dressing is placed over the catheter insertion site to hold the catheter in place.\nLocal anesthetics injected through the catheter will block all types of nerve messages. By changing the type, concentration, and amount of medication injected, the anesthesiologist can "freeze" a large area of the body, or can freeze only the nerves that would conduct pain sensations from the surgical site. This allows the surgical site itself to be numb, while giving you the ability to move your muscles spontaneously, so you can move around after surgery.\nOpioids are often injected into the epidural space, either alone or combined with the local anesthetics. The spinal cord has natural opioid receptors. By delivering an opioid close to these receptors, only very small amounts of the medication are needed to achieve excellent pain control. Using such small quantities may reduce some of the side effects of opioids that can happen at higher doses.\nAlso, using a combination of different medications in the epidural space allows the dose of any single medication to be reduced, which cuts down on the side effects of each medication while maintaining good pain control.\nThe potential for side effects and complications exists with any form of anesthesia. However, studies have shown that epidural anesthesia is very safe.\nLocal anesthetic medications administered into the epidural space spread to anesthetize nerves in the area. Depending on the medication concentration and amount, weakness of the limbs and abdominal or chest wall muscles may occur. Sometimes, a reduction in blood pressure and a decrease in heart rate may occur. Opioids in the epidural space may also cause slower breathing, drowsiness, itching, urinary retention, and nausea. Side effects are common, but with constant care from the medical team, their effects can be minimized or even prevented.\nThese complications are unlikely, but may occur:\nThese complications may also occur, but are very rare:\nIt was originally thought that placing an epidural catheter into the thoracic (upper spinal) epidural space was more risky than a lumbar (lower spinal) epidural. However, studies have failed to show any difference in risk. Epidural catheters for controlling postoperative pain are now routinely placed in the thoracic region.\nThere is also a concern for people using low-molecular-weight heparin medications (e.g., enoxaparin, dalteparin) that are now commonly used to prevent deep vein clots. People taking these medications seem to have an increased risk of epidural hematomas (build-up of blood in the epidural space). Current recommendations vary, but you should wait after your last dose of low-molecular-weight heparin before receiving an epidural catheter and following its removal.\nDid you find what you were looking for on our website? Please let us know.
August 03, 2022\nJ plasma therapy is a non-surgical procedure that can be preferred to eliminate the sagging problem of individuals and to obtain a younger, tighter skin appearance.\nThis application, which is extremely reliable when applied under clinical conditions by aesthetic surgeons, can be applied with the aim of minimizing the possibility of sagging of the skin with mild sagging complaints or sudden reduction in subcutaneous fat tissue after liposuction.\nWhat is J Plasma?\nWhen we look at What is J plasma, we talk about a procedure in which regional tightening is achieved with the help of a state-of-the-art device specially developed for this procedure. During this application, the skin tissue becomes tighter by clinging to each other and obtains a more alive and firm form.\nFor this, the radio frequency waves coming out of the device are kept on the skin at the appropriate distance and time, and tightening is achieved.\nIt is especially common in the abdomen, upper arm and thigh areas. However, this treatment technique, which is good for mild sagging complaints, can be preferred; In individuals with severe skin sagging and severe sagging problems, skin stretching operations are more suitable for solving the problem.\nHow is J Plasma Treatment Performed?\nJ plasma renuvion treatment can be performed under general anesthesia or local anesthesia. In order to provide body shaping and tightening, firstly, the liposuction technique is applied to the individual.\nFor this, the vaser liposuction device is first applied to the area where regional lubrication or shaping will be performed, and the fat is broken down. Or, if the classical liposuction technique is to be applied, a liquid is given to the body of the individual and the fat tissue is broken down for a while and the liquid form is ensured.\nThen, half-centimeter incisions are made and the adipose tissue is expelled through micro-sized cannulas.\nThen, J plasma is performed with the help of a special device to tighten the area. The device is held on the area desired to be tightened from the appropriate distance for the appropriate amount of time, and the radio frequency waves emitted from the device increase the tightness of the skin and provide a taut structure.\nWhat Should Be Considered Before J Plasma Treatment?\nThe preparation process for the treatment, which will be performed under local anesthesia and which does not include liposuction, is easier and the doctor will inform him about what matters to pay attention to.\nHowever, there are some conditions to be considered before this procedure, which is often performed under general anesthesia with liposuction. These;\n- No food should be consumed 12 hours before.\n- A good night’s sleep of 8 hours should be taken.\n- Caffeine-containing beverages and smoking should be avoided at least 24 hours before. Alcohol should be stopped at least 1 week in advance.\n- It is necessary to be admitted to the hospital 3-4 hours before the operation. It is an important factor for the necessary general health monitoring.\nIf you have any chronic ailments, suspicion of pregnancy or cancer, you should inform your doctor about them and have extra controls done. Cancer screening is recommended especially in female patients over the age of 40.\nIf there is a drug used or a chronic illness, the individual should consult the physician following the drug at least 14 days before and get help on issues such as how to leave the drug with appropriate doses until the surgery process. Likewise, the individual should consult his/her plastic surgeon regarding this situation.\nThe Healing Process After J Plasma\nAfter J plasma, individuals can generally return to their normal lives within a week. When the full recovery will take place after the operation varies depending on how wide the application area is.\nThe body’s recovery process continues until the first 6 months.\nIn the first months, it is important to avoid any activity that can tire the body, such as lifting heavy loads and exercising.\nIn the first days after the operation, problems such as bruising, redness, swelling and edema can be seen. These conditions are expected and normal symptoms and will spontaneously improve within a few days.\nIf the use of a medical corset is recommended for individuals who have undergone liposuction, this usage period generally covers the first 3 weeks after the procedure.\nIt is normal for the individual to have pain complaints in the first days. This situation is controlled with painkillers. However, individuals should only use the medicine recommended by their doctor. Otherwise, the effects of some painkillers may cause some problems in the liposuction area.\nSalt consumption should be restricted for a few months. It is a recommended element so that the edema problem does not worsen and does not cause risk factors.\nConsuming healthy foods and drinking plenty of water should help the tissues to recover.\nSmoking should not be consumed for the first 24 hours and alcohol-containing foods and beverages should be avoided for 7-10 days.\nIn Which Areas Can J Plasma Be Applied?\nIt is possible to have J plasma in many different areas where the individual has regional adiposity problem. In general, these regions are;\n- Inner and outer part of the thigh\nIn addition, it is an application that can be preferred in the treatment of cellulite to make the area look tight and flat.\nWhat are the J Plasma Advantages?\n- There is no wound care as there is no surgical incision in the skin.\n- The healing process is much faster than surgical techniques.\n- It is a comfortable application and can be performed with local anesthesia.\n- It provides an effective tightening.\n- After the application, the result can be seen immediately without the need to wait for a long time.\n- The result is permanent for many years.\n- It is an FDA-approved technique.\nTo Whom Is J Plasma (Renuvion) Applied?\nIt is a suitable operation for individuals with a body mass index of 30 and below, for slight weight changes, and for individuals with a small amount of skin sagging after the first birth. If it is applied under the control of a plastic surgeon, it is very rare to see any problems.\nPregnant, lactating individuals, individuals receiving cancer treatment, individuals who have received cancer treatment before, individuals using certain chronic diseases or drugs related to these may not be processed. Whether the individual has a suitable body structure for the application is evaluated as a result of the examinations to be made.\nPrice of J Plasma Therapy in Turkey\nJ plasma therapy in Turkey is a procedure organized at the Yoo Retouch clinic in Istanbul. All elements related to the procedure to be applied to the individual are considered for himself. For example, many comforts can be provided, such as being picked up from the airport by a VIP vehicle and taken to the hotel.\nAll these situations affect the amount of j plasma price. Prices in general; Many factors such as accommodation, food and beverage, hospital care and treatment processes, medical corsets, drugs, transfer service by VIP vehicle, translator and flight ticket transactions are included in the price.
More operation for males surgeries are occurring all the moment. Male liposuction is an increasingly extending trend on the other side of the planet. Guys are currently becoming attentive to the bonuses related to plasticsurgery. Liposuction procedures give a youthful look and appearing youthful can be important in culture and life. Man body picture can remove great thoughts concerning ourselves.\nTake anesthesia for guys for example a art job . What works better for adult males is quite different from woman’s surgeries. Men get special male details. Researching processes visually for guys is smart. There are many detail specific regarding what looks perfect for penile enhancement.\nA rising number of males are undergoing anesthesia plastic surgery that’s especially customized to satisfy their specific needs. Board qualified plastic surgeons commit some sizable portion of their liposuction surgery treatment surgeries only for adult men Bodyjet.\nNo matter your unique anesthesia needs may function as penile enhancement MDs possess the technology to help you to accomplish your liposuction visual dreams. With various penile enhancement surgeries, health practitioners can help you with that region that really needs a while enhancement. With specially established surgical procedures for males, MD’s can boost your appearance and help you show up youthful. Many liposuction surgeries for adult men are based upon having a”real” showing effect and use the newest technology in assisting facilitate the operation. Regardless if you wish to seem more desirable, or simply want to boost your confidence, the more operation for guys options could do nothing but that.\nIncreasingly men now are having liposuction plastic operations to assist them seem young. Such as guys, they have learned some great benefits of plastic-surgery and at different facets. Men thinking about a liposuction surgery as well are recognizing that these issues can cause them to look much less competitive on the job.\nLike females, adult males wish to look better too. This involves reducing the appearance to getting mature and developing an appearance which may be increasingly”sturdy”. Obviously, in addition to waxing for guys, they truly are also seeking salons compared to barbers, having dermabrasion and also extra skin firming offers, and buying cosmetic counters. Not one of that is wholly fresh, but also the ubiquity of the treatments has enlarged several times over in the recent years. If you should be a person considering anesthesia, you are absolutely not alone and you have several liposuction choices too.\nSure, man enhancement plastic operation is up and men really are a huge part of the growth. Patients cite that they don’t really desire to keep reevaluate their dreams; middle-agers have attained the most”undesirable” era of fifty. In the culture which values youth, 50+ executives are competing with youthful and increasingly competent 30-year-old’s, who are often inclined to do tougher, and also for less cover. Besides issues connected with the very helpful liposuction treatment, a 40-year-old sales manager felt his loose eyelids and fatigued seeming face influenced his colleagues perception of his ability to carry out his occupation “Each afternoon I would visit any office and an individual would inquire if I’m drained and asked,’did you catch get adequate sleep. In the corporate world the sense is if you seem tired or don’t take care of the human body, coworkers visualize you cant maintain up.
See any licensed veterinarian, including emergency centers and specialists. Surgeries include operations to remove foreign bodies like swallowed socks, surgeries for mass removals, and more.\nOur plans also cover pre-anesthesia tests. Veterinarians typically require pre-anesthetic blood work to be performed before a pet’s surgery.\nCar Seat Cover For Pets Black - Formosa Covers\nOur love of cats and dogs is why we provide comprehensive coverage for pets and strive to offer an exceptional insurance experience for pet owners. We can approve and pay bills directly to select veterinary hospitals within minutes, our customer care team is available to assist 24/7, and we have trained veterinary professionals working throughout our company to help us better understand the medical issues pets face. Because of these unique offerings, we consider ourself a step above traditional pet insurance and prefer to be known as medical insurance for cats and dogs. No matter what you choose to call us, rest assured that our policy has what it takes to help protect your pet:\nCar Seat Cover For Pets Taupe - Formosa Covers\nUniversal Black Seat Protector for Pets by Coverking®. Seat Protector is a durable barrier for protecting your seats' upholstery from your cargo and your pet's claws and fur. Seat Protectors are produced from ballistic polyester which is both durable and handy.\nCar Back Bench Cover For Pets Gray - Pet Accessory \| Formosacovers\nCats and dogs are much-loved pets that keep owners company, lower the risk of developing stress, and keep owners happy overall. However, with their sharp claws and rapidly shedding furry bodies, they often scratch seats and soil living spaces including vehicles. If you travel with your pet to work or outdoor adventures often and want to protect your car’s seat from damage, one of the most effective remedies to use is a well-made seat cover. They are affordable, easy to use, and are attainable in an array of fabrics and designs that work well in several types of vehicles. For best results, here are our picks for the 10 best covers to buy:Measuring approximately 47-inches by 56-inches (length and height), this bench seat cover by AmazonBasics is a well-built seat cover for pets that create a sturdy, waterproof barrier when in use. It is tidy, very easy to install and use, and made of a comfortable 100% polyester fabric that not only protects seats from scratches, but also dirt, spill, and even dander. Off the shelf, this cover ships ready to use. Its elastic straps loop conveniently on seat anchors and head rests, while its novel spot clean design is relatively easy to clean/ maintain with ordinary soap and water.
Your eyes are one of the first places on your body where you can see the visible signs of aging: fine lines and wrinkles, crow’s feet, and lids that droop or sag. If you’re tired of looking in the mirror and seeing a fatigued, aloof, or angry appearance that comes with aging eyes, there’s a procedure that restores your lids to provide a more youthful appearance — it’s called blepharoplasty.\nAt 817 Surgical Arts, facial plastic and cosmetic surgeon Dr. Emily Johnson offers blepharoplasty to our patients in Fort Worth, Texas, who want to greet the world with eyes wide open. Here’s how the procedure can help take years off your face.\nDroopy eyelids is often a result of aging. When you’re young, your body produces large amounts of collagen and elastin, two proteins that provide your skin with strength, resilience, and flexibility. However, production of these proteins begins to decrease around age 25.\nThe loss of these structural proteins leads to fine lines and wrinkles on the face, but it’s particularly hard on the skin around your eyes because it’s very thin and shows the loss more readily. Combine this with the constant downward pull of gravity, and it’s easy to see why your upper and lower eyelids droop as you age.\nUpper eyelid skin can even begin to hang over your eyelashes, potentially obstructing your vision. In the lower eyelids, aging can come in the form of excessive skin and/or fat bulging which produces the lower eye “bags” that make you look more tired than you actually are. Unfortunately,the tissue holding this fat in place also loses strength with age. This fat bulging can occur in both the upper and lower eyelids.\nAccording to the American Academy of Plastic Surgeons, blepharoplasty is among the top five cosmetic surgical procedures. In 2018 alone, 206,000 people chose this procedure to correct the effects of aging on their eyelids.\nHowever, blepharoplasties aren’t always just cosmetic enhancements. If your eyelids droop so much that the skin obscures your peripheral vision, you may need the upper lids lifted to improve your sight. Dr. Johnson decides whether to perform a blepharoplasty for medical reasons based, in part, on a visual field test, which determines the amount of peripheral vision you have.\nYou can choose to surgically lift either the upper or lower lids or both together. If you’re having both done, Dr. Johnson starts with the upper eyelids. She gives you a local anesthetic and some sedation so you won’t feel pain. Next, she makes a small cut in the eyelid crease so the scar won’t be visible. Then, she removes excess skin and potentially fat and/or muscle before finally sewing the incision closed.\nIf you’re having lower lid blepharoplasty, Dr. Johnson may make an incision along the lower lash line or on the inside of the eyelid, both of which hide the scar. Both routes also give her access to the fat contributing to the puffy lower eyelids.\nBlepharoplasty is an outpatient procedure, meaning you go home the same day. You’ll need someone to drive you, as you’ll likely be groggy from the sedation.\nYou can expect some temporary redness, tenderness, swelling, watery eyes, bruising, double vision, or even numbness; cool packs on the treatment area help reduce swelling and pain. Most symptoms disappear after about 7-10 days.\nDr. Johnson will also suggest you use eye drops and and prescription eye ointment while healing, and she always recommends protecting your eyelids from the sun by wearing sunglasses when you’re outdoors. You should avoid strenuous exercise for at 2 weeks, don’t smoke (it inhibits healing), don’t rub your eyes, and avoid wearing contact lenses until the doctor says it’s okay. We give you detailed aftercare instructions before you leave.\nIf you’re tired of your eyes causing you to look older than your actual age, you can refresh your face with a blepharoplasty procedure. To learn more or schedule a consultation with Dr. Johnson, call us at 817-241-5375 or book online today.
\|\|This article's lead section may not adequately summarize key points of its contents. (October 2011)\|\nEye surgery in the Middle Ages.\nEye surgery, also known as ocular surgery, is surgery performed on the eye or its adnexa, typically by an ophthalmologist. The eye is a fragile organ, and requires extreme care before, during, and after a surgical procedure. An expert eye surgeon is responsible for selecting the appropriate surgical procedure for the patient, and for taking the necessary safety precautions.\n- 1 Preparation and precautions\n- 2 Laser eye surgery\n- 3 Cataract surgery\n- 4 Glaucoma surgery\n- 5 Refractive surgery\n- 6 Corneal surgery\n- 7 Vitreo-retinal surgery\n- 8 Eye muscle surgery\n- 9 Oculoplastic surgery\n- 10 Surgery involving the lacrimal apparatus\n- 11 Eye removal\n- 12 Other surgery\n- 13 See also\n- 14 References\nPreparation and precautions\nSince the eye is heavily supplied by nerves, anesthesia is essential. Local anesthesia is most commonly used. Topical anesthesia using lidocaine topical gel are often used for quick procedures. Since topical anesthesia requires cooperation from the patient, general anesthesia is often used for children, traumatic eye injuries, major orbitotomies and for apprehensive patients. The physician administering anesthesia monitors the patient's cardiovascular status. Sterile precautions are taken to prepare the area for surgery and lower the risk of infection. Sterile precautions include the use of antiseptics like povidone-iodine, sterile drapes, gowns and gloves.\nLaser eye surgery\nAlthough the terms laser eye surgery and refractive surgery are commonly used as if they were interchangeable, this is not the case. Lasers may be used to treat nonrefractive conditions (e.g. to seal a retinal tear), while radial keratotomy is an example of refractive surgery without the use of a laser. Laser eye surgery or laser corneal sculpting is a medical procedure that uses a laser to reshape the surface of the eye. This is done to improve or correct myopia (short-sightedness), hypermetropia (long sightedness) and astigmatism (uneven curvature of the eye's surface). It is important to note that refractive surgery is not compatible with everyone, and some people may find that eyewear is still needed after surgery.\nA cataract is an opacification or cloudiness of the eye's crystalline lens due to aging, disease, or trauma that typically prevents light from forming a clear image on the retina. If visual loss is significant, surgical removal of the lens may be warranted, with lost optical power usually replaced with a plastic intraocular lens (IOL). Owing to the high prevalence of cataracts, cataract extraction is the most common eye surgery. Rest after surgery is recommended.\nGlaucoma is a group of diseases affecting the optic nerve that results in vision loss and is frequently characterized by raised intraocular pressure (IOP). There are many types of glaucoma surgery, and variations or combinations of those types, that facilitate the escape of excess aqueous humor from the eye to lower intraocular pressure, and a few that lower IOP by decreasing the production of aqueous humor.\nCanaloplasty is an advanced, nonpenetrating procedure designed to enhance drainage through the eye’s natural drainage system to provide sustained reduction of IOP. Canaloplasty utilizes microcatheter technology in a simple and minimally invasive procedure. To perform a canaloplasty, an Ophthalmologist creates a tiny incision to gain access to a canal in the eye. A microcatheter circumnavigates the canal around the iris, enlarging the main drainage channel and its smaller collector channels through the injection of a sterile, gel-like material called viscoelastic. The catheter is then removed and a suture is placed within the canal and tightened. By opening up the canal, the pressure inside the eye can be reduced. Long-term results are available, published in the Journal of Cataract and Refractive Surgery.\nRefractive surgery aims to correct errors of refraction in the eye, reducing or eliminating the need for corrective lenses\n- Keratomilleusis is a method of reshaping the cornea surface to change its optical power. A disc of cornea is shaved off, quickly frozen, lathe-ground, then returned to its original power.\n- Automated lamellar keratoplasty (ALK)\n- Laser assisted in-situ keratomileusis (LASIK)\n- Laser assisted sub-epithelial keratomileusis (LASEK), aka Epi-LASIK\n- Photorefractive keratectomy (PRK)\n- Laser thermal keratoplasty (LTK)\n- Conductive keratoplasty (CK) uses radio frequency waves to shrink corneal collagen. It is used to treat mild to moderate hyperopia.\n- Limbal relaxing incisions (LRI) to correct minor astigmatism\n- Astigmatic keratotomy (AK), aka Arcuate keratotomy or Transverse keratotomy\n- Radial keratotomy (RK)\n- Mini Asymmetric Radial Keratotomy (M.A.R.K.) it consists of a series of microincisions, always made with a diamond knife, designed to cause a controlled cicatrisation of the cornea, which changes its thickness and shape. This procedure, if done properly, is able to correct the astigmatism and cure the first and second stage of the keratoconus, avoiding the need for a cornea transplant.\n- Hexagonal keratotomy (HK)\n- Epikeratophakia is the removal of the corneal epithelium and replacement with a lathe cut corneal button.\n- Intracorneal rings (ICRs), or corneal ring segments (Intacs) \n- Implantable contact lenses\n- Presbyopia reversal\n- Anterior ciliary sclerotomy (ACS)\n- Laser reversal of presbyopia (LRP),J.T. Lin, US Pat # 6,258,082 (2001).\n- Scleral expansion bands (SEB),\n- The Karmra inlay The Karmra inlay received the 2005 European CE mark. The 1.6 mm inlay is placed inside the cornea and has a small aperture that gives clearer vision at intermediate and near distances. TGA registration is expected sometime in 2011.\n- Scleral reinforcement surgery for the mitigation of degenerative myopia\nCorneal surgery includes most refractive surgery as well as the following:\n- Corneal transplant surgery, is used to remove a cloudy/diseased cornea and replace it with a clear donor cornea.\n- Penetrating keratoplasty (PK)\n- Phototherapeutic keratectomy (PTK)\n- Pterygium excision\n- Corneal tattooing\n- Osteo-Odonto-Keratoprosthesis (OOKP), in which support for an artificial cornea is created from a tooth and its surrounding jawbone. This is a still-experimental procedure used for patients with severely damaged eyes, generally from burns.\nVitreo-retinal surgery includes the following\n- Anterior vitrectomy is the removal of the front portion of vitreous tissue. It is used for preventing or treating vitreous loss during cataract or corneal surgery, or to remove misplaced vitreous in conditions such as aphakia pupillary block glaucoma.\n- Pars plana vitrectomy (PPV), or trans pars plana vitrectomy (TPPV), is a procedure to remove vitreous opacities and membranes through a pars plana incision. It is frequently combined with other intraocular procedures for the treatment of giant retinal tears, tractional retinal detachments, and posterior vitreous detachments.\n- Pan retinal photocoagulation (PRP) is a type of photocoagulation therapy used in the treatment of diabetic retinopathy.\n- Retinal detachment repair\n- Ignipuncture is an obsolete procedure that involves cauterization of the retina with a very hot pointed instrument.\n- A scleral buckle is used in the repair of a retinal detachment to indent or "buckle" the sclera inward, usually by sewing a piece of preserved sclera or silicone rubber to its surface.\n- Laser photocoagulation, or photocoagulation therapy, is the use of a laser to seal a retinal tear.\n- Pneumatic retinopexy\n- Retinal cryopexy, or retinal cryotherapy, is a procedure that uses intense cold to induce a chorioretinal scar and to destroy retinal or choroidal tissue.\n- Macular hole repair\n- Partial lamellar sclerouvectomy\n- Partial lamellar sclerocyclochoroidectomy\n- Partial lamellar sclerochoroidectomy\n- Posterior sclerotomy is an opening made into the vitreous through the sclera, as for detached retina or the removal of a foreign body .\n- Radial optic neurotomy\n- macular translocation surgery\n- through 360 degree retinotomy\n- through scleral imbrication technique\n- Dexmedetomidine Versus Propofol in Vitreoretinal Surgery Alpha2 adrenergic receptor agonist have been used increasingly as a new armamentarium to provide sedative/hypnotic, analgesic, anxiolytic and sympatholytic effects in the perioperative settings. Dexmedetomidine, a selective and specific alpha2- adrenoceptor agonist has unique properties that makes it an almost ideal sedative drug for monitored anesthesia care in procedures under local or regional block. Unlike other drugs use for sedation, dexmedetomidine induces sedation that is similar to natural sleep (readily arousable) without causing respiratory depression. It attenuates the stress-induced sympathoadrenal response seen with laryngoscopy and intubation. It has anesthetic and opioid sparing effects, hence it may be a useful adjunct to general anesthesia and monitored anesthesia care in patients susceptible to narcotic induced respiratory depression. Another unique property of dexmedetomidine is that its sedative effect is reversible with Atipamezole. A previous study wherein dexmedetomidine has been used in procedures under local and regional block had shown that it provides effective sedation and better operating condition without significant respiratory depression. As a supplement to general anesthesia, it has been shown to provide stable hemodynamics. However, it is associated with some adverse events such as hypertension, hypotension and bradycardia, these commonly occur during bolus administration of the recommended dose of 1ug/kg. Post-operatively it can cause nausea and vomiting. Vitreoretinal surgery requires either an injection of local anesthetic within the muscle cone (retrobulbar block),or into the periorbital space (peribulbar block). This can be done individually or in combination. This surgery can also be done under a safer technique of retrobulbar block that is given using a sub-tenon's approach through a snip peritomy; a blunt cannula can be used with this technique mitigating the complications of retrobulbar hemorrhage or inadvertent injection into the optic nerve sheath or perforation of the globe using a sharp needle. The anesthetic goal is to provide an immobile and uncongested operative field. Hemodynamic stability of the patient is also important since some patients that require this procedure are elderly with co-morbid conditions such as hypertension, diabetes mellitus and CAD. In our study we would like to investigate if Dexmedetomidine alone and in a reduced dose can prevent or reduce the incidence of adverse effects, provide hemodynamic and respiratory stability, provide adequate sedation with patient and surgeon satisfaction and compare it with Propofol.\nEye muscle surgery\n- Eye muscle surgery typically corrects strabismus and includes the following :\n- Loosening / weakening procedures\n- Recession involves moving the insertion of a muscle posteriorly towards its origin.\n- Tightening / strengthening procedures\n- Advancement is the movement of an eye muscle from its original place of attachment on the eyeball to a more forward position.\n- Transposition / repositioning procedures\n- Adjustable suture surgery is a method of reattaching an extraocular muscle by means of a stitch that can be shortened or lengthened within the first post-operative day, to obtain better ocular alignment .\n- Loosening / weakening procedures\nOculoplastic surgery, or oculoplastics, is the subspecialty of ophthalmology that deals with the reconstruction of the eye and associated structures. Oculoplastic surgeons perform procedures such as the repair of droopy eyelids (blepharoplasty), repair of tear duct obstructions, orbital fracture repairs, removal of tumors in and around the eyes, and facial rejuvenation procedures including laser skin resurfacing, eye lifts, brow lifts, and even facelifts. Common procedures are:\n- Blepharoplasty (Eyelift)\n- Ptosis repair for droopy eyelid\n- Entropion repair\n- Canthal resection\n- A canthectomy is the surgical removal of tissue at the junction of the upper and lower eyelids.\n- Cantholysis is the surgical division of the canthus.\n- A canthoplasty is plastic surgery at the canthus.\n- A canthorrhaphy is suturing of the outer canthus to shorten the palpebral fissure.\n- A canthotomy is the surgical division of the canthus, usually the outer canthus.\n- A lateral canthotomy is the surgical division of the outer canthus.\n- Tarsorrhaphy is a procedure in which the eyelids are partially sewn together to narrow the opening (i.e. palpebral fissure).\n- Orbital reconstruction / Ocular prosthetics (False Eyes)\n- Orbital decompression for Grave's Disease. Grave's Disease is a condition (often associated with over-active thyroid problems) in which the eye muscles swell. Because the eye socket is bone, there is nowhere for the swelling to be accommodated and as a result the eye is pushed forward into a protruded position. In some patients this is very pronounced. Orbitial decompression involves removing some bone from the eye socket to open up one or more sinuses and so make space for the swollen tissue and allowing the eye to move back into normal position.\nOther oculoplastic surgery\n- Botox injections\n- Ultrapeel Microdermabrasion\n- Endoscopic forehead and browlift\n- Face lift (Rhytidectomy)\n- Liposuction of the face and neck\nSurgery involving the lacrimal apparatus\n- A dacryocystorhinostomy (DCR) or dacryocystorhinotomy is a procedure to restore the flow of tears into the nose from the lacrimal sac when the nasolacrimal duct does not function.\n- Canaliculodacryocystostomy is a surgical correction for a congenitally blocked tear duct in which the closed segment is excised and the open end is joined to the lacrimal sac.\n- Canaliculotomy involves slitting of the lacrimal punctum and canaliculus for the relief of epiphora\n- A dacryoadenectomy is the surgical removal of a lacrimal gland.\n- A dacryocystectomy is the surgical removal of a part of the lacrimal sac.\n- A dacryocystostomy is an incision into the lacrimal sac, usually to promote drainage.\n- A dacryocystotomy is an incision into the lacrimal sac.\n- An enucleation is the removal of the eye leaving the eye muscles and remaining orbital contents intact.\n- An evisceration is the removal of the eye's contents, leaving the scleral shell intact. Usually performed to reduce pain in a blind eye.\n- An exenteration is the removal of the entire orbital contents, including the eye, extraocular muscles, fat, and connective tissues; usually for malignant orbital tumors.\nMany of these described procedures are historical and are not recommended due to a risk of complications. Particularly, these include operations done on ciliary body in an attempt to control glaucoma, since highly safer surgeries for glaucoma, including lasers, non-penetrating surgery, guarded filtration surgery and seton valve implants have been invented.\n- A ciliarotomy is a surgical division of the ciliary zone in the treatment of glaucoma.\n- A ciliectomy is 1) the surgical removal of part of the ciliary body, or 2) the surgical removal of part of a margin of an eyelid containing the roots of the eyelashes.\n- A ciliotomy is a surgical section of the ciliary nerves.\n- A conjunctivoanstrostomy is an opening made from the inferior conjuctival cul-de-sac into the maxillary sinus for the treatment of epiphora.\n- Conjuctivoplasty is plastic surgery of the conjunctiva.\n- A conjunctivorhinostomy is a surgical correction of the total obstruction of a lacrimal canaliculus by which the conjuctiva is anastomosed with the nasal cavity to improve tear flow.\n- A corectomedialysis, or coretomedialysis, is an excision of a small portion of the iris at its junction with the ciliary body to form an artificial pupil.\n- A corectomy, or coretomy, is any surgical cutting operation on the iris at the pupil.\n- A corelysis is a surgical detachment of adhesions of the iris to the capsule of the crystalline lens or cornea.\n- A coremorphosis is the surgical formation of an artificial pupil.\n- A coreplasty, or coreoplasty, is plastic surgery of the iris, usually for the formation of an artificial pupil.\n- A coreoplasy, or laser pupillomydriasis, is any procedure that changes the size or shape of the pupil.\n- A cyclectomy is an excision of portion of the ciliary body.\n- A cyclotomy, or cyclicotomy, is a surgical incision of the ciliary body, usually for the relief of glaucoma.\n- A cycloanemization is a surgical obliteration of the long ciliary arteries in the treatment of glaucoma.\n- An iridectomesodialsys is the formation of an artificial pupil by detaching and excising a portion of the iris at its periphery.\n- An iridodialysis, sometimes known as a coredialysis, is a localized separation or tearing away of the iris from its attachment to the ciliary body.\n- An iridencleisis, or corenclisis, is a surgical procedure for glaucoma in which a portion of the iris is incised and incarcerated in a limbal incision. (Subdivided into basal iridencleisis and total iridencleisis.)\n- An iridesis is a surgical procedure in which a portion of the iris is brought through and incarcerated in a corneal incision in order to reposition the pupil.\n- An iridocorneosclerectomy is the surgical removal of a portion of the iris, the cornea, and the sclera.\n- An iridocyclectomy is the surgical removal of the iris and the ciliary body.\n- An iridocystectomy is the surgical removal of a portion of the iris to form an artificial pupil.\n- An iridosclerectomy is the surgical removal of a portion of the sclera and a portion of the iris in the region of the limbus for the treatment of glaucoma.\n- An iridosclerotomy is the surgical puncture of the sclera and the margin of the iris for the treatment of glaucoma.\n- A rhinommectomy is the surgical removal of a portion of the internal canthus.\n- A trepanotrabeculectomy is used in the treatment of chronic open and chronic closed angle glaucoma.\n- Surgery Encyclopedia - Ophthalmologic surgery\n- Maguire, Stephen. "Laser Eye Surgery". The Irish Times.\n- "Laser Eye Surgery Eligibility". Optical Express.\n- Uhr, Barry W. History of ophthalmology at Baylor University Medical Center. Hi Proc (Bayl Univ Med Cent). 2003 October; 16(4): 435–438. PMID 16278761\n- Surgery Encyclopedia - LASIK\n- Surgery Encyclopedia - PRK\n- Lombardi, M.; Abbondanza, M. (1997). "Asymmetric radial keratotomy for the correction of keratoconus". Journal of refractive surgery (Thorofare, N.J. : 1995) 13 (3): 302–307. PMID 9183763.\n- Kohlhaas, M.; Draeger, J.; Böhm, A.; Lombardi, M.; Abbondanza, M.; Zuppardo, M.; Görne, M. (2008). "Zur Aesthesiometrie der Hornhaut nach refraktiver Hornhautchirurgie" [Aesthesiometry of the cornea after refractive corneal surgery]. Klinische Monatsblätter für Augenheilkunde (in German) 201 (10): 221–223. doi:10.1055/s-2008-1045898. PMID 1453657.\n- Surgery Encyclopedia - Corneal transplantation\n- Indiana University Department of Ophthalmology - Phototherapeutic Keratectomy (PTK)\n- MDAdvice.com - Pterygium removal\n- Surgery Encyclopedia - Photocoagulation therapy\n- Wolfensberger TJ. "Jules Gonin. Pioneer of retinal detachment surgery." Indian J Ophthalmol. 2003 Dec;51(4):303-8. PMID 14750617.\n- Surgery Encyclopedia - Scleral Buckling\n- Surgery Encyclopedia - Retinal_cryopexy\n- Shields JA, Shields CL. Surgical approach to lamellar sclerouvectomy for posterior uveal melanomas: the 1986 Schoenberg lecture. Ophthalmic Surg. 1988 Nov;19(11):774-80. PMID 3222038.\n- Surgery Encyclopedia - Eye Muscle Surgery\n- Surgery Encyclopedia - Blepharoplasty\n- Cline D; Hofstetter HW; Griffin JR. Dictionary of Visual Science. 4th ed. Butterworth-Heinemann, Boston 1997. ISBN 0-7506-9895-0\n- Indiana University Department of Ophthalmology. "Lacrimal Drainage Surgery (DCR: Dacryocystorhinostomy)." Retrieved August 18, 2006\n- Cherkunov BF, Lapshina AV. ["Canaliculodacryocystostomy in obstruction of medial end of the lacrimal duct."] Oftalmol Zh. 1976;31(7):544-8. PMID 1012635.\n- Surgery Encyclopedia - Enucleation\n- Cassin, B. and Solomon, S. Dictionary of Eye Terminology. Gainsville, Florida: Triad Publishing Company, 1990.\n- Surgery Encyclopedia - Exenteration\n- Cvetkovic D, Blagojevic M, Dodic V. ["Comparative results of trepanotrabeculectomy and iridencleisis in primary glaucoma."] J Fr Ophtalmol. 1979 Feb;2(2):103-7. PMID 444110.
Is A Belly Lump Regular In Cats After Spay Surgery?\nWhen Jan Jannusch noticed that her 13-year-previous cat, BJ, was having bother breathing, she took him to see a veterinarian. In case your cat shouldn’t be consuming by the third day after surgery, please tell us. This orange liquid is one motive your cat’s surgical website looks so weird. Earlier than your cat’s surgical procedure she first received a common anesthetic to induce sleep and a combination of lengthy-lasting analgesics to preemptively prevent any pain.\nIn case your cat’s surgery was in the afternoon, better depart the first meal for the following morning. Cat anesthesia is extraordinarily protected when the sufferers are stabilized earlier than the process and all effort is made to have a great understanding of the cat’s medical condition before surgical procedure.\nYour veterinarian will tell you when the sutures can be eliminated from your cat. Your vet may even give you a specific sort of meals to feed your cat. Your vet may give you extra directions, equivalent to keeping your cat in a cage after orthopaedic surgical procedure, so in all circumstances simply do as they advise.\nNausea is a standard facet impact of surgery, feeding your cat a bland food plan for a few days afterward will assist his abdomen. Next time you pull into your favourite quick-meals place assume how what your physique will have to undergo to deal with that greasy burger, fried rooster or poor excuse for a burrito.\nDo not enable your cat to leap or interact in any strenuous activity that could cause excessive stretching of the surgical incision, especially within the first few days after the operation. If your cat was pregnant at the time of surgical procedure it could take her longer to recuperate.
Feline Spay and Neuter Pet NameOwner NamePrimary Contact NumberPlease select...HomeCellWorkAlternate Contact #Please select...HomeCellWorkI am the owner or agent for the owner, of the above described animal and have the authority to execute this consent. I hereby consent to and authorize the performance of an ovario-hysterectomy (spay) or neuter for this animal. I understand that during the performance of the foregoing procedure(s), unforeseen conditions (as described below) may be revealed that necessitate an extension of the foregoing procedure(s) or a different procedure(s) than those set forth above. MALES – In the event that a testicle(s) is not located in the scrotum, it is medically prudent to locate and remove both testicles. Locating the non-scrotal testicle(s) involves an additional surgical procedure that is performed at the same time as the traditional neuter. We will NOT remove the sole scrotal testicle without locating and removing the other testicle. FEMALES – We occasionally find factors that will increase the risk of surgery. These factors include being obese or pregnant; each of these situations increase the difficulty and expense of the surgery. Additional charges apply in these situations.I have reviewed this information and the related impact on the costs of the procedure(s). If the situations above are identified:Proceed with surgery, no call needed.Call before surgery to discuss any additional charges.I hereby consent to and authorize the performance of such procedure(s) as are necessary in the exercise of the veterinarian’s professional judgment. I understand qualified hospital support personnel will be employed as deemed necessary by the veterinarian. I have been advised as to the nature of the procedure(s) and the risks involved. I realize that results cannot be guaranteed and that any procedure involving general anesthesia carries a risk, although very small, of death.In such case, I authorize the following measure to be taken (refer to Resuscitative measure options form located under the online forms to see details of the following options):No resuscitationExternal resuscitationLaser therapy has been proven to improve healing time, reduce pain and decrease swelling. We offer post-surgical laser therapy to surgical incisions for those reasons at a cost of $12.50 Please indicate below by checking YES or No if you would like this additional pain control. To learn more about Laser Therapy please visit https://babcockhills.com/veterinary-services/laser-therapy/Laser therapy selectionYesNoDECIDUOUS TEETH (baby teeth) do no always fall out on their own. We may not be able to tell if your pet has lost these teeth until anesthetized. If not, we recommend surgical removal while your pet is anesthetized so adult teeth may develop properly with minimal discomfort for your pet.Select Deciduous Teeth Removal Option:YES - please remove deciduous teeth, if found.NO - do not remove deciduous teeth, if found.IF FLEAS OR TICKS ARE FOUND ON YOUR PET AT THE TIME OF ENTRY, YOUR PET WILL BE TREATED AND THE MEDICATION WILL BE REFLECTED ON YOUR INVOICE UPON CHECK-OUT.Acknowledgement of flea/tick statement* YES - I understandWe offer the Home Again Microchip. Micro chipping is as quick and painless as when we administer your pet its regular vaccinations. More than 10 million pets get lost each year. One third of all pets, including "indoor-only" cats and dogs, will become lost during their lifetime. Unfortunately 90% won't return home without effective identification. The City of San Antonio approved an ordinance amendment (effective 4/30/2015) making a registered microchip the primary means of licensing for pets living within the San Antonio city limits. All dogs, cats, ferrets residing in San Antonio city limits must have a registered microchip and the microchip must be properly registered with the microchip company with the current ownership information. Would you like to ensure your pet has a safe return home if he/she ever gets lost?Please select...YES. Please protect my pet today with a microchip and lifetime registration for $71.45My pet has been micro chipped previously, but I have not yet registered and I WOULD LIKE TO REGISTER my pet today for $35.50.My pet is microchipped and is registered with the updated information.I understand that a microchip can help protect my pet and is required by the City of SA, but I DO NOT wish to microchip my pet today.I hereby authorize the veterinarian perform the procedure listed above-for the described pet. I assume responsibility for all charges incurred in the care of this animal. I also understand that all charges must be paid at the time services are rendered and that a deposit may be required for surgical treatment or hospitalization.Please type your Digital Signature:Date* EmailThis field is for validation purposes and should be left unchanged.
Oral & Maxillofacial Surgeons Kathleen Herb Brower, D.M.D., M.D. and Therese DiFlorio Brennan, D.M.D, M.D., of Doylestown practice a full scope of oral and maxillofacial surgery with expertise ranging from corrective jaw surgery to wisdom tooth removal. They can also diagnose and treat facial pain, facial injuries, and perform a full range of dental implant and bone grafting procedures.\nDr. Brower received both her Bachelor of Arts in 1988 and Dental Medicine degrees in 1992 from the University of Pennsylvania. Upon completion of her residency and medical school training at Allegheny General Hospital/ Medical College of Pennsylvania in 1998, she earned a dual licensure in medicine and dentistry.\nIn addition to her private practice in Doylestown, she spent four years as associate director of the department of oral and maxillofacial surgery at Thomas Jefferson University Hospital.\nDr. Brower is licensed to administer intravenous general anesthesia in the office. She also utilizes a nurse anesthetist when desired. As a dual degree surgeon, she cares for many patients with complex medical conditions that other practitioners may not be comfortable treating.\nDr. Brennan graduated from the University of Notre Dame in 1990 with majors in Art History and Science. She then went on to pursue a degree in dentistry, graduating from the University of Pennsylvania School of Dental Medicine in 1994. Her interest in medicine and surgery were furthered by becoming an intern at the Hospital of the University of Pennsylvania with the Department of Oral and Maxillofacial Surgery. This experience prompted her to complete a six-year residency in Oral and Maxillofacial Surgery at the Hospital of the University of Pennsylvania.\nBoth doctors have the education and experience to treat any number of complex oral or maxillofacial conditions. Doylestown Oral and Maxillofacial Surgery provides services for patients of all ages.\nAbout Dental Implants\nPatients looking for permanent solutions to dental issues may have a lot of questions about various options. Dental implants are a viable alternative.\nImplant surgery takes time to heal. After surgery time is allowed to heal and grow around the dental implant. The bone bonds with the titanium, creating a strong foundation for artificial teeth. A support post is then placed on the implant by the patient’s dentist and a new replacement tooth is placed on top of the abutment. In many cases a temporary replacement tooth can be attached to the implant immediately after it is placed. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth.\nDoylestown Oral & Maxillofacial Surgery\n3655 Route 202, Suite 210
Questions on Everyday Dental Care\nAn appointment. Your smile and your goals are unique. Dentistry at East Piedmont offers a wide range of cosmetic services, and after your consultation, you’ll know which services will deliver the smile of your dreams.\nThat sounds like an easy question to answer, but it isn’t! Your smile is unique, and we won’t compromise your individuality with smile enhancements. Smile design dentistry done right requires an initial consultation in which we will discuss your goals, preferences, and options for care. Generally speaking, we may suggest porcelain veneers, teeth whitening, all-white restorations, and/or replacement teeth. Orthodontics may also be involved. After your comprehensive evaluation and consultation, we’ll present a smile makeover plan for your new smile. We offer digital imaging for smile previews, as well.\nYes. We offer whitening solutions to brighten teeth dramatically at home or in our office. Call our Marietta dental office for an appointment today at (678) 648-4214!\nYour safety is important to us, so we sterilize our reusable instruments in an autoclave and use disposable products as much as possible. Each operatory is cleaned thoroughly between patients. We adhere to guidelines set by the CDC and OSHA and perform weekly tests on our sterilization equipment. Our state-of-the-art sterilization center ensures your safety.\nWith innovative CEREC technology, we can create custom crowns, inlays, and onlays in about an hour. This means that in just one visit, you can get a custom-made, all-white, reliable restoration. No temporary crowns. No follow-up visit. It’s that simple.\nDepending on your unique case, we may suggest porcelain veneers or Invisalign clear braces. Read more about these procedures in our services area.\nDark fillings and metal crowns can be replaced with strong, aesthetic solutions. Dr. Patel has placed composite resin fillings for years, and we also offer porcelain crowns.\nFor your convenience, we take cash, check, and major credit cards. Third party financing is available to qualified applicants through CareCredit.\nOne of the things that sets our office apart from other dental offices is our commitment to getting to know you as a person, not just a patient. On your first visit, you will meet with our patient coordinator, discuss your current dental needs in a private consultation room and then go to a serene, relaxing treatment room to start your new patient experience. A full series of digital photos will be taken, digital x-rays (if needed) will also be performed and our hygienist will perform a complete periodontal exam. Dr. Patel will then perform a comprehensive exam, complimentary oral cancer screening and spend time with you reviewing the findings. Many patients complain that their previous dentist never spent any time with them and he/she was in and out of their check-up appointment without so much as a word to them. That will never be the case at Dentistry at East Piedmont. We are dedicated to creating a positive experience every time and with every patient.\nWe have chosen not be participating providers on ANY insurance plans. When you agree to be a provider, you also agree to provide “covered” services, not services that are needed. You should have the right to choose the type of care you need and desire, not what your insurance dictates. Dr. Patel will strive to provide you with options from the most optimal treatment to more affordable short-term options. We will do everything possible to make sure you receive the maximum allowable benefits from your insurance plan, submit claims and pre-treatment estimates and do everything possible to give you accurate estimates for your out of pocket costs and provide you with the highest level of care available.\nNo Prep-Veneers are porcelain restorations that are specifically designed to fit over your existing dentition or teeth with no alteration of the actual tooth itself. These prepless veneers are extremely thin, about the thickness of a contact lens and are an excellent option when building out a smile, placing veneers on someone very young or covering healthy teeth that are stained and do not respond to whitening. To see if you are a good candidate, contact us at (678) 648-4214 and receive a complimentary smile analysis.\nIs there really a difference between whitening products at the drug store and professional whitening?\nIn a word, Yes! Over the counter whitening products are made for the general public with no consideration for the shape of their teeth, how big or small their mouth is and whether or not they have sensitivity. They work “ok” for most people and can bring teeth up a shade or two. Results do not tend to last very long and you need to whiten frequently in order to maintain the result. Professional whitening products are designed to work with custom made, whitening trays. The product is extremely effective, with maximum results being reached typically after a week or so and multiple shades achieved. The actual result depends on the individual’s ability to whiten, however, teeth tend to be consistently white at the gumline and in between the teeth unlike with over the counter whitening strips. Touch ups do occur but it tends to be many months before it is necessary and usually one to two applications are all that are required. Depending on the product chosen, trays need to be worn for only 30 minutes to 1 hour.\nSedation dentistry safely eases worries and discomfort so you can receive the dental care you need, anxiety-free. With your customized treatment plan, the level of sedation will be tailored to your personal needs.\nOur sedation options include Nitrous Oxide (laughing gas), Oral Sedation and IV Conscious Sedation (twilight state).\nWhile it is sometimes referred to as ‘sleep dentistry,’ this is not entirely accurate. During conscious sedation, patients are awake enough to respond to verbal cues and breath independently but may not remember the appointment due to amnesia depending on the level of sedation chosen.\nMedication dosage is custom tailored to maintain maximum comfort. In addition to sedatives, anti-inflammatory and antibiotic medications can be given to increase healing and minimize the medications taken at home.\nMany patients avoid getting the dental care they need due to fear and anxiety. In fact, dental anxiety is one of the top fears reported by Adult Americans. Fortunately, we now offer convenient in house sedation to ensure each patient gets the smile they deserve in maximum comfort.\nSedation Dentistry is available for routine dentistry such as cleanings, fillings and crowns, as well as surgical procedures like extractions, implants, and grafting. This service is also a great solution for patients with a severe gag reflex or certain systemic health issues. A thorough evaluation of your health and medical history will be taken at consult to ensure this treatment option is right for you.\nJaneime & Lindsey\nAnswer Questions on Everyday Dental Care
This article has Open Peer Review reports available.\nReview of knee arthroscopy performed under local anesthesia\n© Law et al; licensee BioMed Central Ltd. 2009\nReceived: 12 September 2008\nAccepted: 19 January 2009\nPublished: 19 January 2009\nLocal anesthesia for knee arthroscopy is a well documented procedure with diagnostic and therapeutic role. Numerous therapeutic procedures including partial menisectomy, meniscus repair, abrasion chondroplasy, synovectomy, loose body removal can be performed safely and comfortably. Appropriate case selection, anesthetic strategy and technical expertise are the key to smooth and successful surgery.\n- 1.Cost is low and cost effective\nRandomized control study by Forssblad M showed that the total hospital time, recovery time were significantly shorter for LA arthroscopy when compared with spinal anesthesia or general anesthesia. The total cost was also significantly lower.\nPatient is awake and can follow the procedures.\n- 3.Complications are rare\nPotential complications of general anesthesia are eliminated e.g. aspiration, malignant hyperthermia\nHowever, in some cases, conversion to general anesthesia (GA) is necessary, mainly because of patient pain tolerance that makes complete examination impossible or the procedure is too complicated to be done under local anesthesia. \nIn order to perform successful arthroscopy under local anesthesia, case selection, anesthetic choice and technical details are important factors to be considered.\nPartial menisectomy (both medial and lateral meniscus)\nMeniscus repair with all inside technique (e.g. FasT-Fix (Smith Nephew Endoscopy, Andover, MA, USA))\nRemoval of loose body\n- 6.Cartilage procedures\nMicrofracture of femoral condyle\nAnd concerning the pain experienced during arthroscopy, Dye has reported on the neurosensory mapping of the internal structure of the knee without anesthesia. They demonstrated that severe pain was reported during probing of the suprapatellar capsule, meniscal capsular margin, infrapatellar fat pad, and the insertion site of the cruciate ligament. Minimal pain was reported while probing cartilage and inner rim of the meniscus.\nAnd according to Takahashi T , local anesthesia provided good pain control during partial menisectomy, chondroplasty and removal of loose body. Patients sometimes experienced more pain during treatment of the suprapatellar pouch, including the plica and the anterior cruciate ligament.\nHypertrophic synovitis (presented as capsular swelling and diagnosed on clinical examination) is a relative contraindication since administration of LA is quite painful for patients with extensive synovitis and the surface of the synovium becomes larger when it is inflamed and the standardized dosage may not have been sufficient to produce adequate anesthesia .\nGross deformity, e.g. severe varus or valgus knee with narrowing of joint space also makes complete examination difficult.\nAbsolute contraindication of local anesthesia arthroscopy include allergy to local anesthesia or local infection at selected portal and injection sites.\nThe most commonly used regime is a combination of intraarticular and portal site injection of local anesthetic with adrenaline. Intravenous sedation may be used in apprehensive patients.\nThe safety dosage has been established by Weiker GG etal. . Fifteen healthy patients were included. 25 ml of 1% lidocaine with epinephrine (1:100,000) and 25 ml of 0.25% bupivacaine were instilled into the knee joint. An additional 40 ml of the combined solution was used to anesthetize four arthroscopic portal sites from the skin into the joint capsule. Arthroscopy was then performed. Blood samples from 5, 15, 30, 60, and 120 minutes after intraarticular injections were taken. Levels of the anesthetic agents in all patients at all time intervals were well within the safety range. And no complications from the anesthetic agents were noted in over 500 similar cases.\nSome authors tried to use a minimal dosage of anesthetics. Iossifidis has performed 53 knee arthroscopies under low volume (20 ml) local anaesthesia using half the recommended safe dose of anesthetic agents (10 ml 0.5% bupivacaine + 10 ml 2% lignocaine with adrenaline 1:200,000), as a single intra-articular injection (10 ml) together with skin infiltration of the arthroscopic portals (5 ml to each portal). 62 lesions were diagnosed and 48 surgical procedures were successfully carried out in 53 patients. 97% of patients were satisfied with the procedure which caused little or no discomfort in 94% of cases. The combination of short acting and long acting anesthetic agent offers advantage of controlled anesthesia localized to the knee joint and provides prolonged post operative analgesia.\nFor apprehensive patients, intravenous sedatives (e.g. Midazolam) can be given. But this requires intraoperative monitoring of oxygen saturation and vital signs. Resuscitation equipment and antidote (Flumazenil) should be available.\nMiskulin M had used diclofenac (1 mg/kg) as preemptive agent. The theoretical advantage is that preemptive administration of diclofenac can reduce hyperalgesia by inhibiting cyclooxygenase (COX) and decreasing tissue prostaglandin synthesis and may reduce analgesic requirement. In a series of 628 patients, 10 ml 2% lidocaine with 1:200,000 epinephrine was injected into the joint cavity, and 5 ml of 2% lidocaine with 1:200,000 epinephrine was injected into each portal site, all with preemptive diclofenac injected intravenously just before the procedure. Arthroscopy was well tolerated by 98.5% of patients and only 1.4% of procedures had to be terminated prematurely because of patient discomfort.\nIn general, most patients tolerate the procedure well without any complication. However, vital signs should still be monitor during the procedure and an intravenous access should be available before the procedure as a minority of patient may develop vasovagal attack.\nLast but not the least, detail explanation of procedures before the operation and communication during the procedure will alleviate most of the anxiety.\nInjection of local anesthetics\nDuring injection of local anesthetics to the portal sites, majority of the drug should be injected into the subcutaneous layer instead of the subcapsular layer, otherwise the fat pad will be pushed into the joint and making initial visualization difficult.\nDuring intraarticular injection of local anesthetics, do make sure that it was injected into the joint and not into the subcutaneous tissue, especially for muscular patients. Bulging from the medial gutter and a positive patellar tap sign will be noted after successful intraarticular injection.\nDo wait for ~20 minutes after injection before the procedure starts.\nDo use a cannula with both inflow and outflow, such that an extra supralateral outflow portal is not necessary. Since according to study by Takahashi T , pain experienced at the time of local anesthetics injection was more severe than pain experienced during the surgical procedure.\nDuring introduction of trocar cannula, initial insertion into the patello-femoral joint is not a must since this will also cause pain, especially when the patient is not relaxed and the quadriceps is contracted. It may be inserted into the femoral notch first and then fluid is instillated and then the PFJ can be entered more easily.\nFor most of the procedures, tourniquet is not necessary for experienced surgeons. But it may be placed as a standby manner, such that it may be inflated for short period of time if there is really difficult bleeding that make visualization difficult.\nAdrenaline may be mixed into the irrigation fluid (10 ml of 1:10,000 adrenaline into 3 L of irrigation fluid), usually the first bag, can help in haemostasis.\nIf difficult bleeding is encountered, the pressure from the water column from the arthroscope is usually sufficient to achieve temporary haemostasis, and identification of bleeding source. Then radiofrequency can be used for haemostasis.\nPain during procedure\nPatient will also experience pain during synovectomy, so extensive synovitis is a relative contraindication of LA arthroscopy.\nMost patients tolerate well for partial menisectomy, shaving of plica, loose body removal or abrasion chondraplasty.\nExperience from a teaching hospital\nFrom July 2003 to June 2005, 190 patients underwent day case knee arthroscopy in Prince of Wales hospital. All procedures were performed under local anaesthesia: using 30 ml (20 ml intra-articular and 5 ml to each portal site) of 1% lignocaine in 1:200,000 adrenaline. There was no complication related to the injection of local anesthesia. 35% were diagnostic procedures and 65% were therapeutic. Therapeutic procedures included partial menisectomy, all inside meniscal repair, removal of loose bodies, microfracture, abrasion chondroplasty, debridement in knee osteoarthritis and shaving of plica. The average operating time was 29.2 minutes (range 12 – 75 minutes). Only 2 cases required a tourniquet during the procedure. Sedatives were not required in all cases. The average intraoperative VAS as reported by the patient was 3.1 (range 1–9). Discomfort was mainly felt during initial introduction of the trocar cannula, and upon shaving of severely inflamed synovium. 3 cases had to be abandoned during the procedure due to patient intolerance from anxiety & pain, as well as tight joint space from advance osteoarthritis. 95% of the patients agreed to have the same procedure performed under local anesthesia in the future.\nKnee arthroscopy under local anesthesia is a safe, well tolerated and cost effective alternative to conventional techniques.\n- Yoshiya S, Kurosaka M, Hirohata K, Andrish JT: Knee arthroscopy using local anesthetic. Arthroscopy. 1998, 4 (2): 86-89.View ArticleGoogle Scholar\n- Jacobson E, Forssblad M, Rosenberg J, Westman L, Weidenhielm L: Can local anesthesia be recommended for routine use in elective knee arthroscopy? A comparison between local, spinal and general anesthesia. Arthroscopy. 2000, 16 (2): 183-90.View ArticlePubMedGoogle Scholar\n- Forssblad M, Jacobson E, Weidenhielm L: Knee arthroscopy with different anesthesia methods: a comparison of efficacy and cost. Knee Surg Sports Traumatol Arthrosc. 2004, 12: 344-349. 10.1007/s00167-004-0523-7.View ArticlePubMedGoogle Scholar\n- Tsai L, Wredmark T: Arthroscopic surgery of the knee in local anaesthesia. An analysis of age – related pathology. Arch Orthop Trauma Surg. 1993, 112 (3): 136-8. 10.1007/BF00449990.View ArticlePubMedGoogle Scholar\n- Rolf CG: Knee arthroscopy under local anaesthesia. Hong Kong Journal of Orthopedic Surgery. 1998, 2 (2): 158-163.Google Scholar\n- Dye SF, Vaupel GL, Dye CC: Conscious neurosensory mapping of the internal structures of the human knee without intraarticular anesthesia. Am J Sport Med. 1998, 26: 773-7.Google Scholar\n- Takahashi T, Tanaka M, Ikeuchi M, Sadahiro T, Tani T: Pain in arthroscopic knee surgery under local anesthesia. Acta Orthop Scand. 2004, 75 (5): 580-3. 10.1080/00016470410001457.View ArticlePubMedGoogle Scholar\n- Weiker GG, Kuivila TE, Pippinger CE: Serum lidocaine and bupivacaine levels in local technique knee arthroscopy. Am J Sports Med. 1991, 19 (5): 499-502. 10.1177/036354659101900514.View ArticlePubMedGoogle Scholar\n- Iossifidis A: Knee arthroscopy under local anaesthesia: results and evaluation of patients' satisfaction. Injury. 1996, 27 (1): 43-4. 10.1016/0020-1383(95)00168-9.View ArticlePubMedGoogle Scholar\n- Miskulin M, Maldini B: Outpatient arthroscopic knee surgery under multimodal analgesic regimens. Arthroscopy. 2006, 22 (9): 978-83.View ArticlePubMedGoogle Scholar
Pip was found as a hatch-year bird in July of 2013 with a fractured left humerus. Although we do not know how he was injured, the fracture was fresh and should have healed well. However, during surgery, Pip did not tolerate anesthesia and required two mouth-to-beak resuscitations when his breathing stopped. Medical staff did not want to risk his life by continuing the surgery on his wing, and though he recovered, his wing did not heal in perfect alignment. Known for their speed in pursuit of avian prey, as well as long migratory journeys, Pip’s limited flight meant he was not eligible for release. Confident and willing to build trust with his trainers, he joined the education team in 2014 and won the “Rookie of the Year” award for his amazing work as an educator in his very first year.\nAdoptive “Parents” of Pip:\nLinus Charpie • Amy Iverson • Xochilt Diaz • Mountain Rose Herbs • Susan Sullivan • Jordon and Sarah Huppert • Silas Kruse • Dixie Feiner
A Leesburg woman who worked as a security guard at Fayette County Memorial Hospital (FCMH) and stole opioids from an anesthesia box was sentenced Monday to 12 days in jail and two years of community control.\nJanice Jones, 54, plead guilty to three charges of theft of drugs, a felony of the fourth degree. Jones was indicted May 15, 2015 after the Ohio State Board of Pharmacy conducted an investigation into missing medications from FCMH at 1430 Columbus Ave. in Washington Court House.\nAccording to the investigation documents, Jones confessed to stealing from an unsecured anethesia box during her night shift as a security guard. Jones admittedly stole five fentanyl 2ml ampoules, two morphine 10 mg syringes, two hydromorphone 2mg syringes, one midazolam 2 mg vial, one ephedrine 50 mg ampoule and one propofol 200mg vial.\nFentanyl and morphine are schedule II controlled substances used in the treatment of severe pain.\nIn a January 2015 recorded interview with an Ohio State Board of Pharmacy compliance agent and specialist, Jones said she had drug use problems since 2014, when she turned to drugs to cope with an emotional and difficult breakup, according to reports. She told the Ohio State Board of Pharmacy that she would buy drugs on the street, including morphine, hydromorphone, and oxycodone, and said she took 10-12 tablets of morphine daily and then turned to using heroin.\nShe was working as a security guard at the hospital June 3, 2014, making sure doors were locked in three buildings, including the surgery area, when she said she went into the surgery area to go to the bathroom and observed the anesthesia box and noticed the padlock was not locked. She said she then took drugs from the box, attached the padlock, and went home and used the drugs.\nEmployees at the hospital noticed the drugs were missing. Jones said she had administered a syringe of morphine to herself just before being called in for a drug screen June 3, 2014.\nShe told the compliance agent and specialist that she had used the drugs in an attempt to commit suicide. She was treated for drug abuse in October of 2014 and was taking Suboxone, but said she soon “weaned” herself off drugs and was drug-free at the time of the January 2015 interview.\nJones had two days of jail-time credit and will serve 10 days in the Fayette County Jail. She was ordered to pay the costs for prosecution.\nFailure to complete the terms of the sentencing could result in a year-and-a-half prison term.\nReach Ashley at the Record-Herald (740) 313-0355 or on Twitter @ashbunton
Guide to Surgery\nBEFORE YOUR SURGERY\nFollow these guidelines on the days before your surgery.\n- One to three days before surgery, expect a 5 to 10 minute phone call from the surgery center nurse. He or she will review your medical history and surgical instructions.\n- Follow your surgeon’s instructions about taking routine medications.\n- Make arrangements for a responsible person over the age of 18 to accompany you to your surgery and stay with you for 24 hours after surgery.\n- You will be called with your arrival time after 2 p.m. on the last business day prior to your surgery.\nDAY OF SURGERY\nFollow these simple rules to make the day of your surgery safer and more comfortable.\n- Do not eat or drink after midnight (unless otherwise directed). This includes mints, lozenges or gum.\n- Bring a list of medications with dosage and frequency information.\n- Bathe or shower on the day of surgery.\n- Brush your teeth, but do not swallow any liquid.\n- Do not use makeup, hair spray, lotions, or oils.\n- Remove all nail polish and body piercings.\n- Wear loose, comfortable clothing and shoes.\n- Leave all jewelry and other valuables at home.\n- Bring all sensory/assistive devices including glasses, hearing aids and c-pap machines.\n- Be prepared to remove contact lenses.\n- If indicated, you must supply guardianship paperwork and/or power of attorney documents. The surgery will be cancelled if these legal documents are not made available.\n- The anesthesia team will be available to discuss anesthesia options and answer any questions.\n- Bring a photo I.D.\n- Do not bring children with you on the day of your surgery.\nIf you are having day surgery:\n- Whether you are driving in a car, taking a cab, or using other public transportation, a responsible person over the age of 18 must accompany you and stay with you for 24 hours.\n- Follow your doctor’s instructions regarding rest, activity, diet, medications, bathing, and returning to work.\n- You will be discharged when your doctor determines it is safe for you to leave the facility.\nIf you are being admitted to the hospital:\n- Contact the hospital floor for the visitor’s policy including child visitor restrictions.\n- You should anticipate leaving at 11 a.m. on the day your doctor discharges you from the hospital.\nINSURANCE AND BILLING\nYour surgery and anesthesia charges will be billed to your insurance company. You are responsible to pay any balance as per your individual insurance policy.\nIf your surgery is not covered by insurance, you are required to pay on or before the day of surgery. An actual bill indicating a total charge will be sent after surgery. Unpaid balances must be paid within 30 days. All major credit cards are accepted.\nIf you have any questions regarding your insurance or billing, please call us at 860-679-1600.\nWe appreciate the confidence you have placed in us and look forward to providing you with the highest quality of medical care. We also welcome any comments or suggestions you may have to help improve our services.
(ARA) - Women (and men) wanting to look younger and healthier have so many choices today for cosmetic medical procedures. But the ever-increasing treatment options - combined with varying costs and widespread availability - may leave some consumers overwhelmed, says Dr. Susan Weinkle, president of the American Society for Dermatologic Surgery (ASDS).\nThat's not surprising when today's options include laser treatments, high-tech light devices, chemical peels, dermabrasion, liposuction, lifts, vein treatments, soft-tissue fillers, neuromodulators (Botox) and hair restoration among others.\nThe first thing to remember is that cosmetic procedures are still medical procedures, Weinkle says, adding that it's a popular misconception that certain procedures are easy to perform and risk-free. Serious side effects - such as burns, infections, scars and pigmentation disorders - can occur when consumers visit untrained, unqualified practitioners.\nOf course, it makes sense to choose an experienced and qualified physician to perform a cosmetic medical procedure. Not only are ASDS doctors board-certified in dermatology, they have the training and experience to determine the best treatment for each patient's unique needs. ASDS doctors have pioneered many of the procedures being performed and perfected today.\nHowever, it's still important for consumers to do a little homework, such as checking a doctor's credentials and making sure the doctor is on site.\nIt's also vital to ask a doctor the right questions before undergoing a cosmetic procedure. Think of it as an interview. To help, the following questions can act as a guide (but feel free to ask any other questions - no matter how minor they may seem):\n* What treatment is right for me? In other words, don't ask the doctor for a specific procedure. Instead, explain the issues that need to be addressed and let the doctor offer the solution. ASDS doctors have extensive experience doing a variety of aesthetic treatments.\n* Is the specific laser, device or technique appropriate for my skin type? ASDS doctors know that cosmetic procedures and treatments are not one-size-fits-all. Each patient is evaluated for skin type as part of the initial evaluation.\n* How much does it cost? As a rule, almost all cosmetic surgery is considered "elective" and is not typically covered by insurance plans. Although some spas, salons and walk-in clinics offer cosmetic medical procedures at lower prices, Weinkle says consumers should be aware that "these discounted prices could put your health at risk as a result of the provider's inadequate training and lack of expertise."\n* What should I do to prepare for the treatment? Carefully following the physician's guidelines before the procedure can greatly impact the final results.\n* Have you reviewed my medical history? Information that a patient may think is unrelated to their treatment may in fact play a key role in recovery or the length of a procedure, says Weinkle. Patients should be sure to disclose their specific surgery history, any allergies and any pharmaceuticals, over-the-counter drugs or herbal supplements that they are taking at the time of their procedure.\n* What are my pain management and anesthesia options? To help avoid the risks associated with general anesthesia, ask the physician about alternative pain management options. Many techniques that are performed in a physician's office can be done under local anesthesia, eliminating some side effects such as nausea and headaches that often accompany general anesthesia. Using a short-term local anesthesia may also eliminate complications that are sometimes related to general anesthesia, including allergies and heart problems.\n* What are the risks? Discuss the potential side effects of the proposed treatment, how often they occur and how they will be handled if they do occur.\n* What should I expect after the procedure is performed? Besides a discussion about the short-term and long-term effects, activity restrictions and the expected recovery period, doctors should share before-and-after photos of previous patients and discuss realistic expectations.\nTo download a pre-cosmetic surgery interview questionnaire or for more information on cosmetic skin procedures and a referral to ASDS doctors, visit www.asds.net.
Anesthesia and Co-existing Diseases provides a timely, rapid overview of common and uncommon co-morbidities that are encountered in the day-to-day practice of anesthesiology. It provides a guide to the perioperative assessment and anesthetic management of patients with widely prevalent co-morbidities such as hypertension, diabetes, obesity, myocardial ischemia, kidney and liver disease. It concisely outlines priorities for patients with special problems who are undergoing unrelated operative procedures, such as the obstetrical patient, the patient with prior organ transplantation, the adult patient with congenital heart disease, the spinal cord-injured patient, the cancer patient with prior chemotherapy, the critically ill patient or the patient with a psychiatric disorder. It also focuses on specific challenges to the anesthesiologist, such as patients with latex allergy, a history of substance abuse, preoperative use of herbal medications, or who are at risk of malignant hyperthermia.\nCambridge University Press; July 2007\n- ISBN: 9780511275760\n- Read online, or download in secure PDF format\n- Title: Anesthesia and Co-Existing Disease\nSeries: Cambridge Pocket Clinicians\n- Author: Robert Sladen (ed.); Douglas B. Coursin (ed.); Jonathan T. Ketzler (ed.); Hugh Playford (ed.)\nImprint: Cambridge University Press
Anesthesiologist Evgeny Tkachenko, MD, had a routine day ahead of him at the clinic where he works in Moscow: two surgeries, one of them elective. The anesthesia for the elective surgery, an aesthetic procedure, should have been straightforward; the 40-year-old female patient was just back from hiking Kilimanjaro, and her blood tests were fine.\nThen she made a passing comment, one that, in retrospect, likely saved her life — but not before it put anesthesiologist, surgeon, and patient at odds.\nThe woman said she had experienced a single instance of shortness of breath since her last visit, lasting about 15 minutes. When Tkachenko rested the stethoscope on her chest, he could hear only one lung. There was nothing from the other.\nAn X-ray suggested pneumothorax, but a CT confirmed a giant bullae. If the giant bullae had ruptured during anesthesia induction and positive pressure ventilation, it could have led to pneumothorax, pneumopericardium, hypoxemia, and even death. Tkachenko immediately decided it was unacceptable to go ahead with the operation. He consulted a colleague to be sure, before breaking the news. Neither patient nor surgeon took it well.\n"The operation was canceled on the morning of surgery. And yes, the surgeon was very upset. Also the patient was quite angry and didn't understand what's happened," Tkachenko posted on Medscape Consult, a crowdsourced social media platform in which clinicians share and discuss real cases.\nIt took 4 hours after the decision to cancel for the team of physicians to convince the patient that she should be discharged and go see a thoracic surgeon. Although the surgeon seemed to understand Tkachenko's decision, it nonetheless left him in a frustrating predicament with an angry patient.\nSeveral anesthesiologists from around the world commented on Tkachenko's Medscape Consult post, affirming his decision to cancel. Other commenters elaborated on the tension that can underlie the anesthesiologist-surgeon relationship. "Pleasing the surgeon by not disrupting the OR schedule with a cancellation vs patient safety is a difficult choice and these days is driven more by economics than patient care," one physician wrote.\nThe tension that arises between the two OR physicians is "an elephant in the room," said Jeffrey Cooper, PhD, a professor and health quality researcher at Harvard Medical School in Boston, Massachusetts. There's not a lot of direct research on the surgeon-anesthesiologist dyad, he told Medscape Medical News, but "talk to either one of them and you'll recognize it."\nNot all surgeon-anesthesiologist relationships are strained, and when they do collaborate well it is a great advantage to the patient, Cooper said. But his qualitative research and that of others has found that even though everyone in the OR agrees that nonhierarchical, collaborative leadership is the gold standard, executing this kind of cooperation is difficult in practice.\nWhen researchers asked 72 surgeons, anesthesiologists, and nurses to watch and respond to three videos depicting tension in the OR, each group viewed responsibility for starting and resolving the tension very differently, rating their own profession as having less responsibility than others, according to a 2005 study.\nA 2002 study of nurses, surgeons, anesthesiologists, and trainees found that during tense conversations team members, especially novices, tend to simplify and distort the roles of others.\nAnd training events were unsuccessful at increasing how often anesthesiologists speak up in the OR, according to a 2016 study. The most frequent hurdles to speaking up the study identified were "uncertainty about the issue, stereotypes of others on the team, familiarity with the individual, respect for experience, and the repercussion expected."\n"I've been involved in situations where I wanted to cancel a case, and the surgeon did not agree with me," K. Gage Parr, MD, an anesthesiologist and professor at George Washington University Hospital in Washington, DC, told Medscape Medical News. "Sometimes it goes well. Sometimes it goes poorly. And I think it depends a lot on your working relationship with the surgeon."\n"Most often the surgeon and anesthesiologist don't really know each other that well," said Richard Cahill, Esq, vice president at malpractice insurer The Doctors Company. It's becoming increasingly common in the United States, he said, for hospitals to contract independent anesthesiology groups rather than employ the physicians directly. In these situations, there's not time or opportunity to form a trusting relationship with the surgeon. He urged that, regardless of the relationship or either party's seniority, it's critical to communicate clearly and immediately for the sake of the patient.\nBetween 2013 and 2018, The Doctors Company found that "communication among providers" contributed to patient harm in 16% of the malpractice claims they closed. In other words, "if communications had been properly held, the damages would have been avoided," Cahill said. In these cases, the consequences can be catastrophic, including sanctions, revocation or suspension of license, and removal from one or more networks.\nConflict in any working relationship can't be avoided completely, said Cooper, but surgeons and anesthesiologists could do more to understand and trust one another for the sake of the patient. Ideally, Cooper writes, "Each would always start with an extension of the 'basic assumption' [of]: 'I believe that you are intelligent, competent, trying your hardest to do your best and seeking to improve, and acting in the best interest of the patient and the organization.'"\nParr suggested communicating in a way that's direct but not affronting to ego. Go out of your way to make it about the patient. Think professional, not personal. She added that the inevitable will happen. "You make the wrong decision sometimes, but you have to err on the side of safety because it's 'first do no harm.'"\nThe key to navigating the tension in Tkachenko's situation, he said, was calling for help. He immediately consulted a colleague, contacted the chief of anesthesiology who works at another branch of the hospital, and sent the scans to a trusted colleague in the United Kingdom. They all affirmed his decision. "After all that," he told Medscape Medical News, "the surgeon and patient, they have to agree."\nDonavyn Coffey is a freelance journalist in New York City. She interned for Medscape in the fall of 2019.\nMedscape Medical News © 2019 WebMD, LLC\nSend comments and news tips to [email protected].\nCite this: Donavyn Coffey. The Elephant in the Operating Room: The Surgeon-Anesthesiologist Relationship - Medscape - Dec 19, 2019.
Latest General anaesthetic Stories\nA new study in the April edition of the Journal of Addiction Medicine suggests that propofol abuse by health care professionals is increasing.\nThe Royal College of Anaesthetists (RCoA) and the Association of Anaesthetists of Great Britain and Ireland (AAGBI) today publish initial findings from a major study which looked at how many patients experienced accidental awareness during general anaesthesia.\nDoctors and surgeons have been using general anesthetic to induce unconsciousness for over one hundred years, but little work has been done to define what unconsciousness actually is.\nA new study has discovered that anesthetic drugs not only switch wakefulness “off” but switch all sleep circuits to “on.”\nLAKE FOREST, Ill., Dec. 20, 2010 /PRNewswire/ -- PharMEDium Services LLC, announced the addition of Propofol to its custom operating room anesthesia syringe preparation services.\nA team of Massachusetts General Hospital (MGH) physicians has developed a new general anesthetic that may be safer for critically ill patients.\nAACHEN, Germany and CAMBRIDGE, UK, Sept. 22, 2008 (GLOBE NEWSWIRE) -- The biopharmaceutical company PAION AG (ISIN DE000A0B65S3) (Frankfurt:PA8) (London AIM: PAI) today announces that its Phase I study with its sedative CNS 7056 has progressed to the dose levels that induce pronounced sedation.\nGeneral anaesthetic can make the pain of operations worse for patients recovering after surgery by activating the body's "mustard receptors", researchers have found. Many of the drugs that send surgical patients to sleep are known to make them more sensitive to pain when they wake up.\nResearchers at the University of California say low doses of a commonly-used anesthetic could prevent the formation of painful memories.\n- The horn of a unicorn considered as a medical or pharmacological ingredient.\n- A winged horse with a single horn on its head; a winged unicorn.
Objectives—To assess pain in young children presenting to an accident and emergency (A&E) department. To evaluate the use of the toddler-preschooler postoperative pain scale (TPPPS) and the use of analgesia in these children.\nMethods—100 children aged 1–5 years presenting to an A&E department were assessed for pain. Pain assessments were carried out using a modified form of the TPPPS; a visual analogue scale by parents and a numerical scale by nursing staff.\nResults—The majority of children were assessed as having pain: 60 by the TPPPS, 58 by the nurses and 63 by parents. Only 30 children, however, received analgesia. Children with the highest pain scores as assessed by nursing staff or using the TPPPS all received analgesia.\nConclusions—The pain scale appears suitable for use in young children in A&E departments. The subsequent management of pain in young children could be improved.\n- pain assessment\nStatistics from Altmetric.com\nIf you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.\nConflicts of interest: IC is in receipt of research grants from Astra and Chiroscience in relation to the managment of pain.
For most of us, our armpits sweat when it’s hot. For too many of us, our armpits sweat whether it’s hot or not. It may seem silly at first, but excessive or unwanted armpit sweating can have a severely negative impact on your life. It can force you to alter so many things, from the way you dress to the way you carry yourself. MiraDry is here to change all of that. With our nigh-miraculous miraDry procedure, you won’t have to worry about armpit sweat anymore.\nSafe miraDry Procedure\nThe first thing to point out about miraDry is that it’s completely safe. Utterly non-surgical, you don’t have to worry about being harmed, cut, or anything like that. You certainly don’t have to plan for some kind of lengthy recovery period. Most people go right back to their regular lives practically immediately. However, you’ll be able to step back into your life without having to worry about underarm sweat or stains anymore.\nHow it Works\nThe procedure itself only takes an hour, but it provides a lifetime of change. First, we use local anesthesia to numb your armpits. So, there’s no general anesthesia to be concerned with or anything like that. Then, we put a temporary tattoo on your armpit to mark where we’re going to perform the treatment. The keyword of this tattoo is “temporary.” You don’t have to worry about having a tattoo on your armpit after the procedure. In fact, after the procedure, you’ll have far fewer worries when it comes to your armpit, period.\nYou’ll Sweat Where you want to\nPerhaps the most asked question we get about miraDry is: “won’t it interfere with my sweating?” Not at all. You’ll still be able to sweat through the other two to four million sweat glands that your body has. You aren’t like a dog that can only sweat through their tongue or something. You’ll be able to perspire healthily just as you did before, only now you won’t have to be concerned about sweating through your clothes. Your body’s perspiration won’t be affected one iota.\nA Better Way to Live\nIf you’re someone that sweats too much, think of all the time you’ve wasted checking your underarms to make sure they aren’t sweating. Maybe you’ve ruined so many undershirts, in a futile effort to keep the water from soaking through. It’s incredibly annoying, and maybe you don’t want to wear black everywhere you go. That’s where miraDry comes in.\nWe understand that some of you may not be sure if miraDry is right for you. That’s why we offer free consultations! All you have to do is message us through our site. Then, we’ll sit down with you and go over how miraDry can help. You can see for yourself how simple and easy the procedure is. A life without pit stains awaits. To step into it, head to the miraDry site or give our pros a call at (408) 579-8795.
Пластика оболочек левого яичка по Винкельману. Погружение левого яичка в мошонку с послойным. При дву стороннем процессе производится анало. Накладывание швов по Донати на кожу рис. Диагноз варикоцеле. Варикоцеле. Сочетанная патология органов мошонки. Ревизия венозных коллекторов реносперматический тип. Ревизия венозных коллекторов илеосперматический тип.\nПрецизионное выделение декомпенсированных расширенных вен Рис. Погружение левого яичка в мошонку. Именно это обстоятель. Через 6 мес после операции без какого-либо до. При проведении маг. Этим больным были прове. Всем этим пациентам было выполнено склерозирова. От установки. Т рансскротальный доступ при оперативном лече. Braz и соавт. У всех пациентов было выявлено левостороннее вари. Через 1 год после операции ослож.\nЛИНИЯ УПАКОВКИ С АВТОМАТИЧЕСКИМ ФОРМИРОВАНИЕМ ПАЧКИ\nОперативный доступ был реко. Zampieri и соавт. Показанием к операции. Время опера. В послеоперационном пе. Iacono и соавт. Швы по Донати на кожу.\nПациент П. В течение 6 мес рецидивов. Он по. Из мошоночного доступа возможно интраоперацион. Вне зависимости от способа ушивания кожи. В послеоперационном периоде у 5. Т ем не менее по сравнению с други. Эти обстоятельства позволили нам рекомен. Кадыров З. Marmar J. T auber R. Antegrade scrotal. Sigmund G. Seyferth W. Lenk S. Palomo A. Radical cure of v aricocele by. Goldstein M. Clinical outcome of microsurgical subinguinal.\nMiersch W. Jungwirth A. Guidelines on Male Infertility.\nAssociation of Urology Braz M. Post Operative Hy drocele. Pediatric Urology. V egas, Nevada. A vailable at:. Camoglio F.\nWarmcomm 3 SW On-Line Support - new service for you\nTrans-scrotal v aricocelectomy. Iacono F. T reatment of bilateral varicocele and other. Citations 0. References Our Experience on 34 Patients. Full-text available. Varicocele is the main cause of infertility in male and the most correctable cause of it too. In this study, we present our experience on 34 patients affected by bilateral varicocele and other scrotal comorbidities treated underwent surgery with a scrotal access.\nMaterials and methods: They all underwent scrotal bilateral varicocelectomy under local anesthesia. Results and discussion: At 6 months, no other complications were reported. No case of testicular atrophy was observed.\nNone had recurrence of varicocele. All scrotal comorbidities were treated as well. Scrotal access with local anesthesia is a safe and useful technique to treat patients with bilateral varicocele and other scrotal comorbidities. Trans-scrotal varicocelectomy in adolescents: Clinical and surgical outcomes. Apr J Pediatr Surg. The gold standard to treat varicocele in adolescents is still under discussion.\nThe aim of this study is to evaluate the role of trans-scrotal varicocelectomy and show the results obtained by using local anesthesia in combination with preoperative sedation.\nBetween January and Januarythis surgical and anesthesiology procedure was proposed to study patients. Inclusion and exclusion criteria were created. Patients received trans-scrotal varicocelectomy with lymphatic париматч латвия artery sparing technique under local anesthesia with mild sedation anesthesia.\nPatients were followed for 6months after surgery, and complications were recorded. Eighteen patients were treated with this technique. Three patients required additional sedation with propofol. None had recurrence of varicocele, and one patient showed post-operative hydrocele. All patients were discharged within 24h following surgery.\nThree patients used ibuprofen and paracetamol for two days after surgery. Local anesthesia in the pediatric age group could be used for varicocelectomy with mild sedation anesthesia. An Artery and Lymphatic Sparing Technique. Marc Goldstein. Conventional techniques of varicocele repair are associated with substantial risks of hydrocele formation, ligation of the testicular artery, and varicocele recurrence. We describe a microsurgical technique of varicocelectomy that significantly lowers the incidence of these complications.\nThe testicle is delivered through a 2 to 3 cm. The testis is returned to the scrotum and the spermatic cord is dissected under the operating microscope. The testicular artery and lymphatics are identified and preserved. All internal spermatic veins are doubly ligated with small hemoclips or 4-zero silk and divided. The vas deferens and its vessels are preserved. Idiopathic varicoceles: Feasibility of percutaneous sclerotherapy.\nPercutaneous retrograde venography was performed in patients with a left-sided idiopathic varicocele. In The different venographic patterns of the testicular veins were classified into seven basic types.\nFive of these, comprising patients, had incompetent or missing valves all along the trunk of the testicular vein. In of the In 43 of the patients 6. The mean fluoroscopy time was 4. There were no serious complications associated with venography or sclerotherapy, and the initial recurrence rate was 9. Percutaneous sclerotherapy of varicocele.\nSeyferth E. Jecht E. The results of selective phlebography of the spermatic vein are reported in infertile men with abnormal sperm morphology and suspected varicoceles. Percutaneous transvenous retrograde sclerotherapy of the internal spermatic vein was performed in of the patients. Comparison of different methods of treating varicocele. Varicocele treatment was performed in patients.\nOne hundred fifteen patients were operated upon according to the technique of Bernardi80 patients underwent occlusion of the testicular vein by detachable balloons, 47 patients were treated with percutaneous sclerotherapy, and 89 patients underwent laparoscopic varicocele treatment. The laparoscopic occlusion of the testicular vessels was done in two different ways: Because of its higher complication rate and recurrence rate, laparoscopic electrocoagulation of the testicular veins proved to be inadequate.\nAntegrade Scrotal Sclerotherapy for the Treatment of Varicocele: Technique and Late Results. Tauber N Johnsen. Antegrade sclerotherapy has been used since to treat patients with varicocele. The method has proved to be easy to perform, safe, economical and effective. The treatment results in patients who had undergone sclerotherapy for a total of varicoceles are presented and discussed. Antegrade sclerotherapy represents an alternative treatment to high ligation and retrograde sclerotherapy, as well as to laparoscopic and microsurgical procedures.\nСоглашение предусматривает предоставление Эксимбанком. On 7 Maythe Bank signed a loan agreement with the. В результате массового вывода средств. We also welcome the decision to op en a credit line for e n er gy savings and are grateful [ Мы. Under the Agreement, China Construction Bank will open a.\nРешение ОАО "Сбербанк. On 6 Julythe Bank signed a second loan agreement. According to the protocol, China may open a spe ci a l credit line for U k ra ine worth 3. China will also [ The agreement will set up a credit line for V T B to provide financial [ Russian Federation- The proceeds of this loan will be used for the purchase of small- and medium-scale equipment and facilities from Japanese exporters by Russian firms. T h e credit line is for K G Sthousand collaterised partially by buildings of KGS 17, thousand note 15 and partially by loans to customers [ Залоговым обесп е че ни е м кредита в р аз ме ретысяч сом частично служат здани я Банка н а сумму 17, тысяч сом Примечание 15 и частично кредиты, [ ЕС по развитию малых и средних предприятий и становится участником программы торгового финансирования ЕБРР.\nКредитная линия в р аз ме ре 60 млн долларов США, [ In NovemberPTP entered into two loan agreements with Sberbank under a n e w credit line t o b e us e d for t h e acquisition of Sovfracht-Primorsk in the amount ofand for financing [ В ноябре года ПТП заключи л два к ре дитных соглашения со Сбербанком по договору об откр ы тии новой кредитной л ини и на приобретение акций Совфрахт-Приморск в размере [ During the Company.\nВ течение года ком функции букмекерских контор ан ия получила кредитную ли н ию Вн ешэкономбанка на сумму [ In September.\nВ сентябре г. Commission fees that were received paid by the ba n k for crediting l i ab ilities reservatio n o f credit line d ur ing initiation or purchase of loan, shall be [ On 27 Augustthe Bank signed a loan agreement with Kyrgyzstan New Zealand Rural Trust to op en a credit line t o g rant sub-loans to inhabitants of villages located in Naryn, Atbashy and Aktaly districts of Naryn ob la s t for t h e purpose of development and increase of living standards in the given region.\nThe Group pledged inventories, land and buildings with total carrying value as at 31 December of RUR 36, as a collat er a l for t h e credit line a g re ements. В обеспечение обязательств по кредитам Группой были переданы в залог запасы, земельные участки и зданиябалансовая ст оимость которых на 31 декабря г.\nInVTB Bank provided a non-revol vi n g credit line w o rt h RUB 2 billion to the municipal company Mosvodokanal to finance the reconstruction, repair and acquisition of capital assets, as well as to refinance earlier loans t ak e n for t h es e purposes.\nAccordingly since the th session of the Executive. Current searches: Most frequent English dictionary requests: Please click on the reason for your vote: This is not a good example for the translation above.\nThe wrong words are highlighted. It does not match my search.
This prospective double-blinded, randomized controlled trial compared adductor canal block (ACB) with femoral nerve block (FNB) in patients undergoing total knee arthroplasty. The authors hypothesized that ACB, compared with FNB, would exhibit less quadriceps weakness and demonstrate noninferior pain score and opioid consumption at 6 to 8 h postanesthesia.Methods:\nPatients received an ACB or FNB as a component of a multimodal analgesic. Quadriceps strength, pain score, and opioid consumption were assessed on both legs preoperatively and at 6 to 8, 24, and 48 h postanesthesia administration. In a joint hypothesis test, noninferiority was first evaluated on the primary outcomes of strength, pain score, and opioid consumption at 6 to 8 h; superiority on each outcome at 6 to 8 h was then assessed only if noninferiority was established.Results:\nForty-six patients received ACB; 47 patients received FNB. At 6 to 8 h postanesthesia, ACB patients had significantly higher median dynamometer readings versus FNB patients (median [interquartile range], 6.1 kgf [3.5, 10.9] (ACB) vs. 0 kgf [0.0, 3.9] (FNB); P < 0.0001), but was not inferior to FNB with regard to Numeric Rating Scale pain scores (1.0 [0.0, 3.5] ACB vs. 0.0 [0.0, 1.0] FNB; P = 0.019), or to opioid consumption (32.2 [22.4, 47.5] ACB vs. 26.6 [19.6, 49.0]; P = 0.0115). At 24 and 48 h postanesthesia, there was no significant statistical difference in dynamometer results, pain scores, or opioid use between the two groups.Conclusion:\nAt 6 to 8 h postanesthesia, the ACB, compared with the FNB, exhibited early relative sparing of quadriceps strength and was not inferior in both providing analgesia or opioid intake.
I'm a Candidate\nI'm a Provider\nLog In / Sign Up\nI'm a candidate\nI'm a provider\nList your practice\nAims to correct issues with the upper eyelid and under eye areas, such as under eye bags and droopy eyelids.\nA surgical or non-surgical eye rejuvenation procedure can wind back the clock on aging and tired eyes.\nAlso known as double eyelid surgery, this procedure creates a new natural looking eyelid crease.\nUsed to create a long lasting and natural looking skin crease in the upper eyelid that shows when the eyes are open.\nA minimally invasive, partial incisional/suture technique used to create natural looking double eyelids.\nAn awake blepharoplasty refers to the type of anesthesia used during the plastic surgery (i.e. local vs. general).\nRequires 2-3 strategically placed sutures to evert the eyelid to correct any issues with an inwardly turned eyelid.\nProvides vertical height and stiffness to support the upper or lower eyelids that look pull-back or don't cover the eye.\nCommonly used when levator function is normal and upper eyelid crease is high and in need of advancement.\nThe upper eyelid is attached to the muscle above the eyebrows, connecting the eyelid and elevating it.\nAims to repair the minimal ptosis by turning the eyelid inside out and shortening the eyelid muscles.
"Anesthetics, Inhalation" is a descriptor in the National Library of Medicine's controlled vocabulary thesaurus,\nMeSH (Medical Subject Headings). Descriptors are arranged in a hierarchical structure,\nwhich enables searching at various levels of specificity.\nGases or volatile liquids that vary in the rate at which they induce anesthesia; potency; the degree of circulation, respiratory, or neuromuscular depression they produce; and analgesic effects. Inhalation anesthetics have advantages over intravenous agents in that the depth of anesthesia can be changed rapidly by altering the inhaled concentration. Because of their rapid elimination, any postoperative respiratory depression is of relatively short duration. (From AMA Drug Evaluations Annual, 1994, p173)\nBelow are MeSH descriptors whose meaning is more general than "Anesthetics, Inhalation".\nBelow are MeSH descriptors whose meaning is more specific than "Anesthetics, Inhalation".\nThis graph shows the total number of publications written about "Anesthetics, Inhalation" by people in the URMC Research Network by year, and whether "Anesthetics, Inhalation" was a major or minor topic of these publication.
EE: Rest Period Duration in Critically Ill 2013\nClick here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.\nEE: Rest Period Duration in Critically Ill\nThe registered dietitian nutritionist (RDN) should ensure a 30-minute rest period prior to resting metabolic rate (RMR) measurement in critically ill patients. One study indicates that energy expenditure is elevated for up to 30 minutes after routine intensive care unit (ICU) care in non-sedated patients. The potential for sedation to shorten the rest period has not been studied.\nRisks/Harms of Implementing This Recommendation\nThere are no potential risks or harms associated with the application of this recommendation.\nConditions of Application\n- Sedation might reduce the time it takes to return to rest after routine ICU care, but the effect is not known\n- For the purposes of this recommendation, routine ICU care includes suctioning, vent adjustments, turning, bathing and dressing changes, as well as any other invasive procedures\n- Further studies are needed to identify the optimal wait time after procedures, such as surgery and hemodialysis\n- Coordination with other healthcare professionals (e.g., nurse, respiratory therapy) is needed to ensure a sufficient wait time.\nPotential Costs Associated with Application\nIf the 30-minute wait time cannot be achieved, then the measurement should be rescheduled or a measurement of total energy expenditure (TEE) may be attempted. Additional costs may occur due to increased time.\nOnly one study was included in the evidence analysis for this recommendation.\n- One neutral-quality study (Swinamer et al, 1987) provides evidence that rest periods greater than 30 minutes are not necessary. Additional research is needed to confirm this and determine the minimum time to recover to rest in critically ill patients, taking into account their sedation level.\n- No new studies were identified in the update of this question.\nRecommendation Strength Rationale\nConclusion statement is Grade III.\n- Risks/Harms of Implementing This Recommendation\nThe recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).\nHow long of a rest period is needed prior to the measurement of resting metabolic rate (RMR) to ensure accuracy in the critically ill population?
Best-selling in Textbooks\nSave on Textbooks\n- AU $74.90Trending at AU $85.93\n- AU $68.00Trending at AU $73.27\n- AU $74.00Trending at AU $85.59\n- AU $41.64Trending at AU $45.10\n- AU $79.95Trending at AU $91.47\n- AU $46.38Trending at AU $48.34\n- AU $81.00Trending at AU $84.40\nAbout this product\n- DescriptionHere is complete coverage of state-of-the-art surgical techniques for the spine and peripheral nerves. This atlas engages the full range of approaches -- anterior, antero-lateral, posterior, and postero-lateral -- for operations on peripheral nerves and in every area of the spine, from cephalad to caudad. Each of the seven sections of the atlas opens with in-depth discussion of pathology, etiology and differential diagsis conveying the underlying scientific principles of diseases and conditions of the spine and peripheral nerves. The authors then present technique-oriented chapters containing step-by-step descriptions of surgical procedures. These chapters delineate the goals, indications, contraindications, anesthesia considerations, positions, as well as the advantages and disadvantages of each technique in a concise manner, ideal for the busy practitioner seeking review. Lavishly illustrated with more than 1,200 images, including 811 beautifull full color drawings, this authoritative text covers all of the critical issues involved in surgeries for the spine and peripheral nerves. Here is an invaluable asset to neurosurgeons, orthopedic surgeons and residents seeking a carefully edited, didactic atlas.\n- Author(s)Laligam N. Sekhar,Richard Glenn Fessler\n- PublisherThieme Publishing Group\n- Date of Publication08/02/2006\n- SubjectSurgery: Professional\n- Place of PublicationStuttgart\n- Country of PublicationGermany\n- ImprintThieme Publishing Group\n- Out-of-print date30/01/2016\n- Content Note1269 illustrations\n- Width210 mm\n- Height280 mm\nThis item doesn't belong on this page.\nThanks, we'll look into this.
The provincial panel tasked with developing privileges for procedural pain management has completed its work. The new privileges result from a 15-month consultation and review process that drew input from across the province, and from multiple practice perspectives.\nProcedural (interventional) pain management (PPM) is an evolving multi-specialty practice, requiring complex graduated care. Currently, BC has no consistent standard for physicians practicing PPM in health authority or community settings. Introduction of the new PPM privileges supports a standardized approach to credentialing requirements across disciplines.\nThe next step is to integrate the PPM privileges into the relevant discipline-specific dictionaries. Representative panels will determine which content is appropriate to include in the practice dictionaries for anesthesia, diagnostic imaging, family medicine, family medicine-anesthesia, neurology, neurosurgery, physical medicine and rehabilitation, and rheumatology. Implementation in the health authorities will follow the panel consultations, which are slated to wrap up in spring 2019.
Breast augmentation is one of the most frequently performed cosmetic surgery procedures worldwide. Women may elect to undergo breast augmentation for many different medical and aesthetic motivations, including balancing breast size and compensating for reduced breast mass after pregnancy, weight loss, or surgery. The procedure may be combined with others such as a breast lift for more satisfying results. Implants are silicone shells filled with either saline (salt water) or silicone gel (recently approved by the FDA). They are placed behind each breast, underneath either breast tissue or the chest wall muscle. The procedure lasts about one hour and is typically performed with general anesthesia as an outpatient. After surgery the patient's bustline may be increased by one or more cup sizes.\nWhen the implant is placed sub muscularly under the breast, there is a lower chance of contracture (contraction of the tissue capsule surrounding the implant), and mammography is more reliable. There is also less risk of visible or palpable implant edges. However, in some cases the implant has a more natural appearance when placed above the muscle, under the breast tissue. The placement of the implant will be decided upon consultation and depends on many factors.\nPatients who undergo breast augmentation are generally able to return home the same day. The side effects of breast augmentation surgery include temporary soreness, swelling, and bruising, all of which subside gradually over 10 to 14 days. Most breast augmentation patients return to work within a few days after surgery; however, strenuous activities should be avoided for up to four weeks after surgery.\nA woman's breasts may droop as a result of the natural effects of aging, heredity, gravity, pregnancy, breastfeeding, or weight loss. A breast lift, also called a mastopexy, is performed to return youthful shape and lift to breasts that have sagged or lost volume and firmness. A good candidate for a breast lift is any woman who has breasts that are pendulous or sag, lack substance or firmness, or if the nipples are too low and pointing downward.\nBreast lifts rejuvenate the breasts by trimming excess skin and tightening supporting tissues to achieve an uplifted, youthful contour. A mastopexy raises and reshapes sagging breasts by removing excess skin and repositioning the breast tissue (and areola) to a higher position. Our goal is to give your breasts a firmer, rounder, and more youthful contour, rejuvenating your figure. The length and location of the scars depend on the amount of excess skin that needs to be removed to achieve the desired results. After a mastopexy, the breasts are higher on the chest and firmer to the touch. Breast lifts can also reposition and reduce the size of the areola-the dark skin surrounding the nipple-which may have stretched or drooped.\nMastopexy is usually performed on an outpatient basis under general anesthesia and lasts from 1 to 3 hours. Most patients are immediately satisfied with their new breasts and can typically return to work in one week following the procedure. Generally, we recommend waiting 3 to 4 weeks before resuming vigorous activities.\nA breast lift (mastopexy) raises and reshapes sagging breasts by removing excess skin and repositioning the breast tissue to a higher position. The difference between this procedure and a mastopexy alone is the addition of breast implants, put in place during the same surgery. The implant is placed behind the breast tissue or under the muscle between the breast and the chest wall to enlarge and reshape the breasts.\nA good candidate for a breast lift with augmentation is any woman who has breasts that are pendulous or sag, lack substance or firmness, or if the nipples are too low and pointing downward. If your breasts have also lost their breast shape and firmness due to age or pregnancy, the breast implants can restore (or even augment) your breasts to a more youthful-looking profile.\nMastopexy augmentation is usually performed on an outpatient basis under general anesthesia and lasts from 1 and a half to 3 hours. Most patients are immediately satisfied with their new breasts and can typically return to work in one week following the procedure. Generally, we recommend waiting 3 to 4 weeks before resuming vigorous activities.\nA breast reduction removes excess skin and breast tissue to make your breasts more proportional to the rest of your figure. Women with large breasts who are unhappy with their appearance and/or want to treat symptoms such as back pain, discomfort during exercise, breathing problems and poor posture may benefit from breast reduction surgery. Other suitable candidates are women who are self-conscious about the large size of their breasts.\nThis surgery is important both functionally and aesthetically. In this procedure, we remove fat and glandular tissue from the breast while tightening skin to produce smaller breasts that are more comfortable and in healthier proportion to the rest of the body.\nThe side effects of the surgery include temporary bruising, swelling, and discomfort. After 2 to 3 weeks, most of our patients resume their normal activities and regular routines.\nBreast reconstruction is designed to create a natural-appearing breast using either your own tissues or an implant. There are several different techniques available for breast reconstruction. The option we choose depends on your individual anatomy, medical history, and personal needs. Whether the reconstruction is performed immediately after a mastectomy (known as immediate reconstruction) where the patient wakes with a “new breast” or later (known as delayed reconstruction), this procedure has a dramatic impact on a woman’s quality of life and emotional well-being.\nWomen whose cancer seems to have been eradicated with mastectomy are the best candidates for breast reconstruction. Those with health problems such as obesity and high blood pressure and those who smoke are advised to wait. Others prefer to postpone surgery as they come to terms with having cancer, consider the extent of the procedure, or explore alternatives.\nThe reconstruction itself consists of three main stages, the first of which involves creation of the breast mound that is symmetric to the other side and is performed during or after mastectomy under general anesthesia. Occasionally, the other breast may need to be altered to create this symmetry. Next is the nipple reconstruction which is an outpatient procedure usually performed in the office and involves creating a small flap from local skin. And finally, the areolar tattoo which matches in colour and size of the areola of the normal breast. This is also an office procedure.\nThere are several ways to reconstruct the breast, both using one’s own tissues and/or with the use of implants. Dr. AlShunnar will work together with you in deciding which is the best for you.\nGynecomastia, a condition of over-developed or enlarged breasts in men, is common in men of any age. It can be the result of hormonal changes, hereditary conditions, disease or the use of certain drugs.\nGynecomastia can cause emotional discomfort and impair your self confidence. Some men may even avoid certain physical activities and intimacy simply to hide their condition.\nGynecomastia is characterized by:\n• Excess localized fat\nMen who feel self-conscious about their appearance are helped with breast reduction surgery. The procedure removes fat (using liposuction techniques) and/or glandular tissue (using direct excision) from the breasts, and in extreme cases removes excess skin, resulting in a contoured chest that is flatter and firmer.
Inclement Weather Notice: Wednesday, Feb 20th, 2019, all FRC offices are CLOSED. Thursday, Feb 21st, 2019, all FRC offices will OPEN at their normal times. Please continue to check our website or call at 703.698.4444 as this may change as the storm progresses. Thank you for your business!\nA CVAC is a small tube that is inserted beneath your skin to quickly and easily allow physicians or nurses to draw your blood or give you medication or nutrients. By having a CVAC inserted ahead of time, you can avoid the sometimes painful and annoying process of having needle pricks every time you need an infusion or need to have blood drawn.\nThere are several types of CVACs from ones that are placed directly through the skin into the vein, to ones placed completely under the skin, and those in between. The type of CVAC your physician recommends for you may depend upon your condition, activity level and age. Catheter types include:\nPICC Line – PICC stands for peripherally inserted central catheter. This type of catheter is inserted into a vein in the arm and is intended for use for a few weeks or several months.\nTunneled Catheter – This type of catheter is inserted into a vein in the neck or chest. The tube passes under the skin and one end of it remains outside the skin, allowing easy access for infusions to be given/blood to be drawn.\nImplanted Port (Mediport) – This is the least obvious type of catheter. It is placed entirely under the skin. When blood needs to be drawn or medicines given, it is done through a prick to the skin and into the catheter.\nYou will be given detailed instructions by our staff before your procedure. In general, do not eat, drink or smoke anything after midnight the night before your procedure. This includes breath mints, gum and tobacco. Patients should notify staff if they are diabetic, taking anticoagulants (blood thinners) or allergic to anesthesia. Be sure to bring your insurance card, photo ID, list of current medications (dose and frequency) and any diagnostic testing results.\nHistorically, surgery was required to insert a CVAC tube. Today, it is a simple procedure performed by Interventional Radiologists on an outpatient basis. Before the procedure, you will receive medication to help you relax and the area where the tube is to be inserted will be numbed. Next, a needle will be inserted into your skin, creating a small opening. The catheter is then placed in the opening leading to a large vein that will receive any medications or nutrients that are infused through it or can be used to draw blood from the vein.\nYou will feel a slight sting when the needles are inserted for the IV line and the anesthesia. If you receive sedation, you will feel relaxed and sleepy and may or may not be partially awake during the procedure. You may feel some pressure when the catheter is inserted, but no serious pain.\nYou may feel slight pressure in the area where the catheter was inserted. This may last up to a week, or it could dissipate shortly after the procedure. The level and duration of discomfort is different for every patient. If the pain is persistent, or if you notice fluid leaking from the tube, call your physician immediately.\nBefore scheduling an appointment, you will need to get a referral from your physician. Once you have a referral, you can schedule an appointment by calling 703.698.4475 Monday through Friday 7am to 5pm.\nI would like to express my sincere gratitude to all who cared for me when I came in for my port placement procedure. My husband and I were treated professionally and courteously (from check-in to being taken out to my car at discharge), but also with a sense of humor, which made me feel comfortable and cared for (it is true, laughter is the best medicine!). It was so helpful that the entire procedure was explained to us along with visual aids. We now have a better understanding how the port will work for my chemo.
Your privacy settings do not allow this content to be viewed.\nMi especialidad: Anesthesiology\nAll Kaiser Permanente Physicians and Surgeons\nIdioma que hablo:\nSe aceptan pacientes nuevos.\nEste proveedor necesita una remisión.\nI hate to confess that I am a California transplant. I was born and raised in the Mother Lode of the Sierra Nevada foothills of California, in a small gold mining and logging town called Grass Valley. Good fortune and hard work led me to the anesthesia department at Stanford University, where I trained with pioneers in the field of anesthesia. I went on to earn a Master of Business Administration, but I must give my wife credit. She worked double duty to support the family and help cover my clinical anesthesia responsibilities. I have now had multiple department chairman positions where I have called on her to continue this support. Probably my greatest achievement and most challenging work has been to help raise eight children. It may be many years before any of them understand my frequent statement: "You will always be treated fairly but not necessarily equally."\nAfter many years in private practice, including 10 years of cardiac anesthesia, I was lured to Kaiser Permanente, which I believe is the model for future medicine in this country. Quality is the keystone of this health system and my passion. There is an unsurpassed commitment to patient safety and emphasis on preventive care. Coordinated integrative medicine provides the best care. Successful anesthesia involves coordination and communication with many subspecialties. I consider it a privilege to be in this medical subspecialty where I can minimize the pain, anxiety, and stress of surgery. My goal is to provide utmost quality, utilizing evidence-based medicine, while treating patients as if family. My skill is providing anesthesia for the complex case and applying goal-directed therapy. I am the current Northwest regional anesthesia chief. I relish the opportunity to oversee and improve the quality of anesthesia for Kaiser Permanente members. My department is involved in multiple quality initiatives: reduction of surgical site infection, surgical and post-op care of patients with obstructive sleep apnea, development of a regionalized pediatric anesthesia care system, improvement of patient safety in the surgical suite, development of standardized orthopedic care for total joints, development of an acute pain service, and outpatient pain catheter service.\nOver the past five years, Kaiser Permanente has changed my life. I have adopted the Kaiser Permanente motto of Thrive. I have been a vegan for two years now with the support of our cafeteria at Sunnyside Medical Center. I have lost 30 pounds while becoming increasingly active in sports, specifically swimming, running, and biking. Now I am training for triathlons. My hope is to eventually run with my two 3-year-old goldendoodles, who have not been separated since birth. The problem is they tangle themselves in their leashes with me included. I probably know every Meals on Wheels route in Portland, Oregon, and can honestly say I feel a loss when one "regular" gets taken off the roster. We've been actively involved in delivering food for 15 years. My wife and I have raised all our children to value and participate regularly in community service. We have eight children and are actively involved in their lives. I am a sports buff and must confess I enjoy lazing on the couch and watching football games on the weekends. My other "couch" passion is reading modern history.
Anesthesiology opportunities in Illinois\n~ Schaumburg - 30mi from Chicago\n~ Geneva - 40mi from Chicago\n~ Vernon Hills - 45mi from Chicago\n~ Bradley - 55mi from Chicago\n~ Gurnee - 50mi from Chicago\nAbout the Opportunities:\n~ Candidates must be Board Certified to apply\n~ Full-time, permanent positions\n~ Schedule: M-F, times can vary depending on surgery schedule. Candidates have options to work weekends only if interested (not required).\n~ 100% Outpatient - No hospital work\n~ Compensation: based upon credentials and experience.\n~ 1099/Independent Contractor status.\n~ Daily patient census: varies by site.\n~ Benefits: the group offers medical, dental, and vision.\n~ Number of other providers: varies by site. Could be anywhere from solo to 4 other providers.\n~ The group is well-established with multiple sites in IL and IN.\n- Board Certified\n- Candidate must be able to perform all blocks\n- Be licensed in IL and IN or willing to get the other if only licensed in one state\n- Have no issues with traveling between locations\nAbout the Group:\n~ The group is dedicated to the well being and health of those it serves. Expertise in the delivery of anesthesia care with an emphasis on quality, safety, value and satisfaction. Each of the group's licensed Independent Practitioners (CRNAs and MDs) provides superior customer service to both the patient and the client, responding to both the individual needs of the patient and the client.\n~ All of specialists are board certified and have had extensive experience in providing anesthesia services in a wide variety of clinical settings, including, but not limited to: inpatient settings, ambulatory surgical treatment centers, private physician surgery suites as well as a other various outpatient surgical settings.\n~ Turnkey mobile anesthesia service\n~ Hospital-quality anesthesia\n~ No cost to your practice\n~ Experienced providers\n~ Avoids hospital scheduling and delays\n~ Can see patients between cases\n~ Less paperwork/EMR\n~ Increased professional reimbursement
Not every morbidly obese patient should undergo an operation.\nSome reasons an operation should be avoided include:\n- Heart valve disease and/or angina pectoris\n- Active peptic ulcer disease\n- Patient is unfit for general anesthesia\n- Patient is not prepared to make necessary lifestyle and/or behavior changes\n- Active alcoholism or drug abuse\n- Hepatic cirrhosis with impaired liver function tests\n- Serious psychiatric disability\n- Patients in very poor overall health\n- Persons desiring the surgery for the wrong reasons (see below)\nUnfortunately, there are many who want surgery for the wrong reasons. If you feel that the surgery will help you attain a “normal” weight, make you “skinny,” or make people like you more then you should probably avoid an operation. Additionally, if you believe that the operation will allow you to eat anything that you want, this procedure is not appropriate for you.
Waterlace Dentistry combines laser energy and a spray of water to gently cut teeth, gums and even bone without generating heat, vibration or pressure that can cause discomfort or damage. The only sound that patients hear is a gentle popping noise, removing much of the anxiety from the experience of being in the dentist’s chair.\nThe system’s laser handpiece never touches the tooth during procedures such as removing dental decay, eliminating the grinding and heat associated with the drill along with the pain triggered by nerves reacting to heat and vibration. The system also helps preserve teeth by eliminating vibrations that can create small cracks and fissures in the surrounding healthy tooth surface.\nIn procedures such as gum surgery, the Waterlase system uses only the energy of the laser to cut and the water to cool as the tip gently touches the tissue. The laser energy helps reduce or eliminate bleeding.\nPatients report a dramatic reduction in pain as well as less post-operative swelling and infection. There is less chance of walking out of the office with a numb lip because fewer and sometimes no shots are needed. That reduced reliance on anesthesia in turn can allow cavities to be filled in multiple areas of the mouth on a single visit, reducing the number of appointments for the patient.
Date: October 13, 2018\nWe would like to welcome you to a prestigious set of simulation courses organized by the Anesthesia, ICU and Perioperative Medicine Department at HMC. These courses are designed to enhance your education and clinical skills by combining education and training to help you adapt to the latest advancements in technology.\nThe Anesthesia Department Simulation Courses (ADSC) will be held on a regular basis in the world class Qatar Robotic Surgery Center in Doha, Qatar and are primarily aimed at medical students, physicians, technicians, technologists, nurses, and other healthcare professionals.\nThe objective of ADSC is to create an educational environment promoting basic and advanced science and clinical applications using technical and non-technical skills in training.\nThese workshops and courses will include a variety of lectures, videos, hands on training and different skill stations in anesthesia and pain management. The program activities will be led by experts and distinguished speakers from different leading institutions worldwide.\nBy offering these courses, it is our mission and commitment to achieve excellent evidence-based patient care through evaluation and dissemination of knowledge and technology and the introduction of innovative solutions in all the relevant areas of our profession.\nWe hope you will join us for ADSC and we will look forward to seeing you. For those of you registering from outside of Doha, we hope the course venue will give you an opportunity to develop ideas in enjoyable surroundings and to explore the magnetic nature, old history and rich cultural heritage of Qatar.\nProf. Marco Abraham E Marcus\nChairman of Anesthesiology, ICU and Peri-Operative Medicine, HMC\nReference URL: https://www.hamad.qa/EN/All-Events/ADSC/Pages/default.aspx
Nowadays, hair transplant has become a common procedure performed to regain your lost hair and restore your natural hairline. Many people suffer from severe hair loss or have lost their hair due to different reasons. They can now opt for a simple hair transplant surgery to fix this problem instead of waiting to get completely bald. Hair transplant in Dubai is an effective technique that offers quite impressive results that are permanent.\nHowever, the hair transplant procedure is not for everybody. Some people cannot undergo this treatment to get rid of baldness. Many conditions should met in order to get the procedure. If you want to know about the people who cannot undergo hair transplantation, you have come to the right place.\nContinue reading the article and find out!\nWho cannot have Hair Transplant?\nThere are times when hair transplant is not among the suitable choices. It is because the health of the person might be at risk. Following people are not suitable for hair transplantation;\n- People with no hair by birth\n- People who have serious health problems\n- People who might be allergic to anesthesia\n- People suffering from Hepatitis C and HIV\n- People under the age of 24\n- People suffering from Hemophilia\nPeople with no hair by birth\nAs you know, hair transplant involves taking hair follicles from the back of the neck and transplanting them to the bald spots. But if the patient undergoing the procedure has no hair from birth then it won’t be possible to harvest hair grafts from the person. Without hair follicles, it is impossible to perform the procedure. Therefore, such people are not eligible for the procedure.\nPeople who have serious health problems\nAnother category of people who cannot have hair transplant includes people with serious health problems. Since it is a surgical procedure, so only people with overall good health can undergo it. In case you have chronic diseases such as diabetes, heart disease or any kidney problem then you cannot have a hair transplant. You can expose yourself to different health risks that can threaten your life. Therefore, share your complete medical history with your hair transplant surgeon and undergo the treatment after your surgeon’s approval.\nPeople who might be allergic to anesthesia\nAlmost all the surgeries involve anesthesia administration so that you don’t feel any pain. Hair transplant is also performed under local anesthesia because it is a painful procedure. The person undergoing the surgery is examined by an anesthesiologist first to determine if he can take the anesthesia well without reacting against it. If his/her body is suitable for it, only then anesthesia is applied.\nSo, if a person is allergic to anesthesia, it becomes impossible to perform the hair transplant procedure on him. Such people cannot withstand the pain of the surgery without anesthesia.\nPeople suffering from Hepatitis C and HIV\nYou cannot have hair transplant if you are suffering from blood-borne diseases like Hepatitis C and HIV. They are extremely dangerous diseases and undergoing serious surgery like hair transplant in this condition can be harmful for patients and surgeons. Therefore, people with these diseases should avoid the hair transplant procedure.\nHowever, there is a possibility for people with Hepatitis B to get the procedure after approval from their doctor. But for that, the treatment area should be extremely sterile.\nPeople under the age of 24\nThe standard age to undergo the hair transplant procedure is 24. The primary reason behind this age limit is that hair loss continues to occur until a specific age. If the hair loss occurs at the age of 22 it will last for one to two years. So, you should be at least 24 or above to get the treatment. Below 24 you are not eligible for the procedure.\nPeople suffering from Hemophilia\nAll those people who have hemophilia cannot undergo a hair transplant. Hemophilia is a disease in which a person lacks the normal blood clotting ability. Hair transplant surgery can pose a major risk for the people with hemophilia. They should consult with their doctor and must have a blood clotting test. If the result of this test is appropriate and your surgeon allows, only then undergo a hair transplant. Otherwise, avoid every kind of surgery.\nThe Bottom Line\nI hope now you must be clear about the people who cannot undergo the procedure. Still, if you have any confusions or concerns, you can consult with an experienced surgeon. They will examine and guide you if you are the right candidate for the surgery or not. Do not risk your life and take the decision of undergoing the treatment after knowing every detail. After all, our life is a precious gift and should not be risked at all.
Quickly extend your wisdom base and grasp your residency with Faust's Anesthesiology Review, the world’s best-selling assessment e-book in anesthesiology. Combining accomplished assurance with an easy-to-use layout, this newly up-to-date clinical reference booklet is designed to successfully equip you with the latest advances, tactics, instructions, and protocols. It’s the suitable refresher on each significant element of anesthesia.\n- Take benefit of concise coverage\nof a vast number of well timed subject matters in anesthesia.\n- Focus your learn time at the most crucial topics\n- Search the complete contents on-line at Expert Consult.com.\n, together with anesthetic administration for cardiopulmonary skip, off-pump coronary pass, and automated inner cardiac defibrillator tactics; arrhythmias; anesthesia for magnetic resonance imaging; occupational transmission of blood-borne pathogens; preoperative evaluate of the sufferer with cardiac affliction; and masses extra.\nThe excellent source, which deals concise content material for every thing wanted for certification, recertification, or as a refresher education for anesthesiology, has now superior with a extra finished view at the most crucial subject matters within the forte with over 60 new chapters.\nRead Online or Download Faust's Anesthesiology Review, 4e PDF\nBest Critical Care books\nWhy waste time guessing at what you must comprehend for the CCRN examination? Maximize your examination practise time with this quick-hit query and solution evaluation. the original query and single-answer structure gets rid of the guesswork linked to conventional multiple-choice Q&A experiences and reinforces merely the proper solutions you will need to understand on examination day.\nA whole “Visual Atlas” for center Critical-Care tactics "As a practising nurse for greater than 30 years and at the moment a scientific probability supervisor, i will say that this ebook as a reference has a number of makes use of. most significantly, it serves as an instructional reference instrument for healthcare employees on the bedside; notwithstanding, it additionally serves as an invaluable reference for possibility administration, as we overview the stairs and a number of complicated approaches enthusiastic about taking good care of our so much seriously ailing sufferers.\nWritten through best American practitioners, the Oxford American Handbooks of medication every one provide a pocket-sized review of a whole area of expertise, that includes fast entry to information at the stipulations which are probably to be encountered. unique and prescriptive, the handbooks supply updated suggestion on exam, investigations, universal strategies, and in-patient care.\nThis re-creation of the Care of the severely unwell Surgical sufferer (CCrISP) path handbook has been absolutely up-to-date and revised through a multidisciplinary group of surgeons and anaesthetists. It is still actual to the unique goals of the direction: to inspire trainees to take accountability for seriously ailing sufferers, to foretell and forestall difficulties that sufferers may come upon whereas in health facility, to operate good in the surgical group and converse successfully with colleagues from different disciplines.\nAdditional resources for Faust's Anesthesiology Review, 4e
Many doctors and medical professionals pride themselves on their high level of medical care and quality bedside manner. However, many Pittsburgh residents realize that this is not always true because of their own experiences.\nMedical malpractice is a legal term for a medical incident that causes harm to a patient’s health and that should have been avoided. Since medical malpractice incidents can occur one time or over the course of many treatments, it can be difficult for many patients to identify.\nAt Savinis, Damico & Kane, L.L.C., we pride ourselves on our ability to handle medical malpractice cases. There can be dozens, or even hundreds, of ways that medical malpractice can rear its ugly head. Oftentimes it comes up in cases of anesthesia malpractice, surgical errors or hospital malpractice just to name a few. People negatively affected by incorrect medical care do have rights and should consider seeking justice for wrongs done to them during their medical care.\nOur medical malpractice attorneys have a proven track record of success for our clients. These clients suffered medical malpractice and a number of injuries associated with such errors. When trusting your life and health to a medical professional, you deserve the highest level of care. If not received, it can have a number of negative affects on your health, finances and other areas of your life.\nWe understand what it is that you and your family are going through if suffering with medical issues. Poor heath is a burden for anyone, but especially if the poor health is the result of a medical malpractice incident. Keep your options open and explore all ways to recoup your losses. Many clients have had success seeking exactly what many injured Pittsburgh residents may be looking for.
Having undesirable fat in different locations of your body can have a considerable influence on your health and self-confidence. While conventional weight loss through exercise and diet plan is an excellent method to slim down in general, even the best workouts cannot target issue areas like the tummy, inner thighs, arms, and butts. Liposuction is a time evaluated treatment that is used to get rid of excess fat from particular areas of the body, enabling an individual to form and contour their body to their liking. Is liposuction right for you? Learn now.\nPros of Liposuction\nThere are numerous advantages to this cosmetic procedure, consisting of:\n• Immediately obvious changes. Unlike conventional weight loss, liposuction develops changes that are instantly noticeable in the body. Some difference is visible immediately, and the wanted outcomes are usually accomplished in just a couple of days.\n• Proven and safe. This cosmetic treatment has been performed by experienced surgeons all over the world for several years and the strategy has actually been improved over and again to be safe and reliable.\n• Healing time is generally fast. The downtime required after having this type of procedure is usually much less than what is required for other kinds of cosmetic procedures, consisting of tummy tucks, breast reduction, and more. Individuals who have had the treatment can often go back to work far more quickly than they expected and can return to living a healthy, active lifestyle.\n• Weight loss can be permanent. With the best upkeep methods, the fat that was eliminated throughout the liposuction treatment will not return.\n• Complete control over your physique. With liposuction, a person can have complete control over how they wish to look, beyond what standard diet and workout can supply. Providing individuals this power over their bodies enhances self-esteem and assistance individuals feel their best.\nWhile there are numerous benefits to liposuction, there are of course a couple of caveats that need to be thought about prior to making the final decision to progress with the procedure.\nCons of Liposuction\nPrior to having actually liposuction done, it is very important to analyze the potential downsides of the treatment and determine if the benefits outweigh the risks in your particular case. Your surgeon can help you find out more about the threats associated with the procedure and can assist you decide if moving on is the best thing for you.\n• Complications with general anesthesia. Since liposuction is carried out under basic anesthesia, the treatment brings the same dangers as any other kind of surgical treatment where basic anesthesia is used. Hidden medical conditions might increase these dangers.\n• Negative responses. Bruising, bleeding, and discomfort are all to be anticipated, however, in uncommon cases can trigger more substantial issues.\n• The possible to gain the weight back. After having liposuction done, it is crucial to preserve a healthy diet plan and workout correctly as recommended by your physician. Failure to do so might result in gaining back the weight that was lost or potentially much more.\nThere are threats associated with liposuction, for numerous individuals, the advantages far surpass them. Inform yourself about the treatment by having extensive discussions with your specialist and think about how liposuction has the prospective to affect you as an unique individual. Just you and your specialist can figure out if liposuction will provide you with the outcomes you are searching for within your expectations.\nLaser Liposuction procedure is a new non invasive procedure to loose unwanted bodyfat in Randlett OK\nLaser liposuction is a newer, minimally intrusive treatment that involves heating the fat cells to melting point and getting rid of the melted fat through a small cannula. The treatment is generally done right in your doctor's office and is an exceptional option for individuals who have less than 500 ml of fat to remove from any one area. Laser liposuction can be a safe, complementary procedure to weight-loss in order to sculpt the body you have actually constantly desired.\nContact a Cosmetic surgeon in your Randlett OK today.\nIf you're considering liposuction as a weight reduction solution, it is necessary that you discuss your desires with a certified plastic surgeon in your location. Your surgeon will carry out a total examination and health history survey to figure out if liposuction can benefit you and assist you reach your physical and emotional objectives. Call today for an assessment and find out more about how liposuction can help you attain the body of your dreams.
Medical Monitoring Devices for Simplified Patient Care from Infinium Medical\nMedical monitoring devices are some of the most important pieces of equipment in a health care facility. Without reliable monitoring equipment you could easily miss a piece of information that could mean the difference between life and death.\nInfinium Medical provides health care facilities of all sizes and types with a variety of affordable, user-friendly medical monitoring devices that are incredibly reliable. What’s more, we’ve designed our offerings to fit even the most restricted budget. From wireless patient monitoring to anesthesia systems, pulse oximeters, capnography monitors, and more, we develop and manufacture patient monitoring equipment that is easy to use so that you can focus on your patient’s care and not your machines.\nOur vast selection of patient monitors and other equipment includes:\n- Vital signs monitors\n- Omni II\n- Omni III\n- Omni Express\n- Anesthesia Systems\n- ADS II\n- ADS III\n- Pulse Oximeters\n- Oxcyon II\n- Infinium O2 SAT\n- Surgical tables\n- Wall and bedside monitor mounts\n- Much more\nWhether you are operating a large hospital or a remote clinic, we have the medical monitoring technology you need to not only make caring for your patients as effortless as possible, but also to provide them with the exceptional care they deserve.\nTo learn more about medical monitoring devices and accessories from Infinium Medical, contact us today.
If you've ever taken a close look at the small print on a bag or can of cat food, you've probably noticed that taurine is among the list of ingredients. Taurine is an amino acid that helps keep yo ...View Article\nYou are using an outdated browser. Please upgrade your browser to improve your experience.\nA Dental Visit to Orange Veterinary Clinic\nWhat happens when my pet has her teeth cleaned? Well, we always try to make the experience the best one possible for everyone involved. We take a lot of precautions to keep your pet safe and as pain-free as possible.\nFast Your Pet\nTo begin, we have you fast your pet the night before her dental cleaning. When you come in the morning of her cleaning, we will have an anesthesia release for you to fill in and an estimate of possible charges for the cleaning. Until we remove tartar and do a more complete exam in her mouth, we will not know if, or how many potential extractions there will be.\nThe next part of our process will be to prepare her for anesthesia. She will have a short blood screen to make sure there are no problems with her organs that would make anesthesia dangerous for her. When that is done, she will have a pre-operative sedative and pain reliever injection. She will be allowed to get sleepy for a few minutes. Next, she will have some anesthetic gas delivered by a mask.\nWhen your pet is fully unconscious, a tube is placed in her throat to protect her airway from water, bits of tartar, and tooth polish. It also allows us to deliver oxygen and anesthesia to her.\nWe will place an I.V. catheter in her leg. She will also be hooked to a heart monitor that will keep track of her heart, her oxygen levels, and her blood pressure. This is a secondary safeguard to the person who will be caring for her. She will have blankets and hot water bottles to keep her warm.\nNow we move on to her dental cleaning. To begin, your pet will get an injection of antibiotics to combat the bacteria we will release when we scale her teeth.\nThen we use our ultrasonic scaler to clean her teeth. This is a machine like the one your dentist uses for your teeth. Then we hand scale any areas we need to pay more attention to.\nNext we polish all the teeth to seal the little pores in the enamel and smooth any imperfections from scaling. Then we do a complete oral exam. We probe the gums around all the teeth to check for gum recession, pockets under the gum line, and loose teeth.\nWe note any abnormalities of the teeth, gums, tongue, and palate. If there are any abnormalities, the doctor will call to let you know what we have found and what our plan is.\nWe will then remove any teeth that are too diseased to stay. Sometimes, this is simple and requires little effort as the tooth is nearly falling out. However, sometimes it requires a great deal of skill.\nA novocaine-like numbing injection is given to allow for additional pain relief that lasts for several hours. When the mouth is cleaned, the exam is done and teeth are extracted, we move on to a thorough rinse of the whole oral cavity to remove debris, tooth polish, and blood.\nThe mouth is then rinsed with chlorhexidine gel. This is an antibacterial solution that inhibits bacteria growth for around 18 hours. This gives time for the gums to seal back to the teeth without so much bacteria present.\nNow it is time for her to wake up. She will be taken off the anesthetic gas and given pain medication.\nWhen she is recovering, she will be dried off, have her nails trimmed, ears checked, and, if she needs one, a fecal parasite (worm) check is done.\nYour pet will have hot water bottles and blankets to help her maintain her body temperature, as she did during anesthesia. She will be monitored closely.\nShe will have a potty break to help her to get anesthesia out of her system.\nWhen she goes home you will receive care instructions, toothpaste, a toothbrush, a dental chart detailing her oral health (any extracted teeth will be noted on it), and a guide to help you learn to brush her teeth.\nAllergies in Pets\nAny critter with an immune system can get allergies. Very simply, allergies are the result of an individual's immune system overreacting to something foreign to the body. This could be food, pollen, or even medication.\nWhile people often have assorted breathing issues, allergies in cats and dogs usually manifest as skin problems. There are many afflictions of the skin, and it can be difficult to pinpoint an exact cause. Often there are multiple causes in play at once.\nIf allergies are a root cause to skin problems, often there are associated bacterial or fungal infections. An animal can lose hair and scratch, lick, and chew at itself. This could be all over the body or in particular areas such as the paws.\nPets with allergies may have chronic ear problems as well, since the ear canal is still part of the skin system. It is rare that a pet has an allergy to one thing; usually there are multiple offenders.\nDealing with any skin problem requires visits to the veterinarian. The doctor will assess your pet's overall health and recommend multiple diagnostic tests to rule out parasite, bacterial, yeast, or ringworm infection.\nCurrent symptoms may be treated with antifungals, steroids, anti-itch medication, antibiotics, medicated shampoos, skin cleansers, and supplements to support the skin. Many of these medications are available as prescription only, or long-term use may have side effects.\nIf the skin problems continue chronically, the veterinarian may recommend changing the diet to see if there could be an allergen in the food. Beef, corn, and wheat have been specifically mentioned as possible allergens.\nThe diet needs to be strictly adhered to for at least 12 weeks to see improvement. The veterinarian may also recommend further diagnostic testing or referral to a veterinary dermatologist in an attempt to find out the exact allergens in food or environment.\nThough a veterinarian needs to be consulted for a pet with allergies, you can do a few things at home to help with symptoms:\n• Thoroughly wipe off your pet's coat and paws with a damp cloth when coming in from outside.\nThis will help remove some pollen and other environmental allergens.\n• Routinely clean out your pet's ears with an ear cleaner at least once a week.\n• Put your pet on a high-quality, low or no grain, or hypoallergenic formula.\n• Add high-quality fish oil to the diet as a supplement for skin and coat.\n• Pure aloe vera (no additives) can be applied topically to raw areas to help soothe the skin.\n• Thoroughly clean out and dry the ears after a swim or bath.\n• Make sure your house and yard are flea-free and flea prevention is applied regularly.
Dr. Jocelyn R Mcclain has the following 2 specialties\nAnesthesiologists are physicians who are trained to administer anesthetics, which are medicines used to block nerve sensation. Anesthesia can be either local to one specific part of a body, like a tooth, or regional to block feeling to a larger portion of the body, such as during an epidural for child birth. It can also be more general to block sensation to the entire body, resulting in unconsciousness.\nAnesthesiologists assist in surgery by determining how much anesthesia is necessary and by monitoring the patient's level of responsiveness and vital signs throughout the procedure. The anesthesia specialist will also bring the patient out of anesthesia and then continue to monitor his or her vital signs post-operation.\nBesides assisting in surgeries, anesthesiologists may also treat patients suffering from chronic pain.\n- Family Medicine\nA family practitioner is a doctor who specializes in caring for people of all ages, at all stages of life. Rather than focusing on the treatment of one disease or patient population, family practitioners are often the doctors that people see for their everyday ailments, like cold and flu or respiratory infections, and health screenings. When necessary, family practitioners will provide referrals for conditions that require the expertise of another specialist.\nThe doctors may also provide physicals, inoculations, prenatal care, treat chronic diseases, like diabetes and asthma, and provide advice on disease prevention.\nDr. Jocelyn R Mcclain is Board Certified in 1 specialty\nSee the board certifications this doctor has received. Board certifications provide confidence that this doctor meets the nationally recognized standards for education, knowledge and experience.\nDr. Jocelyn R Mcclain has the following 1 expertise\nDr. Jocelyn R Mcclain has 1 board certified specialty\nSee the board certifications this doctor has received. Board certifications provide confidence that this doctor meets the nationally recognized standards for education, knowledge and experience\nDr. Mcclain is affiliated (can practice and admit patients) with the following hospital(s).\n32 Years Experience\nHoward University College Of Medicine\nGraduated in 1986\nKings County Hospital Center\nDr. Jocelyn R Mcclain is similar to the following 3 Doctors near Peoria, IL.
Cerebrospinal fluid (CSF) leaks are known to occur under several conditions: lumbar puncture performed for contrast myelography, spinal surgery, spinal stab wounds, fracture of the thoracic spine, inadvertent spinal puncture during epidural anesthesia, traumatic lumbar meningocele, and bronchopleural subarachnoid fistula due to bronchogenic carcinoma. Spontaneous spinal leaks are uncommonly encountered in neurosurgical practice, but they are increasingly recognized as a cause of spontaneous intracranial hypotension. Most CSF leaks are located at the cervicothoracic junction or in the thoracic spine. The disease is often self-limiting. A CSF leak can be detected directly by accumulation of radioactivity outside the subarachnoid space or suggested indirectly by the rapid disappearance of tracer from the subarachnoid space and early appearance in the urinary bladder. In this paper we present two unusual cases of CSF leak identified by radiopharmaceutical cistenogram.\n- Bronchopleural subarachnoid fistula\n- Cerebrospinal leak\n- Radionuclide cisternogram\nASJC Scopus subject areas\n- Radiology Nuclear Medicine and imaging
Who are our volunteers?\nWe have multiple roles for nursing staff, mostly centered around the operating room given that this is mostly a surgical mission. We primarily are looking for staff who routinely work with children although there are roles for adult nursing in our Gynecologic hospital and General Surgery area. Our main jobs are for recovery nurses who care for patients in the recovery room and circulating nurses for assistance in the operating room.\nThe ideal recovery nurse has specific experience in this capacity or works in the ICU or ER setting, and preferably with children. Equipment can be limited, so experience and comfort in this role is a must.\nCirculating nurses perform standard OR assistance in preop care of the patient, helping set up the case in the OR with the scrub assistant, helping Anesthesia, Intraop documentation and supply support, and post op transition to the recovery room.\nWe are always short staffed in the area of recovery nursing, so this is a job we are always recruiting.\nWe perform surgery in the field of Plastics, Orthopaedics, General, and Gynecologic surgery. Our main focus is on caring for children, so pediatric specialists are preferred. Occasionally we have room for oral surgeons or other related specialties. The problems we treat are typically those one would see when access to care is limited. Congenital conditions, chronic neuromuscular diseases, and mostly non-acute concerns are what we treat.\nWe have a regular group who attends the mission so we are not always able to accommodate new surgeon volunteers, but we would always like to hear your interest. Residents and fellows are always welcome to express interest as well given that training is a concomitant goal of our mission.\nAnesthesia is provided for the mission by Certified Registered Nurse Anesthetists (CRNAs) and Anesthesiologists from all over the United States. All supplies and medications required for anesthesia are collected all year from sales reps, hospitals, pharmacies, Americares and individuals who participate in the mission by donating. Volunteers should be comfortable performing anesthesia on children but also some adults. They should also feel comfortable with anesthesia for facial reconstruction as well as children with neuromuscular disorders. Additional skills that are useful include performing neurologic blocks. Anesthesia residents and fellows also participate in the mission.\nIn our orthopaedic hospital, we utilize the skills of Physical, Occupation, and Speech therapists. The ideal rehab volunteer would have pediatric experience or be comfortable working with children and their families. Common diagnoses that are seen include microcephaly, cerebral palsy, prematurity, genetic diseases, developmental delay, orthopedic traumas or injuries, congenital malformations, neurological conditions, club foot, hip abnormalities, amputations, and spinal deformities. You should also be comfortable working with translators or be fluent in Spanish.\nPhysical therapists treat patients in the clinic, provide post op care exercises education, fabricate splints and braces with our orthotist amongst a multitude of other skilled tasks.\nFor occupation therapy, many pediatric specialists may work mainly with children diagnosed with ADHD, sensory processing disorders, learning disorders, amongst others. Our main focus in Ecuador however, is with neuromuscular disorders. OT's for the mission will need to provide oral motor interventions for feeding problems, Neuro-developmental treatment (NDT) and splint fabrication.\nAnother large component of our mission is in custom wheelchair fitting, modification, and repair. This team of specialists come from both the PT and OT world as well as a few non-medical volunteers with mechanical backgrounds. Experience in this area is key.\nAt times we have speech and language therapists who are available to attend and their services are useful for screening preop palate disorders with our surgery team as well as home oral motor education and treatment for our neuromuscular patients.\nLast but not least, one of our most important members is our Prosthetist / Orthotist. A huge component of our rehab work is in custom fitting, modification, and repair of orthotics for neuromuscular patients. This job requires ingenuity, inventiveness, patients, and above all, experience. We set up a complete brace shop in the hospital with tools and supplies brought by our volunteers. We always have a need for additional help in this area and certified P&O specialists are preferred. Students and techs in the field with experience are also useful.\nOperating Room Personel\nSince we are mainly a surgical mission, there is a need for operating room scrub techs, anesthesia techs, and other staff for support of the surgeries. Skilled and experienced scrub techs are preferred, and specifically those used to working in our surgical fields of Plastics, Orthopaedics, General, and Gynecologic surgery.\nThere are a few roles but important roles for non-medical volunteers such as interpreters, medical assistants for helping keep clinic organized and schedule appointments, help with documentation, and "runners" to help move supplies from one facility to another. Unfortunately, skilled volunteers are still preferred for this role. This is one of our biggest volunteer groups to apply, yet it is one of the least accepted as most of our needs are in the positions outlined above. These non-medical volunteers are usually the occasional spouse or family member who is attending with one of our medical workers although there is not enough space on the mission for everyone to bring a spouse or family member. This is a common request but not one that can typically be accommodated. All volunteers are to be above 18 years unless approved by a board member.
With significant weight loss and personal transformation as your goal, every decision you make about your health and well-being is important. As you approach the post weight loss plastic surgery phase of your journey in Sacramento, selecting the right plastic surgeon becomes one of the key choices ahead.\nTo ensure a good overall result and a positive experience, Dr. Kaufman and Dr. Davis offer these recommendations when evaluating post bariatric plastic surgeons in California:\n- Select a surgeon who is, at minimum, board-certified by the American Board of Plastic Surgery (ABPS). The ABPS is the only organization authorized by the American Board of Medical Specialties to certify physicians as qualified to perform plastic surgery from head to toe.\n- Evaluate your prospective surgeon’s experience carefully. As you know, for a patient who has shed dozens or even hundreds of pounds, abdominoplasty isn’t just a simple tummy tuck and breast surgery isn’t just a routine augmentation. Members of the weight loss community have special health considerations that must be taken into account when planning plastic surgery after weight loss. Two or three successful outcomes are not enough to allow a surgeon to claim expertise in the complex arena of body contouring surgery after weight loss. Therefore, we suggest that you ask to see your prospective surgeon’s entire photo gallery and ask many questions about patient experiences and results.\n- Ensure there’s a personality match. You and your plastic surgeon will have a long-term relationship, so a good rapport between the two of you is not a luxury — it’s essential for establishing effective communication and mutual trust. You need to feel certain your physician will take good care of you before, during and after surgery. As a bonus, you’ll find that choosing a physician who cares about you will automatically widen your circle of supporters. Dr. Kaufman, Dr. Davis, and their team will join those cheering you forward and encouraging your renewed sense of health and happiness.\n- Investigate your surgeon’s support system — both the medical team and surgical facilities. Check with your prospective surgeon to make sure the anesthesiologist, the person who will be monitoring your vital signs in the operating room, is certified by the American Board of Anesthesiology, rather than a nurse anesthetist or a nurse performing twilight anesthesia. Also make make sure the surgery center where your procedures will be performed is accredited by JCAHO (the Joint Commission on Accreditation of Healthcare Organizations), AAAHC (The Accreditation Association for Ambulatory Healthcare) or AAAASF (the American Association for Accreditation of Ambulatory Surgical Facilities). Most often, plastic surgery facilities are certified by AAAASF.\nA Word about Cost\nThe cost of plastic surgery after weight loss can be significant. After all, you have shed pounds from practically every inch of your body and you’ll probably want to consider more than one procedure to reshape your new self. That said, it is critical that you make wise decisions that may be more costly but will provide you the results you are looking for, and steer clear of those that seem too good to be true.\nAvoid the temptation to settle for a plastic surgeon you have doubts about just to save a few dollars and think twice before traveling to another country where quality standards may be quite different than here in the U.S. You have already invested in making a big change for the better. When it comes to post-weight loss plastic surgery, it is imperative you select an experienced plastic surgeon with the right background and credentials and who makes you feel comfortable with and excited about your surgical transformation. Your surgeon will work with you to design a surgical plan that makes the most sense for you and your budget.\nAt Kaufman & Davis Plastic Surgery, we regularly work with weight loss patients from all over the country, to complete their transformation. Call us at (916) 983-9895 and schedule a consultation in our Folsom office today!
What to Know about Tooth Extraction\nAny type of gum disease may loosen or damage an entire tooth. A tooth that is severely decayed has to be removed. A dentist or a dental surgeon may do the procedure of removing the tooth.\nWhat to Expect from Tooth Extraction\nBefore the extraction proper, a local anesthetic is applied on the area surrounding the tooth to give a numbing sensation. A stronger anesthesia may be necessary if there are several teeth to be extracted if not all of them.\nGeneral anesthetic is applied for the entire body to numb which makes a person asleep throughout the procedure.\nStitches may be needed after the tooth is removed. You can also bite on a cotton gauze to stop the bleeding.\nWhat to Expect after Surgery\nRecovery period lasts for several days. For faster recovery, there are several things that can be done.\n- You may take painkillers as prescribed by a dentist or an oral surgeon. They will help relieve pain and swelling. An ice-cold pack can be applied as cold compress outside your mouth from 10 to 20 minutes.\n- After 24 hours from tooth extraction, you may gargle with salt water solution several times a day. This helps relieve swelling and pain in the area as well.\n- Change the gauze pads before they become drenched in blood.\n- Do not rub the area with your tongue and avoid smoking.\nYou can also schedule a visit to our other locations:
HealthGains is committed to exceptional health care and patient education. That’s why we’ve formed a Medical Advisory Board made up of the top medical experts in fields like age management, preventive medicine and regenerative medicine.\nEach member of the advisory board has extensive experience in his or her respective specialty and is responsible for creating standards for hormone replacement plans, therapy programs, age management, and procedures. These physicians also help educate and train affiliate doctors in the principles of HealthGains programs.\nAge Management & Medical Advisory Board\nChief Medical Director Richard Gaines MD, HealthGains\nDr. Gaines graduated from Boston University School of Medicine in 1981. After graduation, he completed his internship at Tufts University School of Medicine and his residency at Harvard Medical School, where he was an anesthesiology fellow at Brigham and Women’s Hospital. He also served as a physician at Huntington Memorial Hospital and as an anesthesiologist at Harvard Community Health Plan. During this time Dr. Gaines contributed to the development of Sheridan Healthcorp, the first nationally recognized entity providing hospital-based medical services throughout the country, he served as a senior partner and established high quality anesthesia services in various states.\nAt Memorial Regional Hospital, Dr. Gaines served as Department Chief of Cardiac & Obstetric Anesthesia as well as Director of the Memorial Regional Hospital Pain Clinic and Medical Director of the Same Day Surgery Center, the first established outpatient surgery facility in the country. He also served as a Director and Chairman of Memorial Healthcare System and provided educational services for the department of anesthesia, arranged case studies, discussions and guest lecturers.\nAt Jackson Memorial Hospital, Miami, Dr. Gaines was the Assistant Clinical Lecturer for the Department of Anesthesia and instructed residents in cardiac anesthesia.\nDr. Gaines has been administering bioidentical hormone therapy since 1993. He transitioned into age management medicine officially in 2005 after a distinguished 30 year career as an anesthesiologist. He questioned that a physician’s primary duty is to treat the effects of disease rather than the origin of it. At his practice, HealthGAINS, patients experience first class medical care at reasonable costs. Dr. Gaines will only prescribe medication if a patients hormone levels cannot be improved through lifestyle changes and it’s through an extensive 55panel blood test where he looks at the complete picture of health, before he makes his recommendations. In addition to this, he counsels the patients about diet, exercise, stress management, age management and dietary supplements.\nDr. Gaines is a member in good standing with the following professional organizations; ACAM: The American College for Advancement in Medicine, A4M: The American Academy of Anti-Aging Medicine, IFM: The Institute for FunctionalMedicine and AMMG: Age Management Medicine Group. He has received additional specialized trainings and Certifications including:\n- Fellowship in Anti-Aging and Regenerative Medicine (FAARM) from the American Academy of Anti-Aging Medicine.\n- Board certification from the American Board of Anti-Aging & Regenerative Medicine (ABAARM).\n- Certification as a Functional Medicine Practitioner with advanced training at The Institute for Functional Medicine.\nRichard Gaines MD, Medical Director, HealthGaines.\nBoard-certified physician Christopher Senger is the resident hormone specialist at HealthGains flagship clinic in Miami. Dr. Richard Gaines specializes in anti-aging and regenerative medicine. His many certifications in these fields has earned him recognition within the South Florida medical community, where he is known for his local health seminars and forums. Dr. Gaines also leads an accomplished life outside of medicine; he is a prolific artist and pianist.\nJudi Goldstone MD, Medical Director, HealthGains California.\nJudi Goldstone MD graduated in the top third of her class from Mount Sinai School of Medicine in New York, where she received her medical degree. Board certified by the American Board of Internal Medicine, Dr. Goldstone has practiced age management medicine since 2001.\nDr. Goldstone joined the American Academy of Anti-Aging and Regenerative Medicine in 2005 and is also a member of the American Society of Bariatric Physicians. She’s also held a number of other notable positions, including a role as medical director at New York Life. Over the years, Dr. Goldstone has taken an interest in diet, nutrition, nutraceucials and weight management. She is known for her highly regarded “Lifestyle Weight Management & Fitness” program.\nVernon Williams MD, Medical Director, HealthGains Texas.\nVernon Williams MD, an Albert Einstein College of Medicine graduate, has extensively trained in facial rejuvenation, medical spa procedures and lasers; he is always keeping abreast of the latest age management and anti-aging medical treatments. He has extensive experience treating both men and women with hormone medications and weight-loss programs.\nDr. Williams is a member of various professional and medical organizations such as the American Society for Laser Medicine and Surgery as well as the Texas Medical Association.
It's been slightly more than a year since Jonathan Akindle, 23, underwent weight-loss surgery, and so far, so good.\nHe is now down 130 pounds, and he was able to get through gastric sleeve surgery and recovery without taking any opioids for pain.\n"The pain right after surgery was more like a stomach ache. It was a little uncomfortable, but completely manageable," said Akindle, who manages a security firm in Long Island, N.Y.\nThere is a big push across all of medicine to find alternatives to opioids due to the nationwide opioid epidemic. Many people first become addicted to these powerful painkillers following surgery.\nAnd the risk for addiction may be even higher for people who undergo weight-loss surgery. This is why guidelines from five medical societies, including the American Society for Metabolic and Bariatric Surgery, call for opioid-free or opioid-sparing pain relief during and after weight-loss surgery.\nAbout 3% to 4% of people who receive opioids for the first time after surgery are still taking them a year later, and this jumps to 8% to 10% for people who had weight-loss surgery, said Dr. Dominick Gadaleta, chair of surgery at South Shore University Hospital in Bay Shore, N.Y.\nBetter pain relief\nInstead of opioids, people undergoing weight-loss surgeries at Northwell Health Hospitals in New York receive intravenous acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) before surgery. This is followed by an intravenous infusion of non-opioid anesthetics and a nerve block of the surgical area. So far, surgeons at Northwell hospitals have performed more than 200 procedures using this protocol, including gastric sleeve surgery and hernia operations.\n"We essentially turn the nerve endings down or off before surgery with preemptive acetaminophen or NSAIDs," explained Dr. Don Decrosta, chair of anesthesia at South Shore University Hospital, which is part of the Northwell health system. "When we get hurt or undergo surgery, the nerve endings in the injured area fire at a much higher rate, but if we blunt or eliminate this stress response with preemptive [pain relief], you get through the early healing days without the need for opioids."\nOpioids block pain signals between your brain and body, while the new protocol is more targeted, he said,\nPeople don't get sent home with a prescription for opioids because they don't need them, said Dr. Andrew Bates, director of minimally invasive surgery at South Shore University Hospital.\nThese folks aren't necessarily pain-free in the days following their procedure, and that's a good thing, Bates noted. "They may have some soreness afterward and that's OK because it's a major surgery and pain can give us important information," Bates said. "We never want to completely cover up pain."\nIn addition to a heightened risk of addiction and overdose, opioids cause many short-term side effects that can hamper recovery, including nausea, itching, fatigue, dizziness and constipation, said Dr. David Pechman, a bariatric surgeon at South Shore University Hospital. He is the surgeon who performed Akindle's gastric sleeve procedure in March 2021. Opioids slow down your intestines so you don't have bowel movements, but "with the new protocol, patients have regular bowel movements and are walking around the afternoon of their surgery."\nWhen Pechman was in training, weight-loss surgery patients stayed in the hospital for two to three days. Now, most only stay for one night, and that is partly because opioids are not part of the mix any longer, he said.\nPeople who undergo weight-loss surgery tend to be more susceptible to other opioid-related complications such as trouble breathing, nausea and vomiting, Pechman noted.\nThis can be a double whammy as weight-loss procedures may also increase chances of nausea and vomiting, he said.\nFor the most part, patients are on board with this opioid-sparing protocol. "Patients are very excited when they hear that they won't need opioids as they often know somebody who has been adversely affected or addicted to opioids, or have seen what opioids can do in popular culture and on the news," Pechman said.\nIt's catching on across the United States, too. Many other bariatric surgery centers are getting on board. "Sooner or later this will be standard of care," Pechman added\nMany weight-loss centers are indeed developing their own opioid-sparing protocols, said Dr. Wendy King, an associate professor of epidemiology at the University of Pittsburgh's School of Public Health. "Efforts continue to determine the best way to limit or eliminate opioid use [during and after] bariatric surgery care," she said.\nThe American Society for Metabolic and Bariatric Surgery explains the different types of weight-loss surgeries.\nSOURCES: Dominick Gadaleta, MD, chair, surgery, South Shore University Hospital, Bay Shore, N.Y.; Jonathan Akindle, security firm manager, N.Y.; Don Decrosta, MD, chair, anesthesia, South Shore University Hospital, Bay Shore, N.Y.; Andrew Bates, MD, director, minimally invasive surgery, South Shore University Hospital, Bay Shore, N.Y.; David Pechman, MD, bariatric surgeon, South Shore University Hospital, Bay Shore, N.Y.; Wendy King, PhD., associate professor, epidemiology, University of Pittsburgh School of Public Health, Pittsburgh
Recruitment of lung volume during surgery neither affects the postoperative spirometry nor the risk of hypoxaemia after laparoscopic gastric bypass in morbidly obese patients: a randomized controlled study.\nDEFRESNE, Aline ; HANS, Grégory ; GOFFIN, Pierre et al\nin British journal of anaesthesia (2014), 113(3), 501-7\nBACKGROUND: Intraoperative recruitment manoeuvres (RMs) combined with PEEP reverse the decrease in functional residual capacity (FRC) associated with anaesthesia and improve intraoperative oxygenation ... [more ▼]\nBACKGROUND: Intraoperative recruitment manoeuvres (RMs) combined with PEEP reverse the decrease in functional residual capacity (FRC) associated with anaesthesia and improve intraoperative oxygenation. Whether these benefits persist after operation remains unknown. We tested the hypothesis that intraoperative RMs associated with PEEP improve postoperative spirometry including FRC and reduce the incidence of postoperative hypoxaemia in morbidly obese (MO) patients undergoing laparoscopic gastric bypass. METHODS: After IRB approval and informed consent, 50 MO patients undergoing laparoscopic gastric bypass under volume-controlled ventilation (tidal volume 6 ml kg(-1) of IBW) were randomly ventilated with either 10 cm H(2)O PEEP or with 10 cm H(2)O PEEP and one RM carried out after induction of pneumoperitoneum, and another after exsufflation. Anaesthesia and analgesia were standardized. Spirometry was assessed before operation and 24 h after surgery. Postoperative oxygenation and the apnoea-hypopnoea index (AHI) were recorded during the first postoperative night. RESULTS: Age, BMI, and STOP BANG score were similar in both groups. FRC decrease after surgery was minimal [0.15 (0.14) litre in control and 0.38 (0.19) litre in the RM group] and similar between the groups (P=0.35). FVC, FEV1, mean [Formula: see text], percentage of time spent with [Formula: see text] below 90%, and AHI did not differ significantly between the groups. CONCLUSIONS: This study demonstrates that when added to a protective mechanical ventilation combining low tidal volume and high PEEP, two RMs do not improve postoperative lung function including FRC, arterial oxygenation, and the incidence of obstructive apnoea in MO patients after laparoscopic upper abdominal surgery. CLINICAL TRIAL REGISTRATION: EudraCT 2011-000999-33. [less ▲]Detailed reference viewed: 44 (6 ULg)\nIntraoperative recruitment does not affect postoperative restrictive pulmonary syndrome and hypoxaemia after laparoscopic gastric by-pass in morbidly obese patients: A randomised controlled study\nBINDELLE, Simon ; GOFFIN, Pierre ; HANS, Grégory et al\nin Acta Anaesthesiologica Belgica (2013), 64(3), 124\n[No abstract available]Detailed reference viewed: 59 (9 ULg)\nEffect of an intravenous infusion of lidocaine on cisatracurium-induced neuromuscular block duration: a randomized-controlled trial.\nHans, Grégory ; Defresne, Aline ; et al\nin Acta Anaesthesiologica Scandinavica (2010), 54(10), 1192-6\nBACKGROUND: Intravenous lidocaine can be used intraoperatively for its analgesic and antihyperalgesic properties but local anaesthetics may also prolong the duration of action of neuromuscular blocking ... [more ▼]\nBACKGROUND: Intravenous lidocaine can be used intraoperatively for its analgesic and antihyperalgesic properties but local anaesthetics may also prolong the duration of action of neuromuscular blocking agents. We hypothesized that intravenous lidocaine would prolong the time to recovery of neuromuscular function after cisatracurium. METHODS: Forty-two patients were enrolled in this randomized, double-blind, placebo-controlled study. Before induction, patients were administered either a 1.5 mg/kg bolus of intravenous lidocaine followed by a 2 mg/kg/h infusion or an equal volume of saline. Anaesthesia was induced and maintained using propofol and remifentanil infusions. After loss of consciousness, a 0.15 mg/kg bolus of cisatracurium was administered. No additional cisatracurium injection was allowed. Neuromuscular function was assessed every 20 s using kinemyography. The primary endpoint was the time to spontaneous recovery of a train-of-four (TOF) ratio >/= 0.9. RESULTS: The time to spontaneous recovery of a TOF ratio >/= 0.9 was 94 +/- 15 min in the control group and 98 +/- 16 min in the lidocaine group (P=0.27). CONCLUSIONS: No significant prolongation of spontaneous recovery of a TOF ratio >/= 0.9 after cisatracurium was found in patients receiving intravenous lidocaine. [less ▲]Detailed reference viewed: 151 (4 ULg)\nPulmonary embolism in a trauma patient with liver and orthopedic injuries\nLegrain, Caroline ; Hans, Grégory ; Defresne, Aline et al\nin Acta Anaesthesiologica Belgica (2009), 60(4), 259-262Detailed reference viewed: 103 (4 ULg)\nPneumopericarde dans les suites d'une dehiscence de sternum.\nDEFRESNE, Aline ; Ghaye, Benoit ; et al\nin Revue Médicale de Liège (2009), 64(2), 66-7\nWe report a case of pneumopericardium occuring after cardiac surgery. Pneumopericardium is a rare condition; trauma is the most frequent etiology. Nontraumatic causes include fistulae in relationship with ... [more ▼]\nWe report a case of pneumopericardium occuring after cardiac surgery. Pneumopericardium is a rare condition; trauma is the most frequent etiology. Nontraumatic causes include fistulae in relationship with the bronchial tree or oesophagus and intrapericardial gazeous production due to bacterial pericarditis. Pericardiocentesis is indicated in case of air tamponade and local infection. [less ▲]Detailed reference viewed: 25 (1 ULg)
Phenacetin was introduced in 1887 in Elberfeld by German company Bayer, and was used principally as an analgesic; it was one of the first synthetic fever reducers to go on the market.\nParacetamol, also known as acetaminophen or APAP, is a medicine used to treat pain and fever. It is typically used for mild to moderate pain relief.\nTetracaine, also known as amethocaine, is a local anesthetic used to numb the eyes, nose, or throat.\nBenzocaine Basic Info\nMelting point:88-90 °C\nBoiling point:172 °C (12.7517 mmHg)\nstorage temp. 0-6°C\nsolubility alcohol: soluble1 gm in 5 ml\nform Crystalline Powde\nBenzocaine Product Detail\nBenzocaine is indicated to treat a variety of pain-related conditions. It may be used for:\nLocal anesthesia of oral and pharyngeal mucous membranes (sore throat, cold sores, mouth ulcers, toothache, sore gums, denture irritation), Otic pain (earache), Surgical or procedural local anesthesia.\nBenzocaine is a topical analgesic (meaning it is to be used on the body surface or in the mouth but should not be swallowed) that has a number of different uses in over-the-counter (OTC) medicines. Depending on the dose and form, the active ingredient benzocaine can be used to relieve throat and mouth pain; To alleviate external vaginal itching and burning; To stop pain and itching due to hemorrhoids; Or to relieve minor skin irritations, pain, and itching. Because benzocaine is available in different doses and forms, it is very important to read the Drug Facts label carefully to determine whether the medicine is intended to be used for the symptoms you are experiencing.\nBenzocaine can be the only active ingredient in oral treatments that relieve sore throat or address mouth pain caused by cold sores, canker sores, teething, and other issues. It also can be combined with other active ingredients in oral treatments that not only relieve mouth and throat pain, but also protect irritated areas, provide a soothing coating, or relieve dryness.\nBenzocaine is a kind of fat-soluble surface anesthetic. Compared with several other topical anesthetics such as lidocaine, tetracaine, its intensity is small, so it won't make people feel discomfort because of the anesthesia effect on the mucosa. It is a very strong fat-soluble drugs with easy combination with mucosa or skin and not easy penetration into body to produce toxicity.\nBenzocaine Order Process\n1. email or whatsapp us about what you need,quantity and destination.\n2. we would answer your email in 12 hours with our best price.\n3. If you think the price is workable, we would send you our payment information.\n4. After we received your payment ,we would arrange the shipping for you\n5. You would receive our package in 7-10 working days.\nBenzocaine Our Advantage\n1. Top Quality in the market, most product have the purity of 98%+ and some beyond 99%\n2. Competitive price, we offer speical discount for large amount order.\n3. Fast shipping ,we would deliver your product in 7-10 working days.\n4. Free Re-shipping, we promise that you will receive your package\n5. Security, we will not transfer any of your info to any third party.
Information Technology Applied to Anesthesiology, an Issue of Anesthesiology Clinics (The Clinics: Surgery 29-3)\nBy: Kevin K. Tremper (author), Sachin Kheterpal (author)Hardback\nMore than 4 weeks availability\nThis cutting-edge issue of "Anesthesiology Clinics" is divided into two sections. The first covers topics in perioperative clinical information systems (IS), including the following. The anatomy of an anesthesia information management system; vendor and market landscape; impact of lexicons on adoption of an IS; clinical research using an IS, real-time alerts and reminders using an IS; shortcomings and challenges of IS adoption; creating a real return-on-investment for IS implementation (life after HITECH); Quality improvement using automated data sources and reporting; and, opportunities and challenges of implementing an enterprise IS in the OR. Section 2 is devoted to computers and covers the following topics. Advanced integrated real-time clinical displays; enhancing point-of-care vigilance using computers; and, computers in perioperative simulation and education.\n- ID: 9781455710300\n- Saver Delivery: Yes\n- 1st Class Delivery: Yes\n- Courier Delivery: Yes\n- Store Delivery: Yes\nPrices are for internet purchases only. Prices and availability in WHSmith Stores may vary significantly\n© Copyright 2013 - 2017 WHSmith and its suppliers.\nWHSmith High Street Limited Greenbridge Road, Swindon, Wiltshire, United Kingdom, SN3 3LD, VAT GB238 5548 36
Neck Pain and Sleep\nLinks shared publicly online about this topic\nSpine Back Neck Surgery Pennsylvania \| Lehigh Valley Health Network \| Neuroscience Care \| Spine Surgery\nMost Recently Shared on October 7, 2010 at 5:25 pm By:\nblog.itechtalk.com — “Whiplash is nothing but the neck pain due to the injury to the neck--™s soft tissues. It is caused when an abnormal motion or force is applied on the neck” View full resource at blog.itechtalk.com\nMost Recently Shared on December 23, 2009 at 1:33 pm By:\ncptg.net — “Cole Pain Therapy Group - Chiropractic Care in Bartlett, TN Most people describe a tension headache as a feeling of a tight band or dull ache around the head or behind the eyes. Tension headaches are caused by muscle and joint imbalance in the upper back and neck. Headaches...” View full resource at cptg.net\nMost Recently Shared on November 16, 2011 at 10:44 am By:\njeffersonhospital.org — “Head and neck surgeons at Jefferson usually perform a modification of uvulopalatopharyngoplasty called expansion sphincteroplasty to try and limit the risks and improve outcome for treatment of sleep apnea.” View full resource at jeffersonhospital.org\nMost Recently Shared on October 10, 2011 at 2:27 pm By:\nMost Recently Shared on September 19, 2011 at 2:54 pm By:\nthyroid.about.com — “Thyroid cancer often starts without symptoms, but once a thyroid tumor grows, symptoms can appear. This article looks at the range of symptoms that may signal thyroid cancer.” View full resource at thyroid.about.com\nMost Recently Shared on March 26, 2010 at 4:07 pm By:\nSkin Laser and Surgery Specialists \| Blog \| I read about laser assisted liposuction and feel that I am a perfect candidate for this procedure.\nskinandlasers.com — “I am excited by the advances in plastic surgery. I read about laser assisted liposuction and feel that I am a perfect candidate for this procedure. I have fat in my neck that needs to go. Is this procedure painful? Is there any anesthetic for the procedure? What is wonderful about laser liposuction is that it can both remove fat and tighten surrounding skin. Even better, the procedure is done in the office with only local anesthesia.” View full resource at skinandlasers.com\nMost Recently Shared on September 10, 2012 at 10:50 am By:\nThe Top 3 resources shared on this topic. More resources.\nKey stats and trends about this topic\nFeaturing the top 3 experts for this topic\nLehigh Valley Health Network A Passion for Better Medicine 610-402-CARE LVHN.org \| Contact Kathryn: [email protected]\nOrlando chiropractor David Nahali who loves his family, who loves his patients and friends.\nCole Pain Therapy Group in 2008. He is a third generation\nchiropractor, following Dr. James R. Cole and Dr. Richard Cole." />\nDr. Brad Cole specializes in sports injury rehabilitation, exercise prescription, and anti-inflammatory nutrition. He is a Certified Strength and Conditioning Specialist and has a Master's degree in Sports Science and Rehabilitation. With this advanced training, Dr. Cole integrates the scientific principles of athletic functional performance to improve the life of any musculoskeletal pain sufferer.\nDr. Cole is an alumnus of Evangelical Christian School and graduated with honors from Mississippi State University with a Bachelor of Business Administration. While in chiropractic school at Logan University, he began pursuing a Master's degree in the area of sports rehabilitation.\nAfter graduating cum laude and completing multiple internships, Dr. Cole joined Cole Pain Therapy Group in 2008. He is a third generation chiropractor, following Dr. James R. Cole and Dr. Richard Cole.
We are pleased to inform you that\n7th Congress of the South – East European Society of Perinatal Medicine and 3rd Congress of fetal and neonatal medicine\nwill be held from May 10th – 12th 2018 in Hotel Zira , Belgrade, Serbia\nThe Congress will be organized by South – East European Society of Perinatal Medicine in cooperation with\nSociety for fetal and neonatal medicine.\nThe invited speakers at this Congress will include specialists and subspecialists of all branches of medicine that are related to the pregnancy and the neonatal period: perinatologists-obstetricians,\nneonatologists-pediatricians, transfusiologist, surgeons, anesthesiologists and others, who will contribute to the exchange of new knowledge and skills, so we may expect over 300 active participants with various\nWe are looking forward to welcome you in Belgrade!\n\|Prof. Olivera Kontić – Vučinić\nPresident – elect\n\|Prof. Snežana Plešinac
As women age, the collagen fibers in the vagina can weaken, causing it to lose its elasticity. Just like cosmetic procedures have been used for years to enhance facial features or restore a youthful glow, non-surgical vaginal tightening with FemiLift is used to improve the health of vaginal tissue.\nThis loss of elasticity and overall tightness can cause many women to suffer from conditions such as vaginal dryness, painful intercourse, urinary incontinence, or vaginal laxity. These concerns can affect confidence, overall quality of life, and make it hard to engage in every day activates. Vaginal tightening with FemiLift is a fast, effective cosmetic procedure that restores the vagina to its once youthful state.\nAlma Lasers created FemiLift with a specialized laser probe that is inserted into the vagina by a trained doctor or technician. The CO2 fractionated laser beams repair the tissue, allowing new collagen to be produced. No numbing or anesthesia is necessary. In fact, this treatment is more comfortable than having a pap smear for most patients!\nBenefits of Vaginal Rejuvenation with FemiLift include:\n- Pain-free, fast treatment\n- No downtime\n- Tightens vagina\n- Increases lubrication\n- Treats symptoms of incontinence\n- Boosts sexual satisfaction\n- Treats frequent vaginal infections\n- Reduces vaginal dryness\n- Improves quality of life\n- Improves confidence and self-esteem\nSide effects are minimal, but some patients may experience a watery discharge or spotting for up to 48 hours’ post-treatment. In addition, most women return to their normal activities following their procedure, however intercourse should be avoided for 5 days. Results are noticeable after the first treatment, but 3-4 treatments, performed at 4-week intervals with a yearly touchup, are recommended for optimum results.\nIf you are interested in learning more about the FemiLift procedure, please call (267)-687-2180.
EmbraceRF is a new breakthrough facial contouring procedure that can address the lower third of the face, specifically the neck and jowls. It is a onetime procedure that combines two powerful technologies from industry leader InMode – FaceTite and FDA approved Morpheus8, a Subdermal Adipose Remodeling Device (SARD). This procedure is a great option for patients who have skin laxity in the lower face and neck with or without underlying fat concerns, and for those who may not opt for a facelift but want optimal outcomes.\nFaceTite utilizes RFAL (Radiofrequency-assisted liposuction) to address excess fat deposits as well as skin laxity on the face and neck. In some cases, some of the fat in the face and neck area may need to be preserved to retain a youthful appearance. Depending on the quality of the skin, the aesthetic surgeon can combine EmbraceRF with Morpheus8 externally for remodeling the underlying fat tissues. With its depth of 4 mm and additional 1 mm heat signature, Morpheus8 allows the surgeon to remodel adipose (fat) tissue. Depending on the depth of the dermis in different parts of the face, the surgeon can preserve fat and tighten skin or remold the fat into the contours so as to improve definition of the jaw line, jowls and neck, while retaining the fullness necessary to maintain a youthful appearance. The procedure enables the surgeon to determine how much fat is removed, left behind or molded for precise sculpting of the face.\nHere are some of the benefits of using EmbraceRF\n- Minimally-invasive treatment, no incisions or scars\n- Takes about 45 minutes to complete, with about a 48-hour downtime\n- Performed on an outpatient basis under local anesthesia\n- Treats both superficial and deep tissues\n- Tightens the skin in the neck and jowls\n- Improves the jaw line and rejuvenates the neck\n- Improves skin tone\n- Retains the youthful fullness of the face\n- Superior facial contouring with natural looking outcomes\n- Results are visible immediately and improve over time\n- Uniform treatment and permanent results\nBuilt-in safeguards including real time measurements of skin temperature, impedance monitoring, power cut-off and audible feedback foster patient safety.\nThe categories of patients who can opt for this procedure include:\n- Treatment Gap Patients – Patients who do not have bad enough skin for a facelift and not good enough skin elasticity for liposuction.\n- Sideline Patients – All potential patients who are candidates for a facelift, but have not had surgery due to concerns about scarring and general anesthesia.\n- Facelift Maintenance Patients – Those who have had a previous facelift, but with early recurrence of jowls and neck laxity, and are too early to repeat another facelift.\nLeading AAAASF-accredited practices in NYC offer EmbraceRF. A NYC plastic surgeon with expertise in performing radiofrequency-assisted aesthetic procedures can use this innovative InMode technology to mold the face and provide attractive results.\nThe post EmbraceRF for Superior Facial Contouring Outcomes without Surgery appeared first on bodySCULPT Blogs.
Kidney disease is becoming a common disease, especially among adults. Detecting it in its early stages is slim unless you adhere to your routine medical exams. Houston Kidney Specialists Center team offers Kidney Transplant Cypress surgery to restore your body’s ability to clean your blood.\nTable of Contents\nA kidney transplant refers to an invasive procedure in which your doctor replaces your kidney with a healthy one from a viable donor. You may receive the kidney from a living family member or a deceased organ donor. Kidney donors can still lead a healthy life with one kidney, but they must avoid habits that may cause detrimental effects on their remaining kidneys.\nIf you have kidney failure, your doctor may schedule you for dialysis sessions to filter the waste in your bloodstream. The Houston Kidney Specialists Center team may also put you on a waiting list for a kidney transplant to restore your body’s natural ability to conduct blood filtration.\nA kidney transplant is a more reliable treatment for kidney failure than a lifetime on dialysis. The therapy addresses end-stage renal disease or chronic kidney disease, promoting overall health and helping you live a long, happy life. The benefits of a kidney transplant are incomparable to those of dialysis. These benefits include lower treatment costs, reduced risk of death, and fewer dietary restrictions.\nYou can also consult your doctor about a preemptive kidney transplant, a procedure in which you receive a kidney transplant without undergoing dialysis. However, a kidney transplant may carry more risks than dialysis for advanced age, dementia, and severe heart disease.\nYour provider may recommend dialysis if you have end-stage renal disease or failed kidneys. Additionally, they may assess your eligibility for a kidney transplant. You must be in good health to undergo a major surgical procedure and tolerate a lifelong medication regimen before your doctor can declare you a candidate.\nIt would be best if you agree to adhere to your physician’s instructions and strictly follow your medication regimen. Due to the risks, an underlying medical condition may disqualify you from a kidney transplant. Medical conditions include liver disease, cancer, severe cardiovascular disease, and tuberculosis. You may also not be eligible for the procedure f you use illicit drugs, smoke, or alcohol.\nAfter clearing you as a good candidate for the transplant, your doctor looks for a viable donor. However, if you are receiving the kidney from a deceased donor, you may need to rush to Houston Kidney Specialists Center within your doctor’s notice. Afterward, your provider takes a blood sample to test for antibodies.\nYour doctor declares the kidney viable if the results show a negative crossmatch. The team performs the transplant under general anesthesia, which you receive via an intravenous (IV) line in your arm. Once the anesthesia takes over, your provider creates an incision in the abdomen and lays the kidney in the correct position.\nCall the Houston Kidney Specialists Center office or book your spot online to find out if you are eligible for a kidney transplant.
Urology Medical Billing is a complex medical field that focuses on conditions related to the urinary and reproductive systems in males. This medical discipline presents challenges in medical billing beyond the complexities of the medical procedures. As far as medical billing is concerned, it specifically includes all the practices of translating urology related medical facilities and services into standardized CPT codes. These codes play an imperative role in claim reimbursements. With the evolving medical field, medical billing has played a crucial role in all healthcare aspects. For instance, it has been influencing the revenue cycle and reimbursement rates for insurance providers. On the other hand, the involvement of Urology in surgeries has further amplified the complexity of medical billing. This is because of the diverse range of services required. These requirements specifically include medical devices, surgical procedures, anesthesia, and related medical services.
Anesthesiology RN Jobs in Brooklyn, New York\nInterested in travel jobs as a professional Anesthesiology RN in Brooklyn, New York? trustaff connects health employers to qualified professionals every day. We'd love to help you find the travel health placement that would offer you the flexibility to work in Brooklyn, New York - wherever you'd like and on the rotation of your choice. Experience brooklyn and get a chance to explore beautiful New York on your time off.\n**We are having difficulty finding exact matches for your search right now. Click here for a more advanced search or fill out the form on the right to trigger a deeper search of available positions.\nTravel Nurse and Allied Health Jobs in Brooklyn, New YorkFind a travel Anesthesiology RN job in beautiful New York. Dubbed The Empire State, New York offers diversity, delicious pizza, theatre, fashion and incredible architecture. Some of the best healthcare institutions in the nation, including New York-Presbyterian University Hospital of Columbia and Cornell in New York City, UR Medicine Strong Memorial Hospital in Rochester and St. Peter's Hospital in Albany make New York and excellent destination for both travel placements and career growth. And Central Park, Brooklyn Botanical Gardens, The Adirondacks, and Mohonk Preserve provide natural beauty to make your work feel like a vacation in itself.\nAs a Certified Registered Nurse Anesthetist (CRNA), you will be responsible for administering anesthesia to patients under the direction of a surgeon. The Nurse Anesthetist will review patient medical history and condition in order to determine proper methods of anesthesia and how the patient should respond to anesthetics. The CRNA will attend to patient needs before, during, and after surgery.\nFind my Anesthesiology RN Travel Assignment Today!\nThe Best Benefits, Incredible Pay for Anesthesiology RN Jobs - the 'trustaff' wayFor over fifteen years, trustaff has helped talented professionals like you take their careers to the next level. Nicknamed The Empire State, New York is known for diversity, delicious pizza, theatre, fashion and incredible architecture. With great pay, outstanding benefits, and dedicated personal support, our travelers trust trustaff to accelerate their careers again and again.\nWhat People are Saying\nView Related Pages
Subcutaneous Emphysema With Pneumomediastinum During The Second Stage Of Labour: A Rare Intrapartum Complication\nP Jain, T Vanner\nP Jain, T Vanner. Subcutaneous Emphysema With Pneumomediastinum During The Second Stage Of Labour: A Rare Intrapartum Complication. The Internet Journal of Gynecology and Obstetrics. 2007 Volume 9 Number 1.\nEarly recognition followed by appropriate measures to prevent further complications is the key factor to reduce the morbidity & mortality associated with this condition.\nSubcutaneous emphysema & pneumomediastinum although runs a benign course, but fatalities have been reported.\nThis condition is generally self-limiting; therefore, observation, reassurance & symptomatic treatment with analgesia and oxygen is all that is needed in most cases.\nA 23 year old nulliparous woman presented to the Labour ward at 41 weeks of pregnancy with regular contractions & possible rupture of membranes.\nHer antenatal period was uneventful. She was on medication for asthma & was a non-smoker. On examination, she was in early labour with cervix dilated to 3 cm and intact membranes. She was prescribed Entonox for pain-relief throughout the labour. The cervix was fully dilated 5 hours after admission.\nAfter 30 minutes of pushing, she complained of a sore throat and her face looked flushed. She was advised regarding pushing technique as she appeared to push ‘into her throat'.\nHer face & eyes were swollen after 1 hour and 10 minutes although there was no problem with breathing. After second stage of labour lasting just short of two hours, she had spontaneous vaginal delivery of 3.342 kg baby.\nAfter delivery the facial and neck swelling increased to a significant extent that it was quite painful and she could hardly open her eyes. She also complained of difficulty in breathing along with blocked nose and throat.\nShe was transferred to High Dependency Unit in the labour ward. Examination showed severe facial and neck oedema with crepitus.\nCardio-respiratory status was stable and clear chest with bilaterally equal air entry.\nChest x-ray revealed gross and extensive surgical emphysema across the chest and up into the neck and pneumomediastinum with no evidence of pneumothorax (Fig.1)\nShe was managed conservatively with physiotherapy, analgesics and salbutamol nebulizer. She recovered well in 2-3 days time.\nSubcutaneous emphysema with pneumomediastinum is also known as Hamman's Syndrome. It occurs mostly during the second stage of labour, related to the valsalva manoeuvre during the expulsive phase of labour where ‘pushing down' acutely raises intra-alveolar pressure.\nPneumomediastinum is thought to occur when a marginally situated alveolus ruptures into the pulmonary interstitial space, with tracking of air toward the hilum and mediastinum .1\nThe diagnosis of subcutaneous emphysema is self-evident. The crepitus palpable on the face & the neck is virtually pathognomonic of this condition.\nThe definitive diagnosis is made on the chest x-ray mainly lateral view as they improve the visibility of air in the anterior mediastinum. 2\nThe majority of patients require conservative management alone. Use of Entonox analgesia is probably contraindicated because it is likely to cause further expansion of the pneumomediastinum.3\nIdentification of subcutaneous emphysema is important because potential complications can be serious like pneumothorax & cardiac compression.4\nTo avoid such complications, shortening the second stage of labour by the use of forceps or vacuum extraction is recommended when pneumomediastinum has been diagnosed.\nTo conclude, surgical emphysema with pneumomediastinum is a rare complication of labour. This is generally a self-limiting condition. Early recognition followed by appropriate measures to prevent further complications is the key factor to reduce the morbidity & mortality associated with this condition.\nDr. P. Jain 1 St Thomas Close Sutton Coldfield B75 7QJ West Midlands UK Tel: +44 121 2402256 ( R) +44 77890 72062 (M) e-mail : [email protected] Fax: +44 121 3786182
Doctor insights on:\nDo I Have To Get My Wisdom Teeth Removed\nMy dentist said I have to get my wisdom teeth removed beforr they brake through do they do it n the office or do I go somewere else?\nOral surgeon office: In our pittsburgh based oral surgery office, most of our patients come from referrals from general dentists. Although some general dentists have the training and experience to extract wisdom teeth, oral surgeons are required to have a minimum of 4 years of hospital based surgical training. In general oral surgoens have more experience and expertise in the extraction of impacted wisdom teeth. ...Read moreSee 2 more doctor answers\nYou missed the ideal: "window" before they are fully formed in late adolescence early adulthood - 17, 18, 19 Y.O. At this point though, if they are in your bite (occluding and aligned properly) without crowding, no periodontal pathology, no other bony pathology (cyst, etc.), able to be cleansed properly, restorable with fillings or crowns, non-abscessed - no worries then. For sure leave them intact! ...Read moreSee 1 more doctor answer\nNow or Later: If your wisdom teeth are indicated for removal, early removal before the roots are fully developed is the optimal time. At 35, your wisdom teeth are fully developed. Your anesthetic options can be discussed with your dentist or surgeon who will be performing your surgery. ...Read moreSee 1 more doctor answer\nDepends.: Depending on how many teeth are removed, what their position is (fully erupted, partially impacted, fully impacted, etc..., your post-operative discomfort and time to heal will vary. Your oral surgeon/ dentist should be able to give you a better idea than i can. ...Read moreSee 2 more doctor answers\nWas wondering if i go to the dentist tomorrow, how soon will i be able to get my wisdom teeth removed?\nRemoving teeth: That depends upon the availability of the dentist's open appointment time, your medical ; dental history, the urgency of the need to have the teeth removed as well as your availability. If you are having the teeth removed with local anesthetic ; do not need medical clearance, it can be removed the same day. If you are having IV sedation, special preparation is required. Call the office to discuss. ...Read more\nDo i even need to get my wisdom teeth removed if I have braces on at the time they are growing in?\n- Talk to a doctor live online for free\n- Do i need to have my wisdom teeth removed?\n- Do i have to get my wisdom teeth taken out?\n- Do i need to get my wisdom teeth removed?\n- Ask a doctor a question free online\n- Do you have to get wisdom teeth removed before braces?\n- How do i get my child to have more discipline about brushing her teeth?\n- Do i have to remove my wisdom teeth?\n- Do i have to pull my wisdom teeth?\n- Talk to a dentist online for free
Shawn succinctly shares her thin place in a powerful way. How amazing to serve the God who is near.\nIn 1997 my mom underwent colon cancer surgery. Due to having advanced lung disease the doctors were concerned about her going under anesthesia. Their concerns were valid. She came out of the surgery, remained on a ventilator and in a coma.\nAs the weekend got under way many people were praying for her. We five kids knew that this was the horror mom had always dreaded: living on a machine.\nSunday evening while sitting in church I received a call from the hospital. Mom had taken a turn for the worse and they weren’t expecting her to make it through the next hour or so.\nI called all my siblings and we met at the hospital with the doctors. Her doctors were Christians and told us that it was now in God’s hands. The five of us headed to the ground floor of the hospital and found an unoccupied area. Each of us talked about our love for mom and each other. Then we took turns petitioning God for our Mom.\nNever before and never since have we siblings come together and felt His presence like we did that night. We were there in our little world for several hours. Right as we were getting up to go check on mom one of the nurses found us with the news that she was once again responding to the treatment.\nMom came out of the coma and off the machine. She lived another 6 years. She lived her life to the end for Jesus. I miss her presence still today. I have several of these Thin Moments where God came near. Thank you for letting me share this.
551 5th Ave, RM 1114, New York, NY 10176\nPhone: (212) 867-2730\nURL: https://www.ManhattanNYDentist.com Google Map\nPayments: cash, check, ATM card and all major credit cards\nInsurance: Do not accept direct insurance payments\nManhattan Dentist – David S. Binder, DDS, provides dental implants, crowns, veneers, sedation, sleep apnea therapy and TMJ treatment. Dr. Binder is distinguished in the field of dental implants and in dental sleep apnea treatments.\nDr. Binder teaches the surgical placement and restoration of dental implants to dentists at New York College of Dentistry continuing education program.\n- Sitemap - Manhattan Dentist\n- Image map
Neostigmine methylsulfate injection is used to treat myasthenia gravis disease and postoperative reversal of muscle relaxants after surgeries. The drug acts as an acetylcholinesterase inhibitor that enhances neuromuscular transmission at the neuromuscular junction in the peripheral nervous system. It is administered parenterally via intramuscular or intravenous injection routes. The global neostigmine methylsulfate injection market is estimated to be valued at US$ 180.58 billion in 2024 and is expected to exhibit a CAGR of 9.1% over the forecast period 2024 to 2030.\nKey players operating in the neostigmine methylsulfate injection are Amgen Inc., AstraZeneca PLC, Bayer AG, Johnson and Johnson and Merck & Co. Inc.\nThe key opportunities in the market include rising geriatric population who are more prone to develop myasthenia gravis disease and growing number of surgeries performed worldwide requiring postoperative reversal of muscle relaxants during anesthesia.\nThe neostigmine methylsulfate injection market is expanding globally with presence of major players in developed regions of North America and Europe and growth activities underway by players in developing countries of Asia Pacific and Latin America through new product launches and geographic expansion plans.\nThe rising prevalence of myasthenia gravis neurological disease is a major market driver. The disease has no definitive cure and neostigmine methylsulfate injection provides relief from symptoms and helps control flare ups. According to estimates, the prevalence rate of myasthenia gravis varies from 5-30 cases per million worldwide. Additionally, growing number of surgical procedures requiring perioperative use of neostigmine methylsulfate for muscle relaxation reversal during anesthesia further aid the market growth over the forecast period.\nPolitical: Regulations around clinical trials and approval pathways for new drugs and biologicals may impact the development and availability of Neostigmine Methylsulfate Injection products.\nEconomic: Changes in discretionary spending by hospitals and healthcare providers on specialty drugs and injections due to overall economic conditions could influence market growth.\nSocial: Growing aging population and rising incidence rates of certain medical conditions may increase demand for drugs like Neostigmine Methylsulfate Injection used in treating related symptoms.\nTechnological: Advancements in drug delivery mechanisms and availability of alternative treatment options could change usage patterns and adoption rates of Neostigmine Methylsulfate Injection over time.\nThe North American region currently accounts for the largest share of the global Neostigmine Methylsulfate Injection Market in terms of value sales. This can be attributed to factors such as availability of advanced healthcare facilities, growing prevalence of target medical conditions, and favorable reimbursement policies in countries like the United States and Canada. The Asia Pacific region is anticipated to witness the fastest growth during the forecast period owing to rapidly developing healthcare infrastructure, rising medical tourism, and improving access to specialty treatments across major markets of China and India.\nThe Neostigmine Methylsulfate Injection market in emerging economies is expanding at a noteworthy pace. Countries such as Brazil, Russia, China and India are expected to contribute significantly to the global market over the forecast period due to growing patient disposable incomes, increasing governmental focus on improving public healthcare standards, and rising penetration of health insurance. Additionally, local manufacturers entering partnerships to develop low-cost biosimilar products will support market expansion in these geographies.\n1. Source: Coherent Market Insights, Public sources, Desk research\n2. We have leveraged AI tools to mine information and compile it
The knee is one of the largest, most complex joints in the body. It is made up of four bones: The femur, the tibia, the fibula, and the patella. The muscles that support the knee are the quadriceps, in the front of the knee, and the hamstrings, in the back. These structures are connected through a collection of ligaments and cartilage. The anterior cruciate ligament (ACL) prevents the femur from moving backwards onto the tibia, and the posterior cruciate ligament (PCL) prevents the femur from sliding forwards. There are two collateral ligaments, medial and lateral, that also help to provide support. The meniscus (lateral and medial) is tissue that sits between the femur and the tibia, providing ease of movement between the two bones. There is also articular cartilage that sits behind the patella. The knee is surrounded by bursae, fluid filled sacs which help to cushion the knee joint.\nTypes of Knee Pain\nThe main movement of the knee is bending and straightening. Because the knee is, also, capable of twisting, many traumatic injuries to the ligaments can occur. Some symptoms of this type of injury include a “popping” sound, immediate inability to bear weight on the affected limb, or the sense of the knee “giving way.” These types of injuries, sometimes, require surgical repair. Twisting can cause injury to the tendons or the meniscus as well. Both of types of injuries can cause pain, swelling, and difficulty straightening the leg.\nAnother main cause of knee pain is degeneration. This is called “osteoarthritis”, and it is the “wear and tear” of the cartilage of the knee, which degenerates as we age. When the condition becomes severe, there is no more (or very little) cartilage left between the knee bones, and this can cause significant pain. Chondromalacia patella is also a type of degeneration, and it means that there is damage to the cartilage beneath the kneecap.\nEstablishing a correct diagnosis for knee pain is the first, and most important, aspect of treating knee pain. An MRI is usually used to make this determination. Also, there are several injections that may help knee pain. One of the most common is a corticosteroid, which is injected directly into the knee joint. This type of injection reduces inflammation and pain. Viscosupplementation (Orthovisc, Synvisc) provides lubrication to the knee joint for persons with degenerative conditions such as osteoarthritis. There are several nerve blocks that may be beneficial as well.\nThe most common type of nerve block for knee pain is called a saphenous nerve block. A saphenous block provides relief for many types of knee pain, including the pain that sometimes accompanies total knee replacement. Other treatments for knee pain are – chiropractic therapy, gait analysis, bracing, and TENS unit application. Physical therapy can, also, help to strengthen the muscles surrounding the knee joint, improving its stability. Icing the knee can help decrease pain and swelling, as well, and anti-inflammatory medications (ibuprofen, naproxen sodium, Celebrex) are helpful mainstays of treatment for people with knee pain. However, other types of medication may be helpful as well.\nNeuropathic medications (gabapentin, Lyrica) are beneficial for persons that have neuropathic pain (burning, numbness, ‘pins and needles’), and opioid medications (hydrocodone, oxycodone) are beneficial for people with acute knee injuries. If a person is experiencing an acute-type injury of the knee, an orthopedic surgery referral is may be immediately made by a primary physician.\nIf the patient does not respond to more conservative treatments, neuromodulation through spinal cord stimulation may be a consideration. Spinal cord stimulation involves placing a small electrode within the epidural space of the spine. The stimulation of the large nerve fibers will inhibit the small nerve fibers, blocking the sensation of pain. Peripheral nerve stimulation (PNS) is very similar, but the electrodes are placed along the peripheral nerves instead, typically close to the area of pain. Both are completed under a local anesthetic and minimal sedation. The trial stimulator is typically worn for 5-7 days and connected to a stimulating device. If the trial successfully relieves your pain, it may be beneficial to undergo a permanent SCS/PNS.\nKnee pain can be quite disabling. Arkansas Pain provides a comprehensive and multidisciplinary approach to your pain. If you suffer from chronic knee pain, please call us to schedule an appointment today!\n- Knee Pain– PainDoctor.com\n- Kim, Philip (2004). Advanced Pain Management Techniques: An Overview of Neurostimulation. Retrieved February 16, 2010 from: http://www.medscape.com/viewarticle/473431Tennent, TD, Birch, NC, and MJ Holmes (et al)(1998).\n- Knee Pain and the Infrapatellar Branch of the Saphenous Nerve. Journal of the Royal Society of Medicine 1998;91:573-575.\n- The Center for Orthopaedics & Sports Medicine (2003). Knee Joint- Anatomy and Function. Retrieved February 16, 2010 from: http://www.arthroscopy.com/sp05001.htmThe Mayo Clinic (2008).\n- Knee Pain. Retrieved February 16, 2010 from: http://www.mayoclinic.com/health/knee-pain/DS00555
VCA Wellington Animal Hospital and Family Pet Resort\nQihua started working with the VCA Wellington team in 2017. She is currently the lead surgical assistant, but is also quite helpful in appointments and even sometimes at the reception desk. Qihua really loves taking care of her animal patients, as well as getting to know the owners. Qihua is especially interested in anesthesia, dentistry, and laboratory procedures. When she's not here with your pets, she enjoys hanging out at home with her own Jack Russel Terrier, Henry.\nOur technicians and support team members are all gentle animal lovers who treat your pets with the compassion and respect they deserve. Explore our support team members' biographies and learn about the individuals who make our hospital such a good choice for your pet's care.
A lipoma is a growth of fat cells in a thin, fibrous capsule usually found just below the skin. Lipomas aren't cancer and don't turn into cancer. They are found most often on the torso, neck, upper thighs, upper arms, and armpits, but they can occur almost anywhere in the body. One or more lipomas may be present at the same time.\nLipomas are the most common noncancerous soft tissue growth.\nWhat causes a lipoma?\nThe cause of lipomas is not completely understood, but the tendency to develop them is inherited. A minor injury may trigger the growth. Being overweight does not cause lipomas.\nWhat are the symptoms of a lipoma?\nAre small [ 0.4 in. (1 cm) to 1.2 in. (3 cm)] and felt just under the skin.\nAre movable and have a soft, rubbery consistency.\nDo not cause pain.\nRemain the same size over years or grow very slowly.\nOften the most bothersome symptom is the location or increased size that makes the lipoma noticeable by others.\nHow are lipomas diagnosed?\nA lipoma can usually be diagnosed by its appearance alone, but your doctor may want to remove it to make sure the growth is noncancerous.\nHow are lipomas treated?\nLipomas usually are not treated, because most of them don't hurt or cause problems. Your doctor may order an imaging test, such as an ultrasound. Or your doctor might remove the lipoma if it is painful, gets infected, or bothers you.\nMost lipomas can be removed in the doctor's office or outpatient surgery center. The doctor injects a local anesthetic around the lipoma, makes an incision in the skin, removes the growth, and closes the incision with stitches (sutures). If the lipoma is in an area of the body that cannot be easily reached through a simple incision in the skin, the lipoma may need to be removed in the operating room under general anesthesia.\nWho is affected by lipomas?\nLipomas occur in all age groups but most often appear in middle age. Single lipomas occur with equal frequency in men and women. Multiple lipomas occur more frequently in men.\nAuthor: Healthwise Staff Medical Review: William H. Blahd Jr. MD, FACEP - Emergency Medicine Adam Husney MD - Family Medicine Martin J. Gabica MD - Family Medicine H. Michael O'Connor MD - Emergency Medicine\nMedical Review:William H. Blahd Jr. MD, FACEP - Emergency Medicine & Adam Husney MD - Family Medicine & Martin J. Gabica MD - Family Medicine & H. Michael O'Connor MD - Emergency Medicine
Having unnecessary fat in numerous areas of your body can have a considerable effect on your health and self-esteem. While standard weight-loss through exercise and diet is a great way to reduce weight overall, even the very best workouts can't target issue locations like the belly, inner thighs, arms, and buttocks. Liposuction is a time evaluated treatment that is utilized to eliminate excess fat from particular locations of the body, allowing an individual to shape and contour their body to their liking. Is liposuction right for you? Find out now.\nPros of Liposuction\nThere are numerous advantages to this cosmetic treatment, including:\n• Immediately noticeable changes. Unlike conventional weight loss, liposuction produces changes that are right away visible in the body. Some difference is visible right away, and the wanted outcomes are normally accomplished in just a few days.\n• Proven and safe. This cosmetic treatment has been carried out by experienced specialists all over the world for years and the method has been refined over and once again to be safe and efficient.\n• Healing time is generally quick. The downtime required after having this type of procedure is generally much less than what is needed for other types of cosmetic treatments, including abdominoplasty, breast reduction, and more. People who have had the procedure can often go back to work a lot more rapidly than they prepared for and can return to living a healthy, active way of life.\n• Weight loss can be permanent. With the right maintenance techniques, the fat that was eliminated throughout the liposuction treatment will not return.\n• Complete control over your physique. With liposuction, a person can have complete control over how they wish to look, beyond what standard diet plan and workout can offer. Providing individuals this power over their bodies enhances self-confidence and assistance individuals feel their very best.\nWhile there countless benefits to liposuction, there are naturally a couple of caveats that should be taken into consideration before making the final decision to move on with the treatment.\nCons of Liposuction\nBefore having liposuction done, it is necessary to examine the possible disadvantages of the procedure and determine if the benefits surpass the risks in your particular case. Your specialist can assist you learn more about the dangers connected with the procedure and can assist you decide if moving forward is the right thing for you.\n• Issues with basic anesthesia. Due to the fact that liposuction is carried out under basic anesthesia, the treatment brings the very same risks as other type of surgery where basic anesthesia is used. Underlying medical conditions might increase these threats.\n• Negative reactions. Bruising, bleeding, and discomfort are all to be anticipated, nevertheless, in uncommon cases can cause more significant complications.\n• The possible to get the weight back. After having liposuction done, it is crucial to preserve a healthy diet and workout properly as advised by your doctor. Failure to do so might result in acquiring back the weight that was lost or potentially a lot more.\nThere are threats associated with liposuction, for lots of individuals, the advantages far exceed them. Inform yourself about the procedure by having thorough discussions with your cosmetic surgeon and think about how liposuction has the possible to affect you as a distinct person. Just you and your cosmetic surgeon can determine if liposuction will provide you with the outcomes you are searching for within your expectations.\nLaser Liposuction procedure is a new non invasive procedure to loose unwanted bodyfat in Meeteetse Wyoming\nLaser liposuction is a more recent, minimally intrusive procedure that involves heating the fat cells to melting point and removing the melted fat through a little cannula. The treatment is typically done right in your doctor's office and is an excellent alternative for individuals who have less than 500 ml of fat to eliminate from any one location. Laser liposuction can be a safe, complementary treatment to weight-loss in order to shape the body you've always desired.\nContact a Cosmetic surgeon in your Meeteetse Wyoming today.\nIf you're considering liposuction as a weight-loss option, it is necessary that you discuss your desires with a qualified cosmetic surgeon in your location. Your cosmetic surgeon will carry out a total test and health history survey to figure out if liposuction can benefit you and assist you reach your physical and emotional goals. Call today for a consultation and find out more about how liposuction can help you achieve the body of your dreams.
Start out 720x90 bnr Tag\nHeart Valve Replacing: The best way to Prepare yourself\nSo that you can have got surgical procedure to switch some sort of cardiac valve, you must plan a person's healthcare facility be.\nYou'll have to go to the infirmary or perhaps your current surgeon's business office several days and nights in advance of your current surgery treatment for your hospital preadmission procedure. With this treatment, your own medical workforce will probably instruct an individual pertaining to your coming surgery. They're going to furthermore coach you the way to plan for the functioning, demonstrate just what course of action might be like, and give you recommendations for any effective healing. Many corporations possibly demonstrate a client education and learning video in relation to owning valve replacement unit surgical procedures.\nYou should use these times must inquiries. It can be healthy that you worry previous to a person's function. Thus make sure to talk about the difficulties that could be causing you anxiety.\nOn the list of conditions that your physician or perhaps health professional will certainly check with you actually while in the preadmission period is definitely educated agreement. Your doctor as well as nurse can illustrate the hazards of a control device alternative surgical procedures. Some examples are:\nYou may then get asked so that you can indicator a agreement variety (discharge). Make sure to read it carefully. Ask questions around the form when there is anything that you don't understand.\nYou will find a variety of preparative methods. A person's clinic team will provide you with a couple of preliminary lab tests, just like the EKG and a maintain test out, to make certain a person's bodily processes tend to be standard. You will probably be asked to bathe or maybe bathe through an germ killing cleansing soap, when a technician will certainly cut almost any wild hair from your torso along with tummy, which means your physique is often as clean up as possible throughout surgery.\nWhat about anesthesia ?\nThe most essential chats you've got prior to surgical treatment will probably be with all your anesthesiologist, who will give what about anesthesia ? in your business. Simply because general anaesthesia has sizeable challenges, you have got to express your recent track record, like some other procedures a person has had and also any allergic reactions to meal or prescription drugs. Talk about any kind of background, either personal and also with your spouse and children, with adverse reactions to anesthesia. Get a summary of the particular prescription drugs you are at the moment using.\nJust before surgical procedure\nSimply because device substitution medical procedures is actually a considerable surgical treatment, begin getting yourself ready for this various times early. Seek to end up in good condition by means of eating healthy foodstuff, finding a lot of rest, and also confining energetic exercise. Question your doctor if you will find virtually any treatments it is best to acquire or shouldn't get ahead of your own surgery.\nYour personal doctor offers you information for any night before a person's surgery treatment. As an example, people medical professional will explain when you should never take in or consume everything (as well as h2o) ahead of surgery. Follow the instructions particularly, or maybe ones surgical procedure could possibly be canceled. Should your medical doctor possesses directed you to definitely carry your own remedies on the day involving medical procedures, achieve this using only the sip regarding waters.\nThrough the business\nPrior to surgical procedure takes place, you may be anaesthetise general anesthesia, that is given the two by using an IV line plus by way of a face mask located above orally plus face. While you are provided general anesthesia, you'll be unconscious during the entire procedure and won't feel anything at all.\nWhen you're other than conscious, the doctor will make a scratch along side length of the sternum in addition to present a person's cardiovascular system. The cardiovascular might be attached with a cardiovascular system-lung appliance. Just after the circulation of blood is given to the following appliance, the particular cosmetic surgeon will get rid of your harmed control device and also put it back through an artificial control device.\nWorld wide-Medicalsearch Health care Reference coming from\nThis info doesn't swap exhortation of any medical doctor. disclaims any kind of warranty or responsibility for your use of the details. Ones use of this info ensures that anyone agree to a Terms of Utilize. 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Track topics on Twitter Track topics that are important to you\nLocal anaesthetic agents are often used as an intra-articular analgesic following arthroscopic procedures. However, there is increasing evidence of a potential toxic effect to chondrocytes within the articular cartilage. The aim of this study was to compare the effect on human chondrocyte viability of treatment with bupivacaine, levobupivacaine and ropivacaine. The second aim was to compare the effect on chondrocyte viability of the local anaesthetics with magnesium, a potential alternative analgesic agent.\nChondrocytes were exposed to one of the local anaesthetic agents (levobupivacaine 0.13, 0.25, 0.5%; bupivacaine 0.13, 0.25, 0.5%; ropivacaine 0.19, 0.38, 0.75%), normal saline or 10% magnesium sulphate for 15 min. Cells exposed to cell culture media served as controls. Twenty-four hours after exposure, cell viability was assessed using the CellTiter 96(®) AQueous One Solution Cell Proliferation Assay.\nThere was no significant difference in chondrocyte viability after treatment with either normal saline or magnesium sulphate. With the exception of 0.13% levobupivacine, all local anaesthetic treatment showed significantly greater toxic effects than either normal saline or magnesium sulphate. Statistically significant dose-dependent responses of decreasing cell viability were found with increasing local anaesthetic concentration.\nA dose-dependent reduction in chondrocyte viability after treatment with common local anaesthetic agents was confirmed. Local anaesthetic agents had a greater deleterious effect on chondrocytes than did 10% magnesium sulphate. These findings suggest the need for continuing caution with the use of intra-articular local anaesthetic. Magnesium sulphate is a potential alternative intra-articular analgesic agent.\nC/- O.R.I.F., Suite 4, Sports Surgery Clinic, Santry Demesne, Dublin 9, Ireland, [email protected].\nThis article was published in the following journal.\nName: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA\nDNA methylation has emerged as a crucial regulator of chondrocyte dedifferentiation, which severely compromises the outcome of autologous chondrocyte implantation (ACI) treatment for cartilage defects...\nAdvanced oxidation protein products (AOPPs) have been shown to participate in the progression of rheumatoid arthritis (RA). However, the effect of AOPPs accumulation on catabolic effect in human chond...\nThe purposes of this study were to examine the cartilage degradation effects of triamcinolone acetonide (TA) on normal and osteoarthritic (OA) primary canine chondrocytes and cartilage explants and to...\nThree-dimensional in vitro tumor models are highly useful tools for studying tumor growth and treatment response of malignancies such as ovarian cancer. Existing viability and treatment assessment ass...\nAutologous chondrocyte implantation (ACI) is an effective method of repair of articular cartilage defects. It is a 2-stage operation, with the second stage most commonly performed via mini-arthrotomy....\nThe culturing human embryo in vitro is a process of myriad contributing elements. From these factors is the culture media pH, which is crucial for embryo development. The investigators pla...\nTo perform a comprehensive evaluation of multidetector CT myocardial enhancement patterns in patients with an acute ST elevation MI. In particular we plan to assess the relationship betwe...\nThis protocol is for a number of in vitro studies using human surgical biopsies and evaluating the pharmacology and genetics of human nociceptors ("pain detecting") neurons\nEmbryo preservation through freezing plays a significant role in human assisted reproduction. It provides an opportunity for patients to have more than one attempt following an ovarian st...\nThe purpose of this study is to measure the outcomes of patients who have articular cartilage lesions in the patellofemoral joint and are treated with the Autologous Chondrocyte Implantati...\nThe transfer of mammalian embryos from an in vivo or in vitro environment to a suitable host to improve pregnancy or gestational outcome in human or animal. In human fertility treatment programs, preimplantation embryos ranging from the 4-cell stage to the blastocyst stage are transferred to the uterine cavity between 3-5 days after FERTILIZATION IN VITRO.\nThe potential of the FETUS to survive outside the UTERUS after birth, natural or induced. Fetal viability depends largely on the FETAL ORGAN MATURITY, and environmental conditions.\nA scale comprising 18 symptom constructs chosen to represent relatively independent dimensions of manifest psychopathology. The initial intended use was to provide more efficient assessment of treatment response in clinical psychopharmacology research; however, the scale was readily adapted to other uses. (From Hersen, M. and Bellack, A.S., Dictionary of Behavioral Assessment Techniques, p. 87)\nSystematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.\nEvaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.\nPain is defined by the International Association for the Study of Pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”. Some illnesses can be excruci...\nAn assay is an analytic procedure for qualitatively assessing or quantitatively measuring the presence or amount or the functional activity of a target entity. This can be a drug or biochemical substance or a cell in an organism or organic sample. ...
Liposuction is a cosmetic surgical procedure that removes fat deposits that are not responding to diet and exercise.\nUnwanted and disproportionate fatty deposits commonly occur as we age and our weight slowly increases. Some people will have fat deposits, saddle bags for example, from teenage years, and no amount of diet and exercise will eradicate this. Liposuction is a surgical procedure performed to remove excessive fat deposits and re-contour the area.\nThere are many different tools used to perform liposuction, and most work equally well. Dr. Kerner prefers to use ultrasonic liposuction – VASER – as she feels it removes a greater quantity of fat in thicker, fibrous areas and also promotes better skin tightening.\nLiposuction is performed under anesthesia as an outpatient surgery, and the time varies with the amount of tissue to be removed and the location of the fat. Most patients will decide to treat multiple areas at one time to maximize their results and have only one recovery. During your consultation, Dr. Kerner will discuss how liposuction is performed, examine your areas of concern, and give you an honest opinion as to whether this is right for you.\nAfter liposuction, patients wear a compressive garment after surgery for three to six weeks and are able to resume all normal activities when they feel comfortable. Normally it takes four to five months for all the swelling to dissipate and the skin to contract to see the final result. Cellulite, loose and sagging skin, and obesity are not treated with liposuction, and not everyone is a good candidate for the procedure.\nLiposuction for men is becoming a common and popular treatment.\nMany men notice a progressive and stubborn accumulation of fat both in their abdominal area and in the flanks or “love handles”. Despite exercise and diet, these fat deposits can be very difficult to eradicate. Ultrasound assisted liposuction (UAL) is an excellent way to treat and contour these areas.\nUAL is a newer technique that delivers ultrasonic energy to the fat cells to help emulsify (explode) the cells. It works particularly well in areas where the fat is firmer or fibrotic, which is often the case in men. The ultrasound energy also helps to tighten the overlying skin. A man is a good candidate for liposuction if his skin is not too lose, and if the fat lies just under the skin. The “beer belly” abdomen is caused by fat around the organs (visceral fat). This cannot be treated with liposuction, only with weight loss. In your consultation, Dr. Kerner can advise if you are a good candidate for liposuction.\nLiposculpture is just a form of liposuction where fat is removed along normal indentions and valleys to recreate the look of a “six pack”. If a man has good abdominal tone, this may be a nice enhancement.\nLiposuction is done on an outpatient basis in the operating room, and anesthesia is administered. You will be sore, bruised, and swollen for a week, then rapidly be able to resume all normal activities. For most men, it takes four to five months for reshaping to occur and to see the final result.\nCall 972-981-7144 to schedule your consultation with Dr. Kerner, or email us.\nS. M. \| via Google Ratings Patient \| via vitals.com\nI love my liposuction and Botox!!\nI couldn’t be happier!\nS. M. \| via Google Ratings\nPatient \| via vitals.com
IN THIS ARTICLE\nWhat should I discuss with my healthcare provider before taking rivaroxaban (Xarelto)?\nYou should not use this medication if you are allergic to rivaroxaban, or if you have active or uncontrolled bleeding.\nRivaroxaban may cause you to bleed more easily, especially if you have:\nTo make sure you can safely take rivaroxaban, tell your doctor if you have kidney or liver disease.\nFDA pregnancy category C. It is not known whether rivaroxaban will harm an unborn baby. However, this medicine could cause bleeding complications during childbirth. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.\nIt is not known whether rivaroxaban passes into breast milk or if it could harm a nursing baby. You should not breast-feed while you are using rivaroxaban.\nHow should I take rivaroxaban (Xarelto)?\nTake exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.\nYou may take rivaroxaban with or without food. The 20-milligram dose should be taken with food.\nTell any doctor who treats you that you are using rivaroxaban. If you need surgery or dental work, tell the surgeon or dentist ahead of time that you are using this medication. If you need anesthesia for a medical procedure or surgery, you may need to stop using rivaroxaban for a short time.\nDo not stop taking this medication without first talking to your doctor.\nStore at room temperature away from moisture and heat.\nReport Problems to the Food and Drug Administration\nYou are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.\nNeed help identifying pills and medications?\nFind out what women really need.
Eyelid Surgery in Austin (Blepharoplasty)\nAs you get older, your eyelid skin stretches, muscles weaken and fat can accumulate around the eyes causing “bags.” Eyelid surgery (i.e., blepharoplasty) can correct upper lids, lower lids, or both.\nBefore and After Eyelid Surgery\nView Eyelid Surgery Photo Gallery\nHow is eyelid surgery performed?\nUsing twilight anesthesia, the patient remains awake and comfortable during the entire process. For an upper blepharoplasty, a very fine incision is placed in the natural crease above each eyelid and allowing for repositioning of fat deposits, tightening of muscles and tissue, and/or removal of excess skin. For a lower blepharoplasty, an incision is made just below the lower lash line and excess skin in the lower eyelids is removed. The incisions are closed with very fine sutures.\nWhat kind of downtime is required for eyelid surgery?\nResults of the eyelid surgery appear gradually as swelling and bruising subsides to reveal a smooth, better-defined eyelid and surrounding region. Most people feel ready to go out in public (and back to work) in a week to ten days after an eyelid surgery. By then, depending on your rate of healing, you’ll likely be able to wear makeup to hide any bruising that remains.
Two co-workers of a Fargo surgeon accused of drugging and sexually assaulting his wife say he was a conscientious and compassionate doctor who kept current on new surgical procedures and equipment.\nDr. Jon Norberg is being tried on charges of gross sexual imposition and reckless endangerment. Prosecutors say he took dangerous risks by injecting Dr. Alonna Norberg with the powerful anesthetic propofol.\nA surgical assistant and registered nurse who worked with Jon Norberg testified Thursday afternoon for the defense. They say Norberg managed the administration of sedatives, but did not perform the injections himself.\nJon Norberg says he gave Alonna Norberg propofol to help manage her chronic pain. Prosecutors say he gave her the drug to have sex with her against her will.\nThe prosecution rested its case Thursday morning.
EXCEEDING THE STANDARDS\nThe OUTPATIENT SURGICAL CENTER is built to exceed state and federal standards. It is Medicare certified, licensed by the State of Texas, and accredited by the Accreditation Association of Ambulatory Health Care. Our staff undergoes continuous training to assure that we are up-to–date in routine and emergency procedures. The CENTER includes a preoperative area, major operating room, recovery room, central supply area and minor treatment room.\nThe operating suite contains modern equipment for surgery and general anesthesia. including automatic heart, circulation and blood pressure monitors as will as central suction and oxygen. Equipment is regularly updated and tested., A back-up generator assures uninterrupted electrical power and ventilation in case of a power outage. The three-bed recovery area is designed and equipped to ensure the safest environment for the immediate postoperative period, after which the patient is quickly reunited with a family member or friend.\nIf hospitalization is required, patients will find the care provided by the Abilene Regional Medical Center to be second to none. The hospital is located immediately adjacent to the Center, and provides an added sense of security for any possible emergency that might arise.\nWE CAN ACCOMMODATE YOU IN MANY WAYS\nCosmetic procedure for face, nose, eyes, ears and neck; breast augmentation, elevation and reduction; facial augmentation including cheekbones and chin,; body contouring, tummy tuck and liposuction surgery; treatment of wrinkle; scars, and hair transplantation are procedures that can readily be performed in our SURGICAL CENTER. We can help you with all the arrangements and will assist you with transportation. Financing is available for patients desiring assistance.
Anne Arundel Gastroenterology Associates, PA., an expanding and the leading gastroenterology practice in Annapolis, MD, for more than 40 years, is currently recruiting for a full-time BC/BE clinical Gastroenterologist. The practice currently consists of four clinical sites that include a privately owned surgery center, anesthesia services, in-house pathology, and an infusion center. Currently, the practice has 12 board-certified Gastroenterologists and 2 Nurse Practitioners.\nThe successful candidate will be a fully trained gastroenterologist (board certified or board eligible) with Endoscopy experience who enjoys working in a fast paced, private practice environment. The practice offers a competitive salary with incentive and comprehensive benefits including malpractice and CME.\nAnne Arundel Gastroenterology Associates, PA., is strategically aligned with major healthcare systems. The practice is professionally managed with a state of the art infrastructure and a fully electronic environment. Annapolis offers excellent public and private school systems, outstanding outdoor activities and easy access to the cultural amenities of the Baltimore–Washington metropolitan area. Situated on the Chesapeake Bay, Annapolis is a suburb of both Baltimore and Washington, DC.\nContact InformationShow Contact Details\nHeadquartered in Nashville, Tennessee, Covenant Surgical Partners, Inc. is a privately-held owner and operator of ambulatory surgery centers, anatomic pathology laboratories, anesthesia entities and physician practices.\nA career with Covenant Surgical Partners sets you on a path for personal growth and opportunity. Join us as we become one of the foremost physician services companies in the United States.Back to top\nSign up to receive job postings that match your search criteria —\ndelivered to your inbox daily!
Comparative Study between IV Paracetamol and IM Pethidine for Post Operative Analgesia in Laparoscopic Cholecystectomy\nKeywords:IV Paracetamol, IM Pethidine, laparoscopic cholecystectomy, postoperative analgesia\nBackground: Effective analgesia is important after laparoscopic cholecystectomy. Paracetamol have been used extensively as alternatives, and it seems that they are more effective for mild to moderate pain control postoperatively. As laparoscopic Cholecystectomy poses moderate pain, in this study we compare the quality of analgesia and side effects of paracetamol versus pethidine for post-operative analgesia after laparoscopic cholecystectomy.\nObjectives: This study was designed to observe the effect of I.V. paracetamol and I.M. pethidine for analgesic efficacy in post-operative analgesia with their side effects in laparoscopic cholecystectomy. Material and method: Sixty (60) patients were selected in the pre anaesthetic check up room whose were going to be operated for laparoscopic cholecystectomy. Each patient in group A received intravenous paracetamol (1g/100ml)15mg/kg over 15minutes and group B received intramuscular pethidine (100mg)- 2mg/kg postoperatively.\nResults: In group A that was paracetamol group and group B that was pethidine group the visual analogue scale (VAS) almost similar but total analgesic consumption in pethidine group were slightly higher than paracetamol group and the respiratory rate were significantly lower in pethidine group.\nConclusion: Our results indicate that IV paracetamol 15mg / kg has better analgesic potency and less side effects than 2 mg / kg IM pethidine for postoperative analgesia after laparoscopic cholecystectomy.\nAnwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 46-53

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