The Royal College of Physicians plays a leading role in the delivery of high-quality patient care by setting standards of medical practice and promoting clinical excellence. We provide physicians in the United Kingdom and overseas with education, training and support throughout their careers. As an independent body representing over 20,000 Fellows and Members worldwide, we advise and work with government, the public, patients and other professions to improve health and healthcare.
In the spring of 2010, the Centers for Disease Control and Prevention (CDC) and several
partners embarked on an intensive process to examine the current state of knowledge
regarding chronic obstructive pulmonary disease (COPD) prevention. he process included
identifying public health gaps and generating a set of goals that would deine the unique role
and contributions of public health in the prevention and control of COPD. his workgroup
represented other federal agencies, academia, the health care sector, national organizations, and
other COPD stakeholders.
The publication Approved Drug Products with Therapeutic Equivalence Evaluations (the List, commonly known as the Orange Book) identifies drug products approved on the basis of safety and effectiveness by the Food and Drug Administration (FDA) under the Federal Food, Drug, and Cosmetic Act (the Act). (For more information, see the Orange Book Preface.)
Nitrate, the most common form of nitrogen in surface and groundwater, is directly toxic to human health. In-
fants who drink water with high nitrate levels can develop an acute, life-threatening blood disorder called blue
baby syndrome. high nitrate levels in water can also affect thyroid function in adults and increase the risk of
Phosphorus stimulates explosive blooms of aquatic algae, including the especially dangerous cyanobacteria
(blue-green algae) that produce toxins that can be deadly to pets, livestock, wildlife – and people.
Chapter 045. Azotemia and Urinary Abnormalities
Normal kidney functions occur through numerous cellular processes to maintain body homeostasis. Disturbances in any of these functions can lead to a constellation of abnormalities that may be detrimental to survival. The clinical manifestations of these disorders will depend upon the pathophysiology of the renal injury and will often be initially identified as a complex of symptoms, abnormal physical findings, and laboratory changes that together make possible the identification of specific syndromes.
The most important treatment of acute rheumatic fever is prevention, associated with
improvements in socioeconomic conditions.
Once acute rheumatic fever has occurred, treatment includes penicillin to eradicate the
streptococcal infection, high dose aspirin as an anti-inflammatory drug, or steroids if
the cardiac disease is severe. Heart failure is treated with diuretics, and urgent heart
valve replacement may occasionally be required.
CKD in children is the result of heterogeneous
diseases of the kidney and urinary tract that
range from common congenital malformations
of the urinary tract, to rare inborn errors of
metabolism that affect kidney function
is an irreversible condition that eventually
progresses to end stage renal disease (ESRD).
It is an important cause of morbidity and
mortality in children worldwide [2,3]
The WHO European Region has almost five million nurses; they
constitute the largest health care provider* group. Their actual and
potential contribution to the management* of chronic disease* is un-
der-acknowledged and under-used. Many other types of health care
provider* are similarly under-acknowledged and under-used. Access
by all to recognized programmes of therapeutic patient education* and
disease-specific management* in a multidisciplinary and monodisci-
plinary system should make a significant contribution to the manage-
ment* of chronic diseases*. ...
Greenway has also structured its offerings to physician practices into multi-year business
plans mirroring President Bush’s and former Secretary Thompson’s own Framework for
Strategic Action to ensure that healthcare providers will have quality software solutions
that inform clinical practices, interconnect clinicians, personalize patient care and
improve the overall population health.
Patients with kidney disease may present with abnormal
urinary ﬁndings. A carefully performed urinalysis using
physical, chemical, and microscopic examination is an easy
and informative tool to the practicing physician . The
American Academy of Pediatrics recommends a urinalysis as
a part of preventive pediatric health care at age 5 years and
mid-adolescence . An abnormal urinalysismay be the only
presenting sign of chronic GN.
The most common urinary abnormalities are hematuria
and proteinuria. Hematuria may be gross or microscopic,
discovered during a routine urinalysis.
I have been involved in the treatment of chronic renal insuffi ciency for 40 years,
beginning with peritoneal dialysis immediately after graduation from medical school
in 1965, then with hemodialysis in 1967 after I fi rst experienced it in Kanazawa, and
with renal transplantation since 1972, when I was studying in the United States.
During this period, the number of dialysis patients has continued to increase rapidly
to the present fi gure of 257 765 (at the end of 2005), and with surprising increases in
the survival rate.
There has been a case report of exaggerated
pigmented granulomatous reaction to the artificial joint implant in a 72-year-old man who
had undergone bilateral total hip arthroplasty, in whom, aspirate from the inguinal region
was misinterpreted as metastatic melanoma from an unknown primary. Microscopically, the
smears of this patient showed both intracellular and extracellular black pigment with
obscured cytomorphology; although, appreciable cells were reported to be pleomorphic
with prominent nucleoli. The patient had no evidence of primary cutaneous melanoma.
The official definition of poverty for the U.S. population uses
money income before taxes and does not include capital gains
or noncash benefits (such as public housing, Medicaid, and SNAP).
The definition is based roughly on historical estimates of the
portion of an average household’s income required to purchase a
“minimally nutritious diet” (about 30% in the early 1960s).
The Cancer Centers Program also recognizes that many high quality, cancer-relevant research projects
are funded by other organizations such as the Department of Energy (DOE), Department of Defense
(DOD), Department of Agriculture (DOA), the Center for Disease Control and Prevention (CDC), State
Health Departments etc.
There will be cases where chemical interferences can be identified for a
particular method but the chances of encountering them in real life may be improbable. The
analyst has to decide at what point it is reasonable to stop looking for interferences. These
parameters apply to both qualitative and quantitative analysis. The selectivity of a method is
usually investigated by studying its ability to measure the analyte of interest in test portions
to which specific interferences have been deliberately introduced (those thought likely to be
present in samples).
Mortality rates among children and the absolute number of children dying annually in developing countries have
declined considerably over the past few decades. However, the gains made have not been distributed evenly:
childhood mortality remains higher among poorer people and the gap between rich and poor has grown. Several poor
countries, and some poorer regions within countries, have experienced a levelling off of or even an increase in
childhood mortality over the past few years.
Health care providers* tend to talk to patients about their disease
rather than train them in the daily management* of their condition.
Therapeutic patient education* is designed therefore to train patients
in the skills* of self-managing or adapting treatment to their particular
chronic disease*, and in coping* processes and skills*. It should also
contribute to reducing the cost* of long-term care to patients and to
In spite of remarkable progress in drug therapy,
childhood and adolescent epilepsy is often a
distressing condition lasting several years before
possible recovery. Adaptation problems to the
disease and also to health recovery are likely to
occur. Stigma and discrimination may persist also
Depression in children and adolescents with
epilepsy is a common but often unrecognized
disorder. Both epilepsy and depression are
characterized by a chronic course and poor long-
term psychosocial outcome.