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Cardiology

Sleep Disordered Breathing

I. Sleep Disordered Breathing: What every physician needs to know. Sleep disordered breathing is common in patients with cardiovascular disease and is associated with hypertension, atrial fibrillation, ventricular arrhythmias, vascular disease, and diabetes. In particular, sleep disordered breathing has been linked to worsening heart failure, decreased left ventricular function, and left ventricular hypertrophy both directly…
Dermatology

Xerosis (Dry skin)

Xerosis [synonyms Dry skin] Are You Confident of the Diagnosis? Xerosis is dry skin resulting from dehydration of the stratum corneum (Figure 1, Figure 2, Figure 3). The outer keritanized skin layers require 10-20% of water by volume to compensate for evaporative loss and maintain structural integrity. Pathological loss of lipids in the stratum corneum…
Anesthesiology

Clubfoot Repair

What the Anesthesiologist Should Know before the Operative Procedure Clubfoot (talipes equinovarus) is a common congenital defect that occurs in 1:1000 live births. The male-to-female ratio is about 2:1, with a bilateral occurrence of 50%. The majority of pediatric patients presenting with clubfoot will not be syndromic. Typically, clubfoot will occur as an isolated defect.…
Anesthesiology

Decompression Fasciotomy of the Lower Leg

What the Anesthesiologist Should Know before the Operative Procedure Decompressive fasciotomy of the lower leg is most frequently performed to relieve acute compartment syndromes. Acute compartment syndromes in the lower extremity most frequently result from traumatic insult, but can also be associated with reperfusion after ischemic injury, burns, or prolonged surgical positioning (lithotomy). These are…
Anesthesiology

Mediastinal masses

What the Anesthesiologist Should Know before the Operative Procedure Mediastinal masses can be anterior, middle, or posterior in their location. In general, anterior mediastinal masses (lymphomas, thymomas, germ cell tumors, metastatic lesions, and thyroid masses) are problematic due to compression of both airway and vascular structures. Middle (bronchogenic cysts, granulomas, and lymphomas) and posterior mediastinal…
Hospital Medicine

Acute migraine

I. What every physician needs to know Migraine is derived from the Greek word ‘hemi-kranion’, which literally means half skull. It is classically described as a unilateral headache even though unilateral symptoms are experienced in 59% of the patients. Migraine affects approximately 28 million Americans and 1 in 4 women will experience migraine in her…
Anesthesiology

Congenital Cysts of Neck (Thyroglossal Duct Cysts including Lingual, Brachial Cleft Cysts

What the Anesthesiologist Should Know before the Operative Procedure Congenital cystic lesions of the neck include midline and lateral defects, in descending order of frequency, thyroglossal duct cyst, branchial cleft anomalies, dermoid cysts, hemangiomas, and lymphangiomas. Malformations of the midline Thyroglossal duct cysts (TDCs) are the most common congenital cyst encountered in the neck, representing…
Anesthesiology

Percutaneous valve repair and replacement

What the Anesthesiologist Should Know before the Operative Procedure Percutaneous valve repair and replacement procedures have proven as the treatment of choice in high risk and inoperable patients. These procedures are now being expanded to intermediate risk and are currently in trial in lower risk patients. The rapid advancement in the area of percutaneous valve…
Anesthesiology

Parathyroidectomy

What the Anesthesiologist Should Know before the Operative Procedure Parathyroidectomy is the definitive surgical treatment for elevated levels of parathyroid hormone (PTH). PTH is the principal hormone regulating calcium hemostasis. PTH maintains serum calcium by stimulating bone resorption, thus releasing calcium, and by enhancing gastrointestinal absorption and inhibiting renal excretion of calcium. In primary hyperparathyroidism…
Anesthesiology

Open Globe Injuries

What the Anesthesiologist Should Know before the Operative Procedure? An open globe occurs when there is a breach in the sclera or cornea, usually as a result of either blunt or penetrating trauma. The major concerns in this case include infection of intraocular contents (endophthalmitis) and possible expulsion of intraocular contents, which may cause distortion…
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