Reading the 12-lead ECG

Diseases and Disorders of the Nails

If you have multiple sclerosis (MS), you probably had several tests done before you received your diagnosis. There isn’t one test to diagnosis MS, so testing can vary. Doctors can use neurological exams, information about previous symptoms, blood tests, and spinal fluid tests. A magnetic resonance imaging (MRI) scan isn’t used to diagnose MS but rather to rule out other diseases. A diagnosis of MS requires more information than what a scan alone can give. By looking at more than one test or exam result, doctors can get a clearer picture of what’s going on in your body.

You may have a lot of questions about epilepsy. We will help you understand the basics, answer the most common questions, and help you find resources and other information you may need. However, information alone won’t help you manage your epilepsy and find a way to cope with the effects on your daily life. You’ll need to learn how to use the information and make it work for you.

How are seizures and epilepsy treated? What should I do if someone has a seizure? When seizure medications don't work, what else can be tried? These are just a few of the questions that you'll find answered here. Some treatment goals are common to everyone. Everyone should know what to do when a person is having a seizure. All people with seizures and their families should know that the real goal of treating epilepsy is to stop seizures or control them as best as possible. But you are more than just a seizure and how epilepsy affects you and your family may be different from someone else. Don't forget the most important goal of the Epilepsy Foundation - helping people with seizures and their families lead full and unrestricted lives according to their own wishes. Patient and doctor discussing treatment options"No seizures, no side effects" is the motto for epilepsy treatment. Not every person will reach that goal right now, but research and getting the "right care at the right time" can help more people achieve it each year. You may learn things here that can help you right away or later on. While seizure medicines are the mainstay of epilepsy treatment, there are other approaches to think about too. We hope these sections will help you learn about different treatments and get the help you need. Learn about the basics of Treatment 101 to help you get started. Look at Receiving Quality Care to see what to expect when you have just been diagnosed or after you have already started treatment. Then learn about specific treatments, what to do if seizures don't stop, and how to develop your health care team. You'll also find tools to help you manage your epilepsy or learn about research studies in other sections, so don't stop here!

Focal seizures (also called partial seizures [citation needed] and localized seizures) are seizures which affect initially only one hemisphere of the brain. [citation needed] The brain is divided into two hemispheres, each consisting of four lobes – the frontal, temporal, parietal and occipital lobes.

The accumulation of ascitic fluid represents a state of total-body sodium and water excess, but the event that initiates the unbalance is unclear. Although many pathogenic processes have been implicated in the development of abdominal ascites, about 75% likely occur as a result of portal hypertension in the setting of liver cirrhosis, with the remainder due to infective, inflammatory, and infiltrative conditions. Three theories of ascites formation have been proposed: underfilling, overflow, and peripheral arterial vasodilation. The underfilling theory suggests that the primary abnormality is inappropriate sequestration of fluid within the splanchnic vascular bed due to portal hypertension and a consequent decrease in effective circulating blood volume. This activates the plasma renin, aldosterone, and sympathetic nervous system, resulting in renal sodium and water retention. The overflow theory suggests that the primary abnormality is inappropriate renal retention of sodium and water in the absence of volume depletion. This theory was developed in accordance with the observation that patients with cirrhosis have intravascular hypervolemia rather than hypovolemia. The most recent theory, the peripheral arterial vasodilation hypothesis, includes components of both of the other theories. It suggests that portal hypertension leads to vasodilation, which causes decreased effective arterial blood volume. As the natural history of the disease progresses, neurohumoral excitation increases, more renal sodium is retained, and plasma volume expands. This leads to overflow of fluid into the peritoneal cavity. The vasodilation theory proposes that underfilling is operative early and overflow is operative late in the natural history of cirrhosis. Although the sequence of events that occurs between the development of portal hypertension and renal sodium retention is not entirely clear, portal hypertension apparently leads to an increase in nitric oxide levels. Nitric oxide mediates splanchnic and peripheral vasodilation. Hepatic artery nitric oxide synthase activity is greater in patients with ascites than in those without ascites. Regardless of the initiating event, a number of factors contribute to the accumulation of fluid in the abdominal cavity. Elevated levels of epinephrine and norepinephrine are well-documented factors. Hypoalbuminemia and reduced plasma oncotic pressure favor the extravasation of fluid from the plasma to the peritoneal fluid, and, thus, ascites is infrequent in patients with cirrhosis unless both portal hypertension and hypoalbuminemia are present.

Transjugular intrahepatic portosystemic shunt or transjugular intrahepatic portosystemic stent shunting (commonly abbreviated as TIPS or TIPSS) is an artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein.

Portal hypertension is an increase in the blood pressure within a system of veins called the portal venous system. Veins coming from the stomach, intestine, spleen, and pancreas merge into the portal vein, which then branches into smaller vessels and travels through the liver.

MRI Exam Procedure

Magnetic resonance imaging (MRI) can be an important tool in the diagnosis of multiple sclerosis (MS). MRI can also be used to monitor the progression of the disease in people living with MS. How does it work? MRI uses very strong magnets, radio signals, and computer software to take 3-dimensional pictures of the inside of the body. Will I need contrast material? Maybe. Contrast material is a substance that temporarily changes the way imaging tools interact with the body. They are often used to visualize certain types of MS disease activity on the MRI. If your doctor thinks your scan requires this contrast material, you may get an injection before you get in the MRI machine. How long will it take? The time may vary based on the type of MRI. Be sure to discuss with your doctor in advance so he or she can provide you with exact timing. But don’t worry, you won’t have to stay still the whole time. The technician will let you know when they’re starting a new image.

An MRCP scan is a scan that uses magnetic resonance imaging (MRI) to produce pictures of the liver, bile ducts, gallbladder and pancreas. Note: the information below is a general guide only. The arrangements,and the way tests are performed, may vary between different hospitals.

Gallstones are hardened deposits of digestive fluid that can form in your gallbladder. Your gallbladder is a small, pear-shaped organ on the right side of your abdomen, just beneath your liver. The gallbladder holds a digestive fluid called bile that's released into your small intestine. Gallstones range in size from as small as a grain of sand to as large as a golf ball. Some people develop just one gallstone, while others develop many gallstones at the same time. Gallstones are common in the United States. People who experience symptoms from their gallstones usually require gallbladder removal surgery. Gallstones that don't cause any signs and symptoms typically don't need treatment.

Endoscopic retrograde cholangiopancreatography, or ERCP, is a specialized technique used to study the bile ducts, pancreatic duct and gallbladder. Ducts are drainage routes; the drainage channels from the liver are called bile or biliary ducts. The pancreatic duct is the drainage channel from the pancreas.

Stone Control Catheter

Treatment for kidney stones varies, depending on the type of stone and the cause. Small stones with minimal symptoms Most kidney stones won't require invasive treatment. You may be able to pass a small stone by: Drinking water. Drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day may help flush out your urinary system. Unless your doctor tells you otherwise, drink enough fluid — mostly water — to produce clear or nearly clear urine. Pain relievers. Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) or naproxen sodium (Aleve). Medical therapy. Your doctor may give you a medication to help pass your kidney stone. This type of medication, known as an alpha blocker, relaxes the muscles in your ureter, helping you pass the kidney stone more quickly and with less pain. Large stones and those that cause symptoms Kidney stones that can't be treated with conservative measures — either because they're too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections — may require more extensive treatment. Procedures may include: Using sound waves to break up stones. For certain kidney stones — depending on size and location — your doctor may recommend a procedure called extracorporeal shock wave lithotripsy (ESWL). ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable. ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract. Surgery to remove very large stones in the kidney. A procedure called percutaneous nephrolithotomy (nef-row-lih-THOT-uh-me) involves surgically removing a kidney stone using small telescopes and instruments inserted through a small incision in your back. You will receive general anesthesia during the surgery and be in the hospital for one to two days while you recover. Your doctor may recommend this surgery if ESWL was unsuccessful. Using a scope to remove stones. To remove a smaller stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter. Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing. You may need general or local anesthesia during this procedure. Parathyroid gland surgery. Some calcium phosphate stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam's apple. When these glands produce too much parathyroid hormone (hyperparathyroidism), your calcium levels can become too high and kidney stones may form as a result. Hyperparathyroidism sometimes occurs when a small, benign tumor forms in one of your parathyroid glands or you develop another condition that leads these glands to produce more parathyroid hormone. Removing the growth from the gland stops the formation of kidney stones. Or your doctor may recommend treatment of the condition that's causing your parathyroid gland to overproduce the hormone.

Extracorporeal shock wave lithotripsy (ESWL) uses shock waves to break a kidney stone into small pieces that can more easily travel through the urinary tract camera.gif and pass from the body. See a picture of ESWL camera.gif. You lie on a water-filled cushion, and the surgeon uses X-rays or ultrasound tests to precisely locate the stone. High-energy sound waves pass through your body without injuring it and break the stone into small pieces. These small pieces move through the urinary tract and out of the body more easily than a large stone. The process takes about an hour. You may receive sedatives or local anesthesia. Your surgeon may use a stent if you have a large stone. A stent is a small, short tube of flexible plastic mesh that holds the ureter open. This helps the small stone pieces to pass without blocking the ureter.

Three cholinesterase inhibitors are commonly prescribed: Donepezil (Aricept) is approved to treat all stages of Alzheimer's. Rivastigmine (Exelon) is approved to treat mild to moderate Alzheimer's. Galantamine (Razadyne) is approved to treat mild to moderate Alzheimer's. Currently, there is no cure for Alzheimer's. But drug and non-drug treatments may help with both cognitive and behavioral symptoms. Researchers are looking for new treatments to alter the course of the disease and improve the quality of life for people with dementia. ... Medications for Memory Loss.

Alzheimer's worsens over time. Alzheimer's is a progressive disease, where dementia symptoms gradually worsen over a number of years. In its early stages, memory loss is mild, but with late-stage Alzheimer's, individuals lose the ability to carry on a conversation and respond to their environment. Alzheimer's is the sixth leading cause of death in the United States. Those with Alzheimer's live an average of eight years after their symptoms become noticeable to others, but survival can range from four to 20 years, depending on age and other health conditions. Alzheimer's has no current cure, but treatments for symptoms are available and research continues. Although current Alzheimer's treatments cannot stop Alzheimer's from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer's and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing. Alzheimer's has no current cure, but treatments for symptoms are available and research continues. Although current Alzheimer's treatments cannot stop Alzheimer's from progressing, they can temporarily slow the worsening of dementia symptoms and improve quality of life for those with Alzheimer's and their caregivers. Today, there is a worldwide effort under way to find better ways to treat the disease, delay its onset, and prevent it from developing.

Alzheimer's is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 60 to 80 percent of dementia cases. Alzheimer's is not a normal part of aging, although the greatest known risk factor is increasing age, and the majority of people with Alzheimer's are 65 and older. But Alzheimer's is not just a disease of old age. Up to 5 percent of people with the disease have early onset Alzheimer's (also known as younger-onset), which often appears when someone is in their 40s or 50s.