February 2007

Monthly Archive

February 23, 2007

How is Arthroscopic Surgery performed?

Posted by healthbase under (JCI) USA accreditation, ankle joint surgery, ankle surgery, arthritis, arthroscope, arthroscopic surgery, Arthroscopy, elbow surgery, healthbase, hip joint surgery, hip surgery, JCAHO, JCI, joint surgery, knee joint surgery, low cost, Medical Tourism, overseas, shoulder joint surgery, shoulder surgery, spine surgery, step-by-step guide to arthroscopy, surgery, wrist surgery
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Arthroscopy

Arthroscopic surgery is used to diagnose and treat many joint problems. This significant advance in joint care allows for a rapid return to improved activity. Most commonly used in knees, shoulders and ankles, the arthroscope can also be used for the spine, hips, wrists and elbows.

Step by step guide to the arthroscopic surgery on knee joint:

Step 1: Three small incisions are made around the joint area. Surgical instruments will be positioned in these incisions.

Step 2: A tube-like needle is inserted in one incision. Fluid is pumped through the tube and into the joint. This expands the joint, giving the surgeon a clear view and room to work. The tube will also be used as a drainage needle to regulate the amount of fluid in the joint during the procedure.

Step 3: Through another incision, the surgeon inserts the arthroscope. This instrument has a light and a small video camera that sends images to a TV monitor in the operating room.

Step 4: With the video images from the arthroscope as a guide, the surgeon can look for damaged tissue. If the surgeon sees an opportunity to treat a problem, a variety of small surgical instruments can be inserted through the third small incision.

End of procedure: The surgeon may close the incisions with stitches or tape. Recovery from arthroscopy is faster than recovery from traditional open joint surgery.
(Source: Arthritis Foundation)

Healthbase is a medical tourism facilitator that connects patients to leading JCI/JCAHO/ISO accredited hospitals overseas through a secure, high-tech, information-rich web portal. Healthbase provides a wide range of medical procedures through its partner hospital network. Over two hundred medical procedures are available in various categories: cosmetic and plastic, orthopedic, dental, cardiac, and many more. The savings are up to 80 percent from typical US prices even after adding up the travel costs, hospital stay and other related expenses. Healthbase offers more than just procedural availability; we also provide customers with extensive information on medical treatments, hospital and doctor profiles to help them make an educated decision regarding their treatment; travel planning and booking; applying for medical/dental loan and much more.

To learn more, visit http://www.healthbase.com/ and login to view our extensive hospital profiles including pictures of operating rooms, patient rooms, doctor qualifications, and lots more. Get a FREE quote now!!

Note: All the information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.

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February 23, 2007

Advantages of Minimally Invasive Hip Surgery

Posted by healthbase under (JCI) USA accreditation, arthritis, healthbase, Hip Replacement, Hip Resurfacing, hip surgery, JCAHO, JCI, low cost, Medical Tourism, minimal invasive hip surgery, minimally invasive hip surgery, overseas, surgery
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Hip Surgery

The minimally invasive technique, of particular benefit to those with arthritic hip conditions, is achieved through a small posterior incision and has been acclaimed by patients, surgeons and hospital authorities.

Such groundbreaking hip surgery affords a range of extensive benefits to a patient. Following are some of them.

Small incision
Cosmetically pleasing incision, typically 5.5 – 9 cm in length for hip replacement, 7.5 – 11 cm for hip resurfacing.
Minimal blood loss
Current experience is that 90% of the patients do not require transfusion.
Reduced surgical trauma
Results in quicker mobilization post surgery leading to early discharge from hospital. Most patients discharged day 2/3 as compared to an average in-patient stay of 7 – 10 days.
Less disruption to muscles around the hip joint
Leads to better overall function result allowing patients to return to normal activities.
Immense financial benefits and cost saving
Reduction in transfusions, and early discharge programs result in cost savings averaging 50% of in-patient bed stay.
(Source: minimalinvasivehip.com)

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February 21, 2007

Effectiveness of Total Knee Replacement

Posted by healthbase under (JCI) USA accreditation, healthbase, JCAHO, Knee Surgery, Medical Tourism, overseas, surgery, TKR, Total Knee Replacement
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Total Knee Replacement

Bethesda, Maryland – A panel charged with reviewing all of the available evidence on total knee replacement (TKR) today found that for persons suffering from intractable and persistent knee pain and disability, TKR surgery is a safe and cost-effective therapy that restores mobility and alleviates discomfort.
Over 20 years of follow-up data indicate that the procedure is successful in the vast majority of patients. The panel reported that there is clear evidence of racial, ethnic, and gender disparities in the provision of total knee replacements, as there is for many other health care interventions, but the reasons for this are unclear.Physicians’ beliefs about their patients, limited familiarity with these procedures in minority communities, and patient mistrust of the health care system may all have a role. The consensus panel is calling for more research to determine the causes of these disparities.

“TKR is not for everyone – it’s major elective surgery that carries a variety of important risks, but it often offers dramatic relief after other therapies fail,” said the panel chair, orthopaedic surgeon Dr. E. Anthony Rankin of Providence Hospital in Washington, D.C.

The panel emphasized that for patients considering TKR, important factors to consider include surgeon and hospital volume of TKRs performed, as these are associated with lower complication rates. Dr. Rankin explained, “Basically, the more they do, the better they do it.”

Loosening of the implant is the main cause of failed total knee prostheses that necessitate revision procedures, and that proper alignment of the prosthesis is critical to minimizing long-term wear and loosening of the implant.

The panel noted that computer navigation may eventually reduce the risk of substantial malalignment, but the technology is as yet unproven and its cost may be prohibitive for many hospitals. (Source: Medical News TODAY, 14 Dec 2003)

Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.

February 16, 2007

Plastic Surgery and Insurance

Posted by healthbase under (JCI) USA accreditation, cosmetic, cosmetic surgery, healthbase, insurance, out-of-pocket expense, plastic surgery, reconstructive surgery, Underinsured, uninsured
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Plastic Surgery

Plastic surgery is generally covered by insurance only if it is a reconstructive surgery and not a cosmetic surgery.

Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance. On the other hand, cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient’s appearance and self-esteem. (Source: American Medical Association and American Society of Plastic Surgeons (ASPS))

Cosmetic surgery is usually not covered by health insurance because it is elective. Cosmetic surgery is your choice and not considered a medical necessity. Reconstructive surgery is generally covered by most health insurance policies although coverage for specific procedures and levels of coverage may vary greatly.

The general rule insurance companies follow is that if there is a medical reason for the surgery, it will be covered under reconstructive surgery. For example, a patient may need a rhinoplasty due to obstructive breathing. A second patient may want a rhinoplasty because she feels her nose is not perfect. The first patient may have it covered by insurance, the second patient would not.

Most insurance companies will have medical criteria that must be met in order for the surgery to be covered. This is especially true for breast reduction patients. Depending upon height, weight, and medical conditions, a certain number of grams must be taken off each breast.

And even if you are getting the plastic surgery for a medical reason and you have insurance coverage, it does not mean the insurance carrier will pay the full amount of the surgery cost. Depending upon your specific insurance plan, you may have to pay a deductible, a flat-rate co-payment and a percentage-based co-payment.

Example:
Consider the example of a woman who is planning to undergo a reconstructive breast reduction (reduction mammoplasty), the surgical fee will be $12,000. Her plan has a $500 annual deductible, and will cover 70% of her covered medical costs. If she hasn’t paid anything so far this year in covered medical expenses, she must pay the first $500 of the covered costs of the breast reduction surgery to satisfy her plan’s $500 deductible. If her plan cost’s share is a percentage-based co-payment of 70%-30%, the carrier will pay 70% of the covered costs of the procedure. Once that is settled, she must pay for 30% of the covered costs, plus any costs for which the insurance plan denies coverage.

If the patient’s insurance plan covered the full surgical fee, the cost sharing would look like this:

Reconstructive Breast Reduction Surgery:              $12,000
Balance of deductible:                                          $500
__________________________________________________
                                                                          $11,500
Insurance coverage: $11,500 x 70% =                   $8,050
Patient payment: $12,000 – $8,050 =                     $3,950

The $3,950 is the patient’s responsibility under the percentage-based co-payment arrangement.

It should be noted that the insurance plan may not cover the full surgical fee. Also, sometimes the patient may have to pay in part or full the cost of the prescription drugs.

Needless to mention that had this breast reduction surgery been a cosmetic one, the insurance would not have paid anything even though you had been paying your monthly premiums. However, if you opt to have the same surgery overseas, say in Mexico, you may have to pay just a fraction of the cost in the US.

At Healthbase, we ensure that you get the best quality treatment for low at our partner hospitals overseas so you never have to worry about being fully insured. Sign up for FREE to obtain your treatment quote and consult with our surgeons about how they can help you with your problem.

Healthbase is a medical tourism facilitator that connects patients to leading JCI/JCAHO/ISO accredited hospitals overseas through a secure, high-tech, information-rich web portal. Healthbase provides a wide range of medical procedures through its partner hospital network. Over hundred medical procedures are available in various categories: cosmetic and plastic, orthopedic, dental, cardiac, and many more. The savings are up to 80 percent from typical US prices even after adding up the travel costs, hospital stay and other related expenses. Healthbase offers more than just procedural availability; we also provide customers with extensive information on medical treatments, hospital and doctor profiles to help them make an educated decision regarding their treatment; travel planning and booking; applying for medical/dental loan and much more.

February 12, 2007

Obesity – Risks and Treatments

Posted by healthbase under adjustable gastric banding, biliopancreatic diversion, BMI, body mass index, cardiovascular diseases, coronary artery disease, glucose intolerance, Health risks of obesity, healthbase, heart rhythm, insulin resistance, malabsorptive operation, ObesityInAmerica.org, out-of-pocket expense, overweight, Polycystic Ovary Syndrome, Roux-en-Y gastric bypass, stomach stapling, Treatments for obesity, Type 2 diabetes, Underinsured, uninsured
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Obesity

According to ObesityInAmerica.org, obesity is the second leading cause of preventable death in the U.S. Approximately 127 million adults in the U.S. are overweight, 60 million obese, and 9 million severely obese. Furthermore, an estimated 65.2 percent of U.S. adults, age 20 years and older, and 15 percent of children and adolescents are overweight and 30.5 percent are currently obese.

Obesity defined

Obesity is a complex disease in which having too much body fat increases a person’s risk for developing other health problems. Obesity is measured by body mass index (BMI), a calculation that shows weight in relation to height. Click here to calculate your BMI.

As BMI increases, the risk of some diseases increases. A BMI of 30 or above is considered obese in adults, which means a person is at a higher risk for certain diseases, including heart disease, high blood pressure, and coronary artery disease (CAD). However, BMI is only one of many factors used to predict the risk of developing a disease.

Health risks of obesity

Overweight and obese people are prone to cardiovascular diseases (CVD), including heart attack, congestive heart failure, sudden cardiac death, angina and abnormal heart rhythm.

More than 80 percent of people with the most common form of diabetes, Type 2, are obese or overweight. Obesity complicates the management of Type 2 diabetes by increasing insulin resistance and glucose intolerance, which makes drug treatment for the disease less effective.

Obesity has a negative effect on lipid levels in the blood, which often leads to the development of a condition known as dyslipidemia, which is a primary risk factor for coronary artery disease (CAD).

The majority of patients diagnosed with Polycystic Ovary Syndrome (PCOS), the most common hormonal disorder in reproductive-age women, are either overweight or obese. PCOS is a leading cause of infertility. In addition, PCOS causes significant insulin resistance, thereby increasing the woman’s risk of developing diabetes.

Treatments for obesity

Research has shown that surgery may work better than diet to treat obesity.

Surgery may be an option if you have a body mass index (BMI) of 40 or more. It may also be an option if you have a BMI of 35 and another health problem related to your weight, such as diabetes or arthritis.

The surgery helps by causing significant weight loss thereby reducing obesity-related health problems, including diabetes, type 2 and high blood pressure.

Two types of surgery are used to treat obesity. A restrictive operation such as stomach stapling or adjustable gastric banding decreases food intake, usually by decreasing the size of the stomach. A malabsorptive operation such as a Roux-en-Y gastric bypass or a biliopancreatic diversion restricts food intake and decreases the digestion and absorption of food.

Treatment cost

In the US, the surgery may cost tens of thousands of dollars. If you are uninsured or underinsured, this may mean a huge out-of-pocket expense for your treatment. However, if you opt to have the same surgery overseas you may be out on your healthy way for just a fraction of the cost in the US.

At Healthbase, we ensure that you get the best quality treatment for low cost at our partner hospitals overseas. Sign up for FREE to obtain your treatment quote and consult with our surgeons about how they can help you with your problem.

Healthbase is a medical tourism facilitator that connects patients to leading JCI/JCAHO/ISO accredited hospitals overseas through a secure, high-tech, information-rich web portal. Healthbase provides a wide range of medical procedures through its partner hospital network. Over hundred medical procedures are available in various categories: cosmetic and plastic, orthopedic, dental, cardiac, and many more. The savings are up to 80 percent from typical US prices even after adding up the travel costs, hospital stay and other related expenses. Healthbase offers more than just procedural availability; we also provide customers with extensive information on medical treatments, hospital and doctor profiles to help them make an educated decision regarding their treatment; travel planning and booking; applying for medical/dental loan and much more.

Note: All information shown here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.

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February 12, 2007

How Digestive System Works

Posted by healthbase under bile, carbohydrate, CCK, cholecystokinin, Digestion, enzymes, esophagus, fat, fiber, gallbladder, gastrin, healthbase, Hormone Regulators, lactose, lining of the stomach, lymphatics, maltase, mucosa, NIDDK, nutrients, pancreas, peristalsis, protein, secretin, small intestine, stomach, sugar, Vitamins
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The digestive system is a series of hollow organs joined in a long, twisting tube from the mouth to the anus (see figure). Inside this tube is a lining called the mucosa. In the mouth, stomach, and small intestine, the mucosa contains tiny glands that produce juices to help digest food.

Two solid organs, the liver and the pancreas, produce digestive juices that reach the intestine through small tubes. In addition, parts of other organ systems (for instance, nerves and blood) play a major role in the digestive system.

Why Is Digestion Important?

When we eat such things as bread, meat, and vegetables, they are not in a form that the body can use as nourishment. Our food and drink must be changed into smaller molecules of nutrients before they can be absorbed into the blood and carried to cells throughout the body. Digestion is the process by which food and drink are broken down into their smallest parts so that the body can use them to build and nourish cells and to provide energy.

How Is Food Digested?

Digestion involves the mixing of food, its movement through the digestive tract, and chemical breakdown of the large molecules of food into smaller molecules. Digestion begins in the mouth, when we chew and swallow, and is completed in the small intestine. The chemical process varies somewhat for different kinds of food.

Movement of Food Through the System

The large, hollow organs of the digestive system contain muscle that enables their walls to move. The movement of organ walls can propel food and liquid and also can mix the contents within each organ. Typical movement of the esophagus, stomach, and intestine is called peristalsis. The action of peristalsis looks like an ocean wave moving through the muscle. The muscle of the organ produces a narrowing and then propels the narrowed portion slowly down the length of the organ. These waves of narrowing push the food and fluid in front of them through each hollow organ.

The first major muscle movement occurs when food or liquid is swallowed. Although we are able to start swallowing by choice, once the swallow begins, it becomes involuntary and proceeds under the control of the nerves.

The esophagus is the organ into which the swallowed food is pushed. It connects the throat above with the stomach below. At the junction of the esophagus and stomach, there is a ringlike valve closing the passage between the two organs. However, as the food approaches the closed ring, the surrounding muscles relax and allow the food to pass.

The food then enters the stomach, which has three mechanical tasks to do. First, the stomach must store the swallowed food and liquid. This requires the muscle of the upper part of the stomach to relax and accept large volumes of swallowed material. The second job is to mix up the food, liquid, and digestive juice produced by the stomach. The lower part of the stomach mixes these materials by its muscle action. The third task of the stomach is to empty its contents slowly into the small intestine.

Several factors affect emptying of the stomach, including the nature of the food (mainly its fat and protein content) and the degree of muscle action of the emptying stomach and the next organ to receive the contents (the small intestine). As the food is digested in the small intestine and dissolved into the juices from the pancreas, liver, and intestine, the contents of the intestine are mixed and pushed forward to allow further digestion.

Finally, all of the digested nutrients are absorbed through the intestinal walls. The waste products of this process include undigested parts of the food, known as fiber, and older cells that have been shed from the mucosa. These materials are propelled into the colon, where they remain, usually for a day or two, until the feces are expelled by a bowel movement.

Production of Digestive Juices

The glands that act first are in the mouth–the salivary glands. Saliva produced by these glands contains an enzyme that begins to digest the starch from food into smaller molecules. The next set of digestive glands is in the stomach lining. They produce stomach acid and an enzyme that digests protein. One of the unsolved puzzles of the digestive system is why the acid juice of the stomach does not dissolve the tissue of the stomach itself. In most people, the stomach mucosa is able to resist the juice, although food and other tissues of the body cannot.

After the stomach empties the food and juice mixture into the small intestine, the juices of two other digestive organs mix with the food to continue the process of digestion. One of these organs is the pancreas. It produces a juice that contains a wide array of enzymes to break down the carbohydrate, fat, and protein in food. Other enzymes that are active in the process come from glands in the wall of the intestine or even a part of that wall.

The liver produces yet another digestive juice–bile. The bile is stored between meals in the gallbladder. At mealtime, it is squeezed out of the gallbladder into the bile ducts to reach the intestine and mix with the fat in food. The bile acids dissolve the fat into the watery contents of the intestine, much like detergents that dissolve grease from a frying pan. After the fat is dissolved, it is digested by enzymes from the pancreas and the lining of the intestine.

Absorption and Transport of Nutrients

Carbohydrates: Based on a 2,000-calorie diet, it is recommended that 55 to 60 percent of total daily calories be from carbohydrates. Some of our most common foods contain mostly carbohydrates. Examples are bread, potatoes, legumes, rice, spaghetti, fruits, and vegetables. Many of these foods contain both starch and fiber.

The digestible carbohydrates are broken into simpler molecules by enzymes in the saliva, in juice produced by the pancreas, and in the lining of the small intestine. Starch is digested in two steps: First, an enzyme in the saliva and pancreatic juice breaks the starch into molecules called maltose; then an enzyme in the lining of the small intestine (maltase) splits the maltose into glucose molecules that can be absorbed into the blood. Glucose is carried through the bloodstream to the liver, where it is stored or used to provide energy for the work of the body.

Table sugar is another carbohydrate that must be digested to be useful. An enzyme in the lining of the small intestine digests table sugar into glucose and fructose, each of which can be absorbed from the intestinal cavity into the blood. Milk contains yet another type of sugar, lactose, which is changed into absorbable molecules by an enzyme called lactase, also found in the intestinal lining.

Protein: Foods such as meat, eggs, and beans consist of giant molecules of protein that must be digested by enzymes before they can be used to build and repair body tissues. An enzyme in the juice of the stomach starts the digestion of swallowed protein. Further digestion of the protein is completed in the small intestine. Here, several enzymes from the pancreatic juice and the lining of the intestine carry out the breakdown of huge protein molecules into small molecules called amino acids. These small molecules can be absorbed from the hollow of the small intestine into the blood and then be carried to all parts of the body to build the walls and other parts of cells.

Fats: Fat molecules are a rich source of energy for the body. The first step in digestion of a fat such as butter is to dissolve it into the watery content of the intestinal cavity. The bile acids produced by the liver act as natural detergents to dissolve fat in water and allow the enzymes to break the large fat molecules into smaller molecules, some of which are fatty acids and cholesterol. The bile acids combine with the fatty acids and cholesterol and help these molecules to move into the cells of the mucosa. In these cells the small molecules are formed back into large molecules, most of which pass into vessels (called lymphatics) near the intestine. These small vessels carry the reformed fat to the veins of the chest, and the blood carries the fat to storage depots in different parts of the body.

Vitamins: Another vital part of our food that is absorbed from the small intestine is the class of chemicals called vitamins. The two different types of vitamins are classified by the fluid in which they can be dissolved: water-soluble vitamins (all the B vitamins and vitamin C) and fat-soluble vitamins (vitamins A, D, and K).

Water and salt: Most of the material absorbed from the cavity of the small intestine is water in which salt is dissolved. The salt and water come from the food and liquid we swallow and the juices secreted by the many digestive glands.

How Is the Digestive Process Controlled?

Hormone Regulators

A fascinating feature of the digestive system is that it contains its own regulators. The major hormones that control the functions of the digestive system are produced and released by cells in the mucosa of the stomach and small intestine. These hormones are released into the blood of the digestive tract, travel back to the heart and through the arteries, and return to the digestive system, where they stimulate digestive juices and cause organ movement. The hormones that control digestion are gastrin, secretin, and cholecystokinin (CCK).

Gastrin causes the stomach to produce an acid for dissolving and digesting some foods. It is also necessary for the normal growth of the lining of the stomach, small intestine, and colon.
Secretin causes the pancreas to send out a digestive juice that is rich in bicarbonate. It stimulates the stomach to produce pepsin, an enzyme that digests protein, and it also stimulates the liver to produce bile.
CCK causes the pancreas to grow and to produce the enzymes of pancreatic juice, and it causes the gallbladder to empty.

Nerve Regulators

Two types of nerves help to control the action of the digestive system. Extrinsic (outside) nerves come to the digestive organs from the unconscious part of the brain or from the spinal cord. They release a chemical called acetylcholine and another called adrenaline. Acetylcholine causes the muscle of the digestive organs to squeeze with more force and increase the “push” of food and juice through the digestive tract. Acetylcholine also causes the stomach and pancreas to produce more digestive juice. Adrenaline relaxes the muscle of the stomach and intestine and decreases the flow of blood to these organs.

Even more important, though, are the intrinsic (inside) nerves, which make up a very dense network embedded in the walls of the esophagus, stomach, small intestine, and colon. The intrinsic nerves are triggered to act when the walls of the hollow organs are stretched by food. They release many different substances that speed up or delay the movement of food and the production of juices by the digestive organs.

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February 11, 2007

Catheter Ablation

Posted by healthbase under Ablation, abnormal rhythm, abnormal tissue, arrhythmia, catheter, healthbase, High-frequency electrical energy
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Catheter Ablation

A normal heart rhythm is the result of an electrical impulse passing through the heart tissue in one narrow conduction path. Many tachycardias (extremely fast rhythms) are the result of areas of abnormal tissue which cause this electrical system to short circuit. Catheter ablation is based on the idea that by ablating, or destroying, abnormal tissue areas in the heart, its electrical system can be repaired and the heart will return to a normal rhythm. During catheter ablation, your physician will insert several special long, flexible tubes with wires—called electrode catheters—into your heart. Some of these, called diagnostic catheters, are used to study your abnormal rhythm, or arrhythmia. However, one of these catheters will be used for the actual ablation. Once the doctor determines exactly where abnormal tissue in the heart is located, it can be ablated. Your physician will position the ablation catheter so that it lies on or very close to the abnormal tissue. High-frequency electrical energy is then sent through the ablation catheter into this abnormal tissue. The small area of heart tissue under the tip of the ablation catheter is heated by this high-frequency energy, creating a lesion or tiny scar. As a result, this tissue is no longer capable of conducting or sustaining the arrhythmia.

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February 6, 2007

Hip Replacement

Posted by healthbase under Aging and Drugs, crutches, femur, Fractured Hip, healthbase, Hip Replacement, Intertrochanteric, merck, metal pins, Osteoarthritis, prosthesis, thighbone, total hip replacement, trochanters
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Hip Replacement

More than 270,000 hip fractures occur in the United States each year, with about 90% of them occurring in people older than 60. Hip fractures are more common in older people because of osteoporosis and because older people are more likely to fall. Use of some drugs increases the risk of hip fractures in older people (see Aging and Drugs). One in three women and one in six men who reach age 90 will fracture a hip during his or her lifetime.

The upper end of the femur (thighbone) has large bony bumps (trochanters) where powerful muscles attach, then a short neck, and finally a spherical head that forms the outer half of the hip joint. Most hip fractures occur just below the spherical head (femoral neck or subcapital hip fractures) or through the trochanters (intertrochanteric hip fractures).

Femoral neck hip fractures are particularly problematic because the fracture often disrupts the blood supply to the femoral head, which forms the hip joint. Without a good blood supply, the bone cannot heal and eventually collapses and dies. Intertrochanteric hip fractures tend to create large broken bone surfaces that cause internal bleeding.

Symptoms and Diagnosis

Most older people fracture their hips by falling while walking on level ground, often when indoors. They usually cannot move their leg, much less stand or walk. When a doctor examines the person, the leg appears shortened and turned outward because of the unbalanced pull of muscles and gravity. Swelling and a purplish bruise develop because of blood leaking from the fracture.

An x-ray usually shows an obvious fracture and can help a doctor confirm the diagnosis. However, faint fracture lines may not be seen initially on x-ray. Thus, when a person continues to have pain and is unable to stand a day or more after a fall, the x-ray may have to be repeated or a magnetic resonance imaging (MRI) or bone scan obtained.

Treatment

Most people with a hip fracture are treated with surgery. The type of surgery depends on the type of fracture.

Repairing a Fractured Hip

There are two common types of hip fractures. Femoral neck or subcapital hip fractures occur in the neck of the femur. Intertrochanteric fractures occur in the large bony bumps (trochanters) where the powerful muscles of the buttocks and legs attach. When the fracture is not too severe, metal pins can be inserted surgically to support the femoral head. This surgical procedure preserves the person’s own hip joint.

Treatment of severe femoral neck hip fractures involves removing the broken pieces surgically because the blood supply to the femoral head has been damaged. If damage to the femoral neck is incomplete (the break does not go all the way through), metal pins can be inserted surgically to support the femoral head (internal fixation). This is a smaller surgical procedure and the person’s own hip joint is preserved.

Intertrochanteric hip fractures are treated with an implant, such as a sliding compression screw and side plate. This implant securely holds the bone fragments in their proper position while the fracture heals. The fixation is usually strong enough to permit the person to bear weight as tolerated. While the bone fragments generally heal in a couple of months, most people continue to improve in terms of comfort, strength, and walking ability for at least 6 months.

If partial hip replacement is needed, special metallic implants are used that have a polished spherical surface to match with the joint socket and a strong stem to fit within the central marrow canal of the thighbone. Some prosthetic implants are secured to the bone with a rapid-setting plastic cement. Others have special porous or ceramic coatings into which the surrounding living bone can grow and bond directly.

Replacing a Hip

When the topmost part (head) of the thighbone (femur) is badly damaged, it may be replaced with an artificial part (prosthesis), made of metal. This procedure is called partial hip replacement. Very rarely, the socket into which the femoral head fits (forming the hip joint) must also be replaced. The part used is a metal shell lined with durable plastic. This procedure is called total hip replacement.

After joint replacement surgery, the person usually begins walking with crutches or a walker immediately and switches to a cane in 6 weeks. However, artificial joints do not last forever. The person, especially someone who is active or heavy, may need to undergo another operation 10 to 20 years later. Joint replacement is often advantageous for older people, because the likelihood that additional surgery will be needed is very low. In addition, older people benefit greatly from being able to walk almost immediately after surgery.

Sometimes the whole joint needs to be replaced. This procedure is performed rarely for fractures, but most commonly for osteoarthritis (see Osteoarthritis (OA)).

If people with hip fractures are forced by their illness to stay in bed, they are at increased risk for serious complications, such as bedsores, blood clots leading to pulmonary embolism, mental confusion, and pneumonia. A great benefit of surgical fixation is that it allows the person to get out of bed and begin walking as soon as possible. Usually, the person can take a few steps with a walker 1 to 2 days after the operation. Physical rehabilitation is started as soon as possible

Sources:

http://www.merck.com/mmhe/sec05/ch062/ch062d.html

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The contents or materials provided in this website are for general information only and are not intended as medical advice.

February 3, 2007

Jim Gray Missing: Help find him by searching satellite imagery

Posted by healthbase under 40-foot yacht, Amazon Mechanical Turk, Berkeley, DEC, Farallon Islands, healthbase, IBM, Jim Gray, RDBMS, Skyserver, System R while at IBM, Tandem Computer, Terraserver, Turing Award, University of California, Virtual Earth
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Background

On Sunday, January 28th, 2007, Jim Gray, a renowned computer scientist was reported missing at sea. As of Thursday, Feb. 1st, the US Coast Guard has called off the search, having found no trace of the boat or any of its emergency equipment.
Follow the story here.

Through the generous efforts of his friends, family, various communities and agencies, detailed satellite imagery has been made available for his last known whereabouts.

Please help in finding Jim Gray: http://www.mturk.com/mturk/preview?groupId=J0XZ58STDWJZ5QY4F9M0

About Jim Gray:

Microsoft eScience Group
Gray@microsoft.com
455 Market St, 16^th fl., San Francisco, CA. 94105
Jim Gray is a researcher and manager of Microsoft Research’s eScience Group. His primary research interests are in databases and transaction processing systems — with particular focus on using computers to make scientists more productive. He and his group are working in the areas of astronomy, geography, hydrology, oceanography, biology, and health care. He continues a long-standing interest on building supercomputers with commodity components, thereby reducing the cost of storage, processing, and networking by factors of 10x to 1000x over low-volume solutions. This includes work on building fast networks, on building huge web servers with CyberBricks, and building very inexpensive and very high-performance storage servers.

Jim also is working with the astronomy community to build the world-wide telescope and has been active in building online databases like http://terraService.Net and http://skyserver.sdss.org. When the entire world’s astronomy data is on the Internet and is accessible as a single distributed database, the Internet will be the world’s best telescope. This is part of the larger agenda of getting all information online and easily accessible (digital libraries, digital government, online science …). More generally, he is working with the science community (Oceanography, Hydrology, environmental monitoring, ..) to build the world-wide digital library that integrates all the world’s scientific literature and the data in one easily-accessible collection. He is active in the research community, is an ACM, NAE, NAS, and AAAS Fellow, and received the ACM Turing Award for his work on transaction processing. He also edits of a series of books on data management.

Source: http://helpfindjim.com/

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Sailboat: TENACIOUS

40 ft C&C Sailboat

Sail # 31869

Sailor: JIM GRAY

6’3”, 190 lbs.

Gray Hair, White Beard

May be wearing green sweatshirt and/or red jacket. Missing since Sunday 1/28/07. Sailing from the Golden Gate Bridge to the Farallon Islands (25 miles west of San Francisco).

Medical Tourism Blog, Surgical Tourism Blog, Overseas Medical Travel Blog – Healthbase

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Jim Gray Missing: Help find him by searching satellite imagery

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