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1
23

Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study

Objective To investigate whether objectively measured time spent in light intensity physical activity is related to incident disability and to disability progression.  
bmj.com
over 7 years ago
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1
32

Relation of physical activity time to incident disability in community dwelling adults with or at risk of knee arthritis: prospective cohort study

Objective To investigate whether objectively measured time spent in light intensity physical activity is related to incident disability and to disability progression.  
bmj.com
over 7 years ago
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3
45

Knee exam

Constructive feed back on these videos is always appreciated  
YouTube
over 7 years ago
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1
53

Bones & Ligaments of the Knee, Femur, Tibia, & Pelvis

Bones & Ligaments of the Knee, Femur, Tibia, and Pelvis by Dr. Fabiam  
YouTube
over 7 years ago
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1
39

Haemoarthrosis of the knee,Knee swelling .Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the condition of hemarthrosis of the knee. Become a friend on facebook: http://www.facebook.com/drebraheim Follow me on twitter:...  
YouTube
over 7 years ago
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1
51

Adam Meakins' practical physio tips – explaining neural pain, shoulder rehab and managing knee load

Stream Adam Meakins' practical physio tips – explaining neural pain, shoulder rehab and managing knee load by BMJ talk medicine from desktop or your mobile device  
SoundCloud
over 7 years ago
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1
21

Internal medicine on Instagram: “Osteoarthritis of the knee This preoperative radiograph (x-ray) shows severe loss of cartilage affecting the medial compartment of the knee.”

“Osteoarthritis of the knee This preoperative radiograph (x-ray) shows severe loss of cartilage affecting the medial compartment of the knee.”  
Instagram
over 7 years ago
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1
18

Internal medicine on Instagram: “Large tophus and multiple superficial tophi of the knee in patient with chronic uncontrolled gout.”

“Large tophus and multiple superficial tophi of the knee in patient with chronic uncontrolled gout.”  
Instagram
over 7 years ago
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1
23

Internal medicine on Instagram: “Tuboeruptive xanthomata of the knee Type III hyperlipoproteinemia.”

“Tuboeruptive xanthomata of the knee Type III hyperlipoproteinemia.”  
Instagram
over 7 years ago
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1
166

Plantar Fasciitis | KT TAPE

Trusted by millions, KT Tape is used for common sports injuries such as ITBS, runners knee, shin splints, hamstring strain, & many more. Proven by Professional athletes and Olympians, trusted by healthcare professionals, and relied upon by recreational athletes world-wide.  
kttape.com
over 7 years ago
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1
10

Knee exam

Constructive feed back on these videos is always appreciated  
YouTube
about 7 years ago
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1
26

Bones & Ligaments of the Knee, Femur, Tibia, & Pelvis

Bones & Ligaments of the Knee, Femur, Tibia, and Pelvis by Dr. Fabiam  
YouTube
about 7 years ago
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1
34

Examination of the knee | Arthritis Research UK

Look initially from the end of the bed for loss of symmetry and loss of normal leg alignment such as varus deformity – where distal to the knee is deviated medially leading to a bow-legged appearance – or valgus deformity – where distal to the knee is deviated laterally leading to a knock-kneed appearance.  
arthritisresearchuk.org
almost 7 years ago
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1
75

Virtual Knee Replacement Surgery

Edheads is a non-profit organization that provides free high quality educational activities on the Web at no cost to students or teachers. Edheads creates unique, educational Web experiences designed to make hard-to-teach concepts understandable.  
edheads.org
almost 7 years ago
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1
22

Knee Osteochondritis Dissecans , Wilson's Test - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the condition of Osteochondritis Dissecans of the knee joint - OCD. Become a friend on facebook: http://www.facebook.com/drebrah...  
YouTube
almost 7 years ago
Foo20151013 2023 1eqve0g?1444774030
1
99

LWW: Case Of The Month - May 2013

This month’s case is by Barbara J. Mroz, M.D. and Robin R. Preston, Ph.D., author of Lippincott’s Illustrated Reviews: .Physiology (ISBN: 9781451175677). For more information, or to purchase your copy, visit: http://tiny.cc/PrestonLIR, with 15% off using the discount code: MEDUCATION. The case below is followed by a choice of diagnostic tests. Select the one lettered selection that would be most helpful in diagnosing the patient’s condition. The Case A 54-year-old male 2 pack-per-day smoker presents to your office complaining of cough and shortness of breath (SOB). He reports chronic mild dyspnea on exertion with a daily cough productive of clear mucus. During the past week, his cough has increased in frequency and is now productive of frothy pink-tinged sputum; his dyspnea is worse and he is now short of breath sometimes even at rest. He has had difficulty breathing when lying flat in bed and has spent the past two nights sleeping upright in a recliner. On physical examination, he is a moderately obese male with a blood pressure of 180/80 mm Hg, pulse of 98, and respiratory rate of 22. His temperature is 98.6°F. He becomes winded from climbing onto the exam table. Auscultation of the lungs reveals bilateral wheezing and crackles in the lower posterior lung fields. There is pitting edema in the lower extremities extending up to the knees.  Question Which if the following tests would be most helpful in confirming the correct diagnosis? A. Spirometry B. Arterial blood gas C. Complete blood count D. B-type natriuretic peptide blood test E. Electrocardiogram Answer? The correct answer is B-type natriuretic peptide blood test. Uncomfortable breathing, or feeling short of breath, is a common medical complaint with multiple causes. When approaching a patient with dyspnea, it is helpful to remember that normal breathing requires both a respiratory system that facilitates gas exchange between blood and the atmosphere, and a cardiovascular system that transports O2 and CO¬2 between the lungs and tissues. Dysfunction in either system may cause dyspnea, and wheezing (or bronchospasm) may be present in both cardiac and pulmonary disease. In this patient, the presence of lower extremity edema and orthopnea (discomfort when lying flat) are both suggestive of congestive heart failure (CHF). Elevated blood pressure (systolic of 180) and a cough productive of frothy pink sputum may also be associated symptoms. While wheezing could also be caused by COPD (chronic obstructive pulmonary disease) in the setting of chronic tobacco use, the additional exam findings of lung crackles and edema plus systolic hypertension are all more consistent with CHF. What does the B-type natriuretic peptide blood test tell us? When the left ventricle (LV) fails to maintain cardiac output (CO) at levels required for adequate tissue perfusion, pathways are activated to increase renal fluid retention. A rising plasma volume increases LV preload and sustains CO via the Frank-Starling mechanism. Volume loading also stimulates cardiomyocytes to release atrial- (ANP) and B-type (BNP) natriuretic peptides. BNP has a longer half-life than ANP and provides a convenient marker for volume loading. Plasma BNP levels are measured using immunoassay; levels >100 pg/mL are suggestive of overload resulting in heart failure. How does heart failure cause dyspnea? Increasing venous pressure increases mean capillary hydrostatic pressure and promotes fluid filtration from the vasculature. Excess filtration from pulmonary capillaries causes fluid accumulation within the alveoli (pulmonary edema) and interferes with normal gas exchange, resulting in SOB. Physical signs and symptoms caused by high volume loading include: (1) Lung crackles, caused by fluid within alveoli (2) Orthopnea. Reclining increases pulmonary capillary hydrostatic pressure through gravitational effects, worsening dyspnea when lying flat. (3) Pitting dependent edema caused by filtration from systemic capillaries, an effect also influenced by position (causing edema in the lower legs as in our ambulatory patient or in dependent areas like the sacrum in a bedridden patient). What would an electrocardiogram show? Heart failure can result in LV hypertrophy and manifest as a left axis deviation on an electrocardiogram (ECG), but some patients in failure show a normal ECG. An ECG is not a useful diagnostic tool for dyspnea or CHF per se. Wouldn’t spirometry be more suitable for diagnosing the cause of dyspnea in a smoker? Simple spirometry will readily identify the presence of airflow limitation (obstruction) as a cause of dyspnea. It's a valuable test to perform in any smoker and can establish a diagnosis of chronic obstructive pulmonary disease (COPD) if abnormal. While this wheezing patient is an active smoker who could have airflow obstruction, the additional exam findings above point more to a diagnosis of CHF. What would an arterial blood gas show? An arterial blood gas measures arterial pH, PaCO¬2, and PaO2. While both CHF and COPD could cause derangements in the values measured, these abnormalities would not necessarily be diagnostic (e.g., a low PaO2 could be seen in both conditions, as could an elevated PaCO¬2). Would a complete blood count provide useful information? A complete blood count could prove useful if anemia is a suspected cause of dyspnea. Test result BNP was elevated (842 pg/mL), consistent with CHF. Diuretic treatment was initiated to help reduce volume overload and an afterload reducing agent was started to lower blood pressure and improve systolic function.  
Lippincott Williams & Wilkins
over 8 years ago
Foo20151013 2023 e2a8vo?1444774258
7
348

Monkey See, Monkey Do.

So you're sitting in a bus when you see a baby smile sunnily and gurgle at his mother. Your automatic response? You smile too. You're jogging in the park, when you see a guy trip over his shoelaces and fall while running. Your knee jerk reaction? You wince. Even though you're completely fine and unscathed yourself. Or, to give a more dramatic example; you're watching Titanic for the umpteenth time and as you witness Jack and Rose's final moments together, you automatically reach for a tissue and wipe your tears in whole hearted sympathy ( and maybe blow your nose loudly, if you're an unattractive crier like yours truly). And here the question arises- why? Why do we experience the above mentioned responses to situations that have nothing to do with us directly? As mere passive observers, what makes us respond at gut level to someone else's happiness or pain, delight or excitement, disgust or fear? In other words, where is this instinctive response to other people's feelings and actions that we call empathy coming from? Science believes it may have discovered the answer- mirror neurons. In the early 1990s, a group of scientists (I won't bore you with the details of who, when and where) were performing experiments on a bunch of macaque monkeys, using electrodes attached to their brains. Quite by accident, it was discovered that when the monkey saw a scientist holding up a peanut, it fired off the same motor neurons in its brain that would fire when the monkey held up a peanut itself. And that wasn't all. Interestingly, they also found that these motor neurons were very specific in their actions. A mirror neuron that fired when the monkey grasped a peanut would also fire only when the experimenter grasped a peanut, while a neuron that fired when the monkey put a peanut in its mouth would also fire only when the experimenter put a peanut in his own mouth. These motor neurons came to be dubbed as 'mirror neurons'. It was a small leap from monkeys to humans. And with the discovery of a similar, if not identical mirror neuron system in humans, the studies, hypotheses and theories continue to build. The strange thing is that mirror neurons seem specially designed to respond to actions with clear goals- whether these actions reach us through sight, sound, smell etc, it doesn't matter. A quick example- the same mirror neurons will fire when we hop on one leg, see someone hopping, hear someone hopping or hear or read the word 'hop'. But they will NOT respond to meaningless gestures, random or pointless sounds etc. Instead they may well be understanding the intentions behind the related action. This has led to a very important hypothesis- the 'action understanding' ability of mirror neurons. Before the discovery of mirror neurons, scientists believed our ability to understand each other, to interpret and respond to another's feeling or actions was the result of a logical thought process and deduction. However, if this 'action understanding' hypothesis is proved right, then it would mean that we respond to each other by feeling, instead of thinking. For instance, if someone smiles at you, it automatically fires up your mirror neurons for smiling. They 'understand the action' and induce the same sensation within you that is associated with smiling. You don't have to think about what the other person intends by this gesture. Your smile flows thoughtlessly and effortlessly in return. Which brings us to yet another important curve- if mirror neurons are helping us to decode facial expressions and actions, then it stands to reason that those gifted people who are better at such complex social interpretations must be having a more active mirror neuron system.(Imagine your mom's strained smile coupled with the glint in her eye after you've just thrown a temper tantrum in front of a roomful of people...it promises dire retribution my friends. Trust me.) Then does this mean that people suffering from disorders such as autism (where social interactions are difficult) have a dysfunctional or less than perfect mirror neuron system in some way? Some scientists believe it to be so. They call it the 'broken mirror hypothesis', where they claim that malfunctioning mirror neurons may be responsible for an autistic individual's inability to understand the intention behind other people's gestures or expressions. Such people may be able to correctly identify an emotion on someone's face, but they wouldn't understand it's significance. From observing other people, they don't know what it feels like to be sad, angry, surprised or scared. However, the jury is still out on this one folks. The broken mirror hypothesis has been questioned by others who are still skeptical about the very existence of these wonder neurons, or just how it is that these neurons alone suffered such a developmental hit when the rest of the autistic brain is working just dandy? Other scientists argue that while mirror neurons may help your brain to understand a concept, they may not necessarily ENCODE that concept. For instance, babies understand the meaning behind many actions without having the motor ability to perform them. If this is true, then an autistic person's mirror neurons are perfectly fine...they were just never responsible for his lack of empathy in the first place. Slightly confused? Curious to find out more about these wunderkinds of the human brain? Join the club. Whether you're an passionate believer in these little fellas with their seemingly magical properties or still skeptical, let me add to your growing interest with one parting shot- since imitation appears to be the primary function of mirror neurons, they might well be partly responsible for our cultural evolution! How, you ask? Well, since culture is passed down from one generation to another through sharing, observation followed by imitation, these neurons are at the forefront of our lifelong learning from those around us. Research has found that mirror neurons kick in at birth, with infants just a few minutes old sticking their tongues out at adults doing the same thing. So do these mirror neurons embody our humanity? Are they responsible for our ability to put ourselves in another person's shoes, to empathize and communicate our fellow human beings? That has yet to be determined. But after decades of research, one thing is for sure-these strange cells haven't yet ceased to amaze and we definitely haven't seen the last of them. To quote Alice in Wonderland, the tale keeps getting "curiouser and curiouser"!  
Huda Qadir
over 7 years ago
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Orthopedic Surgeons Use Computer Navigation for Knee, Hip Replacement in Medicine

Orthopedic surgeons at Baptist Medical Center in Jackson, Miss., are among the first in the Metro Jackson area to use computers to help pinpoint perfect alignment…  
vimeo.com
over 6 years ago
Www.bmj
0
20

Advancing equity in healthcare

Healthcare reforms in Massachusetts that began in 2006 might foreshadow the effects of President Obama’s national Affordable Care Act and have been subject to intense scrutiny as a result. Two linked studies of the reforms in Massachusetts indicate that expanding of health insurance is helpful but not enough to eliminate important social and ethnic disparities in care and outcomes.1 2 Hanchate and colleagues (doi:10.1136/bmj.h440) studied joint replacement surgery, an effective treatment for end stage joint disease that reduces pain and improves function and quality of life3 but is underused among patients on low incomes and those from racial and ethnic minority backgrounds.4 In their study, greater access to health insurance in Massachusetts was associated with increased rates of knee and hip replacement surgery among Hispanic and black people compared with white people but was not associated with increased rates among people on low incomes relative to richer people.1 In a second study, McCormick and colleagues (doi:10.1136/bmj.h1480) found no association between Massachusetts healthcare reforms and reduced racial and ethnic disparities in admissions to hospital for diseases such as asthma, diabetes, and heart failure. Many admissions for these “ambulatory care sensitive conditions” are preventable if patients have access to high quality outpatient …  
feeds.bmj.com
over 6 years ago