Cardiac catheterisation and coronary angiography – NHS Choices, catheterisation procedure.#Catheterisation #procedure


catheterisation procedure

Catheterisation procedure Your health, your choices

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Catheterisation procedure

Varicose Vein Treatment New York #varicose #veins,spider #veins,varicose #vein #treatments,varicose #and #spider


Varicose Vein Treatment New York

Spider veins often occur along with varicose veins because of increased venous pressure. These tiny vessels are quite common and medically harmless. Varicose and spider veins are smaller red, purple or blue veins located just under the skin. They have a web-like appearance. Typically, they may be found on the lateral aspect of the thigh but may be found on other parts of the body. They rarely cause pain but are usually cosmetic concerns. Spider veins found on the leg are best treated with sclerotherapy. Some people may develop facial spider veins; these are best treated with Vein Gogh treatments. Laser vein treatments are also used but may be less effective way to treat varicose and spider veins. For spider vein removal new york and new jersey, contact us today!

Spider veins on the thigh

Reticular Veins

Reticular veins are larger blue or green veins located just under the skin. They are usually “feeder” veins of spider veins. They can cause pain occasionally. They are best treated with venous sclerotherapy, foam sclerotherapy or ambulatory phlebectomy (or vein removal surgery).

Reticular veins on the thigh

Varicose Veins

Varicose veins are larger rope-like veins. They cause pain and can lead to other complications including chronic venous insufficiency and occasionally phlebitis. Large varicose veins are often due to failure of the valves in the great (or long) saphenous vein or short saphenous vein. They are best treated with vein ablation surgery in conjunction with vein removal. For varicose vein treatment in New York and New Jersey, contact us today.

Superficial vein anatomy

Larger varicose veins on the calf


Varicose veins are unsightly. Most of the patients that we see for evaluation complain of cosmetic problems. The appearance of varicose veins are an issue but they are also the source of symptoms such as; pain, itching, swelling, burning, leg heaviness or tiredness, skin discoloration. Symptoms typically worsen throughout the day and are partially relieved by elevation or wearing compression socks or stockings.


If the skin over a vein is very thin, they are prone to bleeding. A shower or minor trauma can cause a varicose vein to burst and bleed.


Skin tears or ulceration indicate a very severe case. They can occur spontaneously in a patient with long–standing chronic venous insufficiency. Venous ulcers are very hard to heal.

Varicose veins and spider veins can cause a varying degree of discomfort including:

  • Heaviness
  • Aching
  • Throbbing
  • Swelling
  • Leg cramps (typically worse by the end of the day)
  • Skin changes including wounds of the legs (ulcers)

Treatment of these veins eliminate these symptoms. Left untreated, varicose veins worsen over time.

Synovial Fluid Analysis #synovial #fluid #analysis, # #2006 #21st #abnormal #abnormally #activities


Synovial Fluid Analysis

Synovial fluid analysis is a group of tests that examine joint (synovial) fluid. The tests help diagnose and treat joint-related problems.

Alternative Names

Joint fluid analysis; Joint fluid aspiration

How the test is performed

A sample of synovial fluid is needed for this test. Synovial fluid is normally a thick, straw-colored liquid found in small amounts in joints, bursae, and tendon sheaths.

After the area is cleaned, the health care provider will insert a sterile needle through the skin and into the joint space. Once in the joint, fluid is drawn through the needle into a sterile syringe.

The fluid sample is sent to the laboratory. The laboratory technician will check the sample’s color and clarity, and then place it under a microscope to check it for red and white blood cells, crystals (in the case of gout), and bacteria. In addition, there may be a chemical analysis, and if infection is a concern, a sample will be cultured to see if any bacteria grow.

How to prepare for the test

Normally, no special preparation is necessary, but contact your health care provider before the test to make sure. Tell your doctor if you are taking blood thinners, as they can affect test results.

How the test will feel

Occasionally, the health care provider will first inject local anesthesia with a small needle, which will sting. The aspiration is done with a larger needle and may also cause some pain. The procedure usually lasts less than one minute.

Why the test is performed

The test can help diagnose the cause of pain or swelling in joints. Removing the fluid can also help relieve joint pain.

This test may be used to diagnose:

  • Gout
  • Infection
  • Other inflammatory joint conditions
  • Joint injury
  • Osteoarthritis

What abnormal results mean

Abnormal joint fluid may look cloudy or abnormally thick.

Blood in the joint fluid may be a sign of injury inside the joint or a body-wide bleeding problem. An excess amount of normal synovial fluid can also be a sign of osteoarthritis.

What the risks are

  • Infection of the joint — unusual but more common with repeated aspirations
  • Bleeding into the joint space

Special considerations

Ice or cold packs may be applied to the joint for 24 to 36 hours after the test to reduce the swelling and joint pain. Depending on the exact problem, you can probably resume your normal activities after the procedure. Talk to your health care provider to determine what activity is most appropriate for you.


Knight JA, Kjeldsberg CR. Cerebrospinal, synovial, and serous body fluids. In: McPherson RA, Pincus MR, eds. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 21st ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 28.

Review Date: 7/10/2009

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsements of those other sites. Copyright 2010 A.D.A.M. Inc. as modified by University of California San Francisco. Any duplication or distribution of the information contained herein is strictly prohibited.

Information developed by A.D.A.M. Inc. regarding tests and test results may not directly correspond with information provided by UCSF Medical Center. Please discuss with your doctor any questions or concerns you may have.

Getting Care

Your Personal Gastric Lap Band Surgery Guide #lap #band,stomach #band,gastric #band,stomach #band


Whether you’re considering LAP-BAND ® Adjustable Gastric Band Surgery (sometimes referred to as “stomach band surgery”) or have already had it.

you’ve come to the right place! I’m a dietitian specializing in the gastric banding procedure.

My site will fill you in on all the details about the belly band. and life after bariatric banding.

And of course, since I AM a dietitian, I’ll give extra attention to your new gastric band diet and all the issues surrounding it.

You see, success is not as simple as merely having stomach band surgery. Proper eating after bariatric surgery is a MUST. Your ultimate outcome (how much you end up weighing!) depends largely upon how committed and motivated you are to following the gastric band diet.

I’ll give you those guidelines!

If you’re just starting your research, I’ll give you all the information on LAP-BAND ® surgery you need to know. If you’ve already consulted a doctor or have already the stomach band, I’ll answer those questions you may have been afraid to ask (or didn’t even think to ask)!

LAP-BAND ® Adjustable Gastric Band Surgery is simply a tool. It’s up to YOU to make proper use of it. Allow me to help you. Think of me as your personal gastric band guide. )

Can’t find the answer to a specific question you have? Contact me! I’m only a click away!

Gastric Lap Band Surgery: Stomach Band Surgery Overview Free professional information about gastric lap band surgery. A must read if you’re seriously considering a gastric banding procedure. Gastric Lap Band Diet: How to Eat After Stomach Band Surgery Professional lap band diet advice from a bariatric dietitian specializing in the stomach band surgery diet. Get tips on eating after bariatric surgery including. Bariatric Vitamins: Gastric Lap-Band Patients NEED them Gastric lap-band patients should take bariatric vitamins. Why? Reduced portion sizes make it difficult to take in all the nutrition you need through food alone! Gastric Lap-Band eStore Gastric Lap-Band estore: Find all the bariatric foods and protein powders you’ll need to be successful. Gastric Lap Band Accessories Gastric lap band accessories that are as fun to own as they are to give as gifts. Weight Loss Surgery Recipes: Bariatric Eating Made Simple Weight loss surgery recipes that are delicious AND nutritious. Use these post lap band diet recipes to pack a lot of nutrition into small portions. Lap band recipes can be used with gastric sleeve. Weight Loss Surgery Journal: Record Food Intake in a Gastric Lap Band Journal Using a weight loss surgery journal designed specifically for gastric lap band patients is useful after stomach band surgery. Designed by a bariatric dietitian, this lap band journal is. Gastric Lap-Band Diet Questions Answered by a Bariatric Dietitian Get answers to all your gastric lap-band diet questions: After stomach band surgery can I eat bread, rice, or pasta? Can I drink alcohol? What should I do if I feel hungry all the time? Can I eat. Calculate BMI: Do You Qualify for Weight Loss Surgery? Calculate BMI (Body Mass Index) to determine whether or not your weight makes you a good candidate for gastric lap band weight loss surgery. Gastric Lap-Band Surgery Cost Gastric lap-band surgery cost is an important consideration in your decision about having weight loss surgery. Find out how much will it cost, if your will insurance pay, what financing. Gastric Lap-Band Surgeons:Important Questions to Ask When Interviewing a WLS Doc How do you choose between gastric lap-band surgeons? Interview. Ask the right questions. YOU’RE doing the hiring. How many gastric band surgeries do you perform per month? What is your. Gastric Lap-Band Results Gallery: Real People, Real Results See gastric lap-band results and/or submit YOUR own “before and after” photos to share with those considering weight loss surgery. See the weight loss that’s possible after gastric banding. Your Personal Lap-Band® Blog Your Personal Gastric Lap-Band Guide BLOG informs you of recipes of the week, site updates, and important news from the world of weight loss surgery. Gastric Lap-Band Information: Find the Resources You Need Having the right gastric lap-band information. including resources and support. is equally important as weight loss surgery itself. That’s because weight loss isn’t as simple as having. Gastric Lap-Band Blog Keeping your own gastric lap-band blog provides often needed support, encouragement, accountability, and the knowledge that you’re not alone! Start your own blog with this easy. Tucson Lap-Band: Thinking About Bariatric Surgery? Take the necessary steps to find Tucson lap-band surgeons, dietitians, support groups, and important tools. “The Old Pueblo’s” weight loss surgery step-by-step guide. Bariatric Food: Products That Get the Thumbs Up from a Bariatric Dietitian Magnificant “must have” bariatric food. Get weekly updates on foods that get the stamp of approval for use after weight loss surgery. Gastric Lap-Band Success Depends Largely on Having the Right Tools Improve your chances of gastric lap-band success with this weight loss surgery “toolbox.” Don’t leave home without. Meet Suzette Kroll, RD, Your Personal Lap-Band Guide Bariatric Nutritionist Suzette Kroll of Tucson, AZ, is a Registered Dietitian, certified intrinsic coach and specialist in gastric lap band surgery. Contact Suzette Kroll, RD, Your Personal Lap-Band Guide Contact Your Personal Lap-Band Guide, Suzette Kroll, RD. Ask questions and leave comments about this website here.

The Cost of LASIK – Learn the factors that influence LASIK Prices


Lasik MD


Introduction – What influences the cost of LASIK?

As discussed earlier, most LASIK patients have never shopped for medical services, so comparison to the more familiar process of purchasing a new car can provide perspective.

If the only consideration were price, then the $9,455 Chevrolet Aveo would no doubt be a top selling car. Instead, the average vehicle sells for over $30,000, and many luxury cars top $50,000 due to a combination of technology, performance, safety, reputation and reliability that buyers find attractive. The cost of LASIK varies for many of the same reasons.

When analyzing the cost of LASIK, it is first necessary to clearly define exactly what is included in the price and then to understand the factors that influence LASIK prices.

What’s included in LASIK prices?

Preoperative exam: A preoperative examination is an obvious necessity. However, some discount centers charge separately for the examination in order to quote a lower price for the surgery, so it’s important to verify that the preoperative examination is not an extra charge.

The procedure: LASIK, IntraLASIK, PRK, LASEK or Epi-LASIK.

Antibiotic and anti-inflammatory eye drops: These can cost as much as $150 if not included.

Postoperative care: Again, discount centers sometimes itemize postoperative care separately, so it’s important to verify that postoperative care is included and to document the duration.

Retreatments: A second procedure is often performed when the first one doesn’t fully correct the vision. If not included, a retreatment could cost as much or more than the first treatment. Therefore, it may be wise to document the maximum cost of retreatment before making a commitment.

The factors that influence the cost of LASIK are numerous.

Office overhead: This includes rent, staff salaries and benefits, computers, telephones and other items of infrastructure. Perhaps the greatest source of variance is in personnel, as high-end practices often employ more costly certified ophthalmic assistants and certified ophthalmic technicians to assist in preoperative testing and surgery.

Supplies: Many disposable supplies are used in laser vision correction, including medications, sterile gloves, gowns and drapes, masks, shoe covers and microkeratome blades.

Insurance: With the present legal environment, even surgeons who have never had a malpractice claim must pay several thousand dollars a month for malpractice insurance, in addition to the cost of insuring their equipment.

Preoperative testing: Thorough preoperative testing is essential to identify risk factors and prevent problems. However, it is quite costly from a time standpoint, and the level of detail varies considerably among practices.

Equipment: The instruments used for important tests such as corneal topography, corneal pachymetry, keratometry, tear film analysis and pupil size are available at different price points. For example, some surgeons measure nighttime pupil size by turning off the room lights, holding a piece of paper with small black circles of known size next to the eye, shining a small flashlight on the eye and visually estimating the pupil size to the nearest millimeter. Others spend thousands of dollars on sophisticated instruments that measure to the nearest 1/10th of a millimeter under rigorously controlled lighting.

Surgeon provided care: In traditional private practices, the surgeon provides comprehensive patient care. The process begins with a consultation that includes preliminary tests and a one-on-one discussion with the surgeon. If the results look promising, then the next step is a comprehensive examination with the surgeon and another one-on-one discussion of the results. If surgery is advisable, continuity of care is maintained, as the surgeon performs the procedure and provides the postoperative care.

Because a surgeon’s time is valuable, business-oriented discount centers have cut costs by eliminating the surgeon from most of the process. The initial consultation, preoperative examination and postoperative care are delegated to others. Quite often, the only time the patient ever sees the surgeon is under the laser for the procedure itself. The surgeons in these centers are typically employed as independent contractors and paid on a per-case basis. Known in industry lingo as “shooters”, many of these surgeons travel between offices and perform surgery for multiple centers.

Lasers: The excimer lasers used in laser vision correction are expensive, with a price range of $300,000 to $400,000. Maintenance contracts cost around $50,000 per year, and periodic upgrades are often priced in excess of $100,000. Therefore, practices that invest in the latest technology typically charge higher fees.

Royalty fees: With the exception of NIDEK, all laser manufacturers charge the surgeon a per-eye royalty fee for use of the laser. For conventional treatments, these fees range from $100 to $150 per eye, and custom treatments are more costly, usually around $250 per eye. In a large part due to the lack of royalty fees, the NIDEK is the favorite laser in discount centers.

Advertising: Most practices with significant surgical volume advertise heavily, with monthly advertising budgets of $10,000 to $100,000 or more. Depending on local market factors and the success of a particular campaign, advertising can account for $100 to $300 of the per-eye procedure cost.

Custom wavefront technology: Custom wavefront-guided laser treatments are one of the main reasons for an uptrend in LASIK prices over the last few years. In addition to the higher royalty fees associated with custom treatments, practices that offer wavefront technology must invest approximately $75,000 for a wavefront analyzer and as much as $150,000 for laser upgrades related to wavefront technology.

Intralase: Increased use of the Intralase laser for creation of the LASIK flap is another reason for the uptrend in LASIK prices. The Intralase laser is enormously expensive (about $425,000) and requires its own $40,000 annual maintenance contract, as well as a $160 per-eye fee for the glass cones used in the procedure. Not surprisingly, practices that invest in Intralase must charge more to offset the cost of their investment.


Perhaps it is a testament to laser vision correction’s high rate of success that some patients shop for discount surgery. After all, who shops for discount heart or brain surgery? More likely, bargain shopping is simply due to a lack of familiarity with the many factors that influence prices, which can lead to the erroneous assumption that all providers are the same. Once again an automotive analogy will help provide proper perspective on prices.

Look at the big picture: Almost everyone is excited to drive home in a new car. Unfortunately, by the time the car leaves the dealer’s lot, it has depreciated by more than the cost of quality LASIK, and it will continue to lose value for many years to come. What’s more, some relatively frivolous options cost more than the difference between low-end and high-end LASIK. After all, wouldn’t it be better to forgo the $995 chrome package on a new Ford Fusion and instead upgrade your eye surgery to the highest standards?

LASIK provides long-term value: Unlike automobiles, which continuously lose value, laser vision correction is an investment in better vision that leads to tremendous long-term savings over eyeglasses and contact lenses, in addition to the lifestyle benefits that have made it so popular.

You get what you pay for, so use common sense: Sure, it is possible to get a good deal on a $56,000 Lexus, just like it is possible to find a nice price on a $9,500 Chevy Aveo. But you can’t buy a new Lexus for $9,500. Nor can you find surgeon-provided care, detailed preoperative testing on top-shelf instruments, an Intralase flap, and wavefront-guided custom laser treatment for bargain basement prices.

LASIK is eye surgery. The only thing to consider is what is best for your eyes. There are millions of ways to save money that are better than having cheap eye surgery. Granted, LASIK is popular in part because results are generally very good, regardless of surgeon or center. But make no mistake, state-of-the-art technology in the hands of an experienced, conscientious surgeon produces better vision than outdated technology in lesser hands.

Find the best surgeon and finance, if necessary. When comparing apples to apples, the price difference between surgeons is usually small. However, if faced with a decision between a more experienced surgeon with a higher price and a less experienced surgeon with a lower price, always choose the better surgeon and obtain financing, if necessary. Virtually all LASIK practices offer financing and even at high-end providers, monthly payments are quite affordable.

Find a LASIK surgeon you can trust:

Sugarbaker Oncology Associates #sugarbaker #procedure


Dr. Paul H. Sugarbaker, FACS, FRCS

Dr. Paul H. Sugarbaker, FACS, FRCS graduated from Cornell University Medical College in New York City and received his surgical training at the Peter Bent Brigham Hospital in Boston, a Harvard University affiliated program. There he also received a Masters Degree in Immunology at the Harvard School of Arts and Sciences. In 1976 he accepted a position at the National Institutes of Health/ National Cancer Institute – Surgery Branch, as Senior Investigator until 1986. Subsequently, after a brief stay at the Emory Clinic in Atlanta, Georgia he moved back to Washington, DC to become the Medical Director of the Washington Cancer Institute at MedStar Washington Hospital Center in 1989. Currently, he is the Chief of the Peritoneal Surface Malignancy Program and the Director of the Center for Gastrointestinal Malignancies at the Washington Hospital Center in Washington, DC.

His interests are focused exclusively on gastrointestinal cancer, gynecologic malignancy, and peritoneal mesothelioma of the abdomen – all malignancies which usually present with cancerous spread to the abdominal cavity. Currently, his clinical and investigative work is concentrated on the treatment of the peritoneal surface dissemination of cancers, referred to as PERITONEAL METASTASES, also known as peritoneal carcinomatosis. He has developed, perfected and popularized the combined treatments of cancer surgery with warm chemotherapy, infused into the open abdomen towards the end the surgical intervention.

His mantra, “It’s what the surgeon doesn’t see that kills the patient,” summarizes his thinking as he realizes the limitations of surgery alone, and the limitations of systemic or regional chemotherapy alone. It turns out that the combined application of both the surgical removal of the tumors and the regional treatment directly into the open abdomen where the tumors are located, is especially effective in selected patients. This treatment option and its results have been published extensively in the peer-reviewed literature and in the lay press. Further work to supplement these treatments and to make them even more effective by adding systemic chemo infusions: Perioperative intravenous and intraperitoneal chemotherapy (HIPEC and EPIC> are an essential planned part of these combined surgical and regional chemotherapy interventions.

Over the many years he has published over 900 articles and book chapters, edited 7 books, produced 24 videos, and received 4 honorary professorships. He has traveled to all 5 continents to make these treatments available to patients all over the world.

What Cancers Do We Treat?

Dr. Sugarbaker is a surgical oncologist who specializes in the treatment of peritoneal metastases from these gastrointestinal cancers: Appendiceal (PMP), Colorectal, Peritoneal mesothelioma and Fallopian (ovarian) cancer.

What Treatments Are Provided?

Peritoneal metastases require a comprehensive treatment of extensive (cytoreductive) surgery combined with heated intraperitoneal chemotherapy (HIPEC).

What is the Selection Process?

For most patients, the process starts by calling our office at 202-877-3908 and speaking to the Clinical Coordinator, Ilse. Patients also come to Dr. Sugarbaker by referring physicians.

We are the Center for Surgical Oncology at the Washington Cancer Institute, Washington Hospital Center, in Washington, D.C.

We specialize in the surgical treatment of cancers that arise in the gastrointestinal tract (appendix cancer, colon cancer, and rectal cancer); and other areas of the abdomen and pelvis. Our advanced services include specialty treatment programs for pseudomyxoma peritonei, peritoneal metastases (cancers that have spread to the intraabdominal surfaces), as well as primary peritoneal surface malignancies such as peritoneal mesothelioma.

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