000			02728ngm a2200313 a 4500
001			HST2757
003			UkLoHST
006			m c
007			cr|cna|||a||||
007			vz|czazum
008			110411s2011 enk|||||||||||s|||v|eng d
028	5	0	_a2757 _bHenry Stewart Talks
035			_a(UkLoHST)1917
040			_aUkLoHST _beng _cUkLoHST
100	1		_aReinus, John F. _4spk
245	1	0	_aPortal hypertension _h[electronic resource] / _cJohn F. Reinus.
260			_aLondon : _bHenry Stewart Talks, _c2011.
300			_a1 online resource (1 streaming video file (22 min.) : _bcolor, sound).
490	1		_aGastroenterology and hepatology : pathophysiology, presentation, diagnosis and management, _x2056-452X
500			_aAnimated audio-visual presentation with synchronized narration.
500			_aTitle from title frames.
505	0		_aContents: Portal hypertension causes regional circulatory derangements that result in extra- and intra-vascular volume overload and organ dysfunction -- Vascular tone is mediated by autonomic input and chemical mediators many of which are released by local vascular endothelium -- Intrahepatic portal hypertension develops as a result of anatomic changes in the cirrhotic liver that cause sinusoidal narrowing and loss of compliance -- Reflex SMA vasoconstriction and portosystemic shunting up-regulate VEGF eNOS and iNOS with resultant vasodilation -- There is secondary: ADH secretion with retention of free water; renal salt retention; renal afferent arteriolar vasoconstriction -- Affected individuals develop progressive volume overload with associated afterload reduction and increases in cardiac output (hyperdynamic circulation) -- Fluid is forced off the surface of the liver and accumulates in the abdominal cavity as ascites -- Blood is shunted around the liver through latent venous connections that become varices -- Renal function is impaired (hepatorenal syndrome) -- Volume overload may cause secondary pulmonary hypertension -- Affected individuals may also develop primary pulmonary hypertension due to anatomic alterations of pulmonary microvasculature (porto-pulmonary hypertension) -- The ability of the heart to respond to stress is impaired -- Patients develop intrapulmonary shunts that cause hypoxemia (hepatopulmonary syndrome) -- The only real remedy for these problems is orthotopic liver transplantation.
506			_aAccess restricted to subscribers.
538			_aMode of access: World Wide Web.
650		2	_aHypertension, Portal.
830		0	_aHenry Stewart talks. _pBiomedical & life sciences collection. _pGastroenterology and hepatology.
856	4	0	_uhttps://hstalks.com/bs/1917/
856	4	2	_uhttps://hstalks.com/bs/p/532/ _3Series
999			_c77591 _d77591