birth injuries and developmental abnormalities chapter 74 neonatal neurology

... there is an approximately linear relationship between 1/PCr and time The slope of this line will remain constant for an individual patient, and when values are obtained that not fall on this line, ... should be emphasized that the signs and symptoms of uremia will develop at significantly different levels of serum creatinine depending upon the patient (size, age, and sex), the underlying renal ... (azotemia) such as urea and creatinine Azotemia may result from reduced renal perfusion, intrinsic renal disease, or postrenal processes (ureteral obstruction; see below and Fig 45-1) Precise determination...

Ngày tải lên: 06/07/2014, 15:21

... microvasculature and glomeruli, or tubulointerstitium Ischemic and toxic ATN account for ~90% of acute intrinsic renal failure As outlined in Fig 45-1, the clinical setting and urinalysis are ... tubule toxicity, and/ or tubule obstruction The kidney is vulnerable to toxic injury by virtue of its rich blood supply (25% of cardiac output) and its ability to concentrate and metabolize toxins ... proteinuria and hematuria, whereas renal vein thrombosis typically induces heavy proteinuria and hematuria These vascular complications often require angiography for confirmation and are discussed...

Ngày tải lên: 06/07/2014, 15:21

... antidiuretic hormone, and the sympathetic nervous system, all of which promote excessive renal salt and water reabsorption The severity of edema correlates with the degree of hypoalbuminemia and is modified ... pediatric population, and isolated hematuria is more likely to be "idiopathic" or associated with a congenital anomaly Hematuria with pyuria and bacteriuria is typical of infection and should be treated ... hematuria Hypercalciuria and hyperuricosuria are also risk factors for unexplained isolated hematuria in both children and adults In some of these patients (50–60%), reducing calcium and uric acid excretion...

Ngày tải lên: 06/07/2014, 15:21

... Na reabsorption and indirectly reduces the responsiveness of the tubule to aldosterone Usually, the Na losses are mild, and the obligatory urine output is

Ngày tải lên: 06/07/2014, 15:21

... narrowed and the appropriate diagnostic evaluation and therapeutic course to be determined Each of these syndromes and their associated diseases are discussed in more detail in subsequent chapters ... azotemia, (2) alterations of the urinary sediment and/ or protein excretion, and (3) abnormalities of urinary volume Table 45-1 Initial Clinical and Laboratory Data Base for Defining Major Syndromes ... duration and severity of the disease will affect these findings and typically include one or more of the following: (1) disturbances in urine volume (oliguria, anuria, polyuria); (2) abnormalities...

Ngày tải lên: 06/07/2014, 15:21

... series of neural and humoral responses that include activation of the sympathetic nervous and renin-angiotensin-aldosterone systems and ADH release GFR is maintained by prostaglandin-mediated relaxation ... plasma), and small kidneys on ultrasound, characterized by increased echogenicity and cortical thinning Treatment should be directed toward slowing the progression of renal disease and providing ... vasoconstriction and acute renal failure Angiotensin-converting enzyme (ACE) inhibitors decrease efferent arteriolar tone and in turn decrease glomerular capillary perfusion pressure Patients on NSAIDs and/ or...

Ngày tải lên: 06/07/2014, 15:21

... hypotension and intense renal vasoconstriction) Cortical necrosis, ATN, and rapidly progressive glomerulonephritis can occasionally cause anuria Oliguria can accompany any cause of acute renal failure and ... Fig 45-3 and is typically initiated after detection of proteinuria by dipstick examination The dipstick measurement detects mostly albumin and gives false-positive results when pH > 7.0 and the ... chronic azotemia With nonoliguric ATN, disturbances of potassium and hydrogen balance are less severe than in oliguric patients, and recovery to normal renal function is usually more rapid Proteinuria...

Ngày tải lên: 06/07/2014, 15:21

... function, and physiologic demands of the individual See "Azotemia," above, for discussion of decreased (oliguria) or absent urine production (anuria) The physiology of water formation and renal ... solutes per day, primarily as urea and electrolytes If the urine output is >3 L/d and the urine is dilute (3 L/d and urine osmolality is >300 mosmol/L, then a solute diuresis is clearly present and a search for the responsible solute(s) is mandatory Figure 45-4 ...

Ngày tải lên: 06/07/2014, 15:21

Ngày tải lên: 17/10/2013, 19:15

Ngày tải lên: 07/11/2013, 09:15

... Wiley, 1986 [3] M.S Grewal and A.P Andrews, Kalman Filtering: Theory and Practice Englewood Cliffs, NJ: Prentice-Hall, 1993 [4] H.L Van Trees, Detection, Estimation, and Modulation Theory, Part ... where yk is the observable at time k and Hk is the measurement matrix The measurement noise vk is assumed to be additive, white, and Gaussian, with zero mean and with covariance matrix defined by ... scalar random variables; generalization of the theory to vector random variables is a straightforward matter Suppose we are given the observable yk ¼ xk þ vk ; where xk is an unknown signal and vk...

Ngày tải lên: 13/12/2013, 13:15

Ngày tải lên: 14/12/2013, 12:15

Ngày tải lên: 14/12/2013, 12:15

Ngày tải lên: 14/12/2013, 12:15

Ngày tải lên: 14/12/2013, 12:15

Ngày tải lên: 14/12/2013, 12:15

Ngày tải lên: 14/12/2013, 12:15

Ngày tải lên: 14/12/2013, 12:15

Ngày tải lên: 14/12/2013, 12:15

Ngày tải lên: 14/12/2013, 12:15