Cool Head: the brain cooler!Port egfr above 60 as "≥ 60" rather than as numerical values. Although kidney function tends to decrease with age, this process has not been well investigated. Many people with age-related kidney function decline may not progress to kidney failure. Thus, the prognosis for a 75-year-old patient with an egfr of 55 may be different than that for a 45-year-old patient with the same egfr. In addition, gfr may be too narrow a basis on which to assess risk for progression. The approach to staging is likely to evolve as it is informed by ongoing longitudinal research, e. G. , the chronic renal insufficiency cohort study. Establish cause of ckd because kidney damage is generally irreversible, it is important to identify the etiology as early as possible. Specific treatments are available in many cases (e. G. , membraneous nephropathy, lupus nephropathy) and a diagnosis will guide management. generic low price viagra Although diabetes is the most common cause of ckd, it is important not to assume that a patient with diabetes and ckd has diabetic kidney disease. cheap viagra However, non-diabetic kidney disease is unlikely in a person with diabetes of long duration with other diabetic complications, physical findings of end-organ diabetic damage, and negative screening laboratory studies. Suggested initial evaluation: complete urinalysis (u/a) urine albumin-to-creatinine ratio (uacr) creatinine with estimated gfr, blood urea nitrogen (bun), electrolytes, glucose, calcium, phosphorus, albumin complete blood count (cbc) for further evaluation, the following tests are often ordered, depending on clinical presentation: hepatitis b serology hepatitis c serology antinuclear antibody test (ana) rheumatoid factor (rf) complement 3 (c3) complement 4 (c4) serum protein electrophoresis (spep) and urine protein electrophoresis (upep) (in patients over the age of 40) renal ultrasound to measure kidney size and to check for echogenicity and hydronephrosis dilated retinal exam if a patient with diabetes has retinopathy, albuminuria, and negative screening tests listed above, it is reasonable to assume the diagnosis is diabetic kidney disease. Patients who do not conform to these criteria should be discussed with a nephrologist. Expand references » astor bc, hallan si, miller er (3 rd ), yeung e, coresh j. Glomerular filtration rate, albuminuria, and risk of cardiovascular and all-cause mortality in the u. cheap viagra sales S. Population. American journal of epidemiology. 2008; 167(10): 1226-1234. Buy viagra online without prescription Centers for disease control and prevention. National chronic kidney disease fact sheet: general information and national estimates on chronic kidney disease in the united states, 2010. Atlanta, ga: u. S. Cheap generic viagra Department of health and human services, centers for disease control and prevention, 2010. Www. Cdc. Gov/diabetes/pubs/factsheets/kidney. Htm coresh j, selvin e, stevens la, et al. Prevalence of chronic kidney disease in the united states. Journal of the american medical association. 2007; 298(17):2038-2047. Hemmelgarn br, manns bj, lloyd a, et al. Relation between kidney function, proteinuria, and adverse outcomes. cheap viagra Journal of the american medical association. 2010; 303(5): 423-429. Lash jp, go as, appel lj, et al. generic viagra quick delivery Chronic renal insufficiency cohort (cric) study: baseline characteristics and associations with kidney function. Clinical journal of the american society of nephrology. no prescription cheap viagra 2009;4(8):1302-1311. cheap viagra Miller wg. Estimating glomerular filtration rate. Clinical chemistry and laboratory medicine. 2009; 47:1017-1019. cheap viagra Poggio ed, nef pc, wang x, et al. Performance of the cockcroft-gault and modification of diet in renal disease equations in estimating gfr in ill hospitalized patients. cheap quality viagra American journal of kidney diseases. 2005; 46(2):242-252. Schwartz gj, munoz a, schneider mf, et al. New equations to estimate gfr in children with ckd. buy discount viagra Journal of the american society of nephrology. 2009; 20(3): 629-637. Schwartz gj and work df. Measurement and estimation of gfr in children and adolescents. Clinical journal of the american society of nephrology. 2009; 4 (11): 1832-1843. Stevens la, coresh j, feldman hi, et al. Evaluation of the modification of diet in renal disease study equation in a large diverse population. Journal of the american society of nephrology. 2007; 18(10):2749-2757. Strippoli gfm, bonifati c, craig me, navaneethan sd, craig jc. Angiotensin converting enzyme inhibitors and angiotensin ii receptor antagonists for preventing progression of diabetic kidney disease (review). The cochrane library 2010, issue 4 (john wiley & sons, ltd). U. cheap viagra S. Renal data system, usrds 2010 annual data report: atlas of chronic kidney disease and end-stage renal disease in the united states, national institutes of health, national institute of diabetes and digestive and kidney diseases, bethesda, md, 2010. Purchasr viagra no prescription Verhave jc, fesler p, ribstein j, du cailar g, mimran a. Estimation of renal function in subjects with normal serum creatinine levels: influence of age and body mass index. American journal of kidney diseases. 2005; 46(2):233-241. Wrone em, carnethon mr, palaniappan l, fortmann sp. Association of dietary protein intake and microalbuminuria in healthy adults: third national health and nutrition examination survey. American journal of kidney diseases. 2003;41(3):580â€“587. Evaluate patients with ckd overview assess urine albumin estimate gfr gfr calculators explain gfr and uacr results to patients use nkdep's explaining your kidney test results tear-off pad for clinical use page last updated: march 28, 2012 quick links for general public for people living with ckd for health professionals for laboratory professionals ckd & nutrition pediatric patients gfr federal ckd matrix videos sign up to receive our news for families & communities make the kidney connection news for health professionals nkdep news nkdep nutrition news for dietitians for lab professionals ckd lab news enter email address see all nkdep news contact us national kidney disease education program 3 kidney information way.
Oriel Medical Devices Ltd has designed and developed an instrument which is truly portable and utilises a closed loop system which accurately regulates the temperature of coolant for patients who suffer from medical conditions such as:
This product also overcomes the disadvantages of the hospital based systems which may be invasive; require trained medical staff and access to mains power
The system permits the heating as well as the cooling of the liquid in the closed loop. This can be important when using different attachments for different applications.
To improve patient prognosis following medical conditions such as heart attacks, strokes, head trauma, birth defects, etc… there is a significant consensus amongst the medical profession that early intervention to cool the brain is greatly beneficial.
Induced hypothermia is commonly used to cool the patients body temperature in order to achieve the improvements in prognosis.
In addition, it is known that for patient's undergoing treatments for cancers, cooling the head may ease the discomfort and assist in the retention of hair. However, present methods are generally invasive and involve whole body cooling. Cooling methods are generally restricted to a hospital environment and have potential risks to other body organs. Furthermore, many of the techniques used involve liquid coolant being introduced through nasal passages.
It has also been suggested that the system may be adapted to provide the more efficient and reliable transport of body organs for transplant purposes. The organs may be transported within the desired temperature range and then warmed to the appropriate temperature prior to transplant
The photograph shows the "patient" with the headset fitted & held in position with a chin strap to ensure good thermal contact on the patient's head.
Main features include:
Instrument to control & display the temperature of the liquid which circulates in a closed loop system.
Connecting hose & head piece with additional « nape of neck » & « collar » attachments for enhanced cooling/heating.
Cooling: liquid temperature cools from ambient to +3°C.
Heating: optional liquid heating.
Temperature controller: P.I.D control provides accurate temperature regulation of the circulating liquid and can display either as °C or °F
Patient temperature: a separate display permits the continuous monitoring of the patient's aural membrane temperature.
Power: operates from
Rechargeable batteries for approx. 60mins
12V paramedic vehicle.
Mains power 110/220V with suitable adaptor.
Nasal cannula: this option permits the introduction of chilled or heated air via the nostrils.
This versatile instrument with cooling/heating utilises « snap fit » connectors which facilitates interchangeable and easily detachable pads which can be applied to different body parts (extending the closed loop) to: