Approach to the patient with polyuria. ATN, acute tubular necrosis; ADH, antidiuretic hormone
Excessive filtration of a poorly reabsorbed solute such as glucose, mannitol, or urea can depress reabsorption of NaCl and water in the proximal tubule and lead to enhanced excretion in the urine. Poorly controlled diabetes mellitus with glucosuria is the most common cause of a solute diuresis, leading to volume depletion and serum hypertonicity. Since the urine Na concentration is less than that of blood, more water than Na is lost, causing hypernatremia and hypertonicity.
Endometriosis is a progressive debilitating disease affecting the physical, social and
psychological aspects of normal life quality in nearly 1 of 7 women of reproductive
age. Endometriosis is considered to be an enigmatic disease owing to the lack of
specific set of symptoms, poorly understood pathogenesis, complexity in diagnosis
and limited therapeutic options available for management of the disorder. The last
three decades we have witnessed a significant volume of research related to
Reiko Inagi reviewed very lucidly the role of endoplasmic reticulum in the stress of
responses in glomeruli, while the pathogenic significance of dendritic cells in
autoimmune glomerulonephritis is elaborated by Yahuan Lou. Finally, the relevance
of urinary biomarkers in relation to pathogenesis of glomerulonephritis is put together
in a concise chapter written by Sophie Ohlsson.
Part of the reason that new car manufacturers can choose to maintain prices on their new
cars (and adjust market share instead) is that a manufacturer arguably has market power in
the sale of a particular car. This means that the manufacturer should consider the elasticity
of demand for that car before reducing prices.
Non-state providers including commercial firms, not-for-profit organisations and faith-based
organisations often provide services when governments are unable to meet people’s SRH needs.
Social franchising, or networks of private providers who offer a standard set of services and share
training, referral systems, quality standards and brands is one such example. The high volume of
patients that these networks can provide for enables them to reduce costs of treatment for poor
Biological sciences in nursing has seen a change in status over the last 20
years. As a nurse educator, I became aware that with the introduction of
the ‘nursing model’ all signs of biology were banished from the curriculum.
Anatomy and physiology were thought to be akin to the ‘medical model’,
and as such they fell outside the nurse’s territory. At all costs, nurses had
to be seen as autonomous practitioners in their own right.
Sale activity of large of apartment communities continues to improve. During the first three quarters of
2012 investors purchased 49 apartment communities of 50 or more units in the seven county Denver metro
area. According to Costar and published announcements from brokers, sales volume totaled $1,079.6 million
for 11,557 units or $93,415/unit average.
Following the financial crisis and resulting economic slowdown
in 2008, average unit prices decreased dramatically along
with the sales volume.
Endourology is one of the most important subspecialties in the field of urology because
of the widespread use of endoscopy for the diagnosis and treatment of a variety of upper
genitourinary tract pathologies. Although most clinical urologists incorporate some basic
endourology into their practices, complex upper tract pathology and anatomy require
more advanced endoscopic skills and instrumentation.
Advanced Endourology: The Complete Clinical Guide is intended as a resource guide
for all aspects of clinical endourology, particularly the more advanced procedures.
Approach to the Patient: Hyperchloremic Metabolic Acidoses In diarrhea, stools contain a higher [HCO3–] and decomposed HCO3– than plasma so that metabolic acidosis develops along with volume depletion. Instead of an acid urine pH (as anticipated with systemic acidosis), urine pH is usually around 6 because metabolic acidosis and hypokalemia increase renal synthesis and excretion of NH4+, thus providing a urinary buffer that increases urine pH. Metabolic acidosis due to gastrointestinal losses with a high urine pH can be differentiated from RTA (Chap.