Dermatology Advisor’s Post

NIHR (National Institute for Health and Care Research) Kidney failure: medical insertion of catheters for peritoneal dialysis is as safe as surgery The issue: how safe are medical catheter insertions for dialysis?   People with kidney failure or chronic kidney disease, whose kidneys have stopped working properly, may need dialysis. This therapy takes over the normal function of the kidneys and removes waste products and excess fluid from the blood. Many people have regular dialysis in hospital, where fluids are filtered by a machine (haemodialysis). In peritoneal dialysis, often carried out at home, a catheter is inserted in the abdomen and left there permanently.   A catheter can be inserted under general anaesthetic by a surgeon, or without a general anaesthetic by a physician using a needle (medical insertion). Medical insertions have become more common in recent years due to a lack of access to surgeons and theatre space; they have the advantage of being possible in people who are not well enough to have a general anaesthetic.   https://lnkd.in/eEKU4vYF

Point check this morning at SOP Regulation protocol time without pill. Taking the BP control pill as per regulation? Nope, not taking the redundant SOP BP control pill any further on biostate stabilisation and BP normalisation. Blardy FUBAR prescription/TREATMENT for fictitious diagnoses on(Ambulatory) UNCONFIRMED Clinical HPT. Escalated by hospital compounding issues during my medical 911. Idiots will be idiots in the system Incompetent to the core BASICS of diagnosis, confirmation, prescription, treatment and resolution protocols. Medical 911 haemorrhagic stroke brain bleed NOT withstanding, sustaining an elevated BP at 150s with Increased BP control agents increased to 4 from the base precaution of 1 and IV antibiotics on UNCONFIRMED Infective Endocarditis going further to that fictitious growth in heart diagnosis for EMERGENCY Life shortening open heart surgery.

Fluoroscopy: An OverviewFluoroscopy is a medical imaging technique that allows healthcare professionals to view real-time, moving images of the inside of the body. It uses a continuous X-ray beam that passes through the body, capturing dynamic images that are displayed on a monitor. This technology is commonly used to observe the movement of internal organs, guide diagnostic and therapeutic procedures, and visualize the flow of contrast agents within the body.Key Features and Uses of Fluoroscopy:Real-Time Imaging: Unlike static X-rays, fluoroscopy provides real-time imaging, which is crucial for procedures that require monitoring of movement or immediate adjustments, such as catheter placement, joint injections, and gastrointestinal studies.Guidance for Procedures: Fluoroscopy is widely used to guide a variety of medical procedures, including the insertion of catheters, stents, and needles during surgeries or biopsies. It helps ensure precision and accuracy, reducing the risk of complications.Examination of Dynamic Processes: It is particularly useful for examining dynamic processes within the body, such as the movement of the gastrointestinal tract, blood flow through vessels, and the motion of joints.Use of Contrast Agents: In many fluoroscopic exams, contrast agents (like barium or iodine-based substances) are used to enhance the visibility of specific areas or functions within the body. These agents help to highlight blood vessels, organs, or other tissues, making abnormalities easier to detect.Radiation Exposure: Fluoroscopy involves exposure to ionizing radiation, which can pose risks, especially with prolonged or repeated use. To minimize these risks, protective measures such as lead aprons, thyroid shields, and the use of the lowest possible radiation dose are employed.Applications: Common applications include barium swallow studies, cardiac catheterization, orthopedic surgery guidance, angiography, and the placement of gastrointestinal tubes.Safety Considerations:Radiation Protection: Due to the exposure to X-rays, it's important to use protective gear and minimize exposure time.Patient Preparation: Depending on the procedure, patients may need to fast, take laxatives, or refrain from certain medications.Contraindications: Fluoroscopy may not be suitable for pregnant women or those with certain allergies, especially to contrast agents. #ShehzadAliRadiologyTech

🚨 Understanding Anal Fistula Surgery: Key Insights for Optimal Recovery 🚨 An anal fistula is more than just an uncomfortable condition—it’s a medical challenge that requires informed decisions and careful management. If you or someone you know is dealing with this issue, here’s a comprehensive guide to understanding anal fistula operations, treatment options, and recovery tips. 🌟 🔍 Key Takeaways: - Definition: An anal fistula is an abnormal passageway that connects the anus to the skin outside the body. It often follows an anal abscess. - Symptoms: Pain, swelling, redness, and fluid drainage are common indicators. - Diagnosis: MRI and ultrasound are essential for pinpointing the fistula’s location and severity. - Treatment Options: From non-surgical methods like antibiotics and setons to surgical procedures such as fistulotomy and LIFT, there are various ways to address anal fistulas. - Recovery: Post-operative care is crucial. Expect a recovery period of 3-6 weeks and follow your healthcare provider’s instructions meticulously. Why It Matters: Early diagnosis and treatment can prevent complications and improve recovery outcomes. Whether you’re considering surgery or exploring non-surgical options, understanding your choices is key to effective management. 🌐 Dive deeper into the details of anal fistula surgery, learn about the latest advances, and get practical tips for both pre and post-operative care in our latest blog. 👉 Read the full article here and equip yourself with the knowledge you need for a smoother journey through diagnosis, treatment, and recovery. https://lnkd.in/gbdYmYP2 💬 Have questions or personal experiences to share? Let’s discuss in the comments below! #AnalFistulaOperation #FistulaSurgery #AnalHealth #MedicalTips #HealthAdvice #SurgicalCare #PostOpRecovery #HealthAwareness #PainManagement #SurgicalRecovery #Healthcare #MedicalTreatment #ChronicConditions #DigestiveHealth #PatientCare #HealthInformation #MedicalProcedure #HealthJourney #HealingProcess #MedicalEducation #southlakegeneralsurgery #health #doctor #patients #Treatment #surgery #surgeon #Texas #SouthlakeTx #USA

Ophthopedia Update:Comparing Outcomes of 45 Xen Implantation Ab Interno With Closed Conjunctiva to Ab Externo With Open Conjunctiva Approaches: Précis: Ab externo with open conjunctiva placement may lead to improved gelatin stent (XEN Gel Stent; Allergan) success rate compared with ab interno with closed conjunctiva because it conferred more favorable intraocular pressure (IOP) and medication burden reduction based on our complete and qualified success criteria. Purpose: To compare outcomes of a gelatin stent (XEN 45 Gel Stent; Allergan) placed either ab interno with closed conjunctiva (AIC) or ab externo with open conjunctiva (AEO) with or without cataract surgery in patients with glaucoma. Design: Retrospective, nonrandomized comparative study of 85 eyes from 85 glaucoma patients who received XEN 45 Gel Stent placed either AIC (N=32) or AEO (N=53) with or without cataract surgery between July 2018 and January 2022 at Massachusetts Eye and Ear. Patients were included if they were 18 years of age or above and had at least 30 days of follow-up without any disqualifying event. Results: Baseline demographics were similar between both groups, except for the glaucoma type. Both AIC and AEO procedures resulted in significant patterns of IOP and medication reduction from baseline up to 1 year. At postoperative year (POY)1, mean IOP was reduced to 11.34±4 mmHg on 1.29±1.34 medications after AEO and 13.70±3.32 mmHg on 2±1.81 medications after AIC. The average IOP reduction was significantly greater in the AEO group at all postoperative time points beyond postoperative week 2. There were significant differences in the survival curves of AEO and AIC groups under both the complete success criteria and the qualified success criteria. Under the complete success criteria, the cumulative probability of survival at POY1 was 28.5% in the AEO group and 3.8% in the AIC group. Under the qualified success criteria, the cumulative probability of survival at POY1 was 60.3% in the AEO group and 21.9% in the AIC group. Conclusions: In our study, we demonstrate that both placements reduce IOP and medication from baseline, with AEO placement having more favorable success rates compared with AIC placement. #Ophthalmology #Eye #Ophthotwitter

🔍 **Urethral Stricture in Female Patients: Exploring Surgical Augmented Urethroplasty** Urethral strictures in female patients pose unique challenges, often requiring surgical intervention like augmented urethroplasty. This procedure involves reconstructing the narrowed urethra using tissue grafts to restore proper function. **Pros:** 1. **Improved Urinary Flow:** Augmented urethroplasty can alleviate urinary flow restrictions, enhancing quality of life. 2. **Long-term Relief:** Unlike temporary solutions, this surgery offers lasting results, reducing the likelihood of recurrence. 3. **Customized Approach:** Surgeons tailor the procedure to each patient's specific needs, optimizing outcomes. **Cons:** 1. **Surgical Risks:** As with any surgery, there are inherent risks such as infection, bleeding, or tissue rejection. 2. **Recovery Time:** Patients may experience discomfort and require a period of recovery before returning to normal activities. 3. **Cost:** Depending on healthcare coverage, the cost of urethroplasty can be a consideration for some patients. **Who Needs Urethroplasty:** Patients with recurrent urinary tract infections, urinary retention, or persistent difficulty urinating despite conservative treatments may benefit from urethroplasty. A thorough evaluation by a urologist is crucial in determining the appropriateness of this surgical intervention. Stay informed, stay healthy! #Urethroplasty #FemaleHealth #SurgicalIntervention

In the latest article on the benefits of a “Take Home Catheter”, studies showed that there are many benefits to these nerve block catheters, including: - Less pain after surgery - Less opioid use - Less likelihood of opioid dependence - Faster recovery of movement and function - Greater likelihood of leaving the hospital sooner Solo-Dex Precision Acute Pain Service™️ minimizes health risks often associated with general anesthesia. Our sustained nerve block catheter offers five days of relief after your surgery. It also facilitates quicker recovery and discharge, promotes home recovery with reduced opioid dependance, and greatly improves patient satisfaction post surgery. Ask your surgeon today, “Is Solo-Dex Precision Acute Pain Service™️ right for me?” Learn more at solo-dex.com. #medtech #manufacturing #medicaldesign #medicaldevices #medicalengineering #healthcare #healthtechnology #healthtech https://lnkd.in/gjffGVSC

Opioid free anesthesia (OFA) Anniversary On March 26, 1992, I administered my 1st propofol then ketamine for elective cosmetic surgery 32 years ago, I incrementally titrated propofol to a loss of lid reflex and loss of verbal response before giving ketamine to induce immobility for the plastic surgeon’s local anesthetic injection I was very anxious...I did not know if propofol would block ketamine hallucinations The first patient that emerged with unpleasant mental side effects would be the end of my clinical experiment As the next 24 patients, as well as patient #1, emerged without hallucinations, dysphoria or flashbacks, my working hypothesis was confirmed! Another 25 cases later, I also noticed patients emerged pain and PONV free doi: 10.1007/BF00437102 From ridicule to recognition, what a long, strange trip it’s been >80 letters and articles, 11 textbook chapters, a textbook in 3 languages, a US Congressional award for my contribution to mobile military anesthesia, 240 subsequent references to my work in papers and another 76 in other textbook chapters, >70 presentations of my work, the last live ones in Abu Dhabi & Dubai Outcomes? >6,000 outpatients s a single pain or PONV admission Very honored to have made a contribution to anesthesia I hope posterity will remember me for Friedberg’s Triad tinyurl.com/2p8sh5nu

Radiosurgery Radiosurgery is a minimally invasive medical specialty that utilizes radiation to precisely target and treat tumors and abnormal tissue growths It is a safe and effective treatment option for conditions such as benign and malignant tumors, arteriovenous malformations, and trigeminal neuralgia During a radiosurgery procedure, high doses of radiation are targeted at the area in question while avoiding damage to the surrounding healthy tissue This makes it ideal for patients who may not be able to undergo traditional surgery due to health or physical limitations Radiosurgery can be used in combination with other treatments, such as chemotherapy and targeted drug therapy, to maximize treatment effectiveness It is also a great option for those seeking outpatient treatment, as it is often completed in a single session and there is no need for general anesthesia Radiosurgery is the perfect alternative for those needing to reduce abnormal tissue growths quickly and effectively.