Knee Replacement: Dr. Mary O’Connor Discusses the Surgical Procedure

Mary I. O’Connor, M.D., chair of the Department of Orthopedic Surgery at the Mayo Clinic campus in Florida, explains what is involved with knee replacement surgery, including pain management techniques used during the surgery. She also explains who is a candidate for minimally invasive knee replacement surgery.

Knee Surgery (3-Part-Series)
Part 1: http://www.youtube.com/watch?v=LNPy5-6qWrU
Part 2: http://www.youtube.com/watch?v=sNkaiDo3za8 (This video)
Part 3: http://www.youtube.com/watch?v=JAQW073ZUx8

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What Causes Sleep Apnea?

With sleep apnea, your breathing starts and stops over and over again. But what actually causes it? Learn more: http://wb.md/2f8XQen

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Porphyrin Test: MedlinePlus Lab Test Information

 

What are porphyrin tests?

Porphyrin tests measure the level of porphyrins in your blood, urine, or stool. Porphyrins are chemicals that help make hemoglobin, a type of protein in your red blood cells. Hemoglobin carries oxygen from your lungs to the rest of your body.

It’s normal to have a small amount of porphyrins in your blood and other body fluids. But too much porphyrin may mean you have a type of porphyria. Porphyria is a rare disorder that can cause serious health problems. Porphyria is usually divided into two categories:

  • Acute porphyrias, which mainly affect the nervous system and causes abdominal symptoms
  • Cutaneous porphyrias, which cause skin symptoms when you are exposed to sunlight

Some porphyrias affect both the nervous system and the skin.

Other names: protoporphyrin; protoporphyrin, blood; protoporhyrin, stool; porphyrins, feces; uroporphyrin; porphyrins, urine; Mauzerall-Granick test; acid; ALA; porphobilinogen; PBG; free erythrocyte protoporphyrin; fractionated erythrocyte porphyrins; FEP

What are they used for?

Porphyrin tests are used to diagnose or monitor porphyria.

Why do I need a porphyrin test?

You may need a porphyrin test if you have symptoms of porphyria. There are different symptoms for the different types of porphyria.

Symptoms of acute porphyria include:

Symptoms of cutaneous porphyria include:

You may also need a porphyrin test if someone in your family has porphyria. Most types of porphyria are inherited, meaning the condition is passed from parent to child.

What happens during porphyrin testing?

Porphyrins can be tested in blood, urine, or stool. The most common types of porphyrin tests are listed below.

  • Blood Test
    • A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
  • 24-Hour Urine Sample
    • You will collect all your urine during a 24-hour period. For this test, your health care provider or laboratory will give you a container and specific instructions on how to collect your samples at home. Be sure to follow all instructions carefully. This 24-hour urine sample test is used because the amounts of substances in urine, including porphyrin, can vary throughout the day. So collecting several samples in a day may give a more accurate picture of your urine content.
  • Random Urine Test
    • You can provide your sample at any time of day, with no special preparations or handling needed. This test is often done in a health care provider’s office or a lab.
  • Stool Test (also called protoporphyrin in stool)
    • You will collect a sample of your stool and place it in a special container. Your health care provider will give you instructions on how to prepare your sample and send it to a lab.

Will I need to do anything to prepare for the test?

You don’t need any special preparations for blood or urine tests.

For a stool test, you may be instructed to not eat meat or take any aspirin-containing medicines for three days prior to your test.

Are there any risks to porphyrin tests?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

There are no known risks to urine or stool tests.

What do the results mean?

If high levels of porphyrin are found in your blood, urine, or stool, your health care provider will probably order more tests to confirm a diagnosis and to find out what kind of porphyria you have. While there is no cure for porphyria, the condition can be managed. Certain lifestyle changes and/or medicines can help prevent the symptoms and complications of the disease. Specific treatment depends on the type of porphyria you have. If you have questions about your results or about porphyria, talk to your health care provider.

Is there anything else I need to know about porphyrin tests?

While most types of porphyria are inherited, other types porphyria can also be acquired. Acquired porphyria can be caused by a variety of factors, including overexposure to lead, HIV, hepatitis C, excess iron intake, and/or heavy alcohol use.

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Big Steps for Amarachi

To run, play tag, and try the sport of basketball; those are the new activities a girl from Nigeria is looking forward to most, after a life-changing trip to Mayo Clinic.

“She is very happy, and we are too quite frankly,” says pediatric orthopedic surgeon Todd Milbrandt, M.D. “She’s just a phenomenal young woman and a really motivated patient in this situation,” added orthopedic surgeon S. Andrew Sems, M.D.

Step-by-step, doctors were able to restore her legs to normal, so that she might enjoy the simple steps that most of us take for granted. Here’s Dennis Douda for the Mayo Clinic News Network.

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Immunoglobulins Blood Test: MedlinePlus Lab Test Information

 

What is an immunoglobulins blood test?

This test measures the amount of immunoglobulins, also known as antibodies, in your blood. Antibodies are proteins made by the immune system to fight disease-causing substances, like viruses and bacteria. Your body makes different types of immunoglobulins to fight different types of these substances.

An immunoglobulins test usually measures three specific types of immunoglobulins. They are called igG, igM, and IgA. If your levels of igG, igM, or IgA are too low or too high, it may be a sign of a serious health problem.

Other names: quantitative immunoglobulins, total immunoglobulins, IgG, IgM, IgA testing

What is it used for?

An immunoglobulins blood test may be used to help diagnose a variety of conditions, including:

Why do I need an immunoglobulins blood test?

You may need this test if your health care provider thinks your immunoglobulin levels might be too low or too high.

Symptoms of levels that are too low include:

  • Frequent and/or unusual bacterial or viral infections
  • Chronic diarrhea
  • Sinus infections
  • Lung infections
  • Family history of immunodeficiency

If your immunoglobulin levels are too high, it may be a sign of an autoimmune disease, a chronic illness, an infection, or a type of cancer. Symptoms of these conditions vary greatly. Your health care provider may use information from your physical exam, medical history, and/or other tests to see if you are at risk for one of these diseases.

What happens during an immunoglobulins blood test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don’t need any special preparations for an immunoglobulins blood test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If your results show lower than normal levels of immunoglobulins, it may indicate:

If your results show higher than normal levels of immunoglobulins, it may indicate:

If your results are not normal, it doesn’t necessarily mean you have a medical condition needing treatment. The use of certain medicines, alcohol, and recreational drugs can affect your results. If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about an immunglobulins blood test?

Your health care provider may order other tests to help make a diagnosis. These tests might include urinalysis, other blood tests, or a procedure called a spinal tap. During a spinal tap, a health care provider will use a special needle to remove a sample of a clear liquid, called cerebrospinal fluid, from your back.

References

  1. Hinkle J, Cheever K. Brunner & Suddarth’s Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Quantitative Immunoglobulins: IgA, IgG, and IgM; 442–3 p.
  2. Johns Hopkins Medicine [Internet]. Johns Hopkins Medicine; Health Library: Lumbar Puncture (LP) [cited 2018 Feb 17]; [about 3 screens]. Available from: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/neurological/lumbar_puncture_lp_92,p07666
  3. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2018. Quantitative Immunoglobulins [updated 2018 Jan 15; cited 2018 Feb 17]; [about 3 screens]. Available from: https://labtestsonline.org/tests/quantitative-immunoglobulins
  4. Loh RK, Vale S, Maclean-Tooke A. Quantitative serum immunoglobulin tests. Aust Fam Physician [Internet]. 2013 Apr [cited 2018 Feb 17]; 42(4):195–8. Available from: https://www.racgp.org.au/afp/2013/april/quantitative-serum-immunoglobulin-tests
  5. Mayo Clinic: Mayo Medical Laboratories [Internet]. Mayo Foundation for Medical Education and Research; c1995–2018. Test ID: IMMG: Immunoglobulins (IgG, IgA, and IgM), Serum: Clinical and Interpretative [cited 2018 Feb 17; [about 4 screens]. Available from: https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8156
  6. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2018. Autoimmune Disorders [cited 2018 Feb 17]; [about 2 screens]. Available from: http://www.merckmanuals.com/home/immune-disorders/allergic-reactions-and-other-hypersensitivity-disorders/autoimmune-disorders
  7. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2018. Overview of Immunodeficiency Disorders [cited 2018 Feb 17]; [about 2 screens]. Available from: https://www.merckmanuals.com/home/immune-disorders/immunodeficiency-disorders/overview-of-immunodeficiency-disorders
  8. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests [cited 2018 Feb 17]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
  9. Nemours Children’s Health System [Internet]. Jacksonville (FL): The Nemours Foundation; c1995–2018. Blood Test: Immunoglobulins (IgA, IgG, IgM) [cited 2018 Feb 17]; [about 3 screens]. Available from: http://kidshealth.org/en/parents/test-immunoglobulins.html
  10. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2018. Health Encyclopedia: Quantitative Immunoglobulins [cited 2018 Feb 17]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=quantitative_immunoglobulins
  11. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Immunoglobulins: Results [updated 2017 Oct 9; cited 2018 Feb 17]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/immunoglobulins/hw41342.html#hw41354
  12. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Immunoglobulins: Test Overview [updated 2017 Oct 9; cited 2018 Feb 17]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/immunoglobulins/hw41342.html
  13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Immunoglobulins: What Affects the Test [updated 2017 Oct 9; cited 2018 Feb 17]; [about 9 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/gamma-globulin-tests/hw41342.html#hw41355
  14. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Immunoglobulins: Why It is Done [updated 2017 Oct 9; cited 2018 Jan 13]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/gamma-globulin-tests/hw41342.html#hw41349

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What Are Sea Lice?

First thing’s first: Sea lice aren’t lice at all. They’re tiny baby jellyfish, so small you can’t even see them – about the size of a grain of pepper. And just like their grownup counterparts, they sting. Here’s how to avoid sea lice at the beach.

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Help to Stop Smoking – Mayo Clinic

There are proven treatments that help people stop smoking. Medications and supportive discussion with a health care provider and counseling with a specialist will greatly increase your chances for stopping. In this video, health care providers from the Mayo Clinic describe medication and counseling options and explain how they work to help smokers stop smoking Patients tell how treatment provided for them the help they needed to become and stay smoke-free. There is effective treatment for anyone who smokes. Visit the Mayo Clinic website. www.mayoclinic.org/ndc-rst/

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Testosterone Levels Test: MedlinePlus Lab Test Information

 

What is a testosterone levels test?

Testosterone is the main sex hormone in males. During a boy’s puberty, testosterone causes the growth of body hair, muscle development, and deepening of the voice. In adult men, it controls sex drive, maintains muscle mass, and helps make sperm. Women also have testosterone in their bodies, but in much smaller amounts.

This test measures the levels of testosterone in your blood. Most of the testosterone in the blood is attached to proteins. Testosterone that is not attached to a protein is called free testosterone. There are two main types of testosterone tests:

  • Total testosterone, which measures both attached and free testosterone.
  • Free testosterone, which measures just free testosterone. Free testosterone can give more information about certain medical conditions.

Testosterone levels that are too low (low T) or too high (high T) can cause health problems in both men and women.

Other names: serum testosterone, total testosterone, free testosterone, bioavailable testosterone

What is it used for?

A testosterone levels test may be used to diagnose several conditions, including:

Why do I need a testosterone levels test?

You may need this test if you have symptoms of abnormal testosterone levels. For adult men, it’s mostly ordered if there are symptoms of low T levels. For women, it’s mostly ordered if there are symptoms of high T levels.

Symptoms of low T levels in men include:

  • Low sex drive
  • Difficulty getting an erection
  • Development of breast tissue
  • Fertility problems
  • Hair loss
  • Weak bones
  • Loss of muscle mass

Symptoms of high T levels in women include:

  • Excess body and facial hair growth
  • Deepening of voice
  • Menstrual irregularities
  • Acne
  • Weight gain

Boys may also need a testosterone levels test. In boys, delayed puberty can be a symptom of low T , while early puberty may be a symptom of high T.

What happens during a testosterone levels test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don’t need any special preparations for a testosterone levels test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Results mean different things depending on whether you are a man, woman, or boy.

For men:

  • High T levels may mean a tumor in the testicles or adrenal glands. Adrenal glands are located above the kidneys and help control heart rate, blood pressure, and other bodily functions.
  • Low T levels may mean a genetic or chronic disease, or a problem with the pituitary gland. The pituitary gland is a small organ in the brain that controls many functions, including growth and fertility.

For women:

For boys:

  • High T levels may mean cancer in the testicles or adrenal glands.
  • Low T levels in boys may mean there is some other problem with the testicles, including an injury.

If your results are not normal, it doesn’t necessarily mean you have a medical condition needing treatment. Certain medicines, as well as alcoholism, can affect your results. If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a testosterone levels test?

Men who are diagnosed with low T levels may benefit from testosterone supplements, as prescribed by their health care provider. Testosterone supplements are not recommended for men with normal T levels. There is no proof they provide any benefits, and in fact they may be harmful to healthy men.

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When Do You Need an Antibiotic?

Do you know when an antibiotic is needed and when it’s not? Antibiotics are incredible life-saving drugs. They’re great for bacterial infections, like strep throat and many ear infections. But they aren’t cure-all wonder pills, and sometimes they can cause more harm than good. In this video, Dr. Michael Smith explains how antibiotics work and why you shouldn’t take an antibiotic “just to be safe.”

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Semen Analysis: MedlinePlus Lab Test Information

 

What is a semen analysis?

A semen analysis, also called a sperm count, measures the quantity and quality of a man’s semen and sperm. Semen is the thick, white fluid released from the penis during a man’s sexual climax (orgasm). This release is called ejaculation. Semen contains sperm, the cells in a man that carry genetic material. When a sperm cell unites with an egg from a woman, it forms an embryo (the first stage of an unborn baby’s development).

A low sperm count or abnormal sperm shape or movement can make it difficult for a man to make a woman pregnant. The inability to conceive a baby is called infertility. Infertility can affect men and women. For about one-third of couples unable to have children, male infertility is the reason. A semen analysis can help figure out the cause of male infertility.

Other names: sperm count, sperm analysis, semen testing, male fertility test

What is it used for?

A semen analysis is used to find out if a problem with semen or sperm may be causing a man’s infertility. The test may also be used to see if a vasectomy has been successful. A vasectomy is a surgical procedure that is used to prevent pregnancy by blocking the release of sperm during sex.

Why do I need a semen analysis?

You may need a semen analysis if you and your partner have been trying to have a baby for at least 12 months without success.

If you’ve recently had a vasectomy, you may need this test to make sure the procedure has worked.

What happens during a semen analysis?

You will need to provide a semen sample. The most common way to provide your sample is to go to a private area in your health care provider’s office and masturbate into a sterile container. You should not use any lubricants. If masturbation is against your religious or other beliefs, you may be able to collect your sample during intercourse using a special type of condom. Talk to your health care provider if you have questions or concerns about providing your sample.

You will need to provide two or more additional samples within a week or two. That’s because sperm count and semen quality can vary from day to day.

Will I need to do anything to prepare for the test?

You will need to avoid sexual activity, including masturbation, for 2–5 days before the sample is collected. This will help make sure your sperm count is at its highest level.

Are there any risks to the test?

There is no known risk to a semen analysis.

What do the results mean?

The results of a semen analysis include measurements of quantity and quality of semen and sperm. These include:

  • Volume: the amount of semen
  • Sperm count: the number of sperm per milliliter
  • Sperm movement, also known as motility
  • Sperm shape, also known as morphology
  • White blood cells, which may be a sign of an infection

If any of these results are not normal, it may mean there is problem with your fertility. But other factors, including the use of alcohol, tobacco, and some herbal medicines, can affect your results. If you have questions about your results or other concerns about your fertility, talk to your health care provider.

If your semen analysis was done to check the success of your vasectomy, your provider will look for the presence of any sperm. If no sperm is found, you and your partner should be able to stop using other forms of birth control. If sperm is found, you may need repeat testing until your sample is clear of sperm. In the meantime, you and your partner will have to take precautions in order to prevent pregnancy.

Is there anything else I need to know about a semen analysis?

Many male fertility problems can be treated. If your semen analysis results were not normal, your health care provider may order more tests to help figure out the best approach to treatment.

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Reducing Heartburn, Acid Reflux, GERD-Mayo Clinic

Many people have symptoms of Gastroesophageal Reflux Disease, or GERD, often called acid reflux. This condition can eventually lead to Barretts esophagus, dysplasia and even esophagus cancer (adenocarcinoma.) This video demonstrates ways to reduce the occurrence of reflux and get relief from its symptoms. Mayo Clinic has a very large team with an international reputation for its skill in diagnosing and treating reflux, Barretts esophagus and esophagus cancer. For more information, go to the Mayo Clinic website, http://www.mayoclinic.org/barretts-esophagus/

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Fighting Cancer: Ins and Outs of Immunotherapy

 

Cancer can play a cat and mouse game with our immune systems, hiding cells and making it harder to fight off the disease.

One treatment to help combat this is immunotherapy, a type of cancer treatment that helps strengthen patients’ immune systems and fight off cancer.

NIH and the National Cancer Institute are working to research and improve immunotherapy to help save lives.

What is cancer?

Our body usually forms new cells when our old cells die. Sometimes this process goes wrong. With cancer, new cells grow when you don’t need them, and old cells don’t die when they should. These extra cells can form a mass called a tumor.

How does immunotherapy combat cancer?

Some types of immunotherapy help find extra cancer cells so that they can be destroyed. Others boost your immune system to work better against cancer.

Who could benefit from immunotherapy?

Immunotherapy is not as widely used as surgery, chemotherapy, and radiation therapy. But immunotherapies have treated people with many types of cancer and are being tested in clinical trials.

Ask your health care provider if immunotherapy may be a good option for you or a loved one.

How is immunotherapy given?

Treatment can be given intravenously (in your vein), by taking a pill, or through your bladder. For patients with early skin cancer, there is an immunotherapy cream you can rub on your skin.

Where do you get immunotherapy?

You may get immunotherapy treatment at a doctor’s office, a clinic, or an outpatient unit at a hospital.

What are possible side effects of immunotherapy?

Side effects are unique to each patient and each cancer.

Some common side effects include fever, chills, weakness, dizziness, nausea or vomiting, fatigue, and other flu-like symptoms.

If you had immunotherapy through your vein, you may have pain, swelling, soreness, itchiness, or a rash at the needle site.

What is NIH’s role in immunotherapy research?

NIH and the National Cancer Institute are leading the way in immunotherapy research and development.

NCI’s Center for Cancer Research is dedicated to finding new and better treatments for cancer, including immunotherapy.

Steven Rosenberg, M.D., Ph.D., and his team at the center have pioneered immunotherapy treatment. They also work with patients at the NIH Clinical Center to test new immunotherapies and improve cancer patients’ lives.

What new immunotherapy research is NCI studying?

Just recently, Dr. Rosenberg and his team saw a complete cancer regression in a late-stage breast cancer patient thanks to an experimental immunotherapy treatment they are working on.

The patient, who is part of an ongoing clinical trial at NCI’s Center for Cancer Research, was not responsive to other treatments.

15 percent of patients in the same trial have seen similar results with both liver and colon cancers.

SOURCES: MedlinePlus: Cancer; National Cancer Institute: Immunotherapy; Opens new window National Cancer Institute: Press Releases Opens new window

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