Lara MD

yasasiihitogomi:

Germinal matrix hemorrhage (GMH) in premature newborns.

The germinal matrix is a thick cellular layer of immature cells (neuronal and glial precursors) under the ependymal lining of the ventricles. It  give rise to the neurons of the cerebral cortex during embryologic development. 

The germinal matrix is exceptionally vascular with a network of thin fragile capillaries highly susceptible to injury by hypoxia. In early gestation, the germinal matrix lines the wall of the entire ventricular system, lying just beneath the ependyma, the thin membranous lining of the ventricular system. 
After 12 weeks gestation, the germinal matrix begins to regress. 
By 24 weeks, only the germinal matrix over the caudate nucleus persists. 
By full term at 40 weeks, the germinal matrix no longer exists. 
Thus hemorrhage of the germinal matrix is a disease of premature infants. It originates in the residual germinal matrix that overlies the caudate nucleus in the frontal horns of the lateral ventricles. 
The normal germinal matrix is not visualized by US.

[link]

image

The hemorrhage starts usually between the thalamus and the caudate nucleus, adjacent to the foramina of Monro, and is frequently bilateral. 
If it is large, it ruptures into the ventricles, flooding the lateral, third, and fourth ventricles (intraventricular hemorrhage - IVH). Blood then exits through the foramina of Luschka, causing subarachnoid hemorrhage. Thick clots along the ventral aspect of the brain stem may block the foramina of Luschka.



grade I : confined to the germinal matrix
grade II : intraventricular hemorrhage without ventricular dilatatation
grade III : intraventricular hemorrhage with ventricular dilatation
gade IV : GMH with intraventricular rupture and hemorrhage into the surrounding white matter

[link 2]

(via fuckyeahnarcotics)

Medical Internship - Chapter 6
Internal Medicine Rotation, day one.

whatshouldwecallmedschool:

My interaction with surgery residents:

My interaction with pediatrics residents:

mvivu:

Took this photo of a statue of Asklepios at the Empúries ruins in Spain.
Asclepius was a Greek hero who later become the Greek god of medicine and healing. The son of Apollo and Coronis, Asclepius had five daughters, Aceso, Iaso, Panacea, Aglaea and Hygieia. He was worshipped throughout the Greek world but his most famous sanctuary was located in Epidaurus which is situated in the northeastern Peloponnese. The main attribute of Asclepius is a physician’s staff with an Asclepian snake wrapped around it; this is how he was distinguished in the art of healing, and his attribute still survives to this day as the symbol of the modern medical profession. The cock was also sacred to Asclepius and was the bird they sacrificed as his altar.

via http://www.pantheon.org/articles/a/asclepius.html

mvivu:

Took this photo of a statue of Asklepios at the Empúries ruins in Spain.

Asclepius was a Greek hero who later become the Greek god of medicine and healing. The son of Apollo and Coronis, Asclepius had five daughters, Aceso, Iaso, Panacea, Aglaea and Hygieia. He was worshipped throughout the Greek world but his most famous sanctuary was located in Epidaurus which is situated in the northeastern Peloponnese. The main attribute of Asclepius is a physician’s staff with an Asclepian snake wrapped around it; this is how he was distinguished in the art of healing, and his attribute still survives to this day as the symbol of the modern medical profession. The cock was also sacred to Asclepius and was the bird they sacrificed as his altar.

via http://www.pantheon.org/articles/a/asclepius.html

(via fuckyeahnarcotics)

radiopaedia:

Previously treated for an infection in the liver. Now has headaches. What is the unifying diagnosis? 

ANSWER: http://goo.gl/HAZ4v
via our Facebook page

radiopaedia:

Previously treated for an infection in the liver. Now has headaches. What is the unifying diagnosis? ANSWER: http://goo.gl/HAZ4v

via our Facebook page

Lara MD turned 3 today!

Lara MD turned 3 today!

medicalschool:

Popping A Baby Out Like A Cork, And Other Birth Innovations

An invention to help with obstructed labor has turned some heads — and not just because the idea came from a party trick on YouTube.

The Odon Device, created by Argentine car mechanic Jorge Odon, guides a folded plastic sleeve around the baby’s head. A little bit of air is then pumped between the two plastic layers, cushioning the baby’s head and allowing it to be sucked out. This trick for removing a cork from an empty wine bottle works the same way.

The device has been embraced by the World Health Organization and is being developed by the global medical technology company BD. Once clinical trials are done, the WHO and individual countries will have to approve it before it’s sold. BD hasn’t said how much it will charge, but each one is expected to cost less than $50 to make.

"If proven safe and effective," a 2011 presentation on Odon’s invention said, “the Odon Device will be the first innovation in operative vaginal delivery since the development of forceps centuries ago and vacuum extractor decades ago.”

The Odon device shows that “good ideas can come from anyone and anywhere,” says Wendy Taylor, director of USAID’s Center for Accelerating Innovation and Impact.

If you’re in the business of innovating, she says, there’s no need to strive for mechanical complexity. Some of the biggest breakthroughs are cheap and simple. And, she says, the strategy for scaling something up for worldwide use “is just as important as the innovation itself.”

One of the crowning innovations in preventing death during childbirth was convincing doctors to wash their hands in between handling corpses and delivering babies. And many argue that fancier tools are just part of a tradition of unnecessary interference that circumvented the best tool in the box: gravity.

With that in mind, here are five ideas that struck us as innovative and surprising (some more likely to succeed than others):

1. Ready Yet?

A team at the University of California, San Francisco created a “cervical cap" to check whether a woman is about to go into labor. The device can detect changes in the collagen of the cervix. The softening of collagen as the cervix opens is a telltale sign a baby’s on its way. Information from the cap’s sensors can be transmitted to a nearby cellphone, which can send the data to a doctor. The device can be inserted briefly once a day, without a professional’s help.

2. Back To Basics

A team at Massachusetts General Hospital developed a uterine balloon kit to stop postpartum hemorrhage. It consists of a condom tied to a catheter. Water from the catheter fills the condom in the uterus, creating pressure that can stop the bleeding. The kit has been tested successfully in South Sudan and Kenya. A similar tool in the U.S. can cost more than $300 each, Mass General says, compared with less than $5 each for the simple balloon kit.

Continue reading.

Top Drawing: The Odon Device was inspired by a YouTube video about how to remove a cork from the inside of a wine bottle. (Courtesy of the Odon Device)

Bottom Drawing: A ”cervical cap" detects changes in the collagen of the cervix to determine if a baby’s on its way. Information from the cap’s sensors can be transmitted to a nearby cellphone, which can send the data to a doctor. (Courtesy of UCSF)