Archive for January 23rd, 2008
January 23rd, 2008 -- Posted in Portraits To Art |
What is Ascites?
Ascites is the presence of excess fluid in the peritoneal cavity. It is a common clinical finding with a wide range of causes, but develops most frequently as a part of the decompensation of previously asymptomatic chronic liver disease. The symptoms of ascites vary from patient to patient and depend largely on the quantity of fluid. If trace ascites is present, the patient may be asymptomatic, and fluid is detected only on physical or radiologic examination. If a large amount of fluid is present, the patient may complain of abdominal fullness, early satiety, abdominal pain, or shortness of breath.
Ascites is detected on physical examination of the abdomen by visible bulging of the flanks in the reclining patient (”flank bulging”), “shifting dullness” (difference in percussion note in the flanks that shifts when the patient is turned on the side) or in massive ascites with a “fluid thrill” or “fluid wave” (tapping or pushing on one side will generate a wave-like effect through the fluid that can be felt in the opposite side of the abdomen).
Rapidly developing (acute) ascites can occur as a complication of trauma, perforated ulcer, appendicitis, or inflammation of the colon or other tube-shaped organ (diverticulitis). This condition can also develop when intestinal fluids, bile, pancreatic juices, or bacteria invade or inflame the smooth, transparent membrane that lines the inside of the abdomen (peritoneum). However, ascites is more often associated with liver disease and other long-lasting (chronic) conditions.
Ascitic fluid is derived from the vascular compartment subserving the hepatosplanchnic viscera. Two factors are important in the formation of ascites: an increased total body sodium and water, and increased sinusoidal portal pressure. In cirrhosis, hepatic dysfunction and sinusoidal portal pressure probably both send a message to the kidney to retain excess sodium and fluid, while the portal hypertension serves to localize excess fluid to the peritoneal cavity rather than the periphery.
The ascitic tube (drain) is usually inserted by a doctor and the procedure can be done at the bedside in the ward or in the outpatients clinic. Sometimes the drain may be inserted in the ultrasound department whilst scanning the abdomen. This helps the doctor find exactly where to put the drain, especially if the fluid appears to be in small pockets and cannot be drained all at once. You will be asked to lie on the bed while the skin in the area where the drain is to be inserted is cleaned with an antiseptic solution, which prevents it from becoming infected.
Many patients remain asymptomatic until decompensation occurs. Lack of symptoms and minor liver enzyme elevations are typical of HCV infection and cannot be taken as evidence of lack of progression. HCV RNA testing confirms the diagnosis. Liver biopsy helps assess disease activity and stage the severity of fibrosis and is recommended for most patients with hepatitis C. Once this information is obtained, a rational program for treatment and monitoring can be planned.
Nonspecific abdominal discomfort and dyspnea may occur with massive ascites, but lesser amounts are usually asymptomatic. The diagnosis is made clinically by detecting shifting dullness on abdominal percussion, though US or CT scan can detect much smaller amounts of fluid. In advanced cases the belly is taut, the umbilicus is flat or everted, and a fluid wave can be elicited. Differentiation from obesity, gaseous distention, pregnancy, or ovarian tumors and other intra-abdominal masses usually is easily made by clinical examination, but scanning techniques or diagnostic paracentesis may occasionally be required.
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What is Ascites? / Author: peterhutch
January 23rd, 2008 -- Posted in Portraits To Art |
Island Airline Reports Record Growth
Many airlines, especially low-cost airlines, are accustomed to record sales during the peak travel months of summer.
Air Malta, celebrating its 34th anniversary this year, had a record breaking winter season with more than 500,000 passengers originating from its homebase of Malta’s Luqa Airport.
The winter months, November 2007 through March 2008, showed a 15 percent increase over the 2006 winter season.
Malta’s charter traffic saw a 21 percent increase over last year’s winter season. The market in which the airline reported the largest increase in passengers was Italy with 41 percent. Germany came in a close second at 32 percent with France at 25 percent and the U.K. by 6 percent.
Chief Officer Commercial Brock Friesen said the airline registered double-digit growth every month during the winter season.
Dr. Friesen said Air Malta’s success can be attributed to several factors.
Existing code-share agreements with other airlines, including Lufthansa and Air One, expand Air Malta’s network, allowing travellers daily access via European hubs.
In its entirety, the network of airlines offers access to more than 180 destinations worldwide. The airline had also recently implemented ticket sales on the internet as part of an effort to increase sales during the winter months.
‘This record growth will result into more destinations and frequencies to main European gateways, giving the Maltese public better accessibility worldwide’, Dr. Friesen said.
He also told reporters, ‘These figures did not materialize by chance or other external market factors, including the start of operations of various low-cost airlines, but are the result of number of commercial initiatives which the airline has taken in recent years. We have organized our Commercial Division and outstation office network, enhanced our distribution tools, invested heavily in revenue management systems and reporting tools, setup an e-business unit and an international call center, and launched a new portal and booking engine amongst others.
These initiatives were backed up by aggressive marketing communications campaigns across Europe especially in our core markets of the U.K., Germany, Italy and France. We have focused on the short break market segment and the ‘extension’ of our traditional summer season to include our off-peak months.’
April through October is considered peak flight season. Air Malta’s marketing and product general manager, Brian Bartolo, announced that the airline will offer 200 flights per week to 40 scheduled destinations in Europe, North Africa and the Eastern Mediterranean.
They have also added Leipzig and Innsbruck to the list of available destinations. In addition to the introduction of new available destinations, the airline will be increasing capacity and the frequency of flights to Berlin, Catania, London, Gatwick, Dusseldorf, Frankfurt and Rome.
All good news for tourists in those destinations who want flights to Malta
The success of low-cost airlines proves that current currency exchange rates have not had the negative impact on international travel that was anticipated.
Passengers are simply being more mindful of prices that fit their travel plans and budgets.
In fact, business for most of the low-cost airlines that make frequent flights to and from Malta as well as the Balearic and Canary Islands, has seen a dramatic increase.
Airlines have already promised more frequent flights to and from favorite travel destinations for the 2008 summer travel season. Increased flights at reduced prices and the availability of packaged travel deals are sure to be big hits with tourists for summer 2008.
For Luqa Airport and other Malta information visit yourmalta.com
The guide also has a five day weather in Malta forecast along with today’s weather in Malta
Island Airline Reports Record Growth / Author: Robert Palmer
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January 23rd, 2008 -- Posted in Portraits To Art |
Learning How to Find Disability Discrimination Lawyers Is Important
If you are being discriminated because of your disability, the best thing for you to do is look for disability discrimination lawyers to handle your case.
Before anything else, you should be reminded that there is an effective way of choosing the best disability lawyers. Since the perfect way can consume time and your situation demands immediate legal assistance, there are likewise alternatives that you can consider. In any case, there are options available for both the people who demands lawyers right away as well as those who have the time to scout around and look for the best attorneys.
Here then are the steps in looking for lawyers who will defend your case.
• To boost your chances of getting the services of the right lawyers, you may need to study possible candidates from different sources. In the ideal setting, you should receive recommendations from a legal representative or from another reliable source.
• Another way to look for legal help is by accessing various directories of lawyers as well as groups who will serve as the second member of your legal team. For the third member of your legal representation, you may have to do an online search.
• It is advisable to consult at least three lawyers and set initial meetings with each of them. By choosing three distinct attorneys, it can guarantee that eventually you will be able to locate the representation that is tailor-made for your needs as far as finances, personality, and style is concerned. By doing so, you will be able to find someone who exudes the credibility and competence as well as the experience in disability laws.
Moreover, in trimming down the three lawyers into the perfect one to seek advice from, you might take into consideration their record of practice and their expertise within the field of disability. Likewise, you should take a look at other details that describes their attitude and skills.
In conducting your initial meeting, you should see to it that you can point out your case to them in a brief manner as well as what you expect from your case. Likewise, you should be enlightened on the fees that you will pay in exchange for their legal expertise. Take this moment to clarify what courses of actions they will do to ensure that you will succeed as well as what they intend to do in defending your case.
However, if you are pressed for time, and have no time to talk with three different lawyers, then you can always ask for recommendations from a legal expert and get in touch with the recommended attorney. While there is no guarantee of achieving success, getting the perfect representation through referral can be the better option than looking for one yourself.
In the end, the tips mentioned above can help you hire the best lawyers to defend your case. So if your handicap is the main reason why you are being treated unfairly, then get help from disability discrimination attorneys.
To help you with disability discrimination and other related issues, you can consult with our experienced Los Angeles attorneys or you can log on to our official website and have your case evaluated.
Learning How to Find Disability Discrimination Lawyers Is Important / Author: rainier policarpio
Occupation: writer/researcher
Rainier used to work in a publishing company as a writer and eventually became an associate editor. He dealt in writing instructional materials for secondary and tertiary students. His passion in writing inspired him to read a lot and subsequently enabled him to gain more knowledge and skills.
http://www.mesrianilaw.com