Acute renal failure (ARF) is a common and serious problem in clinical medicine. It is characterised by an abrupt reduction (usually within a 48-h period) in kidney function. This results in an accumulation of nitrogenous waste products and other toxins. Many patients become oliguric (low urine output) with subsequent salt and water retention
Objective Acute kidney injury
Know about definition of Acute kidney injury
Function of kidney
Sign and symptoms of AKI
Know about Risk factor of AKI
Understand about complication of AKI
Contents:
Introduction Of Acute kidney injury
Physiology Of Acute kidney injury
Pathophysiology Of Acute kidney injury
Clinical feature Of Acute kidney injury
Risk Factor Of Acute kidney injury
Diagnosis Of Acute kidney injury
Differential diagnosis Of Acute kidney injury
Complication Of Acute kidney injury
Management Of Acute kidney injury
A simple description of a less understood topic in Intensive Care Medicine. Aim to make understanding and management easy for the residents and prevention steps for all ICU workers.
Final presentation on Acute kidney injury AKI and Chronic kidney disease CKD ...HariSedai
Approach to a patient with AKI or CKD in emergency setup and the relevant analysis of patient who visit emergency setting with the AKI and ckd a retrospective analysis in THTH emergency nepal, a developing country scenario
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
Acute renal failure (ARF) is a common and serious problem in clinical medicine. It is characterised by an abrupt reduction (usually within a 48-h period) in kidney function. This results in an accumulation of nitrogenous waste products and other toxins. Many patients become oliguric (low urine output) with subsequent salt and water retention
Objective Acute kidney injury
Know about definition of Acute kidney injury
Function of kidney
Sign and symptoms of AKI
Know about Risk factor of AKI
Understand about complication of AKI
Contents:
Introduction Of Acute kidney injury
Physiology Of Acute kidney injury
Pathophysiology Of Acute kidney injury
Clinical feature Of Acute kidney injury
Risk Factor Of Acute kidney injury
Diagnosis Of Acute kidney injury
Differential diagnosis Of Acute kidney injury
Complication Of Acute kidney injury
Management Of Acute kidney injury
A simple description of a less understood topic in Intensive Care Medicine. Aim to make understanding and management easy for the residents and prevention steps for all ICU workers.
Final presentation on Acute kidney injury AKI and Chronic kidney disease CKD ...HariSedai
Approach to a patient with AKI or CKD in emergency setup and the relevant analysis of patient who visit emergency setting with the AKI and ckd a retrospective analysis in THTH emergency nepal, a developing country scenario
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
This presentation describes the Acute kidney injury (AKI), formerly known as Acute renal failure (ARF). It offers core insights on its classification, etiology, signs, symptoms, diagnosis, management as well as its prognosis.
Genitourinary disorders are conditions that affect the genitourinary system, which includes the urinary and reproductive systems. Some are congenital, and others are acquired later in life.
Large numbers of patients suffer from a variety of diseases in the genitourinary system, which is composed of kidneys, ureters, bladder, urethra, and genital organs. Genitourinary diseases include congenital abnormalities, iatrogenic injuries, and disorders such as cancer, trauma, infection, and inflammation.
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NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. DEFINITIONS
• Acute renal failure (ARF) is broadly defined as a
decrease in glomerular filtration rate (GFR)
occurring over hours to weeks that is associated
with an accumulation of waste products,
including urea and creatinine
• Clinicians use a combination of the serum
creatinine (Scr) value with change in either Scr or
urine output (UOP) as the primary criteria for
diagnosing ARF
3.
4. Epidemiology
• ARF is an uncommon condition in the
community-dwelling, generally healthy
population, with an annual incidence of
approximately 0.02%
• The hospitalized individual is at high risk of
developing ARF; the reported incidence is 7%
• The incidence of ARF is markedly higher in
critically ill patients, ranging from 6% to 23%
5. Epidemiology
• The high mortality rate related to ARF, which is
reported to range from 35% to 80%, is a
significant clinical concern that has been
relatively unresponsive to therapeutic
intervention over the last four decades
6. Risk factors
Clinical Setting Frequency (%)
Severe Burns 20-60
Rhabdomyolysis 20-30
Aminoglycoside use 10-30
Chemotherapy 15-25
Open heart surgery 5-20
ICU 5-25
General medicine 3-5
7. ETIOLOGY
• The etiology of ARF can be divided into broad
categories based on the anatomic location of
the injury associated with the precipitating
factor(s)
8. ETIOLOGY
• Traditionally, the causes of ARF have been categorized as
(a) Prerenal, which results from decreased renal perfusion in
the setting of undamaged parenchymal tissue
(b) Intrinsic, the result of structural damage to the kidney,
most commonly the tubule from a ischemic or toxic insult
(c) Postrenal, caused by obstruction of urine flow
downstream from the kidney
9. ETIOLOGY
• The most common cause of hospital-acquired
ARF is prerenal ischemia as the result of
reduced renal perfusion secondary to sepsis,
reduced cardiac output, and/or surgery
• Drug-induced ARF may account for 18% to
33% of in-hospital occurrences
10. ETIOLOGY
Other risk factors for developing ARF while
hospitalized include
• Advanced age (>60 years of age)
• Male gender
• Acute infection
• Preexisting chronic diseases of the respiratory
or cardiovascular systems
11. Clinical Presentation
• Community-dwelling patients often are not in
acute distress
• Hospitalized patients may develop ARF after
either a notable reduction in blood pressure or
intravascular volume, significant insult to the
kidney, or sudden obstruction after
catheterization
• Generally, an acute reduction in urine output
coinciding with a rise in BUN and Scr is observed
12. Clinical Presentation
• Symptoms in the outpatient setting include
change in urinary habits, weight gain, or flank
pain
• Signs include edema, colored or foamy urine,
and, in volume-depleted patients, orthostatic
hypotension
13. Specific clinical correlations !
• A decrease in the force of the urinary stream:
obstruction
• Presence of cola-colored urine: Hematuria,
Rhabdomyolysis
• The onset of flank pain: urinary stone
• Headache: HTN
14. Specific clinical correlations !
• Acute anuria is typically caused by either
complete urinary obstruction or a catastrophic
event
• Oliguria (<500 mL/day of urine output), which
often develops over several days, suggests
prerenal azotemia
• Nonoliguric (>500 mL/day of urine output) renal
failure usually results from acute intrinsic renal
failure or incomplete urinary obstruction
15. Laboratory Tests
• Elevations in the serum potassium, BUN,
creatinine, and phosphorous, or a reduction in
calcium and the pH (acidosis), may be present
• An increased serum white blood cell count
may be present in those with sepsis-
associated ARF, and eosinophilia suggests
acute interstitial nephritis.
16. Laboratory Tests
• Urine microscopy can reveal cells, casts, or
crystals that help distinguish among the
possible etiologies and/or severities of ARF.
• Urine chemistry also indicates the presence of
protein, which suggests glomerular injury, and
blood, which can result from damage to
virtually any kidney structure.
17. Other tests
• Renal ultrasonography may be needed to rule
out obstruction; renal biopsy is rarely used,
and is reserved for difficult diagnoses
18. Diagnosis
• Monitoring changes in UOP can help diagnose the
cause of ARF. Acute anuria (less than 50 mL
urine/day) is secondary to complete urinary
obstruction or a catastrophic event (e.g., shock).
Oliguria (400 to 500 mL urine/day) suggests
prerenal azotemia
• Nonoliguric renal failure (more than 400 to 500
mL urine/day) usually results from acute intrinsic
renal failure or incomplete urinary obstruction.
19. PREVENTION OF ACUTE RENAL
FAILURE
• Nephrotoxin administration (e.g., radiocontrast dye)
should be avoided whenever possible. When patients
require contrast dye and are at risk of contrast dye–
induced nephropathy, renal perfusion should be
maximized through strategies
• Such as assuring adequate hydration with normal
saline or sodium bicarbonate solutions and
administration of oral acetylcysteine 600 mg every 12
hours for four doses. Strict glycemic control with
insulin in diabetics has also reduced the development
of ARF
20. PREVENTION OF ACUTE RENAL
FAILURE
• Amphotericin B nephrotoxicity can be
reduced by slowing the infusion rate to in at-
risk patients, substituting liposomal
amphotericin B
• Many other strategies are popular but lack
supportive evidence, including mannitol, loop
diuretics, dopamine an fenoldopam
23. Pharmacotherapy
• The use of diuretics to prevent nephrotoxicity
may actually result in intravascular volume
depletion
• May increase the risk of ARF
24. Pharmacotherapy
• Fenoldopam: Fenoldopam mesylate is a
selective dopamine A-1 receptor agonist
• Fenoldopam had salutary properties for the
prevention of drug-induced nephrotoxicity
25. Pharmacotherapy
• Acetylcysteine: may effectively reduce the risk
of developing CIN in patients with pre-existing
kidney disease, although a therapeutic benefit
has not been consistently demonstrated
• The recommended N-acetylcysteine dosing
regimen for prevention of CIN is 600 mg orally
every 12 hours for 4 doses with the first dose
administered prior to contrast exposure
26. Pharmacotherapy
• Theophylline may reduce the incidence of CIN
with an efficacy that is perhaps comparable to
that reported in studies of Nacetylcysteine
27.
28.
29. Pharmacotherapy
• Glycemic Control
• Tight blood glucose resulted in significant
improvements in mortality and a 41% reduction
in the development of ARF
• Intensive insulin therapy may now also become
the standard of care for all critically ill patients to
prevent ARF and improve mortality