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8781. Factor VIII (Overview)

, Delhanty JD. Preimplantation genetic diagnosis: applications for molecular medicine. Trends Mol Med . 2001 Jan. 7(1):23-30. . Kumar R, Bouskill V, Schneiderman JE, Pluthero FG, Kahr WH, Craik A, et al. Impact of aerobic exercise on haemostatic indices in pediatric patients with haemophilia. Thromb Haemost . 2016 Feb 25. 115 (6): . Chuah MK, Collen D, VandenDriessche T. Gene therapy for hemophilia. J Gene Med . 2001 Jan-Feb. 3(1):3-20. . Matsui H. Endothelial progenitor cell-based therapy for hemophilia (...) inhibitor: ≤5 BU High-titer inhibitor: >5 BU See for more detail. Management The treatment of hemophilia may involve the following: Management of hemostasis Management of bleeding episodes Use of factor replacement products and adjuvant medications Treatment of patients with factor inhibitors Treatment and rehabilitation of patients with hemophilia synovitis Disposition of treatment is as follows: Management ideally should be provided through a comprehensive hemophilia care center Home administration

2014 eMedicine.com

8782. Epilepsia Partialis Continua (Overview)

, Department of Neurology, University of California, Los Angeles, David Geffen School of Medicine Claude G Wasterlain, MD, MSc is a member of the following medical societies: , , , , , Disclosure: Nothing to disclose. Coauthor(s) Michael M Gezalian, MD Resident Physician, Department of Neurology, Loma Linda University Medical Center Michael M Gezalian, MD is a member of the following medical societies: Disclosure: Nothing to disclose. Leo L Chen, MD Consulting Staff, Department of Neurology, Kaiser (...) of Neurology, Boston Children's Hospital; Medical Director, Wrentham Developmental Center Norberto Alvarez, MD is a member of the following medical societies: , , Disclosure: Nothing to disclose. Chief Editor Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida Morsani College of Medicine Selim R Benbadis, MD is a member of the following medical societies: , , , , Disclosure: Serve(d

2014 eMedicine.com

8783. Therapeutic Injections for Pain Management (Overview)

with surgery or ablative procedures. Prophylactic blocks are used to delay and reduce postoperative pain, to prevent complications caused by posttraumatic or visceral pain, to decrease the duration of hospitalization and convalescence, and to prevent development of certain chronic pain syndromes such as autonomic dystrophy and phantom limb pain. For patient education resources, see the patient education articles , , and . Next: Guidelines for Therapeutic Application Numerous technical and medical factors (...) necessity for therapeutic injection also should be well documented. Appropriate subspecialty consultation may be necessary in some cases to support the preoperative diagnosis and the medical necessity for application of specific procedures. Furthermore, the use of adjunctive guidance such as electromyography (EMG), ultrasound, and radiologic studies is recommended in some cases. Injections are rarely the only suggested treatment; therefore, expectations regarding the extent to which the procedure may

2014 eMedicine.com

8784. Tattoo Lasers (Overview)

, and blurred with time, presumably as a consequence of ink particles moving deeper into the dermis through the action of mobile phagocytic cells. Random biopsy samples of older tattoos demonstrate pigment in the deep dermis, in contrast to the more superficial location of newer tattoos. Eventually, tattoo ink appears in the regional lymph nodes of patients with tattoos. Tattoo ink is remarkably nonreactive histologically, despite the frequent use of different pigments of unknown purity and identity (...) abraded surface. Exposed pigment is curetted or removed with fine tweezers. Other mechanical treatments include linear incisions, scratches, punctures, and a grid of crisscross abrasions followed by the application of a caustic chemical. Surgical excision of skin containing tattoo pigment is also common but often results in incomplete tattoo removal, tissue distortion, and scarring because of limitations in wound closure and healing. Small tattoos located in areas of adequate skin laxity that allow

2014 eMedicine.com

8785. Systemic Lupus Erythematosus (Overview)

, premenopausal SLE patients have also been found to have less upper and lower body dynamic muscle strength, which is further associated with low functional performance, decreased quality of life, and fatigue. [ ] Physical medicine and rehabilitation for SLE may involve physical therapy, occupational therapy, speech therapy, recreational therapy, or combinations thereof. Follow-up medical care of patients with SLE must be ongoing. One physician should coordinate the patient’s care. The physician (...) Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine in New Orleans Stephen Kishner, MD, MHA is a member of the following medical societies: , Disclosure: Nothing to disclose. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment

2014 eMedicine.com

8786. Contraception (Overview)

the cervical os by attacking the sperm's flagella and body, reducing their mobility, and disrupting their fructolytic activity, thereby inhibiting their nourishment. Efficacy The perfect-use failure rate within the first year is 6%. The typical-use failure rate within the first year is 26%. Advantages The lubrication provided by spermicides may heighten satisfaction in both partners. Another advantage is the ease of application. Either partner can purchase and apply spermicide because it is easily (...) into the cervix. Cervical cap - Acts as a mechanical barrier to sperm migration into the cervical canal. Spermicidal agent - Prevents sperm from entering the cervical os by attacking the sperm's flagella and body, reducing their mobility, and disrupting their fructolytic activity, thereby inhibiting their nourishment. Hormonal contraceptives Hormonal means of contraception include the following: Implants - The mechanism of action is a combination of suppression of the luteinizing hormone (LH) surge

2014 eMedicine.com

8787. Congenital Patterned Leukodermas (Overview)

, University of Cincinnati College of Medicine Raymond E Boissy, PhD is a member of the following medical societies: Disclosure: Nothing to disclose. Coauthor(s) Steven Hoath, MD Director of Skin Sciences Institute, Professor of Pediatrics, Department of Pediatrics, University of Cincinnati College of Medicine Disclosure: Nothing to disclose. Specialty Editor Board Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology Michael J Wells, MD, FAAD is a member (...) of the following medical societies: , , , Disclosure: Nothing to disclose. Van Perry, MD Assistant Professor, Department of Medicine, Division of Dermatology, University of Texas School of Medicine at San Antonio Van Perry, MD is a member of the following medical societies: Disclosure: Nothing to disclose. Chief Editor William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine William D James, MD

2014 eMedicine.com

8788. Shoulder and Hemiplegia (Overview)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzI4NzkzLW92ZXJ2aWV3 processing > Shoulder Pain in Hemiplegia Updated: Feb 08, 2019 Author: Robert Gould, DO; Chief Editor: Stephen Kishner, MD, MHA Share Email Print Feedback Close Sections Sections Shoulder Pain in Hemiplegia Hemiplegic Shoulder Pain Good shoulder function is a prerequisite for effective hand function, as well as for performing multiple tasks involving mobility, ambulation, and activities of daily living (ADL). A common sequela of stroke is hemiplegic shoulder pain, which can hamper functional (...) of the shoulder and upper extremity (UE) reported by patients with hemiplegia include the following: Reduced mobility of the shoulder Tenderness Swelling/edema Pain with movement Decreased coordination Physical examination The physical examination of a patient with shoulder dysfunction associated with hemiplegia is extensive, because the physician is required to assess the involved musculoskeletal and neurologic conditions. It should include observation, palpation, and neurologic examination. Observation may

2014 eMedicine.com

8789. Bone Marrow Failure (Overview)

and Disclosures Author Srikanth Nagalla, MBBS, MS, FACP Associate Professor of Medicine, Division of Hematology and Oncology, UT Southwestern Medical Center Srikanth Nagalla, MBBS, MS, FACP is a member of the following medical societies: , Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Alexion; Alnylam. Coauthor(s) Emmanuel C Besa, MD Professor Emeritus, Department of Medicine, Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation (...) , Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University Emmanuel C Besa, MD is a member of the following medical societies: , , , , , Disclosure: Nothing to disclose. Chief Editor Koyamangalath Krishnan, MD, FRCP, FACP Dishner Endowed Chair of Excellence in Medicine, Professor of Medicine, James H Quillen College of Medicine at East Tennessee State University Koyamangalath Krishnan, MD, FRCP, FACP is a member of the following medical societies: , , , Disclosure: Nothing

2014 eMedicine.com

8790. Cancer and Rehabilitation (Overview)

resources. [ , , ] See the images below. Breast cancer. Transverse rectus abdominis muscle (TRAM) flap. Breast cancer. Transverse rectus abdominis muscle (TRAM) flap. Surgical rehabilitation in head and neck cancer. Preface Physical medicine and rehabilitation (PM&R) is the medical specialty principally concerned with impairments, disabilities, and handicaps that arise after acute or chronic illness. According to the 1980 classification of the World Health Organization (WHO), impairment is physiologic (...) (ROM). Treatment interventions the physical therapist provides may include therapeutic exercises to maintain or increase ROM, endurance activities, and mobility training (eg, transfers, gait, stair climbing). Physical therapists can also administer various therapeutic modalities depending on the needs of the individual patient. Examples of modalities that may be beneficial include the application of heat and/or cold, electrical stimulation, hydrotherapy, traction, and massage. Occupational

2014 eMedicine.com

8791. Burn Rehabilitation (Overview)

Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics Jorge I de la Torre, MD, FACS is a member of the following medical societies: , , , , , , , , , and Disclosure: Nothing to disclose. Dennis P Orgill, MD, PhD Professor of Surgery, Harvard Medical School; Associate Chief of Plastic Surgery, Brigham and Women's Hospital Dennis P Orgill, MD, PhD is a member of the following (...) medical societies: , , , and Disclosure: Kinetic Concepts, Inc. Grant/research funds Principle Investigator; Brigham and Women's Hospital Royalty None; Kinetic Concepts, Inc. Expert Witness None Richard Salcido, MD Chairman, Erdman Professor of Rehabilitation, Department of Physical Medicine and Rehabilitation, University of Pennsylvania School of Medicine Richard Salcido, MD is a member of the following medical societies: , , , , and Disclosure: Nothing to disclose. Curtis W Slipman, MD Director

2014 eMedicine.com

8792. Brachial Plexus Injury (Treatment)

=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTE5ODgtdHJlYXRtZW50 processing > Brachial Plexus Injury in Sports Medicine Treatment & Management Updated: Jun 19, 2017 Author: Thomas H Trojian, MD; Chief Editor: Sherwin SW Ho, MD Share Email Print Feedback Close Sections Sections Brachial Plexus Injury in Sports Medicine Treatment Acute Phase Rehabilitation Program Physical Therapy At onset of injury, nonsteroidal anti-inflammatory drugs (NSAIDs), early mobilization, and moist heat packs are the favorable methods of treatment for acute injuries (...) Jun. 3(3):125-7. Media Gallery of 0 Tables Contributor Information and Disclosures Author Thomas H Trojian, MD Professor of Family Medicine, Sports Medicine Fellowship Director, Department of Family Medicine, Associate Chief, Division of Sports Medicine, Drexel University College of Medicine; Lead Team Physician, Drexel Athletics Thomas H Trojian, MD is a member of the following medical societies: , , , Disclosure: Nothing to disclose. Coauthor(s) Melissa Mascaro, MD Fellow in Sports Medicine

2014 eMedicine.com

8793. Bowen Disease (Treatment)

Physician in Anatomic Pathology, National Institutes of Health Disclosure: Nothing to disclose. Coauthor(s) Mark P Eid, MD Founder and Director, Virginia Dermatology and Skin Surgery Center Mark P Eid, MD is a member of the following medical societies: , , , Disclosure: Nothing to disclose. Specialty Editor Board David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department (...) of Dermatology, Scott and White Clinic David F Butler, MD is a member of the following medical societies: , , , , Disclosure: Nothing to disclose. Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine Edward F Chan, MD is a member of the following medical societies: , , Disclosure: Nothing to disclose. Chief Editor Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South

2014 eMedicine.com

8794. Classification and Complications of Traumatic Brain Injury (Treatment)

). [ ] Bogner and colleagues found the ABS a reliable instrument for measuring agitation in patients following TBI. [ ] Agitated Behavior Scale, developed by John D Corrigan, PhD, ABPP, Professor, Department of Physical Medicine and Rehabilitation, The Ohio State University. Permission for publication granted by Dr. Corrigan. Before posttraumatic agitation is treated, other medical conditions should be considered. After TBI, the patient may be uncomfortable, and impaired recognition and an inability (...) abuse, dysregulation of emotional expression, and aggressive outbursts Outcome measures The following tools are commonly used to measure outcome after TBI [ , ] : Functional Independence Measure (FIM): An 18-item scale used to assess the patient's level of independence in mobility, self-care, and cognition Glasgow Outcome Scale (GOS) Disability Rating Scale (DRS): Measures general functional changes over the course of recovery after TBI (see the image below) Disability Rating Scale (DRS). Next

2014 eMedicine.com

8795. Chronic Pain Syndrome (Treatment)

was obtained. Active endometriosis with red and powder-burn lesions; adhesions from old scarring are present. of 12 Tables Contributor Information and Disclosures Author Manish K Singh, MD Assistant Professor, Department of Neurology, Teaching Faculty for Pain Management and Neurology Residency Program, Hahnemann University Hospital, Drexel College of Medicine; Medical Director, Neurology and Pain Management, Jersey Institute of Neuroscience Manish K Singh, MD is a member of the following medical societies (...) : , , , , , Disclosure: Nothing to disclose. Coauthor(s) Jashvant Patel, MBBS, MS, MD Jashvant Patel, MBBS, MS, MD is a member of the following medical societies: , , , , , Disclosure: Nothing to disclose. Rollin McCulloch Gallagher, MD, MPH Clinical Professor, Departments of Psychiatry and Anesthesiology, Director for Health Policy and Primary Care, Penn Pain Medicine, University of Pennsylvania School of Medicine; National Program Director for Pain Management, Veterans Health Administration; Editor-in-Chief, PAIN

2014 eMedicine.com

8796. Ambulatory EEG (Treatment)

Contributor Information and Disclosures Author Elizabeth J Waterhouse, MD, FAAN Professor, Department of Neurology, Virginia Commonwealth University School of Medicine; Attending Physician, Neurology Service, McGuire Veterans Affairs Medical Center, Richmond Elizabeth J Waterhouse, MD, FAAN is a member of the following medical societies: , , , Disclosure: Nothing to disclose. Specialty Editor Board Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College (...) of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape. Jose E Cavazos, MD, PhD, FAAN, FANA, FACNS, FAES Professor with Tenure, Departments of Neurology, Neuroscience, and Physiology, Assistant Dean for the MD/PhD Program, Program Director of the Clinical Neurophysiology Fellowship, University of Texas School of Medicine at San Antonio Jose E Cavazos, MD, PhD, FAAN, FANA, FACNS, FAES is a member of the following medical societies

2014 eMedicine.com

8797. Alzheimer Disease in Individuals With Down Syndrome (Treatment)

. In this study, 66% of the persons with AD and no DS were taking rivastigmine or donepezil, and only 26% of persons with AD and DS were on those medications. The differences observed might have been related more to the use of the medications than to the disease itself. [ ] Because no treatment is available for the primary disease, prognosis is poor. AD is responsible for the sharp decline in survival in persons with DS older than 45 years. Only about 25% of persons with DS live more than 60 years, and most (...) . Usually, generalized tonic-clonic seizures are infrequent; if present, they can typically be controlled with antiepileptic medication. Myoclonic seizures occur more frequently than tonic-clonic seizures. The myoclonus may be stimulus-sensitive and can be induced by light or a simple touch. In the advanced stages, myoclonic seizures may be constantly present. This has been described as late-onset myoclonic epilepsy in DS [ ] or senile myoclonic epilepsy. [ ] Personal experience The following

2014 eMedicine.com

8798. Adult Physiatric History and Examination (Treatment)

the introduction of technologic advances in the medical application of heat, massage, electrical stimulation, and radiography, as well as from the flood of debilitating injuries caused by 2 world wars, and from polio epidemics that affected even a US president. The American Board of Medical Specialties designated physiatry as a specialty in 1947. Recognizing the work of such pioneers as John Stanley Coulter, Frank Krusen, known as the "father of Physical Medicine," and Howard Rusk, the "father (...) ) and "iatreia" (art of healing). Physical medicine is defined as the application of physical agents (eg. water, heat, cold, light, electricity) and techniques (eg. massage, stretching/traction, exercise) for the purpose of healing. Rehabilitation is defined as the restoration of the patient to a condition of health or useful and constructive activity. [ ] Through the first half of the last century, these 2 fields were not associated with each other. The confluence of these fields resulted from

2014 eMedicine.com

8799. Adhesive Capsulitis (Treatment)

Adhesive Capsulitis (Treatment) Adhesive Capsulitis in Physical Medicine and Rehabilitation Treatment & Management: Rehabilitation Program, Medical Issues/Complications, Surgical Intervention Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) , MD Director of Coccyx Pain Center, Professor of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School; Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, University Hospital Patrick M Foye, MD is a member of the following medical societies: Disclosure: Nothing to disclose. Chief Editor Stephen Kishner, MD, MHA Professor of Clinical Medicine, Physical Medicine and Rehabilitation Residency Program Director, Louisiana State University School of Medicine

2014 eMedicine.com

8800. Amyotrophic Lateral Sclerosis (Treatment)

the patient’s preferences in the medical records, whether or not formal advance directives have been written. Resource access For patients with limited access to home-based resources, social service professionals may be able to assist with placement. Local branches of advocacy organizations (the and the ) may be excellent sources of information on what resources are available locally. Legal affairs Patients will have decreasing ability to sign documents or to mobilize themselves for taking care of personal (...) , physiatrist, or palliative care physician with special interest in the disease. Multidisciplinary clinics can provide "one-stop shopping", allowing patients to receive all assessments and recommendations in the course of a single visit; most of these clinics provide a combination of on-site and off-site services. In the United States, Muscular Dystrophy Association/ALS centers and ALS Association certified centers have been established at several major medical centers, and in the United Kingdom, the Motor

2014 eMedicine.com

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