Lymphatic Drainage Patterns of the Breast
When considering the chance of a false negative sentinel lymph node biopsy, it is important to understand the lymphatic drainage patterns of the breast.
August 5, 2007
August 5th, 2007The 3-2-1 Bowel Regimen for Spinal Cord Patients
August 4th, 2007
Patients suffering cervical spinal cord injuries often can not evaculate their bowels normally. To prevent obstipation and the possible autonomic
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July 21, 2007
July 22nd, 2007
CA 19-9
Cancer antigen (CA) 19-9 is a tumor marker first described in 1979. An elevated serum level is most closely associated with adenocarcinoma of pancreatic exocrine ducts, which comprise about 95% of all pancreatic cancers.
Although the sensitivity and specificity of an elevated CA 19-9 is 90% and 98% respectively, it can not be used as a screening test for pancreatic cancer as it can be elevated in other gastrointestinal cancers, cirrhosis, and in benign conditions that cause obstructive jaundice.
CA 19-9 is not elevated in pancreatic cancer in patients that have the Lewis antigen blood type. The gene for Lewis antigen causes a deficiency in fucosyltransferase that is required for production of CA 19-9. These patients will have a normal CA 19-9 even in the setting of a large and advanced tumor.
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July 21, 2007
July 21st, 2007
Eosinophils in the Urine
This finding in the setting of worsening renal (kidney) kidney function is suggestive of intersitial nephritis caused by drug toxicity to the kidney.
Copyright 2007 InsideSurgery.com
July 20, 2007
July 20th, 2007
An Unusual Cause of High Serum Amylase in Setting of Normal Serum Lipase
Medical textbooks usually list five causes of hyperamylasemia (high serum amylase) in the setting of normal serum lipase. These are salivary gland
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June 15, 2007
June 15th, 2007
Reading an Electrocardiogram
When trying to decipher an electrocardiogram (ECG or EKG) it is important to know that each “small box” represents a time lapse of .04 seconds and each “big box” is a time lapse of .2 seconds
Copyright 2007 InsideSurgery.com
June 3, 2007
June 3rd, 2007
The Hemostat
One of the workhorse instruments used by surgeons is the hemostatic forcep. Also, know as a “stat”, a “snap”, or a “Wells”, this instrument is placed on tissue to control or stop bleeding.
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May 31, 2007
May 31st, 2007
Acalculous cholecystitis – Signs and Symptoms
Acalculous cholecystitis is inflammation of the gallbladder in the absence of gallstones. It most commonly occurs in the setting of a severe illness or injury – burns, major trauma, sepsis, and major surgery. It is particularly associated with the use of parenteral nutrition in patients who are not being fed by mouth.
The diagnosis is based on having a high index of suspicion. If the patient is awake they usually complain of abdominal pain either diffusely or in the right upper quadrant. They also usually complain of tenderness on palpation. If the patients or obtunded or sedated they may present with unexplained fever or an elevated white blood cell count on laboratory testing. Additonal lab tests that are commonly elevated are serum bilirubin, aspartate aminotransferase (AST), and alkaline phosphatase.
Copyright 2007 InsideSurgery.com
May 29, 2007
May 28th, 2007
Treating Mandible Fractures
The three main tenets in treating a mandible (jawbone) fracture are reduction, rigid fixation, and avoiding infection. Reduction is placing the bony segments
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May 28, 2007
May 28th, 2007
Diagnosing Mandible Fractures
The mandible (jawbone) is not infrequently fractured in trauma to the lower face. However, even severe injury may not be immediately apparent in the
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