The document discusses important red flags in renal disease that medical students should be aware of including polyuria, oliguria/anuria, dysuria, hypertension, edema, pallor, proteinuria, and hematuria. It emphasizes the importance of taking a complete history and physical exam to recognize the signs and symptoms of kidney disease and determine the appropriate workup, diagnosis, and management. Medical students should understand the pathophysiology of common pediatric renal diseases and how to correlate clinical and laboratory findings to form a differential diagnosis and treatment plan.
Nephrotic syndrome is a common pediatric renal condition characterized by proteinuria, hypoalbuminemia, edema, and hypercholesterolemia. The most common causes are minimal change disease and focal segmental glomerulosclerosis. Treatment involves steroid therapy, but many children are steroid resistant or dependent, requiring additional therapies like calcineurin inhibitors or cytotoxic drugs. Renal biopsy helps determine prognosis and guides management, as focal segmental glomerulosclerosis carries a higher risk of steroid resistance. Timely diagnosis and treatment are important to prevent complications like infection.
Simple presentation to understand effects of diabetes on our excretory system so learn urology ,discuss urology at my channel https://www.youtube.com/my_videos?o=U next presentaiton will investigation in non invasive urinary bladder carcinoma .......soon
This document presents a case of an 8-year-old male patient presenting with facial swelling and dark urine. Investigations revealed hematuria, proteinuria, elevated creatinine and low C3 complement levels. A renal ultrasound showed enlarged kidneys. The differential diagnosis includes post-infectious glomerulonephritis given the recent sore throat and positive throat swab for Group A streptococcus. Nephritic syndrome is characterized by glomerular inflammation and injury leading to hematuria, proteinuria, hypertension and possible renal failure. Treatment involves managing complications, antibiotics if infection is present, dialysis for severe cases, and steroids if associated with nephrotic syndrome. Prognosis depends on severity and underlying cause
Acute kidney injury (AKI), previously called acute renal failure, is a reversible increase in blood creatinine and nitrogenous waste products due to the kidney's inability to regulate fluids and electrolytes. AKI is classified using RIFLE and AKIN criteria and can have pre-renal, intrinsic renal, or post-renal causes. Common causes in children include sepsis, cardiac surgery, organ transplantation, hemolytic uremic syndrome, and acute glomerulonephritis. Diagnosis involves physical exam, lab tests of kidney function and urine analysis, and imaging studies may be needed to identify obstruction. Kidney biopsy may be required to determine etiology or prognosis when cause is unknown.
Necrotizing enterocolitis (NEC) is a leading cause of emergency surgery in neonates, most commonly affecting very low birthweight preterm infants. It involves inflammation and necrosis of the bowels. Risk factors include prematurity, enteral feedings, and circulatory instability. Clinically, infants may experience feeding intolerance and abdominal distension. Diagnosis involves abdominal x-rays showing signs like pneumatosis intestinalis or portal venous gas. Treatment involves stopping feeds, antibiotics, and possible surgery for severe or perforated cases. Long-term complications can include strictures and short bowel syndrome.
Necrotizing enterocolitis (NEC) is a leading cause of emergency surgery in neonates. It most commonly affects very low birth weight preterm infants. Classic signs on imaging include pneumatosis intestinalis, portal venous gas, and free air indicating perforation. Treatment involves management of sepsis, circulatory support, and may require surgery for advanced cases. Long-term complications are common, affecting 50% of survivors. Early diagnosis through monitoring for feeding intolerance and abdominal distension along with radiographic findings is important for optimal management of this serious gastrointestinal emergency in neonates.
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
Nephrotic syndrome is a common pediatric renal condition characterized by proteinuria, hypoalbuminemia, edema, and hypercholesterolemia. The most common causes are minimal change disease and focal segmental glomerulosclerosis. Treatment involves steroid therapy, but many children are steroid resistant or dependent, requiring additional therapies like calcineurin inhibitors or cytotoxic drugs. Renal biopsy helps determine prognosis and guides management, as focal segmental glomerulosclerosis carries a higher risk of steroid resistance. Timely diagnosis and treatment are important to prevent complications like infection.
Simple presentation to understand effects of diabetes on our excretory system so learn urology ,discuss urology at my channel https://www.youtube.com/my_videos?o=U next presentaiton will investigation in non invasive urinary bladder carcinoma .......soon
This document presents a case of an 8-year-old male patient presenting with facial swelling and dark urine. Investigations revealed hematuria, proteinuria, elevated creatinine and low C3 complement levels. A renal ultrasound showed enlarged kidneys. The differential diagnosis includes post-infectious glomerulonephritis given the recent sore throat and positive throat swab for Group A streptococcus. Nephritic syndrome is characterized by glomerular inflammation and injury leading to hematuria, proteinuria, hypertension and possible renal failure. Treatment involves managing complications, antibiotics if infection is present, dialysis for severe cases, and steroids if associated with nephrotic syndrome. Prognosis depends on severity and underlying cause
Acute kidney injury (AKI), previously called acute renal failure, is a reversible increase in blood creatinine and nitrogenous waste products due to the kidney's inability to regulate fluids and electrolytes. AKI is classified using RIFLE and AKIN criteria and can have pre-renal, intrinsic renal, or post-renal causes. Common causes in children include sepsis, cardiac surgery, organ transplantation, hemolytic uremic syndrome, and acute glomerulonephritis. Diagnosis involves physical exam, lab tests of kidney function and urine analysis, and imaging studies may be needed to identify obstruction. Kidney biopsy may be required to determine etiology or prognosis when cause is unknown.
Necrotizing enterocolitis (NEC) is a leading cause of emergency surgery in neonates, most commonly affecting very low birthweight preterm infants. It involves inflammation and necrosis of the bowels. Risk factors include prematurity, enteral feedings, and circulatory instability. Clinically, infants may experience feeding intolerance and abdominal distension. Diagnosis involves abdominal x-rays showing signs like pneumatosis intestinalis or portal venous gas. Treatment involves stopping feeds, antibiotics, and possible surgery for severe or perforated cases. Long-term complications can include strictures and short bowel syndrome.
Necrotizing enterocolitis (NEC) is a leading cause of emergency surgery in neonates. It most commonly affects very low birth weight preterm infants. Classic signs on imaging include pneumatosis intestinalis, portal venous gas, and free air indicating perforation. Treatment involves management of sepsis, circulatory support, and may require surgery for advanced cases. Long-term complications are common, affecting 50% of survivors. Early diagnosis through monitoring for feeding intolerance and abdominal distension along with radiographic findings is important for optimal management of this serious gastrointestinal emergency in neonates.
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
- The patient is a 59-year-old male who was admitted to the hospital with difficulty breathing.
- He had a history of flood exposure 3 months prior and fever 2 months prior.
- On examination, he had jaundice, crackles in his lungs, and renal failure.
- He was diagnosed with severe leptospirosis ("Weil's disease") characterized by fever, jaundice, acute renal failure, and respiratory distress.
A 7-year-old boy was admitted with facial puffiness, passing smoky urine, and decreased urine output for 1 week. Examination showed pallor, high blood pressure, and a skin lesion on his elbow. Tests found protein and red blood cells in his urine, and raised blood urea. An ultrasound showed enlarged pale kidneys. The document discusses nephrotic syndrome, including its definition, causes, presentation, diagnosis, management, and nursing care. Nephrotic syndrome results from kidney damage that allows protein to leak into the urine, lowering blood protein levels and causing edema. Management focuses on fluid control, diuretics, ACE inhibitors, and sometimes steroids to preserve kidney function.
The document discusses pharyngeal arches, which consist of pharyngeal arches, clefts, and pouches during the 4th week of development. The mesoderm and neural crest cells of the pharyngeal arches give rise to cartilage, bone, connective tissue, muscles, nerves, and arteries. The first pharyngeal arch derivatives include the maxilla and mandible.
1. Acute kidney injury (AKI) in neonates is defined as a sudden decrease in kidney function resulting in the inability to maintain fluid and electrolyte homeostasis, typically seen as a rise in creatinine and fall in urine output.
2. AKI is common in neonates, occurring in 24% of hospitalized neonates. The highest incidence is after cardiac surgery for congenital heart disease. Pre-renal causes account for 75-85% of cases.
3. Diagnosis is challenging in neonates as creatinine is unreliable until after birth and novel biomarkers like NGAL may detect AKI earlier. Outcomes are generally good if the underlying cause is treated promptly.
acute glomerulonephritis in pediatrics by ritu gahlawatRitu Gahlawat
A 14 year old boy presented with swelling of the face and lower limbs, headache, and tea-colored urine. He had a fever and sore throat 3 weeks prior. His symptoms, including facial swelling worse in the morning and decreasing throughout the day, suggest a diagnosis of acute glomerulonephritis following a streptococcal infection. Laboratory tests showed hematuria, proteinuria, and elevated BUN and creatinine. The patient will need monitoring of vital signs, intake and output, diet management, and treatment of hypertension to manage his acute glomerulonephritis.
Henoch Schönlein purpura nephritis (HSPN) is a type of vasculitis that can affect the kidneys. It is commonly seen in children but can also affect adults. Renal involvement occurs in 20-60% of cases and ranges from mild hematuria to nephrotic syndrome. While renal disease is usually self-limiting in children, it is more severe and likely to progress in adults. Treatment of HSPN is controversial but typically involves steroids and immunosuppressants for more severe cases. Prognosis depends on severity of initial renal involvement, with mild cases having good long-term outcomes and severe nephritis carrying higher risk of chronic kidney disease. Careful
Necrotizing enterocolitis is a disease that primarily affects premature infants, causing necrosis of the bowel. It has a multifactorial pathogenesis involving intestinal ischemia, impaired host defenses, enteral feeding, and bacterial colonization in the immature gut. Clinical features include feeding intolerance and abdominal symptoms. Diagnosis is supported by imaging findings like pneumatosis intestinalis. Management involves bowel rest, antibiotics, monitoring for complications. Outcomes range from complete recovery to death depending on severity.
Kidney infection or pyelonephritis is an infection of the kidney that can be acute or chronic. Acute pyelonephritis causes symptoms like fever, flank pain, nausea, and painful urination. It is usually treated with antibiotics to control the bacterial infection. Chronic pyelonephritis can cause permanent kidney damage if not properly treated. Prompt treatment and prevention of recurrent urinary tract infections can help reduce the risk of chronic pyelonephritis.
Nephritic vs nephrotic syndrome6npoqoa8qakc (1).pdfArun170190
This document discusses and compares nephrotic syndrome and nephritic syndrome. Nephrotic syndrome is characterized by massive proteinuria (>3g/day), hypoalbuminemia (<2.5g/dl), hyperlipidemia, and edema. Nephritic syndrome presents with hematuria, red blood cell casts, hypertension, and proteinuria (<3g/day). The main difference is that nephrotic syndrome involves increased permeability of the glomeruli leading to protein loss, while nephritic syndrome involves inflammation and proliferation of the glomeruli allowing blood and protein into the tubules. Both require investigating the underlying cause and treating any identified conditions.
Primary glomerular diseases include various forms of glomerulonephritis and nephrotic syndrome. Acute glomerulonephritis is defined by the sudden onset of hematuria, proteinuria, and red blood cell casts. It is caused by an immunological reaction, often due to a streptococcal infection, that results in inflammation and proliferation in the glomerulus. Symptoms include edema, hypertension, and decreased kidney function. Treatment involves a low sodium diet, fluid restriction, antibiotics, corticosteroids, diuretics, and dialysis if needed. With treatment, most cases of acute glomerulonephritis resolve though some may progress to chronic kidney disease.
Renal diseases in pregnancy DR PRAYTHIESH BRUCE MBBSPraythiesh Bruce
This document discusses various renal diseases that can occur during pregnancy. It begins with an overview of urinary tract infections, including asymptomatic bacteriuria, cystitis, and acute pyelonephritis. It then covers chronic pyelonephritis, acute renal failure, pregnancy in renal transplant patients, and hypertension and its relationship to renal disease. The document provides details on the causes, symptoms, investigations, and treatment for each condition.
This document discusses posterior urethral valves (PUV), which is the most common cause of urinary outflow obstruction in boys. PUV occurs in about 1 in 5000-8000 male births. It discusses the anatomy, embryology, classification, pathophysiology, clinical presentation, diagnosis, and prognostic factors of PUV. The pathophysiology of PUV universally injures the urinary tract and can cause renal dysplasia, loss of renal function, hydronephrosis, vesicoureteral reflux, and bladder dysfunction. Diagnosis is typically made prenatally by ultrasound or postnatally by voiding cystourethrogram. Prognosis depends on factors like age at correction,
This document discusses hypertension in newborns and children. It begins by defining hypertension in neonates and outlining objectives for identifying and characterizing it. Common causes of neonatal hypertension are then reviewed, including renovascular, renal parenchymal, cardiac, endocrine, and iatrogenic factors. The evaluation, management, and long-term outcomes of hypertension in newborns are also described. The document then discusses hypertension in children, defining pediatric hypertension and outlining an approach to diagnosis, evaluation, and treatment. Risk factors and management of pre-hypertensive and stages I and II hypertension in children are also reviewed.
The document discusses proteinuria and hematuria in children. It covers the definition, causes, evaluation, and treatment of both conditions. Proteinuria can be caused by glomerular, tubular, or overflow mechanisms and is evaluated through urine dipsticks, 24-hour urine collection, and urine protein to creatinine ratio. Hematuria can be gross or microscopic and is seen in conditions like UTI, nephrolithiasis, glomerulonephritis, IgA nephropathy, and Alport syndrome. Evaluation of hematuria involves urinalysis, urine culture, imaging, and considering familial causes. Specific renal diseases like post-streptococcal glomerulonephritis
This document provides information on several diseases of the newborn including necrotizing enterocolitis, transient tachypnea of the newborn, hemolytic disease of the newborn, Down syndrome, temperature control, and the newborn screening program. It describes the definition, causes, signs and symptoms, diagnostic evaluation, and treatment for each condition. It emphasizes the importance of early detection and management of congenital disorders through newborn screening to prevent intellectual disability or death.
This document provides information about necrotizing enterocolitis (NEC) for physicians. It covers the objectives, risk factors, pathogenesis, clinical presentation, diagnosis, treatment and prognosis of NEC. NEC is a disease that primarily affects premature infants and causes necrosis of the intestinal tissue. The main risk factors are prematurity, formula feeding and circulatory instability. Clinically, infants may present with feeding intolerance and abdominal distension. Diagnosis involves radiological evidence of pneumatosis intestinalis or portal venous gas. Treatment involves bowel rest, antibiotics and surgery for severe or perforated cases. Outcomes depend on severity but mortality can be over 50% for cases involving perforation.
This document provides an overview of renal/urinary disorders including pyelonephritis, nephritic syndrome, and renal calculi (kidney stones). It begins with objectives and topics to be covered. For each disorder, it discusses anatomy and physiology, pathophysiology, clinical manifestations, diagnosis, medical management, and nursing care. Key points covered include the causes and risk factors for pyelonephritis, differences between acute and chronic pyelonephritis, pathophysiology and complications of nephritic syndrome, types and risk factors for kidney stones, and medical and surgical treatments for removing stones. The document is intended as an educational reference for understanding these renal/urinary disorders.
Nephrotic syndrome is a manifestation of glomerular disease characterized by nephrotic range proteinuria, hypoalbuminemia, edema, and hyperlipidemia. It is most common in children ages 1.5-6 years and affects boys more than girls. Causes include genetic, secondary, and idiopathic factors. Treatment involves managing edema, infections, and proteinuria with corticosteroids, diuretics, and immunosuppressants. Prognosis is generally good for steroid-responsive nephrotic syndrome but poorer for steroid-resistant cases. Complications can include infections, thrombotic events, and renal failure.
PPT on Direct Seeded Rice presented at the three-day 'Training and Validation Workshop on Modules of Climate Smart Agriculture (CSA) Technologies in South Asia' workshop on April 22, 2024.
- The patient is a 59-year-old male who was admitted to the hospital with difficulty breathing.
- He had a history of flood exposure 3 months prior and fever 2 months prior.
- On examination, he had jaundice, crackles in his lungs, and renal failure.
- He was diagnosed with severe leptospirosis ("Weil's disease") characterized by fever, jaundice, acute renal failure, and respiratory distress.
A 7-year-old boy was admitted with facial puffiness, passing smoky urine, and decreased urine output for 1 week. Examination showed pallor, high blood pressure, and a skin lesion on his elbow. Tests found protein and red blood cells in his urine, and raised blood urea. An ultrasound showed enlarged pale kidneys. The document discusses nephrotic syndrome, including its definition, causes, presentation, diagnosis, management, and nursing care. Nephrotic syndrome results from kidney damage that allows protein to leak into the urine, lowering blood protein levels and causing edema. Management focuses on fluid control, diuretics, ACE inhibitors, and sometimes steroids to preserve kidney function.
The document discusses pharyngeal arches, which consist of pharyngeal arches, clefts, and pouches during the 4th week of development. The mesoderm and neural crest cells of the pharyngeal arches give rise to cartilage, bone, connective tissue, muscles, nerves, and arteries. The first pharyngeal arch derivatives include the maxilla and mandible.
1. Acute kidney injury (AKI) in neonates is defined as a sudden decrease in kidney function resulting in the inability to maintain fluid and electrolyte homeostasis, typically seen as a rise in creatinine and fall in urine output.
2. AKI is common in neonates, occurring in 24% of hospitalized neonates. The highest incidence is after cardiac surgery for congenital heart disease. Pre-renal causes account for 75-85% of cases.
3. Diagnosis is challenging in neonates as creatinine is unreliable until after birth and novel biomarkers like NGAL may detect AKI earlier. Outcomes are generally good if the underlying cause is treated promptly.
acute glomerulonephritis in pediatrics by ritu gahlawatRitu Gahlawat
A 14 year old boy presented with swelling of the face and lower limbs, headache, and tea-colored urine. He had a fever and sore throat 3 weeks prior. His symptoms, including facial swelling worse in the morning and decreasing throughout the day, suggest a diagnosis of acute glomerulonephritis following a streptococcal infection. Laboratory tests showed hematuria, proteinuria, and elevated BUN and creatinine. The patient will need monitoring of vital signs, intake and output, diet management, and treatment of hypertension to manage his acute glomerulonephritis.
Henoch Schönlein purpura nephritis (HSPN) is a type of vasculitis that can affect the kidneys. It is commonly seen in children but can also affect adults. Renal involvement occurs in 20-60% of cases and ranges from mild hematuria to nephrotic syndrome. While renal disease is usually self-limiting in children, it is more severe and likely to progress in adults. Treatment of HSPN is controversial but typically involves steroids and immunosuppressants for more severe cases. Prognosis depends on severity of initial renal involvement, with mild cases having good long-term outcomes and severe nephritis carrying higher risk of chronic kidney disease. Careful
Necrotizing enterocolitis is a disease that primarily affects premature infants, causing necrosis of the bowel. It has a multifactorial pathogenesis involving intestinal ischemia, impaired host defenses, enteral feeding, and bacterial colonization in the immature gut. Clinical features include feeding intolerance and abdominal symptoms. Diagnosis is supported by imaging findings like pneumatosis intestinalis. Management involves bowel rest, antibiotics, monitoring for complications. Outcomes range from complete recovery to death depending on severity.
Kidney infection or pyelonephritis is an infection of the kidney that can be acute or chronic. Acute pyelonephritis causes symptoms like fever, flank pain, nausea, and painful urination. It is usually treated with antibiotics to control the bacterial infection. Chronic pyelonephritis can cause permanent kidney damage if not properly treated. Prompt treatment and prevention of recurrent urinary tract infections can help reduce the risk of chronic pyelonephritis.
Nephritic vs nephrotic syndrome6npoqoa8qakc (1).pdfArun170190
This document discusses and compares nephrotic syndrome and nephritic syndrome. Nephrotic syndrome is characterized by massive proteinuria (>3g/day), hypoalbuminemia (<2.5g/dl), hyperlipidemia, and edema. Nephritic syndrome presents with hematuria, red blood cell casts, hypertension, and proteinuria (<3g/day). The main difference is that nephrotic syndrome involves increased permeability of the glomeruli leading to protein loss, while nephritic syndrome involves inflammation and proliferation of the glomeruli allowing blood and protein into the tubules. Both require investigating the underlying cause and treating any identified conditions.
Primary glomerular diseases include various forms of glomerulonephritis and nephrotic syndrome. Acute glomerulonephritis is defined by the sudden onset of hematuria, proteinuria, and red blood cell casts. It is caused by an immunological reaction, often due to a streptococcal infection, that results in inflammation and proliferation in the glomerulus. Symptoms include edema, hypertension, and decreased kidney function. Treatment involves a low sodium diet, fluid restriction, antibiotics, corticosteroids, diuretics, and dialysis if needed. With treatment, most cases of acute glomerulonephritis resolve though some may progress to chronic kidney disease.
Renal diseases in pregnancy DR PRAYTHIESH BRUCE MBBSPraythiesh Bruce
This document discusses various renal diseases that can occur during pregnancy. It begins with an overview of urinary tract infections, including asymptomatic bacteriuria, cystitis, and acute pyelonephritis. It then covers chronic pyelonephritis, acute renal failure, pregnancy in renal transplant patients, and hypertension and its relationship to renal disease. The document provides details on the causes, symptoms, investigations, and treatment for each condition.
This document discusses posterior urethral valves (PUV), which is the most common cause of urinary outflow obstruction in boys. PUV occurs in about 1 in 5000-8000 male births. It discusses the anatomy, embryology, classification, pathophysiology, clinical presentation, diagnosis, and prognostic factors of PUV. The pathophysiology of PUV universally injures the urinary tract and can cause renal dysplasia, loss of renal function, hydronephrosis, vesicoureteral reflux, and bladder dysfunction. Diagnosis is typically made prenatally by ultrasound or postnatally by voiding cystourethrogram. Prognosis depends on factors like age at correction,
This document discusses hypertension in newborns and children. It begins by defining hypertension in neonates and outlining objectives for identifying and characterizing it. Common causes of neonatal hypertension are then reviewed, including renovascular, renal parenchymal, cardiac, endocrine, and iatrogenic factors. The evaluation, management, and long-term outcomes of hypertension in newborns are also described. The document then discusses hypertension in children, defining pediatric hypertension and outlining an approach to diagnosis, evaluation, and treatment. Risk factors and management of pre-hypertensive and stages I and II hypertension in children are also reviewed.
The document discusses proteinuria and hematuria in children. It covers the definition, causes, evaluation, and treatment of both conditions. Proteinuria can be caused by glomerular, tubular, or overflow mechanisms and is evaluated through urine dipsticks, 24-hour urine collection, and urine protein to creatinine ratio. Hematuria can be gross or microscopic and is seen in conditions like UTI, nephrolithiasis, glomerulonephritis, IgA nephropathy, and Alport syndrome. Evaluation of hematuria involves urinalysis, urine culture, imaging, and considering familial causes. Specific renal diseases like post-streptococcal glomerulonephritis
This document provides information on several diseases of the newborn including necrotizing enterocolitis, transient tachypnea of the newborn, hemolytic disease of the newborn, Down syndrome, temperature control, and the newborn screening program. It describes the definition, causes, signs and symptoms, diagnostic evaluation, and treatment for each condition. It emphasizes the importance of early detection and management of congenital disorders through newborn screening to prevent intellectual disability or death.
This document provides information about necrotizing enterocolitis (NEC) for physicians. It covers the objectives, risk factors, pathogenesis, clinical presentation, diagnosis, treatment and prognosis of NEC. NEC is a disease that primarily affects premature infants and causes necrosis of the intestinal tissue. The main risk factors are prematurity, formula feeding and circulatory instability. Clinically, infants may present with feeding intolerance and abdominal distension. Diagnosis involves radiological evidence of pneumatosis intestinalis or portal venous gas. Treatment involves bowel rest, antibiotics and surgery for severe or perforated cases. Outcomes depend on severity but mortality can be over 50% for cases involving perforation.
This document provides an overview of renal/urinary disorders including pyelonephritis, nephritic syndrome, and renal calculi (kidney stones). It begins with objectives and topics to be covered. For each disorder, it discusses anatomy and physiology, pathophysiology, clinical manifestations, diagnosis, medical management, and nursing care. Key points covered include the causes and risk factors for pyelonephritis, differences between acute and chronic pyelonephritis, pathophysiology and complications of nephritic syndrome, types and risk factors for kidney stones, and medical and surgical treatments for removing stones. The document is intended as an educational reference for understanding these renal/urinary disorders.
Nephrotic syndrome is a manifestation of glomerular disease characterized by nephrotic range proteinuria, hypoalbuminemia, edema, and hyperlipidemia. It is most common in children ages 1.5-6 years and affects boys more than girls. Causes include genetic, secondary, and idiopathic factors. Treatment involves managing edema, infections, and proteinuria with corticosteroids, diuretics, and immunosuppressants. Prognosis is generally good for steroid-responsive nephrotic syndrome but poorer for steroid-resistant cases. Complications can include infections, thrombotic events, and renal failure.
PPT on Direct Seeded Rice presented at the three-day 'Training and Validation Workshop on Modules of Climate Smart Agriculture (CSA) Technologies in South Asia' workshop on April 22, 2024.
Travis Hills of MN is Making Clean Water Accessible to All Through High Flux ...Travis Hills MN
By harnessing the power of High Flux Vacuum Membrane Distillation, Travis Hills from MN envisions a future where clean and safe drinking water is accessible to all, regardless of geographical location or economic status.
Authoring a personal GPT for your research and practice: How we created the Q...Leonel Morgado
Thematic analysis in qualitative research is a time-consuming and systematic task, typically done using teams. Team members must ground their activities on common understandings of the major concepts underlying the thematic analysis, and define criteria for its development. However, conceptual misunderstandings, equivocations, and lack of adherence to criteria are challenges to the quality and speed of this process. Given the distributed and uncertain nature of this process, we wondered if the tasks in thematic analysis could be supported by readily available artificial intelligence chatbots. Our early efforts point to potential benefits: not just saving time in the coding process but better adherence to criteria and grounding, by increasing triangulation between humans and artificial intelligence. This tutorial will provide a description and demonstration of the process we followed, as two academic researchers, to develop a custom ChatGPT to assist with qualitative coding in the thematic data analysis process of immersive learning accounts in a survey of the academic literature: QUAL-E Immersive Learning Thematic Analysis Helper. In the hands-on time, participants will try out QUAL-E and develop their ideas for their own qualitative coding ChatGPT. Participants that have the paid ChatGPT Plus subscription can create a draft of their assistants. The organizers will provide course materials and slide deck that participants will be able to utilize to continue development of their custom GPT. The paid subscription to ChatGPT Plus is not required to participate in this workshop, just for trying out personal GPTs during it.
Describing and Interpreting an Immersive Learning Case with the Immersion Cub...Leonel Morgado
Current descriptions of immersive learning cases are often difficult or impossible to compare. This is due to a myriad of different options on what details to include, which aspects are relevant, and on the descriptive approaches employed. Also, these aspects often combine very specific details with more general guidelines or indicate intents and rationales without clarifying their implementation. In this paper we provide a method to describe immersive learning cases that is structured to enable comparisons, yet flexible enough to allow researchers and practitioners to decide which aspects to include. This method leverages a taxonomy that classifies educational aspects at three levels (uses, practices, and strategies) and then utilizes two frameworks, the Immersive Learning Brain and the Immersion Cube, to enable a structured description and interpretation of immersive learning cases. The method is then demonstrated on a published immersive learning case on training for wind turbine maintenance using virtual reality. Applying the method results in a structured artifact, the Immersive Learning Case Sheet, that tags the case with its proximal uses, practices, and strategies, and refines the free text case description to ensure that matching details are included. This contribution is thus a case description method in support of future comparative research of immersive learning cases. We then discuss how the resulting description and interpretation can be leveraged to change immersion learning cases, by enriching them (considering low-effort changes or additions) or innovating (exploring more challenging avenues of transformation). The method holds significant promise to support better-grounded research in immersive learning.
ESA/ACT Science Coffee: Diego Blas - Gravitational wave detection with orbita...Advanced-Concepts-Team
Presentation in the Science Coffee of the Advanced Concepts Team of the European Space Agency on the 07.06.2024.
Speaker: Diego Blas (IFAE/ICREA)
Title: Gravitational wave detection with orbital motion of Moon and artificial
Abstract:
In this talk I will describe some recent ideas to find gravitational waves from supermassive black holes or of primordial origin by studying their secular effect on the orbital motion of the Moon or satellites that are laser ranged.
PPT on Alternate Wetting and Drying presented at the three-day 'Training and Validation Workshop on Modules of Climate Smart Agriculture (CSA) Technologies in South Asia' workshop on April 22, 2024.
Anti-Universe And Emergent Gravity and the Dark UniverseSérgio Sacani
Recent theoretical progress indicates that spacetime and gravity emerge together from the entanglement structure of an underlying microscopic theory. These ideas are best understood in Anti-de Sitter space, where they rely on the area law for entanglement entropy. The extension to de Sitter space requires taking into account the entropy and temperature associated with the cosmological horizon. Using insights from string theory, black hole physics and quantum information theory we argue that the positive dark energy leads to a thermal volume law contribution to the entropy that overtakes the area law precisely at the cosmological horizon. Due to the competition between area and volume law entanglement the microscopic de Sitter states do not thermalise at sub-Hubble scales: they exhibit memory effects in the form of an entropy displacement caused by matter. The emergent laws of gravity contain an additional ‘dark’ gravitational force describing the ‘elastic’ response due to the entropy displacement. We derive an estimate of the strength of this extra force in terms of the baryonic mass, Newton’s constant and the Hubble acceleration scale a0 = cH0, and provide evidence for the fact that this additional ‘dark gravity force’ explains the observed phenomena in galaxies and clusters currently attributed to dark matter.
(June 12, 2024) Webinar: Development of PET theranostics targeting the molecu...Scintica Instrumentation
Targeting Hsp90 and its pathogen Orthologs with Tethered Inhibitors as a Diagnostic and Therapeutic Strategy for cancer and infectious diseases with Dr. Timothy Haystead.
EWOCS-I: The catalog of X-ray sources in Westerlund 1 from the Extended Weste...Sérgio Sacani
Context. With a mass exceeding several 104 M⊙ and a rich and dense population of massive stars, supermassive young star clusters
represent the most massive star-forming environment that is dominated by the feedback from massive stars and gravitational interactions
among stars.
Aims. In this paper we present the Extended Westerlund 1 and 2 Open Clusters Survey (EWOCS) project, which aims to investigate
the influence of the starburst environment on the formation of stars and planets, and on the evolution of both low and high mass stars.
The primary targets of this project are Westerlund 1 and 2, the closest supermassive star clusters to the Sun.
Methods. The project is based primarily on recent observations conducted with the Chandra and JWST observatories. Specifically,
the Chandra survey of Westerlund 1 consists of 36 new ACIS-I observations, nearly co-pointed, for a total exposure time of 1 Msec.
Additionally, we included 8 archival Chandra/ACIS-S observations. This paper presents the resulting catalog of X-ray sources within
and around Westerlund 1. Sources were detected by combining various existing methods, and photon extraction and source validation
were carried out using the ACIS-Extract software.
Results. The EWOCS X-ray catalog comprises 5963 validated sources out of the 9420 initially provided to ACIS-Extract, reaching a
photon flux threshold of approximately 2 × 10−8 photons cm−2
s
−1
. The X-ray sources exhibit a highly concentrated spatial distribution,
with 1075 sources located within the central 1 arcmin. We have successfully detected X-ray emissions from 126 out of the 166 known
massive stars of the cluster, and we have collected over 71 000 photons from the magnetar CXO J164710.20-455217.
2. Red Flags in Renal Disease
Glomerular Diseases
(Nephritic/ Nephrotic Syndrome)
UTI
Acute VS Chronic Kidney Disease
Pediatric Nephrology 101
What Every Medical Student
Should Know
• Recognize Red Flags in Renal
Disease
• Understand the pahophysiology
of common pediatric renal
diseases
• Correlate and interpret the clinical
and laboratory findings
• Formulate a differential diagnosis
• Plan the appropriate management
• Recognize complications
associated with pediatric renal
disease as well as its prognosis
3. Red Flags in Renal Disease
Pediatric Nephrology 101
4. • - the passage of a larger
amount of urine than
normal
• daily urine output
exceeding 2L
in school-aged children
is unusual
• indicates decrease in
concentrating ability
• important to distinguish
polyuria from frequency
of micturition
Lorem ipsum dolor sit
Dolor sit amet conscter pod
Consectetur adipiscing
Pediatric Nephrology 101
Red Flags in Renal Disease
POLYURIA
5. • healthy neonate Is
oliguric for the first
2–3 days of life until
the onset of the
postnatal diuresis
• 92% - 1st 24 h of life
• Almost ALL in the
first 48 h
• Oliguria is defined a
urine output of less
than 500 ml/24 h/ 1.73
m2
• The most common
cause - intra- vascular
volume depletion
• Other Causes
• intrinsic
• obstructive
Red Flags in Renal Disease
Pediatric Nephrology 101
OLIGO/ANURIA
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DYSURIA
• Symptoms specific to
the urinary tract
• hematuria
• discharge
• malodorous urine
• frequency
• urgency
• refusal to void
• new-onset
nocturnal enuresis
• daytime
incontinence
• pain on urination
• inflammation, irritation,
or obstruction of the
urinary tract
• Associated with
• UTIs
• urethritis
• chemical or
traumatic irritation
• Possible Causes
• exposure to irritants
to the mucosal lining
of the urethra/bladder
• bladder bowel
dysfunction
• trauma
• sexually transmitted
infection
• A family history of
nephrolithiasis
Red Flags in Renal Disease
Pediatric Nephrology 101
7. HYPERTENSION
Flynn JT, Kaelber DC, Baker-Smith CM, et al.
Clinical practice guideline for screening and management of high blood pressure i
n children and adolescents. Pediatrics.
Red Flags in Renal Disease
Pediatric Nephrology 101
8. HYPERTENSION
Flynn JT, Kaelber DC, Baker-Smith CM, et al.
Clinical practice guideline for screening and management of high blood pressure i
n children and adolescents. Pediatrics.
Red Flags in Renal Disease
Pediatric Nephrology 101
• 1-5% prevalence in
children
• secondary to renal,
cardiovascular,
endocrine
• part of spectrum of
essential
hypertension
• 3 most common
symptoms
• headache, difficulty
sleeping and
tiredness
• routine BP screening
starting age 3 years
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+ Free plan
EDEMA
• a major clinical
manifestation of ECF
volume expansion
• Nephrotic Syndrome
• proteinuria
• hypoalbuminemia
• hyperlipidemia
• edema
first evident as swelling
of the periorbital region
more generalized
edema develops in a
gravity dependent
distribution
• Acute Nephritic
Syndrome / acute renal
impairment as a result
of failure of salt and
water excretion
• peripheral edema
• intravascular volume
expansion
• hypertension
• pulmonary edema
Red Flags in Renal Disease
Pediatric Nephrology 101
10. PALLOR
• Anemia is one of the most
common complications of
CKD during childhood
• K/DOQI Anemia
Management guidelines
defined anemia as a
hemoglobin value less than
11 gm/dl in pre-pubertal
patients with CKD
Red Flags in Renal Disease
Pediatric Nephrology 101
11. PROTEINURIA
Significant quantities of protein in the
urine will result in it becoming frothy.
• represents significant
renal disorder
• Dipstick analysis
followed by formal
quantification of
protein content
Red Flags in Renal Disease
Pediatric Nephrology 101
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HEMATURIA
• presence of RBCs in
urine
• Microscopic Hematuria
5 red blood cells
(RBCs)/mL of urine in a
counting chamber
or 2 RBCs/high-power
field (hpf) of urinary
sediment
• Chronic medical
problems,
multisystemic disease -
SLE, Wegener’s
granulomatosis,
Goodpasture syndrome
• History of trauma -
Bleeding in the Urinary
Tract
• Recent Throat/Skin
Infection - PSGN
• Presence/Family
history of hearing loss
- Alport’s Syndrome
• Presence of purpuric
rashes over the lower
extremities - HSP
• Hypertension - Acute
Nephritis
• History of fever, flank
pain, dysuria - UTI
Red Flags in Renal Disease
Pediatric Nephrology 101
13. Any symptom can be a presentation of
kidney disease
Complete History and PE is key
One should be familiar with the modes of
presentation of different renal conditions and
should have a high index of suspicion of renal
disease
Pediatric Nephrology 101
Red Flags in Renal Disease
16. BED1
4 year
old male
edema for 2
weeks frothy
urine
cough 1 week duration
Laboratorie
s Normal
CBC
Serum albumin 20mg/dL
Urinalysis protein +3, RBC3-5, WBC
4-5, bacteria few
18. Protein in Urinalysis
Urinalysis Protein
Trace <0.3g/dL
+1 <1g/dL
+2 1g-3g/dL
+3 3-20g/dL
+4 >20g/dL Avner, et al, Pediatric Nephrology 2007
DOI 10.1007/978-3-662-43596-0
19. T
ypes of Proteinuria
Glomerular proteinuria
increased filtration of protein across
the glomerular membrane
most commoncause of proteinuria in children
~glomerular disease
~other non-pathologic conditions such as
orthostatic proteinuria, fever, and excessive
exercise
Avner, et al, Pediatric Nephrology 2007
DOI 10.1007/978-3-662-43596-0
20. T
ypes of Proteinuria
T
ubular proteinuria
reduced reabsorption of freely filtered LMWProteins
Overflow proteinuria
due to increased levels of low molecular weight
proteins in the plasma
~ overwhelm tubular reabsorptive capacity
Avner, et al, Pediatric Nephrology 2007
DOI 10.1007/978-3-662-43596-0
21. Conditions with Proteinuria
Exercise
Fever
Orthostatic
Dehydration
Drugs
Chemotherap
y Heavy
metals
Antibiotics
Medical conditions
Hemolysis
Rhabdomyolysis
Multiple
myeloma
Amyloidosis
Kidney diseases
Glomerulonephritis
T
ubular diseases
Reflux
nephropathy
Diabetes Mellitus
Avner, et al, Pediatric Nephrology 2007
DOI 10.1007/978-3-662-43596-0
24. UnderlyingAbnormality
in NEPHROTIC
SYNDROME
Podocyte
- epithelial cell
- foot processes
- slit diaphragms
- nephrin
- podocin
- CD2AP
- α-actinin 4
Podocyte Functions
• structural support of the
capillary loop
• major component of the
glomerular filltration
barrier to proteins
• involved in synthesis and
repair of the glomerular
basement membrane
25. UnderlyingAbnormality
in NEPHROTIC
SYNDROME Podocyte injury or genetic
mutations of genes produc-
ing podocyte proteins may
cause nephrotic-range
proteinuria
• foot process effacement of
the podocyte
• decrease in number of
functional podocytes
• altered slit diaphragm
integrity
increased protein “leakiness” across the glomerular capillary wall into the urinary space
26. Immune System
? contributes to the overall
pathogenesis of the nephrotic
syndrome
*MCNS occur after viral infections
*MCNS in children with HL and T cell lymphoma
*use of immunosupressive agents in cases of SRNS
29. Avner, et al, Pediatric Nephrology 2007
DOI 10.1007/978-3-662-43596-0
Nephrotic Syndrome
History
insidious onset of edema
progressing to frank anasarca
Decreased urine output
OtherSymptoms-diarrhea,abdominal
pain,poorappetite and irritability
30. Avner, et al, Pediatric Nephrology 2007
DOI 10.1007/978-3-662-43596-0
Nephrotic Syndrome
Clinical Consequences
• Edema
• Hyperlipidemia
• Increased susceptibility
to infections
• Hypercoagulability
31. Volume Expanded (Overfill)
( FeNa >0.2 , Urine K index >0.6 )
Volume Contracted (Underfill)
(FeNa<0.2, Urine K index
<0.6)
32. Avner, et al, Pediatric Nephrology 2007
DOI 10.1007/978-3-662-43596-0
Nephrotic Syndrome:Work Up
Low Serumalbumin
HighSerumCholesterol
CBC- Hemoconcentrated
KUBUTZ
- normalorenlargedkidneys
Urinalysis
- 3+ urineproteindipstick
- MicroscopicHematuria
Randomspoturine protein
- >2000 mg/g
(200mg/mmol)
24 hourtotal protein excretion
->40mg/m2/hr
Renal Biopsy
33.
34. Avner et al, Pediatric Nephrology 2007
Management
cause
Anti-proteinuric agents
ImmunosuppreS
u
sp
sp
o
ir
ot
i
v
neTreatment
Antibiotics
prednisone or prednisolD
on
iue
retics
Dependass
o
i
n
n
g
u
l
n
e
d
d
e
a
r
l
i
y
l
y
i
n
d
g
o
s
eof 60 m
A
g
l
b
/
m
u
m
2
i
/
n
d
i
n
a
f
y
u
s
o
i
o
r
n
2 mg/kg/da
(A
yCE inhibitors, ARBs)
maximum of 60 mg daily for 4-6
wk Withdrawal of offending
agf
e
o
n
llt
o
s
wed by alternate-day prednisone
(starting at 40 mg/m2 qod or 1.5 mg/kg qod) for a period
ranging from 8 wk to 5 mo,with tapering of the dose
35. Avner et al, Pediatric Nephrology 2007
Management
Depends on underlying
cause
Antibiotics
A
lbum in infusion
Anti-proteinuric agents
ResponseSupportiveT
reatment
the attainment of remission withD
i
iu
nr
e
t
ti
c
hs
einitial 4
wk of corticosteroid therapy
Remissio
(
n
ACE inhibitors, ARBs)
Witu
hd
ri
rn
aw
ea
p
lr
o
o
fto
e
fi
fn
en:
dc
in
r
g
eatinine ratio of <0.2 or
<1+ p
r
o
a
t
e
g
i
e
n
n
t
o
s
n urine dipstick for 3 consecutive
days
37. Avner et al, Pediatric Nephrology 2007
Management
cause
agents
Antibiotics
Diuretics
Albumin infusion
Anti-proteinuric agents
(ACE inhibitors, ARBs)
Alternative Therapies to Corticosteroids in the Treatment of
Nephrotic Syndro
S
m
up
e
portiveTreatment
• C
D
y
e
c
p
l
e
o
n
p
d
h
o
s
s
o
p
n
h
a
u
m
n
d
i
d
e
e
r
l
y
i
n
g
• Calcineurin Inhibitors
•W
M
it
y
h
cd
or
p
a
h
w
en
a
o
llo
at
feoffending
• Rituximab
38.
39. Bed 2
6yo
Male URTI 2 weeks prior to
consult
facial edema and dark colored urine
blood pressure = 120/80mm/Hg
Urinalysis = RBCTNTC/WBC8-10/ Protein +4
80% dysmorphic RBCon phase constrast microscopy
41. Clinical Approach to a
child with
Hematuria
Confirm the presence of hematuria
Differentiate glomerular from non-glomerular
causes
Detailed history and physical examination to
determine the underlying cause
Assess severity and associated complications
of the hematuria
42. HEMA
TURIA
Hematuria
presence of RBCs in urine
Microscopic Hematuria
5 red blood cells (RBCs)/mL of urine in a counting
chamber
or
2 RBCs/high-power field (hpf) of urinary sediment
44. HISTORY & PE PROBABLE DISEASES
Recent throat infection,
skin infection
Post -Infectious Glomerulonephritis
Presence/Family history of hearing
loss
Presence of purpuric rashes over
the lower extremities
Hypertension
History of fever, flank pain, dysuria
Chronic medical problems,
multisystemic disease
History of trauma
Alport’s Syndrome
Henoch-Schonlein Purpura
Acute nephritis/ nephritic syndrome
UTI
SLE, Wegener’s granulomatosis,
Goodpasture syndrome
Bleeding in urinary tract
Causes of Hematuria
Dela Cena, 2017 NKTI PNAA 5th Symposium
51. Hematuria &Acute
Nephritic
Syndrome
Post Streptococcal Glomerulonephritis
immune complex mediated process for Group A Beta
Hemolytic Streptococcus
*gross hematuria ~2-4 weeks post respiratory or skin
infection
*low C3
*+ /-ASO/ Anti DNAse
52. Hematuria &Acute
Nephritic
Syndrome
Ig A Nephropathy
recurrent episodes of gross hematuria 1-2 days after a viral
respiratory infection or GI infection
*absent latent phase
*mesangial IgA deposits on renal biopsy
initially considered a benign condition
spontaneous remission in IgAN patients with minor glomerular abnormalities or focal mesangial
proliferation
20–50 % of adults would ultimately progress to end-stage
renal failure
53. Hematuria &Acute
Nephritic
Syndrome
Henoch Schonlein Purpura Nephritis
within 3 months of onset of a palpable rash, joint pains and
GI complaints
*Hallmark - HEMATURIA
** 8 0 % will manifest in 4 weeks
*** 9 5 % within 3 months
54. Management
Depends on underlying cause
Supportive (PSGN)
Fluid and salt limitation
Diuretics
Anti-hypertensive drugs
Immunosuppression
Nephrology Referral