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Damborg Hassan posted an update 6 months, 3 weeks ago
In 1986 the Emergency Medicine Treatment and Active Labor Act (EMTALA) was passed by the United States Congress. EMTALA was part of the Consolidated Omnibus Reconciliation Act (COBRA), which Congress enacted to address issues with Medicare. The original intent of EMTALA was to attempt to prevent discrimination of patients in the form of “patient dumping.” Patient dumping is a practice of transferring uninsured patients from one hospital to another strictly for financial reasons. This transfer of patients was a practice at the time in which private hospitals would transfer uninsured patients to public hospitals without considering their medical condition or if the patient was stable for discharge. This situation was occurring in most large cities, such as Chicago or Dallas, where public hospitals were receiving an increasing number of transfers strictly for financial reasons. Several reports by both medical professionals and the lay press described the problem of patient dumping at the time. The growing attention from these reports, as well as the increasing presence of the federal government in health-care delivery, led to the development of EMTALA.Neuroplasticity, also known as neural plasticity or brain plasticity, is a process that involves adaptive structural and functional changes to the brain. A good definition is “the ability of the nervous system to change its activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections.” Clinically, it is the process of brain changes after injury, such as a stroke or traumatic brain injury (TBI). These changes can either be beneficial (restoration of function after injury), neutral (no change), or negative (can have pathological consequences). Neuroplasticity can be broken down into two major mechanisms The first mention of the term plasticity in regards to the nervous system was by William James in 1890. However, the term neural plasticity is credited to Jerzy Konorski in 1948 and was popularized by Donald Hebb in 1949.Segond fractures are defined as an avulsion type fracture of the lateral proximal tibia at the attachment of the anterolateral ligament. They are especially important because they are pathognomonic of a more complex knee injury, an anterior cruciate ligament (ACL) rupture. Segond fractures confirmed on plain radiographs necessitate further evaluation and investigation to disprove concomitant knee injuries, as Segond fractures are almost never isolated injuries. The one exception to this is in the pediatric population, where Segond fractures are rarely noted to be isolated injuries. This is, however, not the norm, and even children should undergo thorough evaluation and investigation for knee ligamentous injury.Sulfasalazine is indicated for the treatment of chronic inflammatory diseases such as rheumatoid arthritis in children and adults and ulcerative colitis. It also has off-label uses in treating patients with ankylosing spondylitis, mild to moderately active Crohn’s disease, psoriasis, and psoriatic arthritis.Osteoarthritis (OA) is the most common type of arthritis in clinical practice and is one of the leading causes of disability worldwide. The presence of radiographic evidence of OA occurs in the majority of people by age 65 and is found in about 80% of those over age 75. OA can range from an asymptomatic condition to debilitating oligo or polyarthritis. Mechanical pain is the most common presenting symptom of this disease. The hands, knees, and hips are the most commonly affected joints, although any joint can be affected.Cleft hand, otherwise referred to as ectrodactyly or colloquially as “split hand,” is defined as a central longitudinal deficiency expressed as suppression of bone and soft tissues in the central elements of the hand, including the index, middle, and ring fingers. Classically, this results in a “V-shaped” cleft in the hand with a variable degree of deformity. Generally, the phalanges of the affected digits are absent, and the metacarpals are present. The deficiency is typically bilateral. These central ray deformities typically divide into “typical” and “atypical” cleft hands. Typical cleft hands are generally of a genetic origin and bilateral with the classic “v-shaped” defect. Furthermore, typical cleft hands are often associated with “cleft foot” deformities as well. Atypical cleft hands, in contrast, are a form of symbrachydactyly involving the index, long, and ring fingers, often involving an absence of the digits, syndactyly of the digits, or hypoplasia of the digits. Atypical cleft hands generally appear as more of a “u-shaped” deformity compared to the classic “v-shape.” Because atypical cleft hands are generally the result of a spontaneous mutation, there are rarely associated syndromes or deformities, and the disorder is not inherited.Heavy metal is a broad term used to describe a group of naturally occurring metallic elements of high molecular weight and density when compared to water. At low concentrations, certain heavy metals, such as iron, zinc, copper, and manganese, are essential for human survival but can become toxic agents at higher concentrations. Other heavy metals, such as arsenic, cadmium, lead, thallium, and mercury, serve no biological role. see more However, they will inevitably enter the human body due to their presence in the environment. Similarly to the essential metals, they will induce toxicity once certain concentrations are reached.Arthrocentesis is a procedure performed to collect synovial fluid from joint spaces for the identification of a disease process or the relief of painful or bothersome symptoms. There are numerous indications for joint fluid aspiration, the most important of which includes the evaluation of synovial fluid for evidence of infection or inflammation. While the procedure specifics vary depending on the joint being aspirated, the general technique and steps remain consistent. The procedure tends to be very safe overall with few complications if performed correctly, and only a small number of contraindications exist.The diagnosis of epicardial coronary artery disease (CAD) during left heart catheterization is made through the angiographic interpretation of percent narrowing of the arterial lumen. The severe stenotic lesions typically have an appearance of at least 70 percent diameter reduction. However, there is often inter-observer variability in the assessment of intermediate lesions (40% to 70% stenosis). These lesions may have functional impairment of flow distally to cause myocardial ischemia and eventually left ventricular contractile dysfunction. The physiologic assessment of such lesions is paramount in the cardiac catheterization lab.
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