Wednesday, September 29, 2010

USMLE ALGORITHMS: MENINGITIS

This algorithm is everything you need to know for the diagnosis and management of Meningitis for your exam. It is written and narrated by a USMLE Expert, and is to the point. All of Meningitis in less than 5 minutes.

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Laparoscopic Hysterectomy

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Laparoscopic hysterectomy is a surgical removal of the uterus,Laparoscopic hysterectomy is alternative to abdominal hysterectomy.Hysterectomy is the second most common major operation performed in the United States today, second only to cesarian section.The first laparoscopic hysterectomy (LH) was performed in January 1988 by Harry Reich in Pennsylvania.The indications for laparoscopic hysterectomy are similar to the generally accepted indications for hysterectomy.
The contraindications for laparoscopic hysterectomy include postpartum hysterectomy and adnexal masses which cannot be removed with an endobag. The size of the uterus and access to it also limit the scope of the procedure depending on the experience of the surgeon.Hysterectomy is usually performed for problems with the uterus itself or problems with the entire female reproductive complex. Some of the conditions treated by hysterectomy include uterine fibroids (myomas), endometriosis (growth of menstrual tissue outside of the uterine cavity), adenomyosis (a more severe form of endometriosis, where the uterine lining has grown into and sometimes through the uterine wall), several forms of vaginal prolapse, heavy or abnormal menstrual bleeding, and at least three forms of cancer (uterine, advanced cervical, ovarian). Hysterectomy is also a surgical last resort in uncontrollable postpartum obstetrical haemorrhage.Tags,laparoscopic hysterectomy recovery,laparoscopic vaginal hysterectomy

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Rotator cuff muscles


"The SITS muscles":
· Clockwise from top:

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Advanced Practice in Critical Care: A Case Study Approach – May 2010 Edition


Advanced Practice in Critical Care provides experienced critical care nurses with a clear and distinct evidence base for contemporary critical care practice. Central to the book is the application of research and evidence to practice and therefore, case studies and key critical care clinical situations are used throughout to guide the reader through the patient care trajectory.
Each chapter introduces an initial patient scenario and as the chapter progresses, the patient scenario develops with the theoretical perspectives and application. In this way, it is evident how multi-organ dysfunction develops, impacting upon and influencing other body systems, demonstrating the multi-organ impact that is often experienced by the critically ill patient. In this way, consequences of critical illness such as acute renal failure, haemostatic failure and liver dysfunction are explored. Throughout the text, key research findings and critical care treatment strategies are referred to, applied and evaluated in the context of the given patient case study. Advanced assessment techniques are explained and the underlying pathophysiology is discussed in depth. Advanced Practice in Critical Care is an essential resource for experienced practitioners within critical care whom primarily care for patients requiring high dependency or intensive care.
This key new book provides in-depth rationales for contemporary critical care practice in an effort to increase the depth of knowledge of nurses who care for the critically ill patient, so that they can truly evaluate their care interventions in view of underlying pathophysiology and evidence. Each chapter introduces a patient scenario, which is developed and explored throughout the course of the chapter.

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How to identify Hematoma in Mammography ??

In this article We will show WELL-CIRCUMSCRIBED and ILL-DEFINED HEMATOMA as seen in Mammogaphy...

WELL-CIRCUMSCRIBED HEMATOMA:
Most commonly caused by blunt or surgical trauma, although hematomas may develop in patients who are anticoagulated or have clotting abnormalities. The combination of hemorrhage and edema more commonly results in an ill-defined mass or a diffuse area of increased density. Although the mammographic findings simulate carcinoma, a history of trauma suggests a conservative approach. Follow-up examinations show gradual decrease in size or even disappearance of the lesion. An organized hematoma may occasionally persist as a more sharply defined mass.

Imaging Findings:
Medium to high-density mass, often having slightly irregular margins. Overlying skin edema is usually present in the acute stage if the hematoma is secondary to trauma.
Hematoma. (A) Mammogram of a firm, palpable mass that arose at a recent biopsy site shows a dense lesion associated with skin thickening (arrows). (B) Three months later, there has been almost complete resolution of the hematoma with only minimal residual architectural distortion (arrows).


ILL-DEFINED HEMATOMA
Overlying skin thickening from edema and bruising may simulate carcinoma. Hematomas tend to resolve within 3 to 4 weeks.



Imaging Findings:
May appear as an ill-defined lesion (more commonly a relatively well-defined mass or a diffuse increase in density).

Hematoma. Ill-defined area of increased density (arrows) in the area of a lumpectomy performed 2 weeks previously.

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Algorithm for neonatal resuscitation

Though neonatal resuscitation shares the foundation concepts of airway, breathing, and circulation with adult and pediatric resuscitation, the neonatal algorithm incorporates other concepts central to the care of the newly born infant (e.g. thermal control), emphasizes the importance of establishing adequate lung expansion and ventilation, and dictates key variations in practice resulting from anatomic and developmental differences between neonatal and older pediatric patients.
The algorithm for neonatal resuscitation begins with rapid assessment and the initial steps of resuscitation, then continues through positive-pressure ventilation (including intubation), chest compressions, medications, and special considerations.

This figure shows The algorithm for neonatal resuscitation that begins with a rapid assessment of the infant and continues through the initial steps of resuscitation, positive-pressure ventilation, chest compressions, and medications. Endotracheal intubation may be considered at several steps during resuscitation.

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