University of Maryland Medical Center. Description. An in- depth report on the causes, diagnosis, treatment, and prevention of cirrhosis. Causes include: Alcoholism. Chronic hepatitis B and CAutoimmune hepatitis. Bile duct disorders such as primary biliary cirrhosis and primary sclerosing cholangitis. Nonalcoholic fatty liver disease (NAFLD), which includes nonalcoholic steatohepatitis (NASH)Metabolic disorders such as hemachromatosis, Wilson’s disease, and alpha- 1 antitrypsin deficiency. Prolonged exposure to certain chemicals and medications. Complications. Cirrhosis can cause many serious complications including: Ascites (fluid buildup in the abdomen)Variceal hemorrhage, severe bleeding from varices (enlarged veins in the esophagus and upper stomach)Spontaneous bacterial peritonitis, a severe infection of the membrane lining of the abdomen. Hepatic encephalopathy, impaired mental function caused by buildup in the body of toxins such as ammonia. Hepatocellular carcinoma, a type of liver cancer. Hepatorenal syndrome, when kidney failure occurs along with severe cirrhosis. Dietary and Lifestyle Changes. All patients with cirrhosis can benefit from certain lifestyle interventions. These include: Stop drinking alcohol. Restrict dietary salt. Follow a good diet plan, which may include protein restriction. Get vaccinations for influenza, hepatitis A and B, and pneumococcal pneumonia (if recommended by your doctor). Inform your doctor of all prescription and nonprescription medications, and any herbs and supplements, you take or are considering taking. Treatment. Cirrhosis is an irreversible condition. Treatment focuses on slowing the progression of liver damage and reducing the risk of further complications. Your doctor will treat any underlying medical conditions that are the cause of your cirrhosis. If liver damage progresses to liver failure, patients may be candidates for liver transplantation. Liver donations can come from either a cadaver or from a living donor. Patients with cirrhosis who have a liver transplant have very good chances for survival. Allegro Medical is the largest and most trusted online supplier of home health care supplies and home medical equipment. In the first part of a special BMJ series, Brian Deer exposes the bogus data behind claims that launched a worldwide scare over the measles, mumps, and rubella. Introduction. Cirrhosis is an irreversible result of various disorders that damage liver cells over time. Eventually, damage becomes so extensive that the normal structure of the liver is distorted and its function is impaired. Cirrhosis is a chronic liver disease that is the result of damage to liver tissue with scarring of the liver (fibrosis - nodular regeneration) causing progressive decrease in liver function, excessive fluid in the abdomen (ascites), bleeding disorders (coagulopathy), increased pressure in the blood vessels (portal hypertension), and brain function disorders (hepatic encephalopathy). Excessive alcohol use is the leading cause of cirrhosis. The main damage in cirrhosis is triggered by scarring (fibrosis) that occurs from injuries due to alcohol, viruses, or other assaults. The scar tissue and other changes in liver cells gradually replace healthy liver tissue and act like small dams to alter the flow of blood and bile in and out of the liver. Altered Blood and Bile Flow. The changes in blood and bile flow have significant consequences, with both the liver and other organs responding to the altered flow: The small blood vessels and bile ducts in the liver itself narrow (constrict). Blood vessels in other organs, including the kidney, also narrow. Blood flow coming from the intestine into the liver is slowed by the narrow blood vessels. It backs up through the portal vein and seeks other routes. Enlarged, abnormally twisted and swollen veins called varices form in the stomach and lower part of the esophagus to transport the blood diverted from the liver. Bilirubin also builds up in the bloodstream, resulting in jaundice, a yellowish cast in the skin and eyes, as well as dark- colored urine. Fluid buildup in the abdomen (called ascites), and swelling in the legs (edema) are common. Functions of the Liver. The liver is the largest internal organ in the body. In the healthy adult, it weighs about 3 pounds. The liver is wedge- shaped, with the top part wider than the bottom. It is located right below the diaphragm and occupies the entire upper right quadrant of the abdomen. The liver performs over 5. Damage to the liver can impair these and many other processes. Among them are the following: Processing Healthful Nutrients. The liver processes all of the nutrients the body requires, including proteins, glucose, vitamins, and fats. Producing Proteins The liver is the body’s “factory” where many important proteins are made. The blood protein albumin is one example that is often underproduced in patients with cirrhosis. Producing Bile. The liver produces bile, a green- colored fluid that helps the body absorb fats and fat- soluble vitamins. Bile contains bilirubin, a yellow- green pigment produced from the breakdown of hemoglobin, the oxygen- carrying component in red blood cells. Bile also contains bile salts, fatty acids, cholesterol, and other substances. Bile travels from the liver to the gallbladder, where it is stored until after a meal. It is then secreted into the intestines where it helps digest fat. Because bile can also travel directly from the liver to the intestines, patients who have had their gallbladders removed can still absorb fat normally. Find a Doctor to answer your medical questions, or find health information from our health communities. MedHelp has hundreds of forums for medical information and. A SpokenEdition transforms written content into human-read audio you can listen to anywhere. Perfect for times when you can't read - while driving, at the gym, doing. Turning the Tide on Diabetes 2017, "Updates in Diabetes Management" The Eastern Virginia Medical School Office of Continuing Medical Education will host the Turning. Find program websites, online videos and more for your favorite PBS shows. Special Report: A 10-day series exploring the heroin scourge in Maine and the horrific cost. Get the latest health news, diet & fitness information, medical research, health care trends and health issues that affect you and your family on ABCNews.com. Eliminating Toxins. One of the liver's major functions is to render harmless potentially toxic substances, including alcohol, ammonia, drugs, and harmful by- products of digestion. Structure of the Liver. The vital processes the liver performs rely on well- organized liver architecture. The basic building blocks of the liver are the following structures: Bile ducts. Blood vessels. Working liver tissue (called the parenchyma)Supportive (connective) tissue. The liver is a built on a framework of lobes: Lobes. The liver is divided into two major lobes, a right and a smaller left, which are separated by tough, fibrous connective tissue. Lobules. The liver's two major lobes contain about 1. Each lobule contains microscopic columns of liver cells and blood vessels. Bracing the corners of each lobule column are an artery and a vein that carry blood and a bile duct that drains bile. Bile ducts. The bile ducts in the column corners collect bile draining from tiny canals around the liver cells. These ducts eventually join to form the large common bile duct that leads from the liver to the gallbladder. Arteries and veins. The arteries bring oxygen- rich blood to nourish the liver cells. The veins supply the liver cells with blood containing the nutrients and toxins that the liver cells process. A central vein runs through each column and collects the processed blood from both sources. These veins join to form the hepatic vein. The Liver's Blood Supply. The liver is rich in blood. Its vessels contain about a pint, or 1. It gets its blood from two large vessels, the hepatic artery and the portal vein, and is drained of blood by the hepatic vein. This artery carries blood from the heart directly to the liver. This blood nourishes the liver. The portal vein. The portal vein carries blood that has circulated through the stomach, spleen, and intestine to the liver. The liver processes this blood, extracting nutrients and toxins. The hepatic vein. This vein carries blood away from the liver and connects to the inferior vena cava, a large vein that carries blood back to the heart. Alcoholic liver disease includes fatty liver (build- up of fat cells in the liver), alcoholic hepatitis (inflammation of the liver caused by heavy drinking), and alcoholic cirrhosis. Alcoholic cirrhosis is the primary type of cirrhosis in the U. S. It develops in 1. People who drink heavily and who also have hepatitis C are at particular risk of developing cirrhosis. In the liver, alcohol converts to toxic chemicals that trigger inflammation and tissue injury, which lead to cirrhosis. Chronic Viral Hepatitis. Chronic viral hepatitis, both hepatitis B and hepatitis C, is another primary cause of cirrhosis. Chronic hepatitis C is a more common cause of cirrhosis in developed countries, while hepatitis B is a more common cause of cirrhosis worldwide, especially in sub- Saharan Africa and parts of Asia. People with chronic hepatitis B who are co- infected with hepatitis D are especially at risk for cirrhosis. The longer a patient has had chronic hepatitis, the greater the risk for eventually developing cirrhosis. Hepatitis viruses can produce inflammation in liver cells, causing injury or destruction. If the condition is severe enough, the cell damage becomes progressive, leading to scar tissue in the liver. In advanced cases, the liver shrivels in size, a condition called postnecrotic or posthepatic cirrhosis. Hepatitis C is a virus- caused liver inflammation which may lead to jaundice, fever, and cirrhosis. The people most at risk for contracting and spreading hepatitis C are those who share needles for injecting drugs and health care workers or emergency workers who may be exposed to contaminated blood. People who have autoimmune hepatitis also often have other autoimmune conditions, including systemic lupus erythematosus, rheumatoid arthritis, Sj. Autoimmune hepatitis typically occurs in women ages 1. Bile Ducts Disorders. Disorders that block or damage the bile ducts can cause bile to back up in the liver, leading to inflammation and cirrhosis. These diseases include primary biliary cirrhosis and primary sclerosing chlorangitis. Primary Biliary Cirrhosis. Up to 9. 5% of primary biliary cirrhosis (PBC) cases occur in women, usually around age 5. In people with PBC, the immune system attacks and destroys cells in the liver’s bile ducts. Like many autoimmune disorders, the causes of PBC are unknown. Primary Sclerosing Cholangitis. Primary sclerosing cholangitis (PSC) is a chronic disease that mostly affects men, usually around age 4. The cause is unknown, but immune system defects, genetics, and infections may play a role. House (TV series) - Wikipedia. For the titular character, see Gregory House. House (also called House, M. D.) is an American television medical drama that originally ran on the Fox network for eight seasons, from November 1. May 2. 1, 2. 01. 2. The series' main character is Dr. Gregory House (Hugh Laurie), an unconventional, misanthropic medical genius who, despite his dependence on pain medication, leads a team of diagnosticians at the fictional Princeton–Plainsboro Teaching Hospital (PPTH) in New Jersey. The series' premise originated with Paul Attanasio, while David Shore, who is credited as creator, was primarily responsible for the conception of the title character. The series' executive producers included Shore, Attanasio, Attanasio's business partner Katie Jacobs, and film director Bryan Singer. It was filmed largely in Century City. House often clashes with his fellow physicians, including his own diagnostic team, because many of his hypotheses about patients' illnesses are based on subtle or controversial insights. His flouting of hospital rules and procedures frequently leads him into conflict with his boss, hospital administrator and Dean of Medicine Dr. Lisa Cuddy (Lisa Edelstein). House's only true friend is Dr. James Wilson (Robert Sean Leonard), head of the Department of Oncology. During the first three seasons, House's diagnostic team consists of Dr. Robert Chase (Jesse Spencer), Dr. Allison Cameron (Jennifer Morrison), and Dr. Eric Foreman (Omar Epps). At the end of the third season, this team disbands. Rejoined by Foreman, House gradually selects three new team members: Dr. Chris Taub (Peter Jacobson), and Dr. Lawrence Kutner (Kal Penn). Kutner makes an appearance late in season five and then reappears in season 8 episode 2. Chase and Cameron continue to appear in different roles at the hospital until early in season six. Cameron then departs the hospital, and Chase returns to the diagnostic team. Thirteen takes a leave of absence for most of season seven, and her position is filled by medical student Martha M. Masters (Amber Tamblyn). Cuddy and Masters depart before season eight; Foreman becomes the new Dean of Medicine, while Dr. Jessica Adams (Odette Annable) and Dr. Chi Park (Charlyne Yi) join House's team. House was among the top 1. United States from its second through fourth seasons. Distributed to 6. House was the most- watched television program in the world in 2. On February 8, 2. Fox announced that the eighth season, then in progress, would be its last. The suspects were the germs. But I quickly began to realize that we needed that character element. I mean, germs don't have motives. Jacobs later expressed her gratitude for the network's insistence that the character be reimagined—putting him on his feet added a crucial physical dimension. James Wilson echoes that between Holmes and his confidant, Dr. The main patient in the pilot episode is named Rebecca Adler after Irene Adler, a character in the first Holmes short story, . Moran joined the staff as writers at the beginning of the first season after the making of the pilot episode. Writers Doris Egan, Sara Hess, Russel Friend, and Garrett Lerner joined the team at the start of season two. Friend and Lerner, who are business partners, had been offered positions when the series launched, but turned the opportunity down. After observing the show's success, they accepted when Jacobs offered them jobs again the following year. Since the beginning of season four, Moran, Friend, and Lerner have been credited as executive producers on the series, joining Attanasio, Jacobs, Shore, and Singer. The most prolific have been Kaplow (1. Blake (1. 7), Shore (1. Friend (1. 6), Lerner (1. Moran (1. 4), and Egan (1. The show's most prolific directors through its first six seasons were Deran Sarafian (2. Greg Yaitanes (1. Of the more than three dozen other directors who have worked on the series, only David Straiton directed as many as 1. Hugh Laurie directed the 1. What usually happens is you do a pilot and of the very few picked up, only about a quarter go to a second year. So I thought I'll have three fun weeks. I never dreamed I'd be here three and a half years later. He assembled an audition tape in a hotel bathroom, the only place with enough light. Singer was very impressed by his performance and commented on how well the . Laurie credits the accent to . He assumed that House was a supporting part, due to the nature of the character, until he received the full script of the pilot episode. Laurie, the son of medical doctor Ran Laurie, said he felt guilty for . Spencer believed the program would be similar in style to General Hospital, but changed his mind after reading the scripts. Derek Shepherd on Grey's Anatomy. Eric Foreman, was inspired by his earlier portrayal of a troubled intern on the NBC medical drama ER. Allison Cameron was a complete disaster. The producers originally planned to recruit two new full- time actors, with Foreman, who returns in season four's fifth episode, bringing the team back up to three members; ultimately, the decision was made to add three new regular cast members. As a cost- cutting measure, the three actors were asked to accept reduced salaries. Epps and Leonard came to terms with the producers, but Edelstein did not, and in May 2. Elsewhere, ER, Sports Night, and The West Wing. I'll bet you didn't know that when your kidneys shut down they sound like bubble wrap popping. This is then overlaid with an image of Dr. House's face taken from the pilot episode with the show's full title appearing across his face. House's head then fades and the show's title is underlined and has the . This was the full extent of the title sequence in the pilot episode. Laurie's name appears first, followed by the names of the five other featured cast members in alphabetical order (Edelstein, Epps, Leonard, Morrison, and Spencer, then Shore). Laurie's name appears next to a model of a human head with the brain exposed; Edelstein's name appears next to a visual effects–produced graphic of an angiogram of the heart. Epps's name is superimposed upon a rib cage X- ray; Leonard's name appears on a drawing of the two hemispheres of the brain. Morrison's title card was thus lacking an image; an aerial shot of rowers on Princeton University's Lake Carnegie was finally agreed upon to accompany her name. Between the presentations of Spencer and Shore's names is a scene of House and his three original team members walking down one of the hospital's hallways. A new opening sequence was introduced in season seven to accommodate the changes in the cast, removing Morrison's name and including Jacobson and Wilde's. It was updated in season eight removing Edelstein's name and added Annable and Yi. Because many of his hypotheses are based on epiphanies or controversial insights, he often has trouble obtaining permission for medical procedures he considers necessary from his superior, who in all but the final season is hospital administrator Dr. Frequent disagreements occur between House and his team. Allison Cameron, whose standards of medical ethics are more conservative than those of the other characters. There have been references to the amount of his consumption increasing over time. It's becoming less and less useful a tool for dealing with his pain, and it's something we're going to continue to deal with, continue to explore. James Wilson, to encourage him to go to drug rehabilitation several times. House also frequently drinks liquor when he is not on medical duty, and classifies himself as a . In the following season's debut episode, House leaves Mayfield with his addiction under control. Gregory House. Hugh Laurie. Infectious Disease Specialist, Nephrologist, Head of Department of Diagnostic Medicine. Main. Dr. Lisa Cuddy. Lisa Edelstein. Endocrinologist, Dean of Medicine. Main. Dr. James Wilson. Robert Sean Leonard. Head of Department of Oncology. Main. Dr. Eric Foreman. Omar Epps. Neurologist, Diagnostic Medicine, Dean of Medicine. Main. Dr. Robert Chase. Jesse Spencer. Surgeon, Intensivist, Cardiologist, Head of Department of Diagnostic Medicine (series finale)Main. Dr. Allison Cameron. Jennifer Morrison. Immunologist, Diagnostic Medicine. Main. Guest. Dr. Chris Taub. Peter Jacobson. Plastic Surgeon. Lawrence Kutner. Kal Penn. Sports Medicine specialist. Martha Masters. Amber Tamblyn. Double- Ph. D. Jessica Adams. Odette Annable. Prison clinic physician. Chi Park. Charlyne Yi. Neurologist, Diagnostic Medicine. Main. Main characters. All of them play doctors who work at the fictional Princeton- Plainsboro Teaching Hospital in New Jersey. Gregory House (Hugh Laurie), the title character, heads the Department of Diagnostic Medicine. James Wilson (Robert Sean Leonard), House's one true friend, is the head of the Department of Oncology. Lisa Cuddy (Lisa Edelstein), an endocrinologist. In the finale of season six, Cuddy tells House she loves him. They kiss and agree to try being a couple. However, in the finale of season seven, House drives his car into Cuddy's living room in anger and their relationship effectively ends. House's original team of diagnosticians consists of Dr. Eric Foreman (Omar Epps), a neurologist; Dr. Robert Chase (Jesse Spencer), an intensivist; and Dr. Allison Cameron (Jennifer Morrison), an immunologist. Cameron, who has developed an affection for Chase, soon resigns. Chris Taub (Peter Jacobson), a former plastic surgeon; Dr. Lawrence Kutner (Kal Penn), a sports medicine specialist; and Dr. They break up early in season six. In the 2. 0th episode of season five, . Because Kutner left no note, House suspects foul play, though the death is accepted by the other characters as a suicide. Cuddy orders House to fill her position with another woman. Masters (Amber Tamblyn), who makes her first appearance in the season's sixth episode. They were credited as . By the time the Vogler episodes began to air, the show had become a hit and the character was soon dropped. The audience knows he'll never get fired.
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