Geriatric Nephrology

The medical, psychosocial, nursing, financial and ethical issues of treating end-
stage renal disease in the elderly ... However, Delano et al found that, with home
dialysis, inner-city blacks had as good an outcome as middle class whites (15).

Geriatric Nephrology

Author: Dimitrios G. Oreopoulos

Publisher: Springer Science & Business Media

ISBN: 9400942559

Page: 293

View: 475

The year was 1943. As a third-year medical student at Stanford, I was about to witness the beginning of a medical miracle. Dr. Arthur Bloomfield, Professor of Medicine, had selected my patient, a middle aged man, who was dying of acute pneumococcal pneumonia, as one of the first patients to receive miniscule doses (by today's standards) of his meagre supply of a new drug - penicillin. The patient's response amazed everyone especially this impressionable medical student. The rest of the story is history. With one stroke, the introduction of penicillin removed from the medical scene the 'friend of the aged' - lobar pneumonia. The consequences, which no one could have imagined at the time, are still becoming manifest as other 'miracles' such as respirators, artificial kidneys and many potent new antibiotics have come upon the scene. All of us are aware that these miracles have created a variety of new challenges around the states of dying and near dying. We have no easy answers for these problems. Nevertheless as dialysis techniques, especially CAPD, are applied more widely to the treatment of the elderly, the task of helping the patient meet death with dignity becomes increasingly important and vexing because once begun, dialysis is difficult to terminate.

Nephrology and Urology in the Aged Patient

These inferences are drawn from what appears to be a middle class population,
rather than the population of inner-city poor served by KCHC. From our
preliminary exploration of the very old kidney patient, we are dismayed over their
high ...

Nephrology and Urology in the Aged Patient

Author: Dimitrios G. Oreopoulos

Publisher: Springer Science & Business Media

ISBN: 9401118221

Page: 620

View: 834

The master tool of logic is the syllogism. If A> Band B> C, then it must follow as the night the day that A > C. If the major and minor premises are true or scientifically correct by current knowledge, the conclusion is true or at least scientifically correct by current knowledge. The demographer of today beams a clear message, which if not true is at least scientifically correct by current knowledge. In the first 80 years of the Twentieth Century, the 'over-65' population of Americans increased eight fold. By century's end it will have increased 12-fold and shortly thereafter will include one in five Americans. While initially a fact of the developed world, the pace of similar graying is accelerating even more rapidly in the Second and Third Worlds. This gray delta constitutes about 35 million living Americans, who may use one-half or more of the health care resources. A would have to be a lot more foolish than B if they failed to recognize that in the coming decade the causation, case-mix, and area of the gray delta demands a change from early, mid-or even later-century medicine. If Homer Smith was right in saying, "We are what we are because we have the kind of kidneys we have" and "The kidneys make the stuff of philosophy", then the who, what, where, when, and why the gray delta will be cared for must focus on the stuff of geriatric nephrology.

Oxford Textbook of Clinical Nephrology Volume 3

Egypt and HIVAN, which may present as a nephritic syndrome and rapidly
progressive renal failure accounting for up to 38 per cent of patients on dialysis
programmes in some US inner-city communities (Pastan and Bailey 1998).

Oxford Textbook of Clinical Nephrology Volume 3

Author: Alex M. Davison

Publisher:

ISBN: 9780198567981

Page: 2749

View: 164

Authoritative, well-written, and comprehensive textbook of clinical nephrology, combining the clinical aspects of renal disease important for daily clinical practice while giving extensive information about the underlying basic science and current evidence available. This new edition highlights the numerous changes in clinical management that have arisen as a result of recently concluded clinical trials and there are now specific formal guidelines for optimal treatment of patients. Each section of the textbook has been critically and comprehensively edited under the auspices of one of the leading experts in the field. The emphasis throughout is on marrying advances in scientific research with clinical managment. Where possible treatment algorithms are included to aid patient care.

Pediatric Nephrology

Renal Disease Dynamics : Current Concepts in Diagnosis and Management
José Strauss ... From a renal perspective, an overview of the burdens of the inner
city child include among others, a genetic predisposition for hypertension, with ...

Pediatric Nephrology

Author: José Strauss

Publisher:

ISBN:

Page: 388

View: 709

Legal and Ethical Concerns in Treating Kidney Failure

Attendance at our Renal Disease Division's Morning Report almost immediately
illustrates the pervasive intermixing of medicine, law, and ethics comprising the
everyday practice of nephrology. Situated in the inner-city, we manage more than
 ...

Legal and Ethical Concerns in Treating Kidney Failure

Author: E.A. Friedman

Publisher: Springer Science & Business Media

ISBN: 9401143552

Page: 213

View: 492

Once dialysis treatment, in 1960, permitted life prolongation for some but not all patients in kidney failure, an `ethical genie' was released. The introduction of peritoneal dialysis and kidney transplantation compounded the physician's dilemma by underscoring those left untreated. Who should be selected for uremia therapy? Should exclusion from treatment be properly delegated to administrators or physicians, or better left to a committee? Are some candidates more worthy than others? As examples: Do Presidents and Kings warrant priority in cadaver organ allocation over ordinary citizens? Are rich people more deserving than the poor? Is it ethical to choose a younger over an older patient? Can children and/or mentally incompetent persons serve as living organ donors? Is it proper to market organs under controlled circumstances? Eli A. Friedman, an experienced nephrology training program director, and Medical Advisor to the American Association of Kidney Patients, has collected 24 difficult cases that focus on these and other vexing though common stressful issues faced by those who manage kidney patients. Using a novel approach to each case, the opinions of lawyers, nephrologists, patients, and a transplant surgeon are proffered sequentially. Friedman asks and then answers searching questions arising from the debate. The quality of information presented is positively flavored by the fact that three of the respondents (one an attorney) are kidney transplant recipients. Members of the kidney team, those immersed in seeking truth in medical ethics, and all participating in exploring the legality or ethical basis of organ replacement will find this book pertinent to their effort.

Handbook of Kidney Transplantation

Unemployment in inner-city renal transplant recipients: predictive and
sociodemographic factors. Am J Kidney Dis 1997;29:881–887. Prieto LR, Miller
DS, Gayowski T, et al. Multicultural issues in organ transplantation: the influence
of patients' ...

Handbook of Kidney Transplantation

Author: Gabriel M. Danovitch

Publisher: Lippincott Williams & Wilkins

ISBN: 1451148305

Page: 496

View: 497

This popular handbook is a practical guide for physicians, surgeons, nurses, and other professionals who manage kidney transplant patients. It is concise, readable, and well-illustrated. Chapters outline the major concerns surrounding renal transplantation and the most successful approaches to problems arising in short-term and long-term patient care. Chapter topics include immunobiology and immunosuppression, as well as chapters on surgery, histocompatibility, and the first three months post-transplant surgery. This thoroughly updated Fifth Edition includes new information on options for patients with end-stage renal disease, immunosuppressive medications and protocols for kidney transplantation, and the first two months following transplant.

Medical Disorders in Obstetric Practice

525 Stratta P, Canavese C, Dolgiani M. Pregnancy-related acute and renal
failure. Clin Nephrol 1988; 32: 14±20. 526 Nzerue CM, Hewan-Lowe K, Nwawka
C. Acute renal failure in pregnancy: a review of clinical outcomes at an inner city
 ...

Medical Disorders in Obstetric Practice

Author: Michael De Swiet

Publisher: John Wiley & Sons

ISBN: 047075236X

Page: 624

View: 504

Obstetricians must have a firm grounding in the diagnosis and management of diseases affecting pregnant women as in some cases these may threaten the life of mother or baby or both. This book still remains the standard reference work on medical disorders in obstetric practice in the UK and UK-influenced areas such as the former Commonwealth. Exhaustive in its coverage, it provides clear practical advice on the major medical disorders the obstetrician is likely to encounter. Each chapter reviews the pathophysiology of a complaint then applies the physiological and pathophysiological changes to the problem of diagnosis and management of the disorder as well as giving clear guidance on the welfare of the unborn One of the major strengths of the book is that each chapter teaches the principles of care and gives an appreciation of the natural history of the disease rather than just the facts. Although a scholarly and rigourous account it manages to point out the clinically relevant information that the practising obstetrician will actually need.

Year Book of Nephrology Hypertension and Mineral Metabolism

What is unclear is at what level of dialysis dose outcome results cease to improve
. Analysis of this study suggests that it may be between 1.4 and 1.5 on a single -
pool KtN . S.J. Schwab , M.D. Dialysis Survival in a Large Inner - city Facility : A ...

Year Book of Nephrology  Hypertension  and Mineral Metabolism

Author:

Publisher:

ISBN:

Page:

View: 193

Diabetic Renal Retinal Syndrome

Dismal rehabilitation in geriatric inner-city hemodialysis patients. JAMA 1994;
271:29–33. Cheigh J, Raghavan J, Sullivan J, Tapia L, Rubin A, Stenzel KH. Is
sufficient dialysis a cause for high morbidity in diabetic patients? JAmer Soc
Nephrol ...

Diabetic Renal Retinal Syndrome

Author: E.A. Friedman

Publisher: Springer Science & Business Media

ISBN: 9401149623

Page: 284

View: 502

After a decade or longer, approximately one-third of individuals with either type 1 or type 2 diabetes commence a downhill course in which decreasing renal function and failing vision define a Renal-Retinal Syndrome, dominating all aspects of life and presaging early death. Only a generation ago, survival after onset of end-stage renal disease (ESRD) in diabetes was limited because rehabilitation was preempted by blindness, limb amputation, stroke, and heart disease. By 1998, however, team management has improved the outlook, with preserved sight and return to work and home responsibilities, usually for a decade or longer, following kidney transplantation and laser photocoagulation. Recognition of the critical requirement for blood pressure regulation and metabolic control are central themes in management. In this unique book, the accomplishments of ophthalmologists, nephrologists, diabetologists, transplant surgeons, and basic scientists are blended into a strategic approach that may be readily applied by all those caring for diabetic patients. Each of twenty-one presentations suitable for primary care physicians, as well as for subspecialists concerned with macrovascular and microvascular complications of diabetes, is placed in perspective by an introductory editorial analysis. Promising near-term innovative therapies, including insertion of genetically engineered beta cells or polymer-coated islets of Langerhans, interdiction of kinins that promote retinal angiogenesis, and prevention of synthesis of advanced glycosylated endproducts (AGEs), are presented in detail. While comprehensive care of diabetic patients reflects multiple incremental advances that in sum afford major benefit, this text envisions further remarkable changes likely to suppress and possibly entirely prevent the Diabetic Renal-Retinal Syndrome.

Textbook of Nephrology

The urban nephrologist is likely to be confronted with both primary HIV -
associated renal failure and HIV infection secondarily occurring in the inner city
dialysis patient . Reversible episodes of acute renal failure are occasionally seen
in the ...

Textbook of Nephrology

Author: Shaul G. Massry

Publisher:

ISBN:

Page: 1901

View: 658

Critical Care Obstetrics

Renal failure is now an uncommon complication of pregnancy in developed
countries, occurring in less than 1% of all ... This is in sharp contrast, however, to
another study at an inner city hospital in Georgia from 1986 to 1996 which ...

Critical Care Obstetrics

Author: George R. Saade

Publisher: John Wiley & Sons

ISBN: 1444396145

Page: 760

View: 160

Critical Care Obstetrics provides expert clinical guidance throughout on how you can maximize the chances of your patient and her baby surviving trauma. In this stimulating text, internationally recognized experts guide you through the most challenging situations you as an obstetrician are likely to face, enabling you to skillfully: Recognize conditions early-on which might prove life threatening Implement immediate life-saving treatments in emergency situations Maximize the survival prospects of both the mother and her fetus The fifth edition of this popular book will help you keep your composure in high risk clinical situations, making it an invaluable resource for any healthcare professional responsible for the care and management of pregnant women and their unborn children.

Clinical Nephrology

The presence of renal failure or desmopressin acetate administration may
represent additional confounding factors in this ... serving predominantly an inner
- city or otherwise economically disadvantaged population in the Southeast US .

Clinical Nephrology

Author:

Publisher:

ISBN:

Page:

View: 923

History of Nephrology 2

Reports from the First Congress of the International Association for the History of
Nephrology, Kos, Greece, October 14-16, 1996 ... of nature or as a function of the
knowledge of the human inner life meant setting it in search of truth rather than as
a demonstration of truth . ... restore to the city its ' eternal image as the capital of
Christianity , and to draw their inspiration from the models of classical antiquity .

History of Nephrology 2

Author: International Association for the History of Nephrology. Congress

Publisher: Karger Medical and Scientific Publishers

ISBN: 9783805564991

Page: 198

View: 402

This publication contains contributions from the First Congress of the International Association for the History of Nephrology held on the island of Kos, Greece, in October 1996. The association was founded in 1994 to foster interest, encourage research and disseminate information on the history of nephrology. The text begins with an examination of the origins of nephrology in various medical writings from Greece, Byzantium and the Renaissance. This is followed by an overview of the history of dialysis and the early beginnings of renal transplantation. The concluding section examines early attempts at the conceptualization of the normal kidney, its diseases and metabolic functions. Presenting a wealth of fascinating information, this publication is a sequel to History of Nephrology, Vol. 14, No. 4-6 (1994) of American Journal of Nephrology.

Nephrology in 30 Days

Alcoholic Keloacidosis AKA is a relatively common form of acidosis seen in inner
city hospitals. The acid-base disturbance results from the combination of alcohol
toxicity and starvation. Ethanol itself leads to an increase in cytosolic NAD", but ...

Nephrology in 30 Days

Author: Robert F. Reilly (M.D.)

Publisher: McGraw Hill Professional

ISBN: 9780071437011

Page: 410

View: 858

A concise review of the core principles and clinical entities associated with nephrology at the point of care. 4 STAR DOODY'S REVIEW "This is an absolutely wonderful book and excellent for medical students, physician assistants, and trainees in all the medical disciplines. It differs from other handbooks or concise manuals by providing more detailed coverage of the fundamental pathophysiology and basic science behind each disorder, which facilitates understanding. The leading questions, highlighting key points in a colorful manner, the numerous figures and algorithms, and the easy-to-read style make this book rather unique. Although the width of the pages is wider than the usual handbooks and does not make this book a true "pocket" book, the larger font and the addition of all the tables and figures make it much easier to read. I highly recommend this book to students and trainees rotating on the nephrology service."--Doody's Review Service Covers all major acute and chronic kidney diseases, from acid/base disturbances to stones to end stage renal disease. Features a concise, manageable format with recommended timeframes for mastering the content, case studies, and summary tables. Perfect for trainees and practicing non-specialists.

A Quarter Century of Nephrology

Commemorating the American Society of Nephrology's 25th Anniversary Richard
L. Tannen ... recommended that mandatory HIV testing be carried out routinely in
hemodialysis units , especially in those dealing with inner - city populations .

A Quarter Century of Nephrology

Author: Richard L. Tannen

Publisher: Harwal Publishing Company

ISBN:

Page: 360

View: 957

Nephrology for the House Officer

Results of recent voluntary testing for HIV seropositivity in inner city chronic
hemodialysis patients reveal that in high - risk patients , the prevalence of
seropositivity is high ( 30-40 % ) ; whereas in patients without such risk factors (
intravenous ...

Nephrology for the House Officer

Author: C. Craig Tisher

Publisher:

ISBN: 9780683082760

Page: 310

View: 267

Abstracts

INNER CITY RENAL PAILURE ( RF ) . E.A. Friedman and T.K.S. Rao , SUNY ,
Health Sci . Cntr . , Bklyn , N.Y. , USA . Over the past five years , a remarkable
change in the etiology and prevalence of renal failure was observed in our
municipal ...

Abstracts

Author:

Publisher:

ISBN:

Page: 686

View: 963