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.

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How To Cleanse Colon

Sinusitis and Sinus Surgery Explained (Balloon Sinuplasty and Endoscopic Sinus Surgery)

Procedures Requiring General Anaesthesia

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External breathing lung transplant

Dr. Chadrick Denlinger, MUSC transplant surgeon, describes what must take place when a patient receives a lung transplant.

Echo Therapeutics Symphony tCGM Continuous Glucose Monitor

The hips are one of the hardest places to loose fat. Liposuction can be done on this area to dramatically help loose inches. This area is also one of the most successful areas to show visible improvement after liposuction is done. Liposuction of the hips can help patients to reduce dress and pant sizes. Disclaimer. The photographs on these pages illustrate typical results of some liposuction surgery procedures and may contain some nudity. Viewer discretion is advised. In providing the photos and statements on this web site, Liposuction.com does not state or imply any guarantee.

Congestive Heart Failure

Dopamine is the one neurotransmitter that everyone seems to know about. Vaughn Bell once called it the Kim Kardashian of molecules, but I don’t think that’s fair to dopamine. Suffice it to say, dopamine’s big. And every week or so, you’ll see a new article come out all about dopamine.

Epstein-Barr is the virus that causes mononucleosis. You might know this disease better by its nickname, "mono." It's also called the "kissing disease" because of one way you can spread it to someone else. Even though Epstein-Barr virus (EBV) isn't a household name, you've probably been infected without knowing it. Lots of people carry the virus but don't get sick

This device could save thousands of lives from heart failure.

Wow! amazing tool. The disturbingly fascincating fix of ingrown toenail

Have you ever seen Alzheimer's Brain Vs. Normal Brain?

Scoliosis (pronounced sko-lee-o-sis) is a three-dimensional deformity that occurs when the spine becomes abnormally rotated and curved sideways. Most often this deformity has no known cause, in which case it is called idiopathic scoliosis. While the cause is unknown, idiopathic scoliosis does tend to run in families. The specific genes involved have not all been identified yet, and there could be factors beyond genetics as well

The inflatable penile prosthesis consists of two attached cylinders -- a reservoir and a pump -- which are placed surgically in the body. The two cylinders are inserted in the penis and connected by tubing to a separate reservoir of saline. The reservoir is implanted under the rectus muscles in the lower abdomen. A pump is also connected to the system and sits under the loose skin of the scrotal sac, between the testicles. This penile prosthesis is referred to as a 3-piece inflatable penile prosthesis, due to the three different components. A 2-piece inflatable penile prosthesis consists of only two components: the attached cylinders and the combined reservoir and pump unit. Instead of the reservoir being placed behind the groin, it is combined with the pump into one housing unit that fits comfortably within the scrotum. The advantage of a 2-piece prosthesis in that the surgery is shorter and less complicated and there is no device parts in the abdomen. The disadvantage of the 2-piece prosthesis is that the smaller reservoir may not result in adequate erections in some men. To inflate the prosthesis, the man presses on the pump. The pump transfers saline from the reservoir to the cylinders in the penis, inflating them and causing an erection. Pressing on a deflation valve at the base of the pump returns the fluid to the reservoir, deflating the penis and returning it to the normal flaccid state.

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Watch that video of Horrible Skin Jiggers Removal