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CP is an extremely vascular tumor that mostly obtains its blood supply from the coronary circulation (right coronary artery &gt; left circumflex artery &gt; left coronary artery &gt; left anterior descending artery).Penile injection and aspiration is a bedside procedure used to treat priapism. Priapism is defined as an erection of extended duration (greater than 4 hours) without sexual activity. There are three types of priapism, ischemic, which involves low flow of blood into the penis, non-ischemic, or high flow priapism, which is caused by increased blood flow into the penis, and stuttering, which is recurrent episodes of ischemic priapism and can be treated as such. Ischemic priapism is an emergency, while non-ischemic is not, due to continued arterial blood flow. Causes of ischemic priapism include medications, recreational drug use, blood dyscrasia, malignancy, fat embolism due, intravenous contrast, neurogenic, hormonal, metabolic disease, and toxin-mediated. Due to the emergent nature of ischemic priapism, prompt diagnosis and reversal are required. The cause of non-ischemic priapism includes trauma, causing unrestricted arterial flow within the corpora. Because of the continued blood flow to the penis, prompt reversal is not necessary.Simulation has become a mainstay in the education of not only healthcare professionals but many different professions the world over. As our global medical knowledge continues to expand, and our societal, technological advancements continue to broaden, the idea of learning on a live patient is becoming a less preferred method of teaching medical professionals. Patient safety is a commonly cited reason simulation is a preferred teaching modality. Moreover, research has demonstrated that appropriately constructed simulation learning objectives and scenarios are as effective, and in many cases, more effective than traditional teaching methods used in the education of healthcare providers. As a professional medical specialty, Emergency Medicine is uniquely suited to learning through simulation as Emergency Medicine encompasses the entire breadth of medical specialties and the whole spectrum of patient populations and disease pathology. Also, Emergency Medicine is a quite procedurally oriented specialty, which agaproficiency without having to evaluate patients with specific, often rare pathology or scenarios that are infrequently encountered. Additionally, simulation is an adequate avenue for the maintenance of procedural, clinical, and non-clinical skills and can be used throughout one's professional career. This article is intended to be a basic overview and should serve as a starting point for the introduction to the field of simulation education.Recreational scuba diving is becoming an increasingly popular sport throughout the world, with approximately 1.2 million divers worldwide. Originally, divers concentrated most of their dives in warmer coastal regions. However, recently they have been extending their dives in other bodies of water, including local lakes, quarries, etc. This means that diving-related disorders can present to any hospital, whether inland or coastal, and all clinicians should be aware of signs and symptoms of decompression sickness. The inner ear consists of the vestibulocochlear organ, which is involved in hearing and one's sense of position and balance. This organ is surrounded by a bony exterior and contains a fluid called endolymph, which is responsible for the conduction of sound and changes in position. The cochlea is the portion responsible for the conversion of mechanical sound waves into action potentials in neurons, while the vestibular system modulates the sense of position and balance. Inner ear decompression sickness (IEDCS) is an incompletely understood condition observed in compressed-gas divers likely resulting from precipitation of gas bubbles in the endolymphatic and perilymphatic spaces during a quick ascent. Another suggested mechanism of IEDCS is that patients may also have a right-to-left shunt, suggesting arterial gas embolism (AGE) as a contributing factor if it enters the labyrinthine artery. The classic common presenting symptom of inner ear DCS is a sudden onset of vertigo. However, tinnitus and acute sensorineural hearing loss may also be present alone or in any combination.Digestion in the gastrointestinal tract is a highly complex process involving both mechanical forces and chemical reactions to disintegrate and metabolize food material. A low residue diet is a diet that restricts the ingestion of indigestible material. The term residue refers to the indigestible content of food material that remains in the gastrointestinal tract and ultimately contributes to fecal bulking. In theory, a low residue diet would result in a reduction of stool quantity and frequency. This diet includes eggs, refined grains, white rice, seafood, and poultry. Dairy intake is limited, and high fiber-containing food and whole grains are typically entirely avoided.Eastern equine encephalitis (EEE) is one of the most severe arboviral encephalitis affecting America. Currently considered an emerging disease showing consistently increase incidence across a wider population. In the United States, between six to eight cases are annually reported, predominantly between May through October, mostly in Florida, Georgia, Maryland, Wisconsin, and New Jersey. This virus has also been considered a potential bioterrorism weapon, given its airborne transmission. The case-fatality rate described is 30%, with neurologic sequelae seen in 50% of survivors.Genetic disorders traditionally fall into three main categories single-gene defects, chromosomal abnormalities, and multifactorial conditions. A chromosomal abnormality, or chromosomal aberration, is a disorder characterized by a morphological or numerical alteration in single or multiple chromosomes, affecting autosomes, sex chromosomes, or both. The normal human karyotype contains approximately two meters of DNA organized into 46 chromosomes 22 pairs of homologous autosomal chromosomes and a set of sex chromosomes that compromise two X chromosomes in females or an X and a Y chromosome in males. All the genetic necessary for growth and development derive from chromosomes (around 20 to 25 thousand genes). Chromosome abnormalities usually involve an error in cell division (mitosis or meiosis), which may occur in the prenatal, postnatal, or preimplantation periods. These alterations have significant clinical consequences, i.e., spontaneous abortions, stillbirths, neonatal death/hospitalization, malformations, intellectual disability, or an identifiable syndrome. Accurate identification of these chromosomal errors is essential for prevention strategies, genetic counseling, and appropriate treatment.Oxaliplatin is an FDA approved platinum-based antineoplastic medication. It is indicated in the adjunctive treatment of stage III colorectal cancer after resection of the primary tumor and for the treatment of metastatic colorectal cancer. It is FDA approved in combination with infusional 5-fluorouracil and leucovorin.Cardiac calcification is a broad term that refers to calcium deposits in the heart valves, coronary arteries, myocardium, and pericardium. There is a unique significance of these calcifications in each of these cardiac areas. While coronary artery calcifications can help risk-stratify intermediate-risk patients into low or high risk for atherosclerotic cardiovascular disease (ASCVD), calcifications of valves lead to narrowing of the valve causing stenosis and flow abnormalities and hence symptoms from valve narrowing. Pericardial calcifications may indicate constrictive pericarditis, while myocardial calcification can be a result of previous global myocardial injury (or infarction). When dense and heavy, calcifications can be detected by chest x-rays. However, a more dedicated study such as computed tomogram (CT) for myocardial and pericardial calcifications, cardiac computed tomogram angiogram (CCTA) for coronary artery calcifications (CAC), and echocardiogram for valvular calcifications are more specific studies.Healthcare system improvement depends on the ability of a system as a whole to accurately identify critical information on which to create policies and procedures and to translate these into improvement initiatives resulting in improved patient care and outcomes. Effective implementation requires the development of interventions that align with improvement goals. To champion these improvement efforts, collaborative teams must be created, incorporating strong physician and clinician leaders who are engaged in patient care. According to complexity leadership theory, when leaders move to the role of facilitating information of flow, they can create "the container for change" instead of trying to dictate the change." Simulation program directors are ideally suited to provide this "container for change" by designing the "diagnostic" and "therapeutic" opportunities demonstrative of translational simulation. According to the Society for simulation in healthcare, this functional approach to systems integration incorporates a multi-dimensional evaluation of quality outcomes such as "efficiency, effectiveness, safety, patient-centered in this, and equity." This process involves the utilization of simulation, instructional, and assessment strategies that are "consistent, planned, collaborative, integrated and interactive" while assuring that they incorporate "systems engineering and risk management principles". Success is noted through the achievement of the following goals optimal bedside clinical care, patient safety enhancement, and "improved metrics across the healthcare system."Suction drains are appliances used to collect blood, pus, or body fluids. They are active drains that maintain a negative pressure gradient. The collection reservoir of an active drain collects fluid by exchanging negative pressure, and the drain may become ineffective if the vacuum is lost. The type of drainage system is based on the needs of a patient, type of surgery, type of wound, expected amount of drainage, and surgeon preference.Systemic sclerosis is a rare, complex, and chronic multisystem disease. Scleroderma means hard and thick skin. It is derived from the ancient Greek words "skleros," which means (hard) and "derma," which means (skin). Skin involvement is one of the features of systemic sclerosis (SSc). The hallmark features of systemic sclerosis include immune dysregulation with inflammation, vascular injury with an anatomic and functional abnormality, and systemic interstitial fibrosis of organs and skin, leading to multisystem organ damage. Cardiac involvement is well recognized in systemic sclerosis, which can affect the pericardium, the myocardium, and the conduction system. Primary cardiac disease is reported in both diffuse and limited systemic sclerosis. However, it was found to be more prevalent and more severe in diffuse systemic sclerosis.Around 6,000 years ago, laboratory medicine began with the analysis of human urine as uroscopy, which later became termed urinalysis. The word "uroscopy" derives from two Greek words "ouron," which means urine and "skopeoa," which means to 'behold, contemplate, examine, inspect'. Ancient physicians spoke of urine as a window to the body's inner workings and reflected different diseases. [https://www.selleckchem.com/products/proteinase-k.html find more] For instance, Hindu civilizations recognized a "sweetness" in certain people's urine, which attracted black ants. Hippocrates (460–355 BC) hypothesized that urine was a filtrate of the humors in the body, originating from the blood filtered through the kidneys. In Aphorisms, he described bubbles on the surface of fresh urine as a sign of long-term kidney disease and associated urinary sediment with fever. Galen used the phrase "diarrhea of the urine" to describe excessive urination. Theophilus Protospatharius, a seventh-century physician who wrote the first manuscript focused exclusively on urine called "De Urinis", determined heating urine would precipitate proteins, documenting proteinuria as a disease state.