This document summarizes the case of a 56-year-old Thai woman who presented with hemoptysis and renal failure. She has a history of tuberculosis as a child and rheumatoid arthritis. On examination, she had coarse lung crepitations and signs of renal impairment. Tests showed p-ANCA positivity. She was diagnosed with microscopic polyangiitis and treated with plasma exchange, antibiotics, and steroids. Her condition gradually improved with treatment.
This was a review of different guidelines on lupus nephritis from ACR, EULAR, and KDIGO. Goal is appreciate similarities and differences between the different guidelines.
This was a review of different guidelines on lupus nephritis from ACR, EULAR, and KDIGO. Goal is appreciate similarities and differences between the different guidelines.
Pulmonary renal syndrome by Dr Bharat Rewaria Bharat Rewaria
by Dr Bharat Rewaria . 14 dec 2021
Pulmonary-renal syndrome refers to combination of diffuse alveolar hemorrhage and rapidly progressing glomerulonephritis .
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.
Stroke in people under 45 years of age is less frequent than in older populations but has a major impact on the individual and society. In this article we provide an overview of the epidemiology and etiology of young stroke.
download link : https://www.dropbox.com/s/xc0fpdul47g1gu8/IgA%20Nephropathy.ppt?m
Join us on our facebook group: NephroTube...............Follow our blog: www.nephrotube.blogspot.com
Sudden impairment of kidney function occurring over a period of hours to days.
AKI is present in 7% of all hospitalized patients, and up to 30% of patients in ICU
The incidence is increasing at an alarming rate
That's why we need ideal biomarker to diagnose the AKI as early as possible and deliver better treatment to the patient.
Presentation given to our fellowship program about diabetic kidney disease.
2022 update discussing SGLT2i, MRA (e.g. finerenone), health economics and beyond
Update on Patterns of Study in ANCA Associated Vasculitis presented at regional Northern Ireland Nephrology Meeting with Dr David Jayne as guest speaker..
Pulmonary renal syndrome by Dr Bharat Rewaria Bharat Rewaria
by Dr Bharat Rewaria . 14 dec 2021
Pulmonary-renal syndrome refers to combination of diffuse alveolar hemorrhage and rapidly progressing glomerulonephritis .
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.
Stroke in people under 45 years of age is less frequent than in older populations but has a major impact on the individual and society. In this article we provide an overview of the epidemiology and etiology of young stroke.
download link : https://www.dropbox.com/s/xc0fpdul47g1gu8/IgA%20Nephropathy.ppt?m
Join us on our facebook group: NephroTube...............Follow our blog: www.nephrotube.blogspot.com
Sudden impairment of kidney function occurring over a period of hours to days.
AKI is present in 7% of all hospitalized patients, and up to 30% of patients in ICU
The incidence is increasing at an alarming rate
That's why we need ideal biomarker to diagnose the AKI as early as possible and deliver better treatment to the patient.
Presentation given to our fellowship program about diabetic kidney disease.
2022 update discussing SGLT2i, MRA (e.g. finerenone), health economics and beyond
Update on Patterns of Study in ANCA Associated Vasculitis presented at regional Northern Ireland Nephrology Meeting with Dr David Jayne as guest speaker..
This presentation is about Parathyroid Disorders which are hypo and hyperparathyroidism and their relationship to teeth and oral cavity including oral and dental manifestation of these disorders , and correct management patients seeking dental care with these disorders.
Goodpasture syndrome (GPS) also known as Goodpasture’s disease is a rare autoimmune disease in which antibodies attack the basement membrane in lungs and kidneys, leading to bleeding from the lungs and to kidney failure
Some forms of the disease involve just the lung or the kidney, most times, both.
Men are eight times more likely to be affected than women. The disease most commonly occurs in early adulthood.
by Bushra Ibnauf as part of SAMA's Visiting Faculty Program in Salam Rotana Hotel on June 24th 2011. This was in collaboration with the Sudanese Society for Gastroenterology.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
17. What to do next? Bronchoscope? CT scan? Dexamethasone? hemodialysis? Plasma exchange? Continue antibiotic? Kidney biopsy? Doppler ultrasound? Consult nephro? V/Q scan? CPR? Factor VIIa ? Echo? Cyclophosphamide? S p u t u m P C R - T B
20. What to do next? Bronchoscope? CT scan? Dexamethasone? hemodialysis? Plasma exchange? Continue antibiotic? Kidney biopsy? Doppler ultrasound? Consult nephro? V/Q scan? CPR? Factor VIIa ? Echo? Cyclophosphamide? S p u t u m P C R - T B
39. Granulocyte antigen of ANCA MPA, SLE, RA, UC, CD, PSC, AIH Clin Exp Rheumatol 2000: 18: 629-635.
40. Problem with pANCA detection Perinuclear staining by ANA granulocyte-specific ANA? Epitope conformation
41.
42. does ANCA has role in pathogenesis ? I have no MPO Anti-MPO Pauciimmune NCGN Systemic vasculitis lipopolysaccharide Now I have MPO Anti-PR3 and pauciimmune glomerulonephritis ! Normal mice reduced leukocyte rolling augmented adhesion and transmigration across the endothelium Nat Rev Rheumatol . 2010 Nov;6(11):653-64.
43. What does ANCA do with body ? Kelly’s textbook of Rheumatology, 8 th ed.
51. Clinical presentation Murray and Nadel’s Textbook of Respiratory Medicine, 5 th ed. 10–50% of patients . Mononeuritis multiplex reported cerebral infarction Neuro 35–60% of patients . Commonly purpura skin 35–55% of patients . Pain, bleeding, ischemia . Rare visceral aneurysms . GI 10–15% of patients . CHF and pericarditis have been described . Cardiac 0–30% of patients . Scleritis, episcleritis, uveitis . eyes Arthralgias and myalgias in at least 50% of patients musculoskeletal 5–30% of patients, with sinus disease most common Upper airway Segmental necrotizing glomerulonephritis and RPGN is almost universal . renal 25–55% of patients . 10–30% with diffuse alveolar hemorrhage . Fibrosis, focal infiltrates, effusions, pulmonary arterial hypertension pulmonary
52. Pathology Neutrophilic capillaritis without granuloma, fibrinoid necrosis and arterial wall disruption, intra alveolar RBC and hemosiderin-laden macrophages Focal segmental necrotizing glomerulonephritis
58. fine reticular pattern superimposed on a background of groundglass attenuation that is the crazy-paving pattern J Comput Assist Tomogr . 2004 Sep-Oct;28(5):710-6
59. F 74y MPO. F/U HRCT show new honeycombing at 5 months 3 mo.
60. M 60Y MPO resemble IPF CT show GGO and reticulation in subpleural region VAT Bx shows irregular interstitial fibrotic thickening, hemosiderin laden macrophages Radiology . 2010 May;255(2):322-41
Schematic representation of the immune mechanisms hypothetically involved with antineutrophil cytoplasmic antibody ( ANCA ) enhancement of vascular injury . An infectious trigger or other environmental stimulus leads to a burst of cytokines, which primes the neutrophils or monocytes and may lead to the local upregulation of adhesion molecules on endothelium . The priming process within the inflammatory cells leads to enhanced expression of ANCA antigens on the cell surface . Activated neutrophils or monocytes may degranulate and release reactive oxygen species and lysosomal enzymes, leading to endothelial injury and further activation of the endothelial cell surface . The magnitude of this effect is influenced by the specificity of ANCA for proteinase 3 ( PR3 ) or myeloperoxidase ( MPO ) , as well as different epitopes of these respective antigens . The reaction may be further influenced by the immunoglobulin G ( IgG ) and Fc γ receptor phenotype engaged . Products released from degranulated inflammatory cells become bound to endothelial cells and further serve as targets of ANCA . Release of chemotactic chemokines such as interleukin-8 ( IL-8 ) and macrophage chemoattractant protein-1 ( MCP-1 ) serve to augment chemotaxis and inflammatory cell transmigration, in conjunction with other adhesion molecules . Thus, the scheme provides the prerequisites for endothelial and vascular injury induced by ANCA : the presence of ANCA, the expression of target antigens for ANCA on primed neutrophils and monocytes, the interaction between primed neutrophils and endothelium via adhesion molecules, and, finally, the activation of endothelial cells and ultimate efflux of inflammatory cells to the extravascular and perivascular tissues . Fc γ R, Fc γ receptor;ICAM-1, intercellular adhesion molecule-1; PMN, polymorphonuclear leukocyte; TNF, tumor necrosis factor .
Rituximab versus cyclophosphamide for ANCA - associated vasculitis .
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