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.

A heart attack is a medical emergency. A heart attack usually occurs when a blood clot blocks blood flow to the heart. Without blood, tissue loses oxygen and dies. Symptoms include tightness or pain in the chest, neck, back, or arms, as well as fatigue, lightheadedness, abnormal heartbeat, and anxiety. Women are more likely to have atypical symptoms than men. Treatment ranges from lifestyle changes and cardiac rehabilitation to medications, stents, and bypass surgery.

Heart Anatomy - Right Ventricle c

Jennifer Lawton, M.D., is professor and chief of the Johns Hopkins Division of Cardiac Surgery, as well as director of the Cardiac Surgery Research Laboratory and program director of the cardiothoracic fellowship training program at Johns Hopkins. Her areas of expertise include valve surgery, including minimally invasive surgery, coronary artery bypass grafting on- and off-pump, all arterial revascularization, as well as surgery for aortic dissection and ascending aneurysm. For more information about Dr. Lawton visit http://www.hopkinsmedicine.org..../heart_vascular_inst

Major signs and symptoms include enlargement of the liver and spleen (hepatosplenomegaly), a low number of red blood cells (anemia), easy bruising caused by a decrease in blood platelets (thrombocytopenia), lung disease, and bone abnormalities such as bone pain, fractures, and arthritis.

Multiple endocrine neoplasia type 2 (MEN2) (also known as "Pheochromocytoma and amyloid producing medullary thyroid carcinoma", "PTC syndrome," and "Sipple syndrome") is a group of medical disorders associated with tumors of the endocrine system. The tumors may be benign or malignant (cancer).

Both selegiline and rasagiline can improve the symptoms of Parkinson's disease, although their effects are small compared with levodopa. They can be used alongside levodopa or dopamine agonists. MAO-B inhibitors are generally very well tolerated, but can occasionally cause side effects, including: nausea.

In developing countries, domestic animals (eg, dogs) are common sources of infection. In the United States, bats and wild animals (eg, raccoons) are the most common reservoirs of infection. The acquisition of rabies from bats can occur from an unrecognized bite or a scratch, and possibly by inhalation of aerosolized viral particles. Bats are found in all states except Hawaii, and spelunking (cave exploration) is a risk factor for rabies acquisition from bats.

Atrial fibrillation vs Atrial Flutter

Hepatitis A signs and symptoms, which typically don't appear until you've had the virus for a few weeks, may include: Fatigue Nausea and vomiting Abdominal pain or discomfort, especially in the area of your liver on your right side beneath your lower ribs Clay-colored bowel movements Loss of appetite Low-grade fever Dark urine Joint pain Yellowing of the skin and eyes (jaundice) If you have hepatitis A, you may have a mild illness that lasts a few weeks or a severe illness that lasts several months. Not everyone with hepatitis A develops signs or symptoms.

Capnography, the graphic display of the exhaled and inhaled carbon dioxide concentration plotted against time, is used to monitor ventilation. This video reviews the principles of capnography and explains how to interpret the information it provides.

The eustachian tube drains fluid from your ears to the back of your throat. If it clogs, otitis media with effusion (OME) can occur. If you have OME, the middle part of your ear fills with fluid, which can increase the risk of ear infection. OME is very common. According to the Agency of Healthcare Research and Quality, about 90 percent of children will have OME at least once by the age of 10.

Adenomyosis is a condition in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium). Adenomyosis can cause menstrual cramps, lower abdominal pressure, and bloating before menstrual periods and can result in heavy periods.

Formerly called toxemia, preeclampsia is a condition that pregnant women develop. It is marked by high blood pressure in women who have previously not experienced high blood pressure before. Preeclamptic women will have a high level of protein in their urine and often also have swelling in the feet, legs, and hands.

The Estech COBRA Fusion™ 150 Surgical Ablation System combines intuitive, real-time TCRF (Temperature Controlled Radiofrequency) energy control with proprietary Versapolar technology. Versapolar™ energy delivery is the first of its kind—an adaptable and effective platform that can deliver both bipolar and monopolar energy so that surgeons can easily and efficiently create reproducible transmural lesions with more flexibility, confidence and control.

An animated description of the use of a cannulated Herbert screw for surgical treatment of scaphoid fractures.

The human body as seen with MRI and X-RAY

High-Cervical Nerves (C1 – C4) Most severe of the spinal cord injury levels Paralysis in arms, hands, trunk and legs Patient may not be able to breathe on his or her own, cough, or control bowel or bladder movements. Ability to speak is sometimes impaired or reduced. When all four limbs are affected, this is called tetraplegia or quadriplegia. Requires complete assistance with activities of daily living, such as eating, dressing, bathing, and getting in or out of bed May be able to use powered wheelchairs with special controls to move around on their own Will not be able to drive a car on their own Requires 24-hour-a-day personal care

Liddle syndrome is an inherited form of high blood pressure (hypertension). This condition is characterized by severe hypertension that begins unusually early in life, often in childhood, although some affected individuals are not diagnosed until adulthood. Some people with Liddle syndrome have no additional signs or symptoms, especially in childhood. Over time, however, untreated hypertension can lead to heart disease or stroke, which may be fatal.